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.

Why To Exercise Today: To Promote Cognitive Health (It’s Official)

(Diabetes Care/Flickr)

(Diabetes Care/Flickr)

The venerable Institute of Medicine came out with a report this week on cognitive aging (yes, that means you…) and a few things that can help avert the inevitable. The panel’s No. 1 recommendation? “Be physically active.” Enough said.

To be clear, “cognitive aging is not a disease,” the report notes. “Instead, it is a process that occurs in every individual, beginning at birth and continuing throughout the life span.”

That process impacts the brain like no other body part, the authors say. And while the extent and quality of cognitive aging (read: decline) varies greatly, many older men and women will experience problems related to the speed at which they process information, the ability to problem-solve and make decisions and, of course, memory. (Lost keys, anyone?)

Putting a little silver lining on things, the IOM news release quotes the chairman of the committee, Dan G. Blazer, the J.P. Gibbons Professor of Psychiatry Emeritus at Duke University Medical Center, saying that “…wisdom and knowledge can increase with age, while memory and attention can decline.”

So what should we do about our aging brains? The report is clear:

· Be physically active.

· Reduce and manage cardiovascular disease risk factors, including high blood pressure, diabetes, and smoking.

· Regularly discuss and review health conditions and medications that might influence cognitive health with a health care professional. A number of medications can have a negative effect — temporary or long term –on cognitive function when used alone or in combination with other medication.

The committee also identifies additional actions for which there is some scientific evidence to suggest positive effects on cognitive health:

· Be socially and intellectually active, and continually seek opportunities to learn.

· Get adequate sleep and seek professional treatment for sleep disorders, if needed.

· Take steps to avoid a sudden acute decline in cognitive function, known as delirium, associated with medications or hospitalizations.

· Carefully evaluate products advertised to consumers to improve cognitive health, such as medications, nutritional supplements, and cognitive training.

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Wide Hips? Take Heart: Study Finds You Can Run Just As Efficiently

As a woman who describes herself — matter-of-factly, not self-hatingly — as shaped like a cello, I’m deeply pleased by this fascinating marathon-season report from our friends over at Boston University’s Research Website, headlined “In Defense of Wide Hips.” Re-posted with their permission:

Biological anthropologist and evolutionary anatomist Kristi Lewton of BU School of Medicine. (Jackie Ricciardi for BU)

Biological anthropologist and evolutionary anatomist Kristi Lewton of BU School of Medicine. (Jackie Ricciardi for BU)

By Kate Becker

What can you learn from a pelvis? Among the qualities that make humans unique are two physical features: our way of walking and running upright on two legs, and our newborn babies’ very large heads. Those two traits of humanity meet at the pelvis, a set of bones that includes the ilium, ischium, pubis, and sacrum.

For more than 50 years, anthropologists thought that the human pelvis was shaped by an evolutionary tug-of-war between the competing demands of bipedalism and childbirth. Now, a team of scientists that includes Kristi Lewton, an assistant professor in the department of anatomy and neurobiology at Boston University School of Medicine, and colleagues at Harvard University and Hunter College has shown that this so-called “obstetric dilemma” might not be a dilemma at all.

They found no connection at all between hip width and efficiency: wide-hipped runners moved just as well as their narrow-hipped peers.

Humans give birth to very large (“ginormous!”) newborns, says Lewton. While chimps and other nonhuman primate babies emerge from the birth canal with room to spare, human infants must perform a complicated series of rotations to make their way into the world, and the pelvic opening is just barely big enough. If something goes wrong, the lives of both mother and baby are at risk. So, why hasn’t the human body evolved a wider pelvis? Anthropologists have long believed that an evolutionary trade-off was at work; they assumed that a wide pelvis was “bad for bipedalism,” says Lewton. Yet, until now, no one had rigorously tested this assumption.

