New Study: Stress Can Kill

Lose the anger and stress, say researchers, and you'll substantially reduce your risk of a heart attack. A new study says heart patients with higher levels of "irritability" and "anger" in response to a mental stress test were more likely to suffer a reduced oxygen supply to the heart.

That, in turn, increases the risk of heart attack, say researchers in the study, published in the January Journal of Health Psychology. "Anger," says the study, "has to be thought of as a risk factor for heart disease."

Anger and hostility make the heart beat faster, raise blood pressure, narrow arteries and thicken the blood. For those with heart disease -- whether they know they have it or not -- this can reduce blood flow to the heart and oxygen supply to the heart muscle, a condition known as "ischemia."

Some people will know they're at risk because of chest pains or angina; others will have no warning signs. Baby boomers, take note: You don't have to be old to be at risk. Researchers have found results of anger tests can predict health problems as much as 10 years before the fact.

So chill out, take a walk, get counseling, do breathing exercises, take a course in hostility management. Whatever it takes, reduce the stress and anger in your life -- and you'll have more of it to live.

Pregnant Women Warned of Risky Food

So when the Florida woman got pregnant again, she wanted a list of listeria-prone foods so she could avoid the risk. However, two doctors she consulted couldn't tell her anything.

``They didn't know themselves what it was,'' said Lenkersdorf, who searched the Internet to discover that the Brie and cold cuts she loved actually can be high-risk foods during pregnancy. ``They should know about this. ... It's a preventible thing if you're informed.''

A consumer advocacy group today began a campaign to let more women know there are precautions they need to take during pregnancy to avoid foods that could harm or even kill their developing baby.

This information ``is widely known within public health circles, but it isn't widely known by physicians who treat pregnant women, or the women,'' said Caroline Smith deWaal of the Center for Science in the Public Interest, which is distributing free brochures explaining ``Healthy Eating for Pregnant Moms.''

At issue actually are two infections:
• Listeria is a bacterium that just causes flu-like symptoms in most healthy people, although it can be serious in the young, old or weak.

  But it's of special concern for pregnant women because the bacterium can cause miscarriage or stillbirth even if the mother feels no symptoms.

  Listeria is estimated to sicken 2,500 Americans a year and kill 500 of them, and experts estimate one-third of those cases involve pregnant women and their babies.

  It is most often found in soft cheese like Brie or feta, unpasteurized milk products, undercooked meat, poultry or seafood - or even ready-to-eat products like deli meats and hot dogs.

• Toxoplasmosis is a parasitic infection that can cause miscarriage or birth defects. Many women may know not to clean a cat's litter box during pregnancy because it is commonly carried by cats, but the parasite also can be found in undercooked meat, mostly pork, or unwashed fruits and vegetables that came into contact with contaminated soil, CSPI said.

  There are no good statistics, but the advocacy group cited government estimates that anywhere from 400 to 6,000 infants are born infected with toxoplasmosis each year.

Among CSPI's recommendations for pregnant women:

• Do not eat products made from unpasteurized milk, and avoid soft cheeses like Brie. (Hard cheeses, yogurt, cream cheese and cottage cheese are all safe.)
• Reheat ready-to-eat foods - even cold cuts - until they are steaming or do not eat them. Cook meat and poultry until well-done.
• Wash your hands before preparing foods and after handling raw meats and avoid using the same utensils on raw and cooked foods.

Listeria actually is fairly rare, but the government is hunting new ways to better prevent it because it is such a threat during pregnancy, said Food and Drug Administration food safety chief Robert Buchanon. The good news is recalls of listeria-tainted food are declining each year, he said.

Dr. Kaye Wachsmith, an Agriculture Department food safety expert, said CSPI's new brochure ``will go a long way'' to educating women on ways to prevent listeria.

But as a result of the Bil Mar outbreak, Agricultural Department officials have urged ready-to-eat food manufacturers to take better steps to detect and prevent listeria, and ``we certainly haven't rule out'' new regulations, she said.

Note: Listeria is from the same family that causes diphtheria. It can be found in the soil so all fruits and vegetables should be washed properly. It prefers a salty medium and uses the carbohydrates present for growth. So any foods that have a sugar or starch content as well as high salt (sodiums, nitrite, nitrate) concentration.
~Diagnostic Microbiology , Connie R Mahon and George Manuselis,Jr, W.B. Saunders, 1995 - pg 374-375

Few doctors recommend natural contraception

Dr. Joseph B. Stanford, now at the University of Utah in Salt Lake City, and associates at the University of Missouri-Columbia asked doctors how often they discuss two natural ``rhythm'' methods for preventing pregnancy: the cervical mucus method and the symptothermal method.

Using the mucus method, a woman monitors her vaginal discharge, which increases and becomes more watery just before an egg is released. She should stop having intercourse when the amount of mucus starts to increase and not start again until at least 4 days after she observes the greatest amount.

Using the symptothermal method, a woman determines when an egg has been released by monitoring her vaginal discharge and also by taking her temperature each morning while she is still in bed. The temperature falls slightly before an egg is released and rises slightly after the egg is released. The woman also stays alert for other symptoms of egg release, such as slight cramping pain.

The researchers sent surveys to 840 primary care doctors and obstetrician-gynecologists in Missouri. A total of 375 doctors reported that they counsel women about contraception, and that group was the subject of the study. The results are published in the November issue of Obstetrics & Gynecology.

Overall, fewer than half of the doctors (47%) said that they mention the temperature method or the mucus method at least sometimes when discussing contraception with their patients. Forty percent said that they sometimes discuss the mucus method, and 54% said that they sometimes discuss the symptothermal method.

In addition, the doctors underestimated the effectiveness of natural family planning. Only 22% knew that the best possible effectiveness of the two ``rhythm'' methods is greater than 90%, and only one third knew that the typical effectiveness is greater than 70%.

Stanford told Reuters Health that many physicians seem to lack up-to-date information on natural family planning. Often, ''what they think they know (is) wrong,'' he explained, or is ''based on old or outdated information.''

He and his colleagues note that natural family planning has important advantages for many patients. These include low cost, ''lack of side effects, education of women about their bodies, shared responsibility between female and male partners for family planning issues, and compatibility with religious or philosophical values of those who might not wish to use various contraceptive technologies.''

The authors add that ``rhythm'' methods are helpful for infertile couples, not just those who want a natural method of contraception. The methods can also help couples identify the best times to have intercourse, when the woman is most fertile.

SOURCE: Obstetrics & Gynecology 1999;94:672-678.

High fiber intake linked to weight loss, healthy hearts

In fact, ``fiber may play a greater role in determining cardiovascular disease risk than total or saturated fat intake,'' report a team of researchers led by Dr. David S. Ludwig of Children's Hospital in Boston, Massachusetts.

Dietary fiber -- from fruits, vegetable, and grains -- remains largely undigested in the gastrointestinal tract. However, experts believe that fiber slows the progress of food through the gut, reducing the absorption of food, and keeping insulin secretion at low or moderate levels.

In their study, Ludwig's team examined the diets and cardiovascular risk factors of over 2,900 individuals between 18 and 30 years of age.

They found that high-fiber diets were associated with lowered ``insulin levels, weight gain, and other risk factors for cardiovascular disease in young adults.''

``Individuals eating the most fiber gained less weight than those eating the least fiber,'' they write. Subjects ranked in the highest 20% in terms of fiber intake weighed 8 pounds less, on average, than did those in the lowest 20%.

High fiber intake was also associated with lowered blood pressure, especially among whites, according to the researchers.

Ludwig and colleagues believe that the health benefits of fiber stem largely from its ability to reduce insulin secretion. High insulin levels are associated with increased fat absorption, hypertension, and other heart disease risk factors.

In a related statement from the American Heart Association (AHA), Nutrition Committee member Dr. Alice Lichtenstein notes that the findings ``are consistent with the heart-healthy dietary guidelines of the AHA,'' which now recommend that individuals consume at least 25 to 30 grams of dietary fiber per day from food.

According to Lichtenstein, the study does not confirm a direct cause-and-effect relationship between fiber and improved cardiovascular health. ``The subjects in this study with the highest fiber intake smoked less and exercised more,'' she points out. ``Therefore, one shouldn't conclude that adding a dietary fiber supplement, without adapting a heart-healthy lifestyle, will decrease an individual's risk.''

SOURCE: The Journal of the American Medical Association 1999;282:1539-1546.

More evidence that vitamin C blocks exercise-induced asthma

Patients with this type of asthma have symptoms -- breathlessness, wheezing and cough -- when they engage in physical activity.

``We think vitamin C has some effect to improve (exercise-induced asthma) in children with asthma,'' Dr. H. Nakano, from the Saitama Medical School in Moroyama and colleagues reported Tuesday at the World Congress of Asthma.

Nakano's group studied 17 patients between 3 and 14 years of age who had exercise-induced asthma confirmed by a standard exercise test. None of the children studied had taken drugs commonly used to treat asthma, such as inhaled steroids or disodium cromoglycate.

The Japanese team gave each child 2 grams of vitamin C per day for 4 weeks and performed a second exercise test. They also surveyed patients regarding the frequency and severity of asthma attacks during the study.

Eight of 17 patients reported ``decreased frequency of attack and improved lung function,'' the investigators reported.

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