Seven tips for safer cantaloupes

The Food and Drug Administration (FDA) has issued a warning on cantaloupes produced by a Honduran grower and packer, which have been linked to cases of Salmonella. According to the agency, there have been reports of 50 illnesses in 16 states (and a further nine cases in Canada), which are linked to consumption of the cantaloupes. The melons are from Agropecuaria Montelibano, a grower that produces 2.5 million boxes of cantaloupes each year for the United States.

This alert adds to the intense scrutiny that imported products have recently come under in the United States and adds to Consumers Union’s position on stronger border detection and country of origin labeling. "The FDA only has funding to inspect less than 1 percent of the imported food that comes into the country, so what you see here is typical," said Jean Halloran, director of food policy initiatives at Consumers Union. "We discover the problem through reporting of the disease in people, not through detection at the border."

If you have recently bought cantaloupe, the FDA advises you to check with the place of purchase to determine if the fruit came from this Honduran grower. If so, throw it out immediately. The cantaloupes were distributed in cardboard cartons with the brands "Mikes Melons" or "Mayan Pride" with "Produce of Honduras" printed on the carton's four side panels.

"We have been fighting for years for country of origin labeling, so that in just this type of situation, consumers will know where their cantaloupes come from," said Halloran. "It was enacted as law in 2002, but Congress repeatedly delayed it at the request of industry. Now, it’s supposed to go into effect as of a September 2008 deadline."

The cause is not clear yet of this particular Salmonella outbreak, but there are a number of possible scenarios, including contaminating by wildlife or human handlers. Salmonella is a group of bacteria that can cause diarrhea and it is transmitted through the feces of people or animals.

To safely enjoy cantaloupe, the FDA recommends the following precautions:

• Purchase cantaloupes that are not bruised or damaged. If you buy it freshly cut, make sure it is refrigerated or surrounded by ice.
• Refrigerate the fruit promptly after buying it.
• Wash your hands with hot, soapy water before and after handling fresh cantaloupe.
• Scrub the outside of whole cantaloupes by using a clean produce brush and cool tap water immediately before eating.
• Cut away any bruised or damaged parts of the melon before eating it.
• Throw out leftover cut cantaloupe if left at room temperature for more than two hours.
• Use clean cutting surface and utensils when cutting melon and wash them with hot water and soap afterwards.

Read more on protecting yourself from food-borne illness.

—Nicole A. Sarrubbo, Editorial Assistant

Q&A: Are coffee and tea iron-blockers?

I’ve heard that coffee and tea can block the body’s ability to absorb iron. Is that true? —S.L., Montpelier, Vt.

Yes, but that applies to only one type of iron, and most people have high enough iron levels that they needn’t be concerned about it. Coffee, tea, and red wine can inhibit the body’s ability to absorb nonheme iron, the iron found in plant and dairy foods. The reason: Those beverages contain compounds that bind to the mineral in your intestine. One small study found that drinking a cup of coffee while eating lowered the amount of nonheme iron absorbed from the meal by 39 percent; a cup of tea reduced absorption by 64 percent. Red wine also appears to have a potent iron-blocking effect, based on other research. But the beverages don’t appear to block absorption of the other main type of iron, heme iron, which is found in meat.

In any case, most Americans consume more iron than they need. (Even vegetarians, who get iron exclusively from plant sources or supplements, appear to have no higher rates of iron deficiency than meat eaters.) So unless your doctor says you suffer from low iron levels, there’s no reason to avoid coffee, tea, or red wine.

This article first appeared in the February 2008 issue of Consumer Reports On Health.

Stay fit, be safe: Tips for preventing workout injuries

Planning on getting in shape for the warmer months? Here are some tips that will get your body up and running (or walking or swimming) without breaking down.

Get checked. See a physician before starting an exercise program.

Warm up. Muscles become more pliant and less likely to tear when they’re warm. Before you work out, spend 5 to 10 minutes (closer to 10 if you’re older or the weather’s cold) warming up. Choose a gentle exercise that engages the major muscles you'll be using during your workout.

Stretch. Don't confuse stretching with warming up; they’re separate but equally beneficial ways to loosen the muscles and joints. When stretching, pay extra attention to the muscles that will absorb the most shock.

Cool down. Stopping suddenly after vigorous exercise can trigger a potentially dangerous drop in blood pressure. Walk around until your heart rate drops to just 10 to 15 beats per minute over your resting rate. Then stretch again.

