Health Weekender: Going somewhere? 6 ways to stay healthy and safe

Whether your summer travel plans call for an international adventure or a road trip to the beach, we’ve got some tips to keep you and your family in good health.

Know the risks. Traveling to foreign countries can put you at risk of catching diseases that have been mostly eradicated in the U.S. Malaria and dengue fever, for example, are widespread in Africa and Latin America. And many cases of hepatitis A among American travelers are acquired in Mexico or Central America. You can check with the Centers for Disease Control and Prevention to see what precautions you should take for the country you’re traveling to.

There are regional health risks within the U.S. as well. Lyme disease, for example, spread by ticks, is most common in the Northeast and north-central states, so travelers to those places should be especially cautious when they’re outdoors. Most U.S. states have also seen cases of West Nile virus, spread by mosquitoes, so be sure to use insect repellent if you’re going outside.

Get vaccinated. If you’re going somewhere that has a risk of disease, talk to your doctor or a travel-medicine specialist about immunizations and drugs you should take with you, preferably a month to six weeks before you depart. You can find a travel specialist at the International Society of Travel Medicine. Also check to see if you're up to date on routine immunizations, such as shots for flu and diphtheria/tetanus.

Pack a medical travel kit. Be sure to bring a full supply of your prescription medicines—even more in case you are delayed or decide to extend your trip. Pack them in their original bottles in your carry-on bag if you are flying. If you have a serious medical problem or allergy, consider an alert bracelet. Also pack copies of your prescriptions, just in case.

Your emergency kit should have a first-aid manual, emergency contacts, basic medications (such as acetaminophen, or NSAIDs for pain or fever, antihistamines for allergies, motion sickness drugs, and stomach and anti-diarrhea medications), and sterile wound-care supplies. Other useful items include a flashlight, blanket, plenty of water, sunscreen, insect repellent, and extra eyeglasses or contact lenses, if applicable.

Q&A: Prescription drugs in tap water?

I read that prescription medications have been detected in some community water supplies. Will a home water filter remove them from tap water? —S.M., Washington, D.C.

It might, depending on the drug. Tests of water samples from around the country have found numerous drugs, including antibiotics, hormones, and medications for cholesterol and blood pressure. The levels were minuscule, and it’s not clear what health risks they may pose. It’s also not clear how effectively a water filter—either the kind that attaches to the kitchen sink or a whole-house model—might remove them, since we couldn’t find any independent studies testing them for that purpose. But in theory, our experts say they’d probably filter out at least those drugs that dissolve into particles of similar size to the ones the filters are known to remove, such as chlorine and pesticides.

Take a look at 10 ways to reduce your exposure to chemicals and read more on how to safely dispose of unused medications.  

Thin people can’t get type 2 diabetes, and other myths

When I was 12, my well-meaning uncle told me I could "catch diabetes" from eating too much candy. Of course, his advice was likely a scare tactic to help me tame my overactive sweet tooth. I later found out that while loading up on sweets is not a direct cause of diabetes, sugary foods can trigger the condition in someone with prediabetes.

Type 2 diabetes is a complicated and often deceptive disease—and popular misconceptions can make it tricky for a person to be diagnosed and effectively manage their condition. Public-health officials estimate that of the 24 million Americans with type 2 diabetes, and nearly one-quarter are unaware they have the disease. Our recent diabetes survey also revealed confusion when it came to listing risk factors, symptoms, and complications related to type 2 diabetes.

One such risk factor, obesity, brings us to another big diabetes myth: You have to be overweight to develop diabetes, and thin people can’t get the disease. While there’s no doubt that obesity is a major contributor to type 2 diabetes, genetics also play a role. Blood sugar levels can increase even in thin people and our experts recommend that people aged 45 and older have their blood sugar checked every three years.

AdWatch: Abilify finds lucrative new audience

American doctors wrote more than 164 million prescriptions for antidepressants in 2008, making it the third most-prescribed of any class of drugs. Now Bristol-Myers Squibb (BMS) is tapping into that vast market with an aggressive advertising campaign for Abilify (aripiprazole), its blockbuster antipsychotic medication. Originally approved for treating schizophrenia and soon after that, bipolar disorder, Abilify hit the real jackpot in late 2007 when it won approval as an add-on treatment for people with major depression who haven’t gotten adequate relief from taking an antidepressant alone. It’s the first antipsychotic medicine approved by the U.S. Food and Drug Administration for that use.