Lewton and her colleagues set out to discover whether wide hips really do make running and walking less efficient. They recruited 38 undergraduates, including both men and women, and had them walk and run on a treadmill while gauging how hard they were working by measuring their oxygen consumption. While the participants exercised, their motion was tracked by eight cameras trained on infrared markers attached to the participants’ hips, knees, ankles, thighs, and shanks. Lewton and her colleagues estimated the subjects’ hip width using the results from the infrared trackers, and later combined their data with results from a Washington University in St. Louis research team that used MRI to get a direct measure of hip width. (True hip width is defined as the distance between the hip joints, points out Lewton, and is different from what you would measure with a tailor’s tape.)

If the basic assumptions of the obstetric dilemma are right, says Lewton, participants with wider hips should run and walk less efficiently than those with narrow ones. But that wasn’t what Lewton and her team found. Continue reading

Time The Healer Moves Slowly For 2 Boston Marathon Survivors

Marathon bombing survivor Martha Galvis is learning to use a hand doctors are still reconstructing. Here Galvis attempts to pick up a pen off a table after a physical therapy session at Faulkner Hospital. (Jesse Costa/WBUR)

Marathon bombing survivor Martha Galvis is learning to use a hand doctors are still reconstructing. Here Galvis attempts to pick up a pen off a table after a physical therapy session at Faulkner Hospital. (Jesse Costa/WBUR)

It’s just the crumb of a muffin, but Martha Galvis must pick it up. Lips clenched, eyes narrowed, she goes after the morsel, pushing it back and forth, then in circles, across a slick tabletop.

“I struggle and struggle until,” Galvis pauses, concentrating all her attention on the thumb and middle finger of her left hand. She can’t get them to close. Oh well.

“I try as much as I can. And if I do it I’m so happy, so happy,” she says, giggling.

Galvis, 62, has just finished a session of physical therapy at Boston’s Brigham and Women’s Faulkner Hospital, where she goes twice a week. She’s learning to use a hand doctors are still reconstructing. It’s been two years to the day since she almost lost it.

On April 15, 2013, Martha and her husband Alvaro Galvis headed for Cleveland Circle — mile 22 on the Boston Marathon route. This would be the first of three spots from which they’d enjoy the race and the boisterous crowd. Their last stop would be at or near the finish line in Boston. Continue reading

The Complex Interplay Of Genetics And The Placebo Response

Why do some people respond to placebos while others don’t?

One possible answer: genetics.

A provocative new paper introducing the concept of a “placebome” — that is, the complex interplay between genetics and an individual’s response to placebos — raises questions that might ultimately lead to changes in how clinical studies of drugs are evaluated.

Indeed, researchers from Harvard Medical School suggest that genes, and genetic variation, might play a far bigger role in the placebo response than previously thought.

That the placebo effect is an actual physiological response is well established. But the new report, a research review, looks specifically at the placebo response in the context of drug studies, where some participants get the active medication while others get a placebo, or non-active version of the drug.

The new findings, “call into question whether or not the outcomes in a drug treatment arm of a clinical trial are limited to the effect of the drug on the condition,” says Kathryn Hall, an integrative medicine fellow in the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center, and one of the study authors.

Instant Vantage/flickr

Instant Vantage/flickr

Several neurotransmitters, such as dopamine, appear to be involved in the placebo response, Hall said, and variation in the genes in these pathways appears to change our response to placebo. So different people with different genotypes respond differently to placebos.

But Hall takes it one step further. “When you are in a trial you don’t know if you are getting the drug or the placebo, so not just the people in the placebo arm can have placebo responses. We are curious about the drugs’ effect on the placebo response.”

It’s all a bit tough to wrap your brain around, so I asked Hall to give me an example. Here’s what she said:

In the literature we see several studies in which in the placebo arm one group of people with a certain genotype have a strong placebo response and the other group has a weak placebo response. And when we look at the drug treatment arm, we see the outcomes are reversed, the people who had the strong response in the placebo arm now have a low response and the people who didn’t have a response in the placebo arm now have a strong response. The historical interpretation of these results has been that only one group of people responds to the drug and we’re pointing out that it’s more complicated than that. It’s that one group responded to the placebo and that response is eliminated in the drug treatment arm.

