Pressure rises to stop antibiotics in agriculture

The mystery started the day farmer Russ Kremer got between a jealous boar and a sow in heat.

The boar gored Kremer in the knee with a razor-sharp tusk. The burly pig farmer shrugged it off, figuring: "You pour the blood out of your boot and go on."

But Kremer's red-hot leg ballooned to double its size. A strep infection spread, threatening his life and baffling doctors. Two months of multiple antibiotics did virtually nothing.

The answer was flowing in the veins of the boar. The animal had been fed low doses of penicillin, spawning a strain of strep that was resistant to other antibiotics. That drug-resistant germ passed to Kremer.

Like Kremer, more and more Americans — many of them living far from barns and pastures — are at risk from the widespread practice of feeding livestock antibiotics. These animals grow faster, but they can also develop drug-resistant infections that are passed on to people. The issue is now gaining attention because of interest from a new White House administration and a flurry of new research tying antibiotic use in animals to drug resistance in people.

Researchers say the overuse of antibiotics in humans and animals has led to a plague of drug-resistant infections that killed more than 65,000 people in the U.S. last year — more than prostate and breast cancer combined. And in a nation that used about 35 million pounds of antibiotics last year, 70 percent of the drugs went to pigs, chickens and cows. Worldwide, it's 50 percent.

"This is a living breathing problem, it's the big bad wolf and it's knocking at our door," said Dr. Vance Fowler, an infectious disease specialist at Duke University. "It's here. It's arrived."

The rise in the use of antibiotics is part of a growing problem of soaring drug resistance worldwide, The Associated Press found in a six-month look at the issue. As a result, killer diseases like malaria, tuberculosis and staph are resurging in new and more deadly forms.

In response, the pressure against the use of antibiotics in agriculture is rising. The World Health Organization concluded this year that surging antibiotic resistance is one of the leading threats to human health, and the White House last month said the problem is "urgent."

"If we're not careful with antibiotics and the programs to administer them, we're going to be in a post antibiotic era," said Dr. Thomas Frieden, who was tapped to lead the Centers for Disease Control and Prevention this year.

Also this year, the three federal agencies tasked with protecting public health — the Food and Drug Administration, CDC and U.S. Department of Agriculture — declared drug-resistant diseases stemming from antibiotic use in animals a "serious emerging concern." And FDA deputy commissioner Dr. Joshua Sharfstein told Congress this summer that farmers need to stop feeding antibiotics to healthy farm animals.

Farm groups and pharmaceutical companies argue that drugs keep animals healthy and meat costs low, and have defeated a series of proposed limits on their use.

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America's farmers give their pigs, cows and chickens about 8 percent more antibiotics each year, usually to heal lung, skin or blood infections. However, 13 percent of the antibiotics administered on farms last year were fed to healthy animals to make them grow faster. Antibiotics also save as much as 30 percent in feed costs among young swine, although the savings fade as pigs get older, according to a new USDA study.

However, these animals can develop germs that are immune to the antibiotics. The germs then rub into scratches on farmworkers' arms, causing oozing infections. They blow into neighboring communities in dust clouds, run off into lakes and rivers during heavy rains, and are sliced into roasts, chops and hocks and sent to our dinner tables.

"Antibiotic-resistant microorganisms generated in the guts of pigs in the Iowa countryside don't stay on the farm," said Union of Concerned Scientists Food and Environment director Margaret Mellon.

More than 20 percent of all human cases of a deadly drug-resistant staph infection in the Netherlands could be traced to an animal strain, according to a study published online in a CDC journal. Federal food safety studies routinely find drug resistant bacteria in beef, chicken and pork sold in supermarkets, and 20 percent of people who get salmonella have a drug resistant strain, according to the CDC.

Here's how it happens: In the early '90s, farmers in several countries, including the U.S., started feeding animals fluoroquinolones, a family of antibiotics that includes drugs such as ciprofloxacin. In the following years, the once powerful antibiotic Cipro stopped working 80 percent of the time on some of the deadliest human infections it used to wipe out. Twelve years later, the New England Journal of Medicine published a study linking people infected with a Cipro-resistant bacteria to pork they had eaten.

Johns Hopkins University health sciences professor Ellen Silbergeld, who has reviewed every major study on this issue, said there's no doubt drug use in farm animals is a "major driver of antimicrobial resistance worldwide."

"We have data to show it's in wastewaters and it goes to aquaculture and it goes here and there," agreed Dr. Stuart Levy, an expert on antibiotic resistance at Tufts University in Boston. "Antibiotic use in animals impacts everything."

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Farmer Craig Rowles remains unconvinced.

It's afternoon in one of his many rural Iowa pig barns, roaring with snorting and squealing pigs. Some snooze in corners, while others hustle toward their troughs, their slop laced with a steady supply of antibiotics.

"If there was some sort of crossover between the use of the antibiotics in animals and the antibiotics in humans, if there was in fact a real issue there, wouldn't you think we would have seen it?" said Rowles, also a veterinarian who sells 150,000 hogs a year. "That's what the science says to me."

The modular modern barn, home to 1,000 pigs, is a hygienic place. Manure plops through slatted floorboards; an invisible funk steams back up. Rowles dons a sanitary white paper jumpsuit and slips plastic booties over his shoes; he's anxious that his 100-pound pigs aren't exposed to outside germs. A few sick swine are isolated, corralled in a pen near the entrance.

Antibiotics are a crucial part of Rowles' business, speeding growth and warding off disease.

"Now the public doesn't see that," he said. "They're only concerned about resistance, and they don't care about economics because, 'As long as I can buy a pork chop for a buck 69 a pound, I really don't care.' But we live in a world where you have to consider economics in the decision-making process of what we do."

Rowles gives his pigs virginiamycin, which has been used in livestock for decades and is not absorbed by the gut. He withdraws the drug three weeks before his hogs are sent for slaughter. He also monitors his herd for signs of drug resistance to ensure they are getting the most effective doses.

"The one thing that the American public wants to know is: Is the product that I'm getting, is it safe to eat?" said Rowles, whose home freezer is full of his pork. "I'm telling you that the product that we produce today is the safest, most wholesome product that you could possibly get."

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Some U.S. lawmakers are fighting for a new law that would ban farmers like Rowles from feeding antibiotics to their animals unless they are sick.

"If you mixed an antibiotic in your child's cereal, people would think you're crazy," said Rep. Louise M. Slaughter, D-N.Y.

Renewed pressure is on from Capitol Hill from Slaughter's bill and new rules discussed in regulatory agencies. There is also pressure from trade issues: The European Union and other developed countries have adopted strong limits against antibiotics. Russia recently banned pork imports from two U.S. plants after detecting levels of tetracycline that the USDA said met American standards.

Farmers and drugmakers are battling back. Pharmaceutical companies have spent $135 million lobbying so far this year, and agribusiness companies another $70 million, on a handful of issues including fighting the proposed new limits. Opponents, many from farm states, say Slaughter's law is misguided.

"Chaos will ensue," said Kansas Republican Congressman Jerry Moran. "The cultivation of crops and the production of food animals is an immensely complex endeavor involving a vast range of processes. We raise a multitude of crops and livestock in numerous regions, using various production methods. Imagine if the government is allowed to dictate how all of that is done."

He's backed by an array of powerful interests, including the American Farm Bureau, the National Pork Producers Council, Eli Lilly & Co., Bayer AG, Pfizer Inc., Schering-Plough Corp., Dow AgroSciences and Monsanto Company, who have repeatedly defeated similar legislation.

The FDA says without new laws its options are limited. The agency approved antibiotic use in animals in 1951, before concerns about drug resistance were recognized. The only way to withdraw that approval is through a drug-by-drug process that can take years of study, review and comment.

In 1977 the agency proposed a ban on penicillin and tetracycline in animal feed, but it was defeated after criticism from interest groups.

There has been one ban: In 2000, for the first time, the FDA ordered the poultry medication Baytril off the market. Five years later, after a series of failed appeals, poultry farmers stopped using the drug.

In 2008 the FDA issued its second limit on an antibiotic used in cows, pigs and chickens, citing "the importance of cephalosporin drugs for treating disease in humans." But the Bush Administration — in an FDA note in the federal register — reversed that decision five days before it was going to take effect after receiving several hundred letters from drug companies and farm animal trade groups.

Laura Rogers, who directs the Pew Charitable Trusts Campaign on Human Health and Industrial Farming in Washington D.C., says the federal government, from Congress to the administration, has failed to protect the public.

"Because of poor regulations and oversight of drug use in industrial farm animals, consumers in the U.S. do not know what their food is treated with, or how often," she said. "Nor is there a system in place to test meat for dangerous antibiotic resistant bacteria."

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Back in Missouri, farmer Kremer finally found an antibiotic that worked on his leg. After being released from the hospital, Kremer tested his pigs. The results showed they were resistant to all the same drugs he was.

Kremer tossed his hypodermic needles, sacked his buckets of antibiotic-laced feed, slaughtered his herd and started anew.

"I was wearing a syringe, like a holster, like a gun, because my pigs were all sick," he recalled. "I was really getting so sick and aggravated at what I was doing. I said, 'This isn't working.'"

Today, when Kremer steps out of his dusty and dented pickup truck and walks toward the open-air barn in the foothills of the Ozark Mountains, the animals come running. They snort and root at his knee-high gum boots. There are no gates corralling the 180 pigs in this barn. He points to a mound of composting manure.

"There's no antibiotics in there," he says proudly.

Kremer sells about 1,200 pigs annually. And a year after "kicking the habit," he says he saved about $16,000 in vet bills, vaccinations and antibiotics.

"I don't know why it took me that long to wake up to the fact that what we were doing, it was not the right thing to do and that there were alternatives," says Kremer, stooping to scratch a pig behind the ear. "We were just basically killing ourselves and society by doing this."

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Martha Mendoza is an AP national writer based in Mexico City. Margie Mason is an AP medical writer who reported from Missouri and Iowa while on a fellowship from The Nieman Foundation at Harvard University.

Cholesterol Vital for Human Existence

"Cholesterol-free" sign can be found even on vegetable oil labels these days. Yet, vegetable oil simply cannot contain any cholesterol since the latter can be found in animal products only. We will forgive manufactures this advertisement trick and will try to find out whether cholesterol is indeed as scary as it is portrayed.

Vasiliy Petrov, M.D., a cardiologist, will assist us in this task.

High cholesterol level is on the top of the list among the risk factors causing fatal diseases linked to atherosclerosis. It outruns any other risk factor, including high blood pressure, smoking, obesity and diabetes.

On the other hand, cholesterol is a required component contained in most of the tissue. It is vital for human existence. Cholesterol aids in building new cells, hormone production, and creation of intercellular membranes isolating internal organs from negative environment; helps to digest vitamins and accumulate energy.

Yet, cholesterol is only good for you until its level exceeds safe limits. As soon as it exceeds the mark of 200–250 mg/dL, it turns from a helper into an enemy.