BMS is promoting the depression indication in print ads and in the ubiquitous TV commercial critiqued in the video at right. We chose Abilify for this seventh edition of our AdWatch series because, frankly, the ad scares us.

It’s not the commercial itself that we find frightening; watch it and you’d swear that it’s just another antidepressant ad. But Abilify isn’t just another antidepressant. It’s a member of a class of drugs known as atypical (or "newer") antipsychotics, which have different—and in some cases, more serious—side effects than the SSRI antidepressants (which have plenty of safety concerns of their own). Abilify’s popularity hinges partly on the fact that it may be less likely to cause certain side effects, such as weight gain and elevated blood-sugar levels, than other drugs in its class, such as olanzapine (Zyprexa). But it still carries some risk of those, as well as of restlessness, decreased white blood-cell count, and a condition called tardive dyskinesia, or involuntary repetitive movements of the limbs and body that can become permanent. In two studies sponsored by the manufacturer, 25 percent of patients who added Abilify to their antidepressant drug experienced akathisia (inner restlessness and urge to move around), compared to 4 percent of patients taking an antidepressant plus a placebo. And, Abilify costs around 45 times as much per month as many antidepressants.

Thin people can’t get type 2 diabetes, and other myths

When I was 12, my well-meaning uncle told me I could "catch diabetes" from eating too much candy. Of course, his advice was likely a scare tactic to help me tame my overactive sweet tooth. I later found out that while loading up on sweets is not a direct cause of diabetes, sugary foods can trigger the condition in someone with prediabetes.

Type 2 diabetes is a complicated and often deceptive disease—and popular misconceptions can make it tricky for a person to be diagnosed and effectively manage their condition. Public-health officials estimate that of the 24 million Americans with type 2 diabetes, and nearly one-quarter are unaware they have the disease. Our recent diabetes survey also revealed confusion when it came to listing risk factors, symptoms, and complications related to type 2 diabetes.

One such risk factor, obesity, brings us to another big diabetes myth: You have to be overweight to develop diabetes, and thin people can’t get the disease. While there’s no doubt that obesity is a major contributor to type 2 diabetes, genetics also play a role. Blood sugar levels can increase even in thin people and our experts recommend that people aged 45 and older have their blood sugar checked every three years.

Healthy living really does pay off

If good intentions helped you live longer, I’d live till 100. Much as we all aspire to live healthy lives, the day-to-day temptations of having another cookie, or watching TV instead of going for a run, make it hard.

Also, so many things affect your chances of illness that it’s tempting to give up entirely, and blame ill health on your genes, or just on your luck. So, two new studies, published in the Journal of the American Medical Association, come as a timely reminder that the choices you make really do have a big impact on your health.

The first study shows that an amazing 8 in 10 cases of high blood pressure in women could be avoided, if all women lived as healthily as they could. And the second study shows that men can cut in half their lifetime chances of getting heart failure, from 2 in 10 down to 1 in 10, simply by making healthy choices.

CDC puts 5 groups at the top of list for swine flu vaccine

Expert advisers to the Centers for Disease Control and Prevention earlier today identified five groups of people who should be the first to get immunized against swine (H1N1) flu when the vaccine becomes available, probably sometime this fall:

• Health care workers and emergency medical responders, because their jobs are critical.
• Pregnant women, children age 6 months to 24 years, and adults age 24 to 64 with chronic conditions such as asthma, diabetes, or heart disease, because they face a higher risk of complications.
• People caring for infants under 6 months old, because infants can’t be vaccinated themselves and also face higher risks.

Notably absent from that list: People age 65 and over. Anne Schuchat, M.D., director of the National Center for Immunizations and Respiratory Diseases, said that older people were not included because the evidence now suggests that they are not as vulnerable to the swine flu as they are to regular seasonal flu, or as younger people are to the swine flu.

Keep your cool, avoid heat-related illnesses

As temperatures and humidity rise, seniors are at a heightened risk for heat-related illnesses, collectively known as hyperthermia. Hundreds of people die each year from the effects of extreme heat, which includes heat stroke, heat fatigue, heat syncope (sudden dizziness after exercising in the heat), heat cramps, and heat exhaustion.