What all this means in the real world is still hard to know. But in their paper published this week in the journal, Trends in Molecular Medicine, the researchers offer these three key takeaways in the abstract:

•The predisposition to respond to placebo treatment may be in part a stable heritable trait.

•Candidate placebo response pathways may interact with drugs to modify outcomes in the drug treatment arms of clinical trials.

•Genomic analysis of randomized placebo and no-treatment controlled trials are needed to fully realize the potential of the placebome.

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Sexual Reality: The Checkup Podcast Debunks A Few Myths (Like Size And Age Matter…)

Possibly our juiciest segment yet, the latest installment of The Checkup podcast, our joint venture with Slate, takes on some sexual myths and offers a bit of reality.

We bring you surprises about penis size, stories of great sex over 70 and new insights on how both men and women are lied to about their sexuality. As we have in past segments, Carey and I offer our fresh take on research-based news that could brighten up your life below the waist. Check it out here:

And in case you missed our last episode, “Grossology” (including a look at the first stool bank in the nation and research on the benefits of “bacterial schmears” from a mother’s birth canal) — you can listen now.

And if you want to hear earlier episodes: “Scary Food Stories” includes the tale of a recovering sugar addict and offers sobering news to kale devotees. And “On The Brain” includes fascinating research on dyslexia, depression and how playing music may affect our minds.

Make sure to tune in next time, when we present: “High Anxiety,” an episode on the (arguably) most prevalent of mental health disorders.

Each week, The Checkup features a different topic — previous episodes focused on college mental health, sex problems, the Insanity workout and vaccine issues. If you listen and like it, won’t you please let our podcasting partner, Slate, know? You can email them at podcasts@slate.com.

You Are When You Eat: Study Explores Body Clock Effects On Blood Sugar

(Macro Mondays/Flickr Creative Commons)

(Macro Mondays/Flickr Creative Commons)

You know the old saying (or maybe you should): “Eat breakfast like a king, lunch like a prince and dinner like a pauper.”

A new study in the journal PNAS looks into some of the underlying biology: that our bodies tend to regulate blood sugar better after breakfast than after dinner.

Led by researchers at Brigham and Women’s Hospital, it also helps explain why night shift workers tend to be at heightened risk for Type 2 diabetes.

Says the study’s senior author, Frank A. J. L. Scheer of the Brigham, on Radio Boston today: “What we wanted to explore was whether the biological clock — the internal clock — is playing an important part in this day/night variation, or that it might just be due to the sleep/wake and feeding/fasting cycle.”

The study pinpoints two separate mechanisms at work:

• Our basic body clocks, also known as circadian rhythm, have major influence on our blood sugar regulation: our glucose tolerance is naturally higher in the morning than the evening.

• And, independently, when our clocks are misaligned — when we’re forced to flip our days and nights — that, too, lowers our glucose tolerance.

Bottom line, for those of us who are not shift workers: The same exact meal can lead to more of an increase in blood sugar when eaten at night than when eaten in the morning (and higher blood sugar is considered a risk factor for developing diabetes.) Chalk one up for the writers of old sayings.

On the study: Continue reading

Daughter Born To Widow Of Slain Boston Surgeon

Mikaela Jane Davidson (Courtesy of Brigham and Women's Hospital)

Mikaela Jane Davidson (Courtesy of Brigham and Women’s Hospital)

This poignant birth announcement is just in from Brigham and Women’s Hospital:

Davidson Family Welcomes Baby Girl

Boston, MA – On behalf of Dr. Terri Halperin and the Davidson family, Brigham and Women’s Hospital announces the arrival of Mikaela Jane Davidson, born Saturday, April 4, 2015. Mother and baby are doing well.