Slow down in extreme weather. Don't try to work as hard or as long as usual during the hottest or coldest times of the year.

Drink up. For most moderate exercisers, drinking as much as thirst dictates during or after a workout will usually prevent dehydration. But if you are overweight or over age 65, or if you tend to sweat heavily or exercise intensely or for a long time (especially in the heat), staying well-hydrated may take extra effort.

Graduate gradually. Increase the duration, distance, or intensity of your workouts by no more than 10 percent per week. And increase just one factor at a time. If you've lapsed in your exercise program, start at 50 to 75 percent of your old level and slowly work your way back.

Toss it up. Doing a mixture of different exercises can help fend off injury. Adding strength training to your aerobic workouts can fortify the muscles and joints, but if you do both on the same day, schedule the aerobic one first, since strength training temporarily tightens the muscles.

Don't work through the pain. Listen to your body. Aches and pains signal increased susceptibility to injury. As soon as you feel pain or shakiness, stop. If you're hurt, don't rush back to your regular workouts before you're fully recovered.

Block the shock. To protect your joints, shins, and feet, choose low-impact exercises and soft surfaces whenever possible.

Choose the right shoes. Make sure your footwear is designed for the type of exercise you're doing.

Check your medicine cabinet. Many drugs can impede athletic performance. If you suspect that a drug is interfering with your workouts, talk to your doctor.

Jump in the pool. Experts say that the greater resistance of water compared with air, combined with its buoyancy, offer benefits that are difficult to get on land.

Read more about preventing sports injuries and the perks of exercise.

Herbal hay fever remedies to watch out for

If you are thinking of trying an alternative treatment for seasonal allergies, you could run the risk of using a product that, at best, isn’t very useful and at worst, could aggravate your symptoms. We put four popular herbal remedies under the microscope and here's what we found.

Butterbur
One of the best-studied natural medicines for allergies, butterbur may ease hay-fever symptoms, possibly by reducing levels of histamines and leukotrienes, chemicals that can set off an allergic response. But the long-term safety of butterbur is unknown. And some preparations might also contain certain chemicals, called pyrrolizidine alkaloids (PAs), that can harm the liver and lungs. If you decide to try it, look for products containing at least 7.5 mg of petasin and isopetasin, the presumed active ingredients. And only use butterbur products that are labeled as free of PAs. Finally, steer clear of the herb if you're allergic to ragweed; it's related to that plant family and could produce an allergic response.

Echinacea
Though some research has suggested that this common herb acts as an anti-inflammatory, there's no solid evidence that it eases hay-fever symptoms. Echinacea might also interact with drugs that suppress the immune system, such as cyclosporine (Sandimmune and generic). People with an immune-system disorder should avoid it, as should those with ragweed allergies, because it’s also related to that plant family.

Grape-seed extract
Derived from parts of the grape plant, grape-seed extract is sometimes vaunted as a natural antihistamine. But it does not appear to quell hay-fever symptoms.

Stinging nettle leaf
Early evidence suggests that extracts of this plant might fight inflammation and modestly curb hay-fever symptoms. But it’s still too soon to tell, so don’t rely on it. Avoid stinging nettle if you’re diabetic; it might increase the effects of some diabetes medications. It might also decrease the effectiveness of the blood-thinning drug warfarin (Coumadin and generic).

Many experts recommend first trying better-established strategies to treat hay fever, such as avoiding the allergens that can cause reactions and taking prescription or over-the-counter allergy medication, which both have a fairly reliable track record. And remember, there is little government oversight of the potency, purity, and identity of supplements, compared to that of prescription and over-the-counter drugs (see "Five steps to choosing a nutritional supplement"), so, in general, exercise caution. That applies especially to young children. And avoid taking them if you are pregnant.

For more information, see our free Best Buy Drugs report on allergy treatments, and read our complete ratings on Natural Medicines (subscribers only).

Preventing MRSA: Why I wear a bowtie

I made my debut as a medical intern on a hot first of July morning long, long ago, wearing a brand-new white suit, white bucks, and a multicolored imported silk Countess Mara necktie. I think I recall some applause on the part of a few patients who had known me as a lowly medical student just a day or so before.

Before long my first admission arrived—a middle-aged truck driver with severe headaches, fever, and a skin rash. Since meningitis was a prime suspect, I told the nurses to set up for a spinal tap. Following the hospital house staff hierarchy protocol, my immediate superior, the assistant resident, did the tap while I held the patient in position.