According to the National Institute on Aging, older people (65 and older) are at a greater risk for heat-related illnesses because of age-related changes to the skin such as poor blood circulation and inefficient sweat glands. People with heart, lung, or kidney disease, and high blood pressure are vulnerable as well. Other risk factors include:

• Being dehydrated
• Drinking alcoholic beverages
• Being substantially overweight or underweight
• The inability to perspire brought on by medications such as diuretics, sedatives, tranquilizers, and certain heart and blood pressure drugs.
• Taking several drugs for various conditions. Note: be sure to talk to your doctor about any medications you’re taking and how they might affect you during extremely hot days.

Sweet temptation: Getting kids hooked on lollipop flavors

This week I spoke on Good Morning America about the dangers of hookah smoking (also called waterpipe, shisha (sheesha), goza, or hubble bubble) for teens. I blogged about the subject last year after my son—then only fifteen years old—told me how easy it was to get served at hookah bars in New York City. Like many adolescents, he was convinced that, unlike cigarettes, it was not harmful.

In fact, hookahs do use tobacco (referred to as Massel) which comes in a wide variety of flavors— including apple, strawberry, cappuccino, coconut and mango—intended to provide smokers with a pleasant smoking experience. Because it provides a much less irritating smoking experience, hookahs are considered more pleasant by many smokers, and as a result, they may smoke for longer durations and inhale more deeply. A typical one hour session exposes the user to about 100-200 times the volume inhaled from one cigarette and produces far higher blood levels of nicotine because a session involves from 50 to 200 puffs, rather than the 5-10 minutes and 8 to 12 puffs it takes to smoke a cigarette. And studies show that degree of exposure is more than enough to cause nicotine dependence and lead to a cigarette habit.

Tobacco-free kids, a non-profit organization dedicated to reducing tobacco use, reports that tobacco companies have a long history of creating new flavored products that appeal to kids and marketing them aggressively. Internal tobacco company documents released several years ago called this a "graduation strategy" meant to hook kids by starting them with milder tasting, more flavored substances. This trick is also used with a product called "Snus", a non-chew, no-spit oral tobacco that’s available in variety of flavors including peppermint, apple, and cranberry. Also increasingly popular with teens, Snus lets them stay under the radar at school and still get their nicotine fix because it’s stuffed between the lip and the gum.

FDA: Stop using body-building products that make steroid-like claims

The Food and Drug Administration warned consumers today to stop using body-building products that claim to contain steroid-like ingredients, but that may actually contain synthetic steroids. The FDA has received reports of serious adverse events associated with use of these products, including cases of serious liver injury, stroke, kidney failure, and pulmonary embolism. The products marketed as supplements and as an alternative to steroids, are sold both online and in retail stores and include "TREN-Xtreme," "MASS Xtreme," "ESTRO Xtreme," "AH-89-Xtreme," "HMG Xtreme," "MMA-3 Xtreme," "VNS-9 Xtreme," and "TT-40-Xtreme."

In a warning letter to the manufacturer, American Cellular Laboratories, Inc., the FDA claims that the company violated the Federal Food, Drug, and Cosmetic Act by marketing these products as dietary supplements when they are actually misbranded and unapproved drugs that have not been reviewed by the agency for safety and effectiveness.

This latest action by the FDA comes after a string of recent supplement recalls, including products marketed for weight loss, improved erections, and body-building. Last year, we reported on risky dietary supplements that contain hazardous ingredients linked to serious adverse events. Some ingredients on our high-risk list include androstenedione and bitter orange, found in supplements used to boost athletic performance.

Active days mean better bedtimes

My husband and I did the unthinkable the other night: we watched four back-to-back episodes of Mad Men (season 2 is on DVD—hurray!) and still got to bed by 11:30. So why is this a big deal? Well, our two young children aren't particularly fond of sleep, and with the summer sun shining till 9, their bedtime has crept later, leaving little time for such grown-up pursuits. On this particular day, however, the kids were practically begging for bed after an afternoon spent splashing about in a pool. They were in bed by 7:15 and asleep within minutes, leaving Mom and Dad with some unexpected TV time.

Like many parents, I've noticed that vigorous days frequently mean earlier and easier bedtimes. It makes sense, after all, that kids will be more tired and ready for sleep if they've been physically active during the day. Now researchers have done a large study published in the medical journal Archives of Disease in Children to put these parental observations to the test.

The study included 519 healthy 7-year-olds from New Zealand, who each wore a device called an actigraph for 24 hours. An actigraph records movement, providing an objective measure of a child's activity level and sleep time. Parents also noted when their child went to bed, which allowed researchers to calculate how long after bedtime children actually fell asleep.

Swine flu update: CDC reminds camps about proper anti-viral use; vaccine expected in October

Swine (H1N1) flu has dipped this summer from peak levels in spring, but it has remained far more active than seasonal flu—especially in places where children and young people congregate, such as summer camps and military academies. Last week, the New York Times reported on steps camps are taking to protect children from swine flu, including providing the antiviral Tamiflu to all campers.

On Friday, officials from the Centers for Disease Control and Prevention sent a reminder that antiviral drugs approved for swine flu, including Tamiflu (oseltamivir) and Relenza (zanamivir), are recommended for the treatment of the flu—not typically for prevention. "There is a place for preventive use of these drugs, mainly for the very high-risk people who are in extremely close contact with someone with the virus," said Anne Schuchat, the Director of the National Center for Immunization and Respiratory Diseases. But camps and other institutions should generally focus on other more important prevention methods, such as separating the sick from others and encouraging hand washing and good hygiene.

Are Americans healthier than other nations?

We spend more per capita, both in total and in tax dollars, on health care than other major industrialized countries, according to the latest figures from the Organization for Economic Cooperation and Development. But all that extra money doesn’t buy us extra-large helpings of doctor or hospital care.

(If you want to dig into the OECD data yourself, you can download it here.)

The goal of health care, of course, is better health. Does our huge monetary outlay at least buy us this? That’s a trickier question to answer than you might think, but let’s take a stab at it.*

Start with the most basic comparisons, such as infant mortality. Among the eight wealthy, industrialized countries in our comparison group, ours is the highest (that’s bad).

Our life expectancy at birth, on the other hand, is the lowest (also bad).

Health Weekender: Egg safety—in defense of home-grown eggs

About a year ago I took my 11-year-old daughter to the emergency room with what turned out to be salmonella poisoning. My first thought when I heard the diagnosis: Did she pick up the infection from our flock of chickens? But the public-health outreach worker at the local department of health said that was unlikely.

While eggs are indeed a leading cause of salmonella poisoning, the bacteria that causes the infection may be more likely to breed in the cramped confines of factory farms than in free-range, backyard chicken runs like ours. And people tend to eat home grown eggs when they’re fresher, and thus less likely to be contaminated*.

That was reassuring since one of the main reasons we raise our own eggs is they somehow seem healthier to us. Since they feed mainly on bugs and our table scraps, we know what they’re eating. And since we let them range free we know they’re treated humanely. Plus, they just taste better and the brown and even green and blue eggs we get from our different breeds make every day look like Easter.

But in truth, all eggs can be good nutritional choices, containing not only protein but also vitamin D and choline, a nutrient recently linked to a reduced risk of birth defects and possibly breast cancer. While eggs are relatively high in dietary cholesterol, most people can eat about six a week without worry. Even those of us with high cholesterol levels can safely consume them in moderation, as long as they watch out for other sources of cholesterol. And in early July, the Food and Drug Administration announced new rules aimed at reducing salmonella contamination in store-bought eggs are contaminated with salmonella.

Do you think you might have diabetes? Get to know your blood sugar

Recently a close friend told me she suspected she had type 2 diabetes. My first thought was, "No you don’t! You’re too young and healthy to be diabetic." I was hoping her concerns were a misguided attempt to self-diagnose her constant tiredness. After finally seeing her doctor, she found out she wasn’t diabetic, but definitely needed some rest. Her diabetes scare got me thinking about how much I really know about diabetes. Very little. And, it turns out, I’m not alone—many Americans don’t know much about diabetes, according to a new Consumer Reports National Research Center survey. Overall, the survey found that people were more than twice as likely to know their blood pressure as their blood sugar level.

Based on gender, my friend might have had an advantage over men in getting preventative care and treatment for diabetes. According to the survey, women are more likely to report they talk with a doctor about vital health statistics for blood pressure, blood sugar, and cholesterol. Still, both genders revealed confusion when it came to recognizing the risk factors, symptoms, and complications related to type 2 diabetes.