Cholesterol comes from food and penetrates the blood where it transforms into serum cholesterol which can be good or bad. Good cholesterol is composed of high-density lipoprotein (HDL). HDL cleans the arteries. Bad cholesterol is composed of low-density lipoprotein (LDL) that clogs the vascular walls with atherosclerosis plaques.

High-density lipoprotein comes from monounsaturated fats contained in nuts, legumes and corn, and polyunsaturated fatty acids contained in vegetable oils, fowl, and fish.

Bad cholesterol comes from butter, meat, egg yolks, and milk.

Exercise is an important part of preventing high cholesterol levels. Regular physical activity can help to reduce dangerously high levels, especially if it is accompanied by quitting smoking. Dietary supplements that are effective in preventing atherosclerosis contain nicotinic acid, vitamins C and E, and calcium.

Unfortunately, diet and exercise are only effective if cholesterol level insignificantly exceeds the norm. If cholesterol level is higher than the norm by 25% or more, only medication will help.

It is not enough to measure the level of cholesterol in the blood to find out if it is within the safe limits. Significant atherosclerosis is possible with low cholesterol levels, while insignificant atherosclerosis is possible with high levels. It all depends on a proportion of high-density and low density lipoprotein determined through a separate test. Ideally, LDL level should be relatively high (no less than 35 mg/dL, ideally – 65–70 mg/dL), and HDL level should be low (less than 130 mg/dL), while the total amount of serum cholesterol should not exceed 200 mg/dL.

Human body produces on average 1 gram of cholesterol per day. The largest amount (800 mg) is synthesized in the liver, 200 mg is produced by the rest of the cells, and 500 mg comes with food.

According to WHO, the recommended dose of cholesterol for healthy people should be no less than 300 mg per day, while people with high cholesterol levels and those suffering from cardio vascular diseases should consume less than 200 mg per day.

Study: Teens smoking more pot, less tobacco

Cigarette smoking is out but pot use is in among the nation's teenagers, who also report a higher use of prescription painkillers and a waning perception about the risk of illicit drugs, a federal study on students has found.

As more states move to approve medical marijuana, and pot legalization and decriminalization become more mainstream in the national discussion, teens seem more accepting of pot use, according to a study released Monday by the National Institute on Drug Abuse.

The national survey, "Monitoring the Future," was conducted by the University of Michigan and queried 47,097 students in the eighth, 10th and 12th grades.

It found that one-fifth of seniors - 20.6 percent - reported using marijuana in the previous month, up from 18.3 percent in 2006. High school sophomores' pot smoking rose from 13.8 percent in 2008 to 15.9 percent this year, statistics that researchers said should capture the nation's attention.

"So far, we have not seen any dramatic rise in marijuana use, but the upward trending of the past two or three years stands in stark contrast to the steady decline that preceded it for nearly a decade," said Lloyd Johnston, who serves as principal investigator on the Michigan study, which has tracked teen drug use since 1975.

"Not only is use rising, but a key belief about the degree of risk associated with marijuana use has been in decline among young people even longer, and the degree to which teens disapprove of use of the drug has recently begun to decline," Mr. Johnston said. "Changes in these beliefs and attitudes are often very influential in driving changes in use."

Judy Kreamer, president of Educating Voices Inc., a nonprofit drug-education and drug-prevention organization in Naperville, Ill., called the survey results "very disturbing" but said they come as no surprise given the messages that advocates have sent youths in recent years.

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Scientists crack gene code of common cancers

Two common forms of cancer have been genetically mapped for the first time, British scientists announced, in a major breakthrough in understanding the diseases.

The maps have exposed the DNA mutations that lead to skin and lung cancers, in a discovery scientists said could transform the way these diseases are diagnosed and treated in coming years.

All cancers are caused by damage to genes -- mutations in DNA -- that can be triggered by environmental factors such as tobacco smoke, harmful chemicals or ultraviolet radiation, and causes cells to grow out of control.

Scientists from Britain's Wellcome Trust Sanger Institute and their collaborators have mapped this genetic damage from the tumours of two patients suffering from lung cancer and malignant melanoma, a deadly skin cancer.

"This is a fundamental moment in cancer research. From here on in we will think about cancers in a very different way," said Professor Mike Stratton who led the institute's cancer genome project.

"Today for the first time, in two individual cancers, a melanoma and a lung cancer, we have provided the complete list of abnormalities in DNA in each of those two cancers," he told the BBC.

"We now see uncovered all the forces that have generated that cancer and we now see all the genes that are responsible for driving those two cancers."

The scientists' research, published in the journal Nature, also gained deeper insights into the way the body tries to repair the damage caused by the cancers and stop the disease spreading.

Stratton said the research could in future change the way cancers are treated -- by using genetic maps to find the defects that caused them.

"Now that we have these comprehensive complete catalogues of mutations on individual cancers, we will be able to see how each cancer developed, what were the exposures, what were the environmental factors and that's going to be key for our understanding generally of how cancers develop," he said.

"And for our individual patients, we will see all the genes that are abnormal and are driving each cancer and that's really critical, because that will tell us which drugs are likely to have an effect on that particular cancer and which are not."

Peter Campbell, a cancer-genomics expert involved in the research, said the number of mutations discovered -- 33,345 for melanoma -- and 22,910 for lung cancer -- was remarkable.

"It is amazing what you can see in these genomes," he said on the website of the journal Nature.

The research shows most mutations could be traced to the effects of chemicals in tobacco smoke (in the lung tumour) or ultraviolet light (in the melanoma tumour), supporting the idea that they are largely preventable.

"Every pack of cigarettes is like a game of Russian roulette," he said.

"Most of those mutations will land where nothing happens in the genome and won't do major damage, but every once in a while they'll hit a cancer gene."

Fake sugar may alter how the body handles real sugar

Combining artificial sweeteners with the real thing boosts the stomach's secretion of a hormone that makes people feel full and helps control blood sugar, new research shows.

It's unknown whether this means anything for people's health, but "in light of the large number of individuals using artificial sweeteners on a daily basis, it appears essential to carefully investigate the associated effects on metabolism and weight," conclude Dr. Rebecca J. Brown and colleagues from the National Institute of Diabetes and Digestive and Kidney Diseases.

Because artificial sweeteners are virtually carbohydrate-free, they have been thought not to have any effect on how the body handles glucose (sugar), the researchers explain.

But there's some evidence that artificial sweeteners may trigger secretion of glucagon-like peptide-1 (GLP-1). GLP-1 is released from the digestive tract when a person eats as a "fullness" signal to the brain, curbing appetite and calorie intake.

To investigate further, Brown's team had 22 healthy normal-weight young people take two glucose challenge tests. These tests, which measure how well the body metabolizes glucose, require a person to drink a sugar-filled beverage after fasting for several hours.

Ten minutes before consuming the "glucose load," study participants drank either roughly two-thirds of a diet soda containing an artificial sweetener or the same amount of carbonated water.

In both cases, the increase in a person's blood glucose was the same. But the researchers did find that people secreted significantly more GLP-1 when they drank diet soda before the glucose challenge compared to when they drank carbonated water.

Studies in humans and animals have shown that when artificial sweeteners are consumed without carbohydrates they do not trigger GLP-1 secretion. "However, our data demonstrate that artificial sweeteners synergize with glucose to enhance GLP-1 release in healthy volunteers," Brown and colleagues report.

What this all means to the average diet soda drinker is not known, but the fact that the effect occurred with less than a single can of diet soda suggests it "may be relevant in daily life," the researchers say.

Future research is needed to understand the significance of enhanced GLP-1 secretion for health, they conclude, and studies should be conducted in people with type 2 diabetes and other abnormalities in metabolism.

SOURCE: Diabetes Care, December 2009.

NHS maternity services in meltdown: A former midwife reveals how understaffed wards are sinking into chaos

Clutching her husband's hand and with agony and exhaustion etched on her face, a young woman struggled into a room in the maternity unit where I worked.

She was in the early stages of labour with her first baby, she was terrified, in excruciating pain and desperate for any crumb of support.

Helpless beside her, her overnight bag in his hand, her poor husband looked equally traumatised.

My heart went out to them. But I knew there was little I could do. With five other pregnant women to care for at the same time, all with hugely different and complex problems, I was rushed off my feet and didn't have the time to look after her properly, to allay her fears or to hear about how she wanted the birth to unfold.

I longed to sit with this poor young woman, calm her and remind her gently to breathe deeply through each contraction.

Just half an hour of my time could have made all the difference. Instead, I put on my cheeriest smile and followed hospital procedure. 'Would you like a painkiller?' I asked.

Ten hours later, after she had been drugged to the eyeballs to dull the pain, I heard she'd given birth.

Her baby was healthy, but I knew I'd let her down.

As I watched her being wheeled into the ward, I felt eaten up with guilt. She'd effectively been ignored from the moment she turned up until the moment she gave birth.

Plonked on an antenatal ward until her time came, with no one to reassure her during what was most likely the most terrifying moment of her life.

No woman should have to give birth in these conditions - let alone in a modern hospital with professional staff at hand.

Welcome to the modern NHS maternity ward. A world of shoddy practice, poor hygiene standards and a shocking disregard for patients' individual needs.

When I read about newly qualified midwife Theresa Naish, who hanged herself in January after a premature baby died on her shift, I couldn't help wondering if she, too, was a victim of the over-worked and under-resourced labour wards I have experienced.

Her father Thomas told the inquest into her death: 'Like all NHS staff, she was over-worked, doing too many hours in a department that was understaffed.'

Although the child had little chance of survival, poor Theresa spent weeks torturing herself that she was to blame, before killing herself.

I don't want to alarm people for, of course, the vast majority of babies are born healthy and safe, but I think it's time we admit what is happening in our hospitals.

Driven by targets and mired in red tape, our NHS maternity wards are becoming baby-producing factories where mothers' needs come very low on the agenda.

The quicker midwives turn out babies, the more successful everyone tells us that we are. We might as well be producing sausages. It's utter madness.

I started working as a midwife in Basildon in 1995. I left to work as an independent midwife in January last year because I simply could not bear to let any more women down.

Midwife and baby

Special job: Midwives play a vital role throughout the birth

During a typical 12-hour shift, I could be the sole midwife in charge of six women in the antenatal ward - some in early labour - or one of two qualified midwives running a postnatal ward with up to 32 women.

If I was in the delivery unit, I would assist in the births of up to three babies a shift.

Obviously, if there was a crisis during a woman's labour - such as a sudden need for an emergency Caesarean - there was always a surgical team on call, and there would be an anaesthetist available to administer epidurals and so on.

But in terms of the normal care through labour, that was all down to the midwives.

Although we were under huge stress even back in 1995, current cutbacks mean fewer and fewer midwives are caring for more and more women.

No wonder new mothers are encouraged to leave hospital just hours after giving birth.

When I started in the mid-Nineties, there were 35,000 midwives working in Britain. A year or two ago, that number had fallen to 25,000, more than half of whom were part-time.

So, how bad did it get? Take one typical day I remember a few years ago. I found myself with up to six patients to look after at once and no back-up.

From the moment I stepped into the admissions ward, the area was crammed with women clamouring for attention.

Two women were in early labour. I longed to reassure them. But my stress levels rocketed when I saw the dramas that lay ahead.

One young woman, expecting her second baby in three months, had arrived in an ambulance with high blood pressure.

She had been sent by her GP, who feared that her life and her baby's were in danger.

High blood pressure is often a symptom of pre-eclampsia - one of the most serious risks facing a pregnant woman and one of the most difficult to detect.

Terrified she was going to lose her baby, or die, or both, she was frightened. I tried to reassure her.

All the while, half my brain was on the screams of the two women in early labour a few doors away.

Did they need more pain relief? When would they need to go into the delivery suite?

I had to check my new patient's blood pressure every 15 minutes as well as taking blood samples to be sent for analysis to see exactly what the problem was.

It was a race against time because if her blood pressure carried on rising I'd have to ensure she was whisked off for emergency surgery.

As I ran between her bed and the two women in early labour, I barely had time to greet another patient.

Midwife and baby

Bonding: But staff need to teach mothers how to feed their infants and are rarely given the time

She was in floods of tears. Her baby was due in a month. He had stopped moving and she was convinced he was dead.

Strapping her up to a monitor to check the baby's heartbeat, I tried to calm her. But I didn't even have time to offer her a cup of tea before rushing to another new arrival.

She'd arrived in an ambulance after her waters broke while she was out shopping. The baby wasn't due for another week. Again, her unborn baby had to be urgently monitored.

I was frantically checking my watch to ensure I remembered my patient with high blood pressure when a young woman, hair matted with sweat and eyes wild with fear, staggered towards me.

'I can't take any more,' she said, gripping my hand. 'You've got to help me.' She'd been in labour for five hours and the pain was excruciating. I knew she'd be happier in a delivery room - which is more comfortable and has better specialist equipment - rather than a bed on the ward, but my heart sank. There was no room.

I felt sick with guilt as I led her back to her bed. She was in agony, but she'd have to wait.

It was an hour before she was wheeled into the labour room. And in between nursing, I had to write up notes on each patient.

There were days when I barely had time to go to the toilet.

In the 13 years since I joined the NHS, conditions have deteriorated. Starting from the moment they arrive through the hospital doors, birth plans tucked neatly in their overnight bags, women are being betrayed.

There is reams of evidence to prove that a woman's labour is likely to be shorter and she runs less chance of needing medical intervention if she feels calm and relaxed in the early stages. It's not rocket science.

Yet because midwives don't have time to sit with women in early labour for more than a few minutes at most, we are encouraged to do the next best thing.

We offer them strong painkilling drugs such as pethidine or diamorphine - which is a form of heroin.

Drugs keep the mother nice and quiet which, of course, suits staff.

But they also likely to make her and her unborn baby terribly sleepy.

Although these drugs can sometimes increase contractions, they all too often slow them down.

The end result at the woman will need more drugs, not fewer, and labour will take longer.

But, of course, we don't explain of that as we dole out our pain killers. Besides, on a busy ward, what's the alternative?

Once a woman is in full labour, you'd thought we'd put her needs first. But I'm embarrassed to admit that, all too often, we were not allowed to.

Most hospitals rigidly enforce the rule that, once in labour, a woman's canal must dilate at the rate of 1cm an hour.

If that isn't happening, midwives are encouraged to tell the her that her baby may be getting in distress - even if that isn't the case.

Terrified and exhausted by a haze of drugs, the woman agrees to anything which is offered.

In practice, this means we give her extra drugs to intensify the contractions and so speed the arrival of the child.

Her pain levels increase and she'll need an epidural injection in her spine to numb the pain around her groin.

It's a vicious circle. I felt terribly mean persuading women to go along with it. I knew I wasn't always acting in their best interests. But what could I do?

It's a joke to say women have choices over how they give birth. The truth is - thanks to the drive to cut costs and improve efficiency - births are turning into conveyer-belt productions.

Women dream of having a natural birth and there is often no medical reason why they can't.

Instead, they leave the delivery room with a healthy baby, but feeling like a failure because they have used drugs.

Some are on such heavy drugs they don't remember giving birth at all. It's heartbreaking.

I also get very angry when I hear NHS authorities extolling the virtues of breastfeeding.

According to the NHS website, it's the 'best start in life'. I couldn't agree more.

But the truth is that breastfeeding rates are plummeting in the hospitals I've worked in.

The reason is simple. Midwives don't have the time to spend helping mothers to feed properly.

And without that vital support in the early days, women give up. With three women arriving on a ward at any one time, and three ready to leave, how could I possibly sit for an hour and help a new mother?

It's physically impossible, particularly as we are encouraged to rush women home as soon as they are on their feet.

It's to save money, but it does at least reduce the risk of the new mums and their babies picking up an infection.

It's no news that hospitals are often dirty. By the time I left, I was almost inured to the filth around me.

With so many women and too little time, it was impossible to keep the wards spotless.

I regularly found myself wiping off blood which had been missed by the cleaners in their rush.

It's a huge relief to have left the NHS. As an independent midwife in Northwich, Cheshire, I am finally able to help women the way they deserve.

Calm, supported and not rushed, my mothers give birth in six to seven hours. In the units where I worked, the average labour was ten to 14 hours.

I feel guilty about the women I let down as an NHS midwife. Weak and in pain, they don't have the knowledge or strength to stand up for themselves.

Instead, they end up being patronised by doctors and bullied by midwives into taking drugs they don't want.

But what makes me most sad and angry is that those hospital staff - everyone from managers down - are taking advantage of women when they are at their most vulnerable.

Interview: TESSA CUNNINGHAM


Read more: http://www.dailymail.co.uk/health/article-1235921/Midwives-meltdown-A-NHS-worker-reveals-understaffed-maternity-wards-sinking-chaos.html#ixzz0Zor9tYSl

CT Scans Could Cause Thousands of Cancer Cases

(Dec. 15) -- Common CT scans deliver much more radiation than scientists believed, and could be blamed for as many as 29,000 new cancers -- and 14,500 deaths -- annually, according to two studies reported in USA Today and the Los Angeles Times.

The research, published this week in the Archives of Internal Medicine, shows that the same CT scans at different hospitals could expose patients to highly varied, and sometimes dangerous, doses of radiation. MORE>>>>>>>>>>>>>>>>>>>>>

Plastic Bottle Chemical Inflames Intestines

The chemical Bisphenol A used in plastic containers and drinks cans has been shown for the first time to affect the functioning of the intestines, according to a French study published Monday.

National Institute of Agronomic Research researchers in Toulouse found the digestive tract of rats react negatively to even low doses of the chemical also called BPA, the Proceedings of the National Academy Sciences journal reported.

Their research, also conducted on human intestine cells, found that the chemical lowered the permeability of the intestines and the immune system's response to digestive inflammation, it said.

BPA is used in the production of polycarbonated plastics and epoxy resins found in baby bottles, plastic containers, the lining of cans used for food and beverages, and in dental sealants.

More than 130 studies over the past decade have linked even low levels of BPA, which can leach from plastics, to serious health problems, breast cancer, obesity and the early onset of puberty, among other disorders.

The French study focuses on the first organ to come in contact with the substance, the intestine.

The researchers orally administered doses of BPA to the rats that were equivalent to about 10 times less than the daily amount considered safe for humans, a statement from the Toulouse institute said.

They saw that BPA reduced the permeability of the intestinal lining through which water and essential minerals enter the body, it said.

They also found that newborn rats exposed to BPA in the uterus and during feeding have a higher risk of developing severe intestinal inflammation in adulthood.

The study "shows the very high sensitivity on the intestine of Bisphenol A and opens news avenues for research" including to define new acceptable thresholds of the substance for humans, the institute said.

In May this year, the six major baby bottle makers in the United States agreed to stop using the chemical.

STDs Continue to Spread in U.S.

American squeamishness about talking about sex has helped keep common sexually transmitted infections far too common, especially among vulnerable teens, U.S. researchers reported Monday.

Latest statistics on chlamydia, gonorrhea, and syphilis show the three highly treatable infections continue to spread in the United States.

"Chlamydia and gonorrhea are stable at unacceptably high levels, and syphilis is resurgent after almost being eliminated," said John Douglas, director of the division of sexually transmitted diseases at the U.S. Centers for Disease Control and Prevention.

"We have among the highest rates of STDs of any developed country in the world," Douglas added in a telephone interview.

The administration of President Barack Obama has signaled a willingness to move away from so-called abstinence-only sex education approaches that his predecessor, George W. Bush, and conservative state and local governments have promoted.

Several studies have shown such approaches do not work well and that it is better to encourage abstinence while also offering children and teens information about how to protect themselves from diseases as well as pregnancy.

"We haven't been promoting the full battery of messages," Douglas said. "We have been sending people out with one seatbelt in the whole car."

The CDC's latest study on STDs found:


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Extraordinary Benefits of Exercise

The results of two new German studies emphasize that exercise is one of the most effective methods of preventing disease. The first study found that exercise has an extraordinary potential to prevent stroke. Rapid walking or cycling lowered the risk of cerebral hemorrhage (bleeding in the brain) by 40 percent in men and cerebral infarction (blood supply blocked by a clot) by 27 percent.

The second study found that regular walking lowers the risk of colorectal cancer by 40 percent. It also found that patients with colorectal carcinoma can improve their chances of survival by exercising.

Professor Dieter Leyk of the German Sport University in Cologne raises the question of why the tremendous benefits of exercise, both preventive and therapeutic, are not fully utilized by medical professionals.

Food Poisoning Can Cause Lifelong Problems

More than just a bad bout of stomach flu, some food-borne illnesses can cause long-term consequences, especially for young people, a report released on Thursday has found.


Researchers at the Center for Foodborne Illness Research & Prevention in Pennsylvania studied the five most common food-borne diseases and found they can cause life-long complications including kidney failure, paralysis, seizures, hearing or visual impairments and mental retardation.


"It's not just a tummy ache," the center's Tanya Roberts told a news briefing.
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Acetaminophen Increases Asthma Risk

An analysis of 19 studies provides additional evidence of increased asthma risk in children and adults given acetaminophen.


The study's lead author told Reuters Health, while this type of study isn't the best way to prove that the medication actually causes the illness, it does show that the relationship should be investigated further.


"We know acetaminophen affects inflammatory cells in the airway," said Dr. J. Mark FitzGerald of the Vancouver Coastal Health Research Institute in British Columbia. But even if the medication does boost asthma risk, he added, it's likely only one factor in the rise in asthma prevalence seen in recent years.


Asthma has become increasingly common worldwide, and some investigators have suggested that more widespread acetaminophen use could be one contributing factor, given that the drug lowers levels of an antioxidant called glutathione found in lung tissue, FitzGerald and his team note in the journal CHEST.


Also, the researcher pointed out in an interview, a study of about 200,000 patients published in 2008 suggested an increased risk of asthma and wheezing in those who took acetaminophen.


To investigate further, FitzGerald and his associates searched the medical literature for studies that looked at acetaminophen and risk of asthma and wheezing.


When the researchers did a combined analysis of the 19 studies they identified, which included 425,140 patients in all, they found acetaminophen use was associated with a 1.6-fold increased risk of asthma. Children exposed to the drug in the womb were at 1.3-fold greater risk of asthma and 1.5-fold increased risk of wheezing.


The one study that looked at high-dose acetaminophen in children found it more than tripled asthma risk.


At this point, FitzGerald said, parents shouldn't purge their medicine chests of acetaminophen.


When a pediatrician recommends acetaminophen to treat fever in a child, according to the researcher, parents should follow this advice. The drug "works very well to do what it is supposed to do," he noted, adding "there's always a risk benefit in terms of medication."


SOURCE: CHEST, November 2009.

Australian Scientists Can Help Cancer Patients Re-Grow Breasts

Bra promises to banish wrinkles

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WRINKLE-RIDDER: La Decollette cushions the breasts and keeps them apart during sleep allowing the cleavage time to recover from wrinkles.
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SMOOTH OPERATOR: Before and after shot.

A woman has invented a bra which promises to rid women of unsightly cleavage wrinkles.

The UK's Daily Mail newspaper reports that the Dutch-invented bra will go on sale in the UK this week for about £44 (NZ$100).

The bra, called 'La Decollette' was invented by former air hostess Rachel De Boer after she noticed folds in her cleavage at the age of 30.

"I spent many happy years as an air hostess travelling the world and obviously enjoying the sunshine and beaches," she told the Daily Mail.

"In those days we were not as aware of how much damage this can do to the skin and I was only in my early 30s when I was horrified to see my skin wrinkling."

"I was afraid to show my cleavage and none of the creams and treatments I tried seemed to help."

The bra, called 'La Decollette', works by keeping the breasts apart during sleep reducing the amount the skin wrinkles around the chest.

"There are plenty of sexy bras out there and this is not a sexy bra, but it can help you get your sexy cleavage back." De Boer said.

It is now being sold throughout Europe from the company's website, www.decollette.nl.

There's no word on when the bra might be available to New Zealand shoppers.

Jogging pants 'cause weight gain'

Karl Lagerfeld says wearing jogging pants makes you put on weight.

The German fashion designer thinks wearing the comfortable item of clothing is "dangerous" because people eat more as the trousers have an elasticated waist.

He said: "I never wear jogging pants. Those things are dangerous. Because they have an elastic band. It stretches and then you don't know when you put on weight. Also, I hate it when you let yourself go! I'm always looking the way you see me now."

Karl - who is the head designer for French fashion house Chanel - also says he has no plans to retire because there are a lot more projects he wants to do.

The 76-year-old told German magazine Freundin: "Retirement is not one of the topics with which I deal. Why should I? I still have so many projects that I sometimes don't know where to begin. Chanel will still need some clothes when I'm 89. The world can count on me for a long time."

10 Facts You Didn't Know About Your Body

1.Our body is capable of producing aspirin
15 Facts You Didn't Know About Your Body

Eating fruits and vegetables may help the human body make its own aspirin. Findings from the Journal of Agriculture and Food Chemistry indicate that study participants who received benzoic acid, a natural substance in fruits and vegetables, could make their own salicylic acid, the key component that gives aspirin its anti-inflammatory and pain-relieving properties.

2.Taking a nap at work is good for your boss
15 Facts You Didn't Know About Your Body

A 20-minute nap can improve your overall alertness, boost your mood, and increase productivity. William Anthony, co-author of The Art of Napping at Work (Larson Publications, 1999), says the post-nap boost can last for several hours. In addition, your heart may reap benefits from napping. In a six-year study of Greek adults, researchers found that that men who took naps at least three times a week had a 37 percent lower risk of heart-related death.

3.Ejaculation may cause men to sneeze
15 Facts You Didn't Know About Your Body

Some men experience pain, headaches, or sneezing as a result of ejaculation. The increased activity in the nervous system during orgasm may be the culprit in triggering headaches. A possible explanation for the sneezing is that in the brain, the center for orgasms is close to the centers for yawning and sneezing.

4.Every person has a unique tongue print
15 Facts You Didn't Know About Your Body

Just like fingerprints. The tongue is a unique organ in that it can be stuck out of mouth for inspection, and yet it is otherwise well protected in the mouth and is difficult to forge. The tongue also presents both geometric shape information and physiological texture information which are potentially useful in identity verification applications.



5.The appendix isn't as useless as you think
15 Facts You Didn't Know About Your Body

Long denigrated as vestigial or useless, the appendix actually has a reason to be – as a “safe house” for the beneficial bacteria living in the human gut. The beneficial bacteria in the appendix that aid digestion can ride out a bout of diarrhea that completely evacuates the intestines and emerge afterwards to repopulate the gut.

6.The body is taller in the morning than in the evening
15 Facts You Didn't Know About Your Body

The body is taller in the morning than in the evening. You might want to schedule that basketball game for first thing in the morning. That's because our bodies are on average about half an inch taller in the morning, thanks to excess fluid between our discs, which is replenished while we sleep. As the day goes on, and our bodies undergo the strain of standing, the discs get compressed and the fluid seeps out, so the body loses that small bit of extra height.

7.The stomach produces a new lining every 3 days to avoid digesting itself with its own acids
15 Facts You Didn't Know About Your Body

There's one dangerous liquid no airport security can confiscate from you: It's in your gut. Your stomach cells secrete hydrochloric acid, a corrosive compound used to treat metals in the industrial world. It can pickle steel, but mucous lining the stomach wall keeps this poisonous liquid safely in the digestive system, breaking down your lunch but not your own stomach.

8.Body position affects your memory
15 Facts You Didn't Know About Your Body

Can't remember your anniversary, hubby? Try getting down on one knee. Memories are highly embodied in our senses. A scent or sound may evoke a distant episode from one's childhood. The connections can be obvious (a bicycle bell makes you remember your old paper route) or inscrutable. A recent study helps decipher some of this embodiment. An article in the January 2007 issue of Cognition reports that episodes from your past are remembered faster and better while in a body position similar to the pose struck during the event.



9.Blondes have more hair
15 Facts You Didn't Know About Your Body

They're said to have more fun, and they definitely have more hair. Hair color determines how dense the hair on your head is. The average human has 100,000 hair follicles, each of which is capable of producing 20 individual hairs during a person's lifetime. Blondes average 146,000 follicles while people with black hair tend to have about 110,000 follicles. Those with brown hair fit the average with 100,000 follicles and redheads have the least dense hair, with about 86,000 follicles.


10.Having orgasms prevent men from prostate cancer
15 Facts You Didn't Know About Your Body

Two large studies, reported in 2003 and 2004, found that middle-aged men who had (or at least remember having) at least four orgasms a week throughout their 20s, 30s and 40s had a reduced risk of prostate cancer by as much as one-third. Some researchers speculate that ejaculations may clear the prostate of carcinogens.

SIMPLE SECRET OF A HEALTHY HEART

GENTLE exercise can dramatically cut the danger of an early death from heart disease, according to new research.

Just 30 minutes of jogging or cycling three times a week has amazing results for people with heart problems – the UK’s biggest killer – a study has found.

In just three months it slashed the risk of an early death by 60 per cent in those who followed the ­fitness regime.

The results will come as welcome news for thousands of Britons who suffer from heart-related illness.

One-in-five men and one-in-seven women die of heart disease in the UK, equivalent to 250 deaths a day. Overall, 200,000 people die each year from conditions related to circulation, including strokes, heart attacks and heart disease.

These figures are expected to go up as the population ages and thanks also to a rise in obesity, which leads to furring of arteries.

The study, released today, found the biggest gains were in patients who were also stressed. The authors believe it is because stress can quadruple the risk of death in people with heart problems.

Exercise can offer the double benefit of reducing stress levels while also improving heart health.

The study concludes: “Exercise reduces mortality in patients with coronary artery disease…in part because of the effects on psycho­social stress.”

Patients with heart problems are usually put on drugs – statins to lower cholesterol and blood pressure pills – to reduce the risks.

But in recent years the NHS been pushing a rehabilitation programme that includes advice on diet, ­exercise, smoking and stress.

Previous studies have demonstrated a wealth of life-prolonging benefits from exercise.

People who work out have a lower risk of contracting long-term conditions such as cancer, heart disease and neurological disorders. It also slows death and disability rates.

Exercise acts by improving the health of hearts and arteries, strengthening bones and reducing inflammation. It also boosts the immune system and improves thinking, learning and memory.

This latest study by the Department of Cardiology in New Orleans and published in the American ­Journal of Medicine reveals in detail just how much these simple changes can boost lifespan.

The team followed 522 cardiac patients, including 53 who had high stress levels and 27 control patients who had high stress levels but who refused cardiac rehabilitation.

Patients were offered 12 weeks of exercise classes, where they did 10 minutes of warm-up, 30 to 40 ­minutes of aerobic exercise such as walking, rowing or jogging, and then a 10-minute stretch to wind down.

The classes were three times a week and patients were also asked to try to do a further one-to-three exercise sessions a week.

They were also given advice on how to improve diet and lifestyle, and their progress was followed for up to six years.

Those who got fitter were 60 per cent less likely to die in the following six years. Exercise also helped reduce stress levels from one-in-10 patients to fewer than one-in-20 which in turn lowered the death rate for stressed patients by 20 per cent.

However, the weight of patients did not change much, suggesting the benefits are from exercise alone.

Health charities welcomed the report. The British Heart Foundation, said: “This study proves once again that exercise has both psychological and physical benefits for patients with heart disease.

“Health authorities must ensure that all suitable heart patients are offered cardiac rehabilitation.

“Structured, well-resourced programmes have been shown to improve physical and psychological wellbeing and reduce mortality.”

Low Vitamin D May Be Deadly

Low vitamin D levels in the body may be deadly, according to a new study hinting that adults with lower, versus higher, blood levels of vitamin D may be more likely to die from heart disease or stroke.

Vitamin D is an essential vitamin mostly obtained from direct sunlight exposure, but also found in foods and multivitamins.

Dr. Annamari Kilkkinen, at the National Institute for Health and Welfare in Helsinki, Finland, and colleagues compared blood levels of vitamin D and deaths from heart disease or stroke over time in 2,817 men and 3,402 women in Finland.

At enrollment, participants were just over 49 years old on average, and had no indicators of cardiovascular disease, the researchers note in the American Journal of Epