Medsarticles. Medical Weblog

Scientific studies have rather consistently demonstrated that companionship contributes to good health. The quality of relationships also is a factor, found Xinhua Steve Ren, Ph.D., assistant professor at the Boston University School of Public Health and research health scientist with the Center for Health Quality, Outcome, and Economic Research of the Veterans Affairs Medical Center in Bedford, Massachusetts. Here are some of his other findings.

•     Separation and divorce can actually improve health – but only in cases where there were serious ongoing marital problems. Separation and divorce are most detrimental to health when the marriage had no prior serious problems and the crisis arose with the sudden discovery of infidelity.

•     Being separated is more injurious to health than divorce. The separated were more than 2 times as likely to consider themselves in poor health than were married folks, while divorced people were about 1.3 times more likely to think themselves in ill health.

•     The quality of a relationship-whether marriage or cohabitation-affects the participants’ health. Those in unhappy relationships are at higher health risk than those who are in happy relationships and, surprisingly, even than those who are divorced.

•     Compared to married people, the unmarried tend to have higher death rates from all causes, have higher levels of stress, and use more health services.

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Genetic predisposition

Some 5 per cent of breast cancers are related to an abnormal gene. Although this gene is rarely implicated in postmenopausal women who develop breast cancer, it is much more commonly present in pre-menopausal women with this disease, particularly in those under the age of 30.

Your risk of developing breast cancer is higher if you have a close relative with pre-menopausal breast cancer than if an affected relative is older than 50. The risk increases if you have two relatives with pre-menopausal breast cancer or one with the disease in both breasts.

The breast cancer family gene which has been identified is found not only in families with cancer of the breasts, but also in those with ovarian and colon cancer. Families with this gene should be given specialist advice and counseling at clinics run by geneticists or breast surgeons.

Geographic differences

Breast cancer is about eight times more common in Northern Europe, North America and Australia than it is in parts of Asia and Africa. However, women who move from low-risk countries, such as Japan, to high-risk countries such as North America, show a sometimes immediate increase in risk – certainly within one or two generations. Although this does not rule out the possibility of a genetic predisposition, it does seem to indicate an important role for some factor(s) in the environment.

Diet

Some dietary factor(s) may play a part in the increase in risk. Although it is not known how these exert their effects, it may be that they influence hormone synthesis or metabolism.

Many foods contain hormones or hormone analogues, either naturally or otherwise. For example, milk is a hormone-derived substance, as, therefore, are butter and cheese etc. Chickens and pigs are often injected with hormones which may be present in the meat from these animals. The early oral contraceptive pill was made from hormones naturally present in the sweet potato. Ginseng also contains naturally occurring oestrogen. These are just a few examples.

There is evidence to suggest an association between diet and various cancers, including cancer of the breast, although this is not conclusive and some studies have failed to find any such link.

Other studies suggest that a diet high in fat and in animal protein, common in most countries in the more affluent West, may be a significant factor in the development of this disease, although there is as yet no conclusive proof of this. Although the Japanese are now a well-nourished nation, they do not eat a large amount of animal fat, and, as mentioned above, do not have a high incidence of breast cancer when living in their own country.

It is also possible, but unproven, that vitamins A and C, found in dark green and yellow vegetables and in fruit, may have a protective effect.

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Tonometry

This is a simple, painless method of measuring the pressure of the fluid in the eyeball. It is valuable to be aware of this pressure because an early rise, if caught, can be treated and can save the person’s sight. It is a test worth doing every two to five years after the age of 40.

Sigmoidoscopy (Looking inside the rectum or back passage)

Most cancers of the bowel lie within the view of a special instrument, called a sigmoidoscope. It is generally considered sensible to have a sigmoidoscopy every three to five years following two negative examinations a year apart at age 50. Other experts recommend one examination at age 56 because this is the peak age for this cancer, which is the second commonest.

Testing the stools for blood

Because microscopic amounts of blood can be lost in the stools in people who have bowel cancers this can be a very good way of detecting such cancers early and certainly long before they start to produce symptoms. It is probably sensible to have such a test done every year after the age of 50.

Testing for anaemia

Recommendations for the screening of adults for anaemia range from, every two to every five years. Women are particularly at risk because of having periods and childbearing. Many millions of people, women especially, are walking around sub-clinically unwell with anaemia yet remain unscreened. This is an easy and cheap test to do and the treatment is straightforward and inexpensive.

Blood sugar tests

Whether or not it is worth screening populations for their blood sugar levels to see if they are undiagnosed diabetics is controversial-mainly because there is no evidence yet that the early detection of diabetics without symptoms does anything to alter the long-term outlook. Some experts think that as the test is relatively cheap it is worth doing every five years until 65 and then every two years. Others feel that looking for sugar in the urine (another sign of diabetes) every five years is quite sufficient.

Screening for sickle cell trait

Certain high-risk populations (mainly black) should be screened prior to childbearing so that they can receive genetic counseling about the likelihood of having an affected baby. Some experts recommend that the test be done at the age of 10 years.

Checking for German measles (rubella) immunity

This disease, whilst not serious during normal life, can produce terrible handicaps in the baby of a pregnant woman who catches it. It is estimated that even with rubella vaccinations being widely available, about 15 per cent of women get to childbearing with no immunity to the disease. The most logical time for screening is just before childbearing age. Pregnancy should not be allowed to occur for three months after the immunization. A girl who is not immune can be vaccinated in her early teens. Many authorities think that every pregnant woman should be routinely tested for antibodies to rubella.

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After the birth of her second daughter, Melissa Katz was stunned to discover that her weight had settled in at 240 pounds. The veteran yo-yo dieter from Brooklyn found herself at a crossroads.

“I thought, ‘If I don’t get a handle on this now, I’m going to be fat my whole life,’” she says.

She decided to join Weight Watchers. After just a few meetings, she realized just how much food she had been eating each and every day. “No wonder I had gained so much weight,” she says. “The problem was that I was used to eating big meals and big snacks. I felt hungry all the time.”

Weight Watchers taught her that she could have plenty of food—if she made-the right choices. So she turned to fruits and vegetables to fill her plate. “They made me feel full without supplying lots of calories,” she explains.

As the weight started to melt away, her self-esteem grew. “As I became more confident, I became more physically active,” she says.

It took only a year for Melissa to lose 100 pounds. She has maintained that loss for 214 years. And her casual interest in exercise has turned into a career as a physical trainer.

But what Melissa, age 35, is most proud of is the impact that her new eating habits are having on her daughters. “They make good food choices, too,” she says. “They’ll pick a piece of fruit over a piece of cake. That’s what gives me the biggest joy.”

WINNING ACTION

Stock up on produce with a high satisfaction quotient.

Australian researchers put together a list of “bargain foods” that, calorie for calorie, have the greatest potential to satisfy your hunger. At the top of the list: the baked potato. It fills you up faster and with fewer calories than any other food tested.

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