As he lay on his right side facing me, I slid one hand behind his flexed knees and the other over his neck to keep him from moving. As the spinal needle hit home, he gave a grunt. At once I felt a warm, wet sensation spread over my chest and the strong odor of urine permeated the air. My beautiful Countess Mara tie was now a sodden, blotchy mess. I showered, changed my shirt, and switched to wearing bow ties. Little did I realize that by making that permanent change in my daily dress code, I would probably be saving lives. Indeed, I had made the right move for the wrong reason.

Germ carriers
That incident came to mind when I read an article in the British Medical Journal a couple of years ago reporting that neckties worn by doctors in hospitals were implicated as carriers of such dread organisms as Clostridium difficile (a bacterium capable of causing severe diarrhea, fever, and dehydration) and methicillin-resistant Staphylococcus aureus, the much-feared MRSA. The report, based on the author’s review of several papers in the medical literature, prompted the British Medical Association’s head of science and ethics to say: "It’s up to individuals, but what we’re saying to doctors is that ties are a potential reservoir and they’re unnecessary. Doctors have to recognize the potential risk."

Although the initial focus was on the necktie, attention rapidly turned to other potentially germ-laden items of attire and adornment, such as the traditional white coat, long-sleeved shirts, wristwatches, bracelets, dangling earrings, long fingernails, beards, and long hair. Also on the list were the doctor’s tools of the trade—the stethoscope and blood pressure cuff.

Doctors, it seems, are walking arsenals of pathogens. While all of the above may be capable of harboring organisms that can cause disease, hard evidence is not easy to find. Nevertheless, it is up to you as a savvy patient to be aware of the potential risk for life-threatening infections carried on your physician's attire and tools. And you should require that any physician treating you keeps those risks to a minimum. A dirty white coat or an otoscope with the previous patient's earwax on it might raise suspicions that all is not well and invite a few inquiries on your part.

The infection chain
But all of those possible routes of disease transmission pale in comparison with the human hand, the only part of the body that can come in contact with every other body part, including the heavily contaminated parts—the genitals, mouth, skin, and rectum. When that hand belongs to a doctor examining sick patients, the risk of cross-contamination and disease transmission is magnified.

Common sense, backed up by strong evidence, suggests that hand washing is the single most important measure that can be taken to prevent the spread of infection. Yet our nation has not taken this simple task to heart. Studies and polls indicate that a significant number of people exit public rest rooms without washing their hands.

Health professionals are no exception. In one of many studies done in hospital settings, hand washing took place in only 48 percent of possible opportunities. Nurses had the distinction of out-distancing doctors, 52 percent to 30 percent.

The availability of portable alcohol-containing gels and foams has made hand cleaning easier than in out-of-the-way sinks in hospitals and offices. Although probably not as good as thorough washing with soap and water, they can cut the chain of infection.

This article first appeared in the March 2008 issue of Consumer Reports On Health.

—Marvin M. Lipman, M.D.

Seven tips for safer denture cleaning

The Food and Drug Administration (FDA) reports that 73 adverse events, including at least one death, have been linked to an ingredient in denture cleansers. The ingredient, persulfate (a known allergen), is used in these cleansers as part of the cleaning and bleaching process. Some reactions may be due to product misuse, but some have also occurred when the product was used properly.

FDA is recommending that manufacturers of denture cleansers revise their labeling and consider using appropriate alternatives to persulfates. These products are for cleaning dentures in a container—they should never be used while the dentures are in your mouth. Current labeling, however, can mislead consumers into believing the products may be chewed, gargled or swallowed.

Symptoms of an allergic reaction may include: irritation, tissue damage, rash, hives, gum tenderness, breathing problems, and low blood pressure.

Symptoms from product misuse may include: abdominal pain, bleaching of tissue, blood in the urine, breathing problems, burns, damage to the esophagus, internal bleeding, low blood pressure, seizures, and vomiting.

Who’s at risk? People who are allergic to persulfates. All denture cleanser users should be aware that an allergic reaction might occur not only soon after the first use of the product but also after many years of use. Some symptoms might not appear for several minutes or even hours, and reactions may become more frequent and severe with repeated use of the product. People who are unable to read or understand the product label are at risk for product misuse.