Mikaela’s father, Dr. Michael J. Davidson, was tragically shot and killed by a patient’s son at BWH on January 20, 2015, leaving behind his beloved wife Terri, daughters Kate (10) and Liv (8) and son Graham (2). Mikaela was named after her dad and shares his initials – MJD.

Terri said, “Michael was very much looking forward to the birth of this beautiful baby girl. At a time when my children and I are completely heartbroken over the loss of Michael, we are finding joy in Mikaela’s arrival. We have been humbled and touched by the tremendous outpouring of love and support coming from family, friends, patients and all those kind-hearted souls who have been moved by Michael’s senseless death.”

Brigham and Women’s Hospital established the Davidson Family Fund to provide support for the Davidson children.

The press release notes that Dr. Halperin is not otherwise interacting with the media right now.

A woman wears a button honoring Michael Davidson at his January funeral service. (Jesse Costa/WBUR)

A woman wears a button honoring Michael Davidson at his January funeral service. (Jesse Costa/WBUR)

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Visionaries: MIT Scientist Helps Blind Indian Children See, And Then Learns From Them

MIT neuroscience professor Pawan Sinha (Robin Lubbock/WBUR)

MIT neuroscience professor Pawan Sinha (Robin Lubbock/WBUR)

MIT neuroscience professor Pawan Sinha still gets goosebumps when he thinks about it, he says: “Things just happened so perfectly, so well-timed.”

Back in 2002, Sinha was grappling with a deep scientific question: How do we learn to recognize the objects we see? How do our brains know, “That’s a face”? Or “That’s a table”?

A fateful taxi ride set his research — and his life — onto a new road.

He was back visiting New Delhi, where he grew up on the elite campus of the Indian Institute of Technology before coming to America for graduate school. He was on his way to see a friend one evening, when the taxi he was riding in stopped at a traffic light.

“I noticed, by the side of the road was this little family, a mother and her two children,” he says. “And it felt really terrible to see these two children, who were barely wearing any clothes, very young children on this cold winter day. So I called over the mother to give her a little bit of change.”

When she approached, Sinha noticed that both of the children holding on to her sari had cataracts clouding their eyes.

It was the first time that he had seen children with cataracts. When he looked into childhood blindness in India, he learned that it is a widespread problem, often caused by rubella during the mother’s pregnancy. Blind children in the developing world suffer so much abuse and neglect that more than half don’t survive to age 5, he says.

Sinha wanted to help, but he figured that what he could contribute on his academic salary would be just a drop in the ocean.

“And that’s when the realization struck me that in providing treatment to those children, I would have exactly the approach that I had been looking for in my scientific work,” he says.

“If you have a child, say, a 10-year-old child who has not seen from birth, has only seen light and dark, and in a matter of half an hour you’re able to initiate sight in this child, then from the very next day, when the bandages are removed, you have a ringside seat into the process of visual development.”

Sinha applied for a federal grant to pay for cataract operations, which are relatively simple, and for studying the children who got them. Usually, American research money stays in America, “but I took a chance because I completely, honestly believed, and believe, that in providing that surgery, we are benefiting science that belongs to all of mankind, it’s not just specifically India.”

That grant eventually came though and to continue the work, Sinha founded a nonprofit based in New Delhi. He named it Project Prakash; Prakash means “light” in Sanskrit. Since 2005, he says, nearly 500 Indian children have gained sight through the project.

Now, at 48, Sinha is planning a major expansion of Project Prakash, to create a center that includes a hospital, a school and a research facility. The goal is to serve many more children than the current 40 to 50 a year. Continue reading

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Shops Remove Possibly Dangerous Diet Supplements After Study Faults FDA

Following a report this week that the U.S. Food and Drug Administration kept silent about synthetic stimulant contamination in some popular diet supplements, a major vitamin seller announced it will pull products that may be tainted with the chemical BMPEA.

Here’s The Vitamin Shoppe announcement via PR Newswire:

Mike Mozart/flickr

Mike Mozart/flickr

Because the health and safety of our customers is our number one priority, and out of an abundance of caution, we are immediately removing all acacia rigidula containing products, due to the concern that some of them may contain BMPEA, from our stores and website. BMPEA is a synthetic drug-like substance that should not be used in dietary supplements.

We are concerned by the findings outlined in the study published yesterday in Drug Testing and Analysis, which state that some acacia rigidula containing products may also contain BMPEA. If these findings are confirmed by the FDA, these products should not be sold as dietary supplements.

The Vitamin Shoppe requires that all manufacturers of the products we carry comply with all applicable laws. The Vitamin Shoppe decided to remove these products because the safety of these products is now in question and may not be in compliance with FDA regulations. In addition, the Vitamin Shoppe continues to encourage the FDA to use its authority to remove any dietary supplements from the market which it deems unsafe.

On Wednesday, The New York Times offered a detailed account of the tainted supplement study, which was published in the journal Drug Testing and Analysis:

Popular weight-loss and workout supplements on sale in hundreds of vitamin shops across the nation contain a chemical nearly identical to amphetamine, the powerful stimulant, and pose dangers to the health of those who take them, according to a new study. The Canadian health authorities in December called the chemical, BMPEA, “a serious health risk,” and pulled supplements that contain it from store shelves.

The Food and Drug Administration documented two years ago that nine such supplements contained the same chemical, but never made public the names of the products or the companies that made them. Neither has it recalled the products nor issued a health alert to consumers as it has done with other tainted supplements. The F.D.A. said in a statement that its review of supplements containing the stimulant “does not identify a specific safety concern at this time.”

But public health experts contend that the F.D.A.’s reluctance to act in this case is symptomatic of a broader problem. The agency is not effectively policing the $33 billion-a-year supplements industry in part because top agency regulators themselves come from the industry and have conflicts of interest, they say.

Dr. Pieter Cohen, an assistant professor at Harvard Medical School, and the lead author of the study, said in an email that he has some short-and long-term hopes for what happens next in the tainted supplement saga. Cohen, also a primary care doctor at Cambridge Health Alliance wrote:

I would hope the FDA stops hiding their head in the sand and immediately warns consumers that they have found a synthetic stimulant in many supplements. The FDA should use it’s full enforcement capabilities to remove BMPEA from all supplements. The FDA should also clarify that the plant being used as cover for this stimulant, a shrub called Acacia rigidula, has no legitimate place in supplements and all supplements labeled as containing Acacia rigidula should be immediately withdrawn from the market. Continue reading

Mass. VA Clinic, Hospital Wait Times Vary Widely

In a state that prides itself on access to great health care, wait times at Veterans Affairs hospitals and clinics vary widely, with some facilities in central and western Massachusetts delaying appointments at much higher rates than in the affluent east.

Nearly 9,000 medical appointments at VA facilities in Massachusetts – about 2 percent of the state’s total during the six-month period ending in February- failed to meet the department’s goal of completing medical appointments within 30 days.

That’s better than the national average of 2.8 percent, but nearly half the delays in Massachusetts occurred at only three of the state’s 20 facilities, according to government data reviewed by the Associated Press.

“We’re working to get the veterans into their appointments in a more timely manner. It’s a work in progress.”

– Dennis Ramstein, Central Western Mass. VA spokesman

The AP analysis of six months of appointment data at 940 VA hospitals and clinics nationwide found that the number of medical appointments delayed 30 to 90 days has stayed flat since Congress began pumping $16.3 billion dollars into the VA system in August. The number of appointments that take longer than 90 days to complete has nearly doubled.

Many of the delay-prone hospitals and clinics are clustered within a few hours’ drive of each other in a handful of Southern states, often in areas with a strong military presence, a partly rural population and patient growth that has outpaced the VA’s sluggish planning process.

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