If you or someone you care for uses denture cleansers be sure to:

• Read all instructions carefully.
• Never chew, swallow, or gargle with denture cleansers; Use the cleansers only by placing them in a container with the dentures.
• Always thoroughly rinse dentures and other dental appliances before placing in your mouth.
• Remember that reactions might not occur right away.
• If symptoms do occur, remove dentures and contact your dentist.
• Ask your dentist about using an alternate method to clean dentures.
• Keep all denture cleansers out of children’s reach.

For more information, read the FDA alert.

—Desiree Calamari, Associate Web Editor

Homeopathic remedies can cause confusion

Spring is here, and if you're not careful, the Zicam you buy from a local pharmacy may not be the hay-fever medicine you expected.

The over-the-counter products Allergy Relief and Intense Sinus Relief are both made by Zicam, and both promise relief of hay-fever symptoms. But there's a big difference. Intense Sinus Relief contains oxymetazoline, a decongestant the Food and Drug Administration has found to be safe and effective. The other product is homeopathic; it hasn't been reviewed by the FDA and its active ingredients, including sulphur, have been diluted almost to the vanishing point. Yet we often found the two products in drugstores shelved alongside each other.

In fact, our 11 mystery shoppers, who visited 52 drugstores throughout the U.S., often found products labeled "homeopathic" alongside conventional over-the-counter drugs. Such product placements could lead consumers to buy a homeopathic remedy when they're really looking for a standard medicine. That not only wastes money but might also lead to inadequately treated health problems. Even people seeking homeopathic products might not get what they expected. Our check of labels found that many of the remedies might not meet the standards set by the industry's own oversight organization.

Homeopathy is a centuries-old form of medicine that takes a substance that might otherwise cause symptoms or harm and dilutes it until the substance becomes virtually undetectable. Yet homeopathy's supporters say the infinitesimal amount of active ingredients somehow improves health. Not surprisingly, there's little good evidence backing up that notion. The most comprehensive analysis of homeopathy we know of—a 2005 review published in The Lancet of 110 placebo-controlled homeopathy trials matched with 110 conventional-medicine trials—found that any benefit from homeopathic remedies was "compatible with" the placebo effect. An accompanying editorial, "The End of Homeopathy," said that the findings were less surprising than the fact that debate over homeopathy continues "despite 150 years of unfavorable findings."

While the FDA is officially required to regulate homeopathic remedies, a spokeswoman for the agency told us that in practice it doesn't review those products and thus doesn't approve them as safe and effective, partly because of "limited resources," and partly because the products are so diluted they're not thought to pose any risks.

Andy P. Bormeth, executive director of the Homeopathic Pharmacopoeia Convention of the United States, says that "official" homeopathic remedies should state "HPUS" on their labels, indicating that they conform with his organization's guidelines. But only 4 of the 12 products our mystery shoppers found included those initials on their labels.

Check whether over-the-counter products are labeled homeopathic. If they are, we think you should put them back on the shelf. There's not enough evidence to justify their use, and they may cause problems if they allow a treatable ailment to worsen. If you opt for one anyway, stick with a product labeled "HPUS." But be leery of those that include alcohol, especially for children, since the FDA does not limit how much alcohol homeopathic remedies can contain.

For more information, read our Natural Medicine Ratings (for subscribers).

This article first appeared in the April 2008 issue of Consumer Reports on Health.

—Doug Podolsky, senior health editor

Tracking down migraine triggers

If you can pinpoint exactly what’s causing your migraines, you might be able to better treat them—or even prevent them from occurring in the first place.

Migraines affect 18 percent of women and 6 percent of men in the U.S. and are a leading cause of absenteeism and decreased productivity at work. The overall cost burden of migraines to society exceeds that of other chronic conditions, including asthma, depression, diabetes, and heart disease. Although medications called triptans, such as rizatriptan (Maxalt) or sumatriptan (Imitrex), can often halt a migraine in progress, nearly half of migraine sufferers who take those or other pain-relieving drugs are still dissatisfied with their ability to function or work afterward. And when used on a regular basis, over-the-counter and prescription pain relievers can even cause headaches. Quite a few commonly used preventive medications, such as amitriptyline or divalproex (Depakote), might have unwelcome side effects, including weight gain and/or sedation. That might be why only 12 percent of migraine patients take them.

A better and more satisfying approach to preventing migraines is to find and avoid the triggers that set them off. Surprisingly, research has shown that more than three quarters of sufferers are ultimately able to identify triggers, such as:

• Beer, red wine, chocolate, and cheeses
• Hunger
• Odors, including perfume
• Bright or fluorescent lights, the sun, or glare from TV or computer screens, particularly if flickering
• Insomnia (regular, but not too much, sleep is known to protect against attacks.)
• Tension, irritability, and stress

But it’s not a precise exercise. Not all culprits cause migraines each time, and sometimes migraines result only when factors occur simultaneously—so-called “stacked triggers.” For instance, while perfume alone might not cause a problem, drinking a glass of red wine might change those odds for the worse. To further complicate matters, some sufferers have a delayed response to stimuli, and triggers can even change over time.

Some doctors recommend keeping a headache diary —a log detailing your attacks and the medication responses that can help patients and doctors identify possible triggers and assess treatment effectiveness. You should document each headache episode, describe its connection to meals and beverages, and note situational factors such as fatigue, sleep patterns, or stress. You should also list the medications you took, and write down how you felt afterward. Women should note their menstrual cycle as well.

If a trigger is a food or fragrance, simply avoiding the offending substance will do the trick. For light-related triggers, sunglasses or tinted glasses can be helpful. Behavioral therapies, such as biofeedback and meditation, are recommended when stress is a factor. Keeping to a regular sleep schedule can help with sleep-related headaches. Alas, some triggers, such as weather and time zone changes, can’t be easily manipulated.

Visit our conditions section for more details about migraines, our detailed Treatment Ratings (for subscribers), and our free CR Best Buy Drugs report on triptans.

—Orly Avitzur, M.D., medical adviser to Consumers Union

See Dr. Avitzur talking about migraine triggers and treatments on ABC news.

Marijuana—in "moderate doses"—can relieve pain

Pain relief is emerging as a potential use for marijuana—although one new study published in the journal Anesthesiology found that too strong a dose can actually worsen pain.

California researchers gave 15 volunteers marijuana cigarettes with small, medium, and large doses of tetrahydrocannabinol (THC), the herb’s main active ingredient. They then inflicted mild pain by injecting the volunteers with capsaicin, the substance that gives chili peppers their bite. Volunteers who smoked the medium dose—4 percent THC—reported less pain than those who got a lower dose or a placebo. But higher doses seemed to increase pain sensitivity.

Another trial of 50 patients with HIV-associated nerve pain, published in Neurology, found that a moderate marijuana dose relieved burning, aching, and nerve pain as effectively as the oral pain drugs typically prescribed. More than half of those who smoked the drug achieved a significant decrease in pain, compared with a quarter of those in the placebo group.

Long-term use of marijuana can expose users to a significant risk of lung damage. In patients with limited life expectancy, such as those with advanced AIDS and terminal cancer, the benefits of smoking modest doses of marijuana may outweigh the risks. Twelve states now allow the medical use of marijuana: Alaska, California, Colorado, Hawaii, Maine, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont, and Washington. It remains illegal under federal law in the U.S.

For more on marijuana, read our Natural Medicine Ratings (subscribers only).

Lipitor: The controversial ad proves highly effective

Don’t feel too sorry for pharmaceutical giant Pfizer, which announced late last month that it would put a halt to a highly publicized ad campaign featuring Robert Jarvik, M.D. as a spokesperson for their bestselling drug, Lipitor.

A new study by the Consumer Reports National Research Center (and reported in our March issue) suggests that the ads were extremely effective while they ran, and probably helped sustain Lipitor’s position as the No. 1 cholesterol-lowering drug -- even though the ads eventually were pulled.

The ads suggested, among other things, that Lipitor—a member of the class of cholesterol-lowering drugs known as statins—is a better choice than less-expensive generic statins that have come on the market. 

The Lipitor ad campaign came under scrutiny in recent weeks by both the media and the U.S. House of Representatives, which launched an investigation into celebrity endorsements of prescription drugs in direct-to-consumer advertising.

The committee is looking into Jarvik’s professional qualifications and his financial arrangement with Pfizer. Among the concerns: Jarvik, known for inventing the Jarvik artificial heart in the 1980s, is not a practicing physician, and it’s been reported that images of him rowing in one widely-aired TV spot turned out to be a body double.

The Consumer Reports survey, however, shows that Dr. Jarvik was a very effective and believable spokesman while the ads were running. In December 2007, we showed the television ad for Lipitor to 978 people who’d been advised by a doctor to lower their cholesterol.  Afterward, we asked viewers for their impressions. Among the key findings:

• Sixty-five percent said the ad conveyed that leading doctors prefer Lipitor.
• Forty-eight percent said Dr. Jarvik’s endorsement made them more confident about Lipitor. More than one-quarter (29 percent) got the impression from the ad that Dr. Jarvik sees patients regularly.
• More than two-thirds of respondents taking Lipitor said they were inclined to stay with it after seeing the ad. One third of those taking a brand-name statin other than Lipitor were likely to speak to their physician about switching.
• Forty-one percent said the ad conveyed that Lipitor is better than generic alternatives. (In fact, the vast majority of people who need to take a statin can get the same protection from a generic, and for less than half the cost.)

What’s more, people just plain liked the ad. Ninety-three percent of respondents found it friendly; 92 percent found it believable; and 91 percent perceived it as factual. No question those types of impressions have helped keep Lipitor the top-selling prescription drug in the United States for six years running.

We believe these findings underscore the need for consumers to view all drug advertising with caution. The ads may not include false information, but they also may not tell the whole story about the drugs they promote. That’s why we’ve launched Consumer Reports’ AdWatch, a series of video critiques that aim to fill in the blanks on direct-to-consumer drug ads. The first two installments critiqued television spots for Requip, the drug approved to treat Restless Legs Syndrome, and the sleep aid Rozerem. Stay tuned for our third AdWatch in the coming weeks.

For more information, see our comprehensive high cholesterol guide and Treatment Ratings (for subscribers) and our free CR Best Buy Drug report on statins.

—Jamie Hirsh, associate editor

Q&A: Tea tree oil: A cure-all?

Many personal hygiene products now contain tea tree oil. Is there any evidence that it has curative powers? —B.J.M., Jacksonville, Texas

Only a little, and it’s not impressive. Test-tube studies suggest that tea tree oil kills some bacteria and fungi. A few small human studies have found that various concentrations of it helped reduce mild acne, athlete’s foot, and toenail fungus. But more research is needed to establish those benefits. Even if the oil works, you’d have to apply it daily for a month and a half (for acne) to six months (for toenail fungus). Don’t drink tea tree oil; that may cause confusion, disorientation, and even coma.

Read our Natural Medicine Ratings for tea tree oil (subscribers only).

Heart attack? Get to the ER on time

If you suddenly felt faint and developed shoulder discomfort, would you call 911? You should. Those are two of the five most important heart-attack warning signs. And more than half of cardiac deaths may occur within an hour of developing the first symptom.

But according to an article in the February 22, 2008 issue of Morbidity and Mortality Weekly Report, published by the federal Centers for Disease Control and Prevention, less than a third of adults recognize all five warning signs of a heart attack:

1. Pain and discomfort in the jaw, neck or back
2. Feeling weak, lightheaded or faint
3. Chest pain or discomfort
4. Pain or discomfort in the arms or shoulder
5. Shortness of breath

Even more disturbing, the CDC study found that many people who did suspect a heart attack would delay calling 911. That hesitation can be fatal: Your odds of surviving an attack are much higher if you get to the emergency room within an hour of the onset of symptoms. After you call 911, chew and swallow one 325-mg (regular) aspirin or four 81-mg (baby) aspirins, since that can help prevent artery-clogging blood clots from forming.

The CDC data revealed striking variability across the country.  In Washington, D.C., for example, only 34 percent of respondents recognized pain or discomfort in the jaw, neck, or back as a sign.  Joel Rosenberg, M.D., Clinical Director of Cardiology at the George Washington University Hospital, said, “We’ve done a very poor job of educating people on how heart attacks present.” Rosenberg is not surprised by the poor results in D.C. given a financially devastated healthcare infrastructure, substantial numbers of low income residents, and poor access to care. “We have to start investing more time, money and effort into prevention of disease as opposed to just focusing on treatment” said Rosenberg, adding, “This includes teaching the public about the warning signs of heart attacks.”

Minnesota—which ranked number one in residents’ ability to identify chest pain as a heart-attack symptom and in calling for emergency assistance—may provide some clues as to how to accomplish that goal.  Thomas Behrenbeck, M.D., Ph.D., Associate Professor of Cardiology at the Mayo Clinic in Rochester, Minn., attributes these stats to focused public service campaigns and grass roots efforts, such as CardioVision 2020, dedicated to improving heart health. “As a result, Minnesota folks are probably more in tune with the warning signs and get medical attention faster than most,” Behrenbeck said. And efforts to improve the care chest pain patients receive once they get to the ER has improved the heart-attack survival rate at Mayo’s emergency room to between 94 and 97 percent, proving, said Behrenbeck that “time is life.” 

—Orly Avitzur, M.D., medical adviser to Consumers Union

It’s not too late for you—and now all your children—to get the flu vaccine

I got the flu shot for the first time this past fall, soon after I started working at Consumers Union, thanks to my new employer’s policy of offering free flu immunization to all of its employees. And, possibly no coincidence, I didn’t get the flu this year—though my wife and youngest daughter did. The federal Centers for Disease Control and Prevention says that my wife, as a health-care professional, should have gotten the vaccine. But, like a lot of people, for one reason or another she just didn’t. My healthy 11-year-old daughter, on the other hand, wasn’t a candidate for the shot—until now.

Previously, the recommendation was for children from 6 months through 4 years old to be vaccinated. However, a panel of immunization experts voted on Feb. 27 to expand the recommended ages for annual flu shots for kids to include all children from age 6 months through 18 years old. The panel said that the recommendation should start “as soon as feasible,” and no later than the 2009-2010 flu season.

While the flu season is already in full swing, and there are concerns that this year’s flu shot isn’t as effective as some, there are still lots of good reasons for you, and your kids, to get vaccinated:

• As we reported in October 2007, the disease can peak in April or May, so even a late, and less-than-perfect, shot is better than none
• We think that all adults should consider getting an annual flu shot, not just those at highest risk
• Though some parents avoid the shot because of safety concerns, our analysis of the research suggests those fears are unfounded
• Children are prime transmitters of the flu. The illness causes a lot of children to miss school, and parents to miss work—as I know all too well.

Read more about:
Flu prevention and our Treatment Ratings (for subscribers)
CDC flu recommendations
Our recommendations on other adult vaccines and a childhood vaccine checklist

—Joel Keehn, senior health editor

Workout needs for every age

Physical-activity needs shift with age and with longer days and (slightly) warmer weather, here’s how to keep moving, from age 20 on up.

20s and 30s
Aim for at least five weekly 30-minute sessions of aerobic exercise. The sooner you start, the lower your lifetime risk of several common health problems, including coronary heart disease, hypertension, type 2 diabetes, obesity, and possibly certain cancers. Women should include weight-bearing exercises to help prevent osteoporosis later in life.

Ideally you should also work in two weekly strength-training sessions, although you can get by with one 20- to 30-minute session that involves all the major muscle groups. Stretch for 10 minutes at least every other day, preferably after workouts, when muscles are still pliable.

40s and 50s
Strive for a minimum of 30 minutes of aerobic exercise four days weekly, but squeeze in more if you can. Research shows that multiple bursts of activity are nearly as effective as one continuous session, so break it up if you need to. If you enjoy high-impact activities such as running or aggressive fitness classes, it’s a good idea to alternate with a lower-impact dance class, swimming, or other activity that is easier on the joints.

Try to strength train three times per week, but two sessions will still provide substantial benefit. Aim for 8 to 12 repetitions per set (15 if you’re out of shape) with enough resistance to make the last repetition difficult. Three sets are optimal; two work nearly as well. (Beginners can start with a single set.) Continue to stretch at least every other day.

60s and beyond
Aim for three to four 30 minute sessions of aerobic exercise each week, minimizing or eliminating high impact activities. Also, make time for strength, flexibility, and balance training, which become increasingly important as you age. Continue to stretch at least every other day.

If brisk walking or other weight-bearing exercises have become difficult, try water exercise. Two weekly strength-training sessions are enough, but wait at least a day, and possibly two, between sessions, as muscles need more time to recover. Use lighter weights and more repetitions—10 to 15 in each set. “It’s critical that people in this age group exercise with proper form to avoid injury,” says Cedric Bryant, Ph.D., chief science officer of the American Council on Exercise. It’s worth paying for at least a couple of sessions with a certified personal trainer to develop a safe, effective routine you can continue on your own. Look for someone certified by fitness organizations such as the American College of Sports Medicine, the American Council on Exercise or the National Strength and Conditioning Association.

Never too late
If you’ve never been active, or have fallen off the wagon, you can still significantly increase your strength and fitness at any age. And good news is that exercise can slow or even reverse age-related physical declines. It’s never too late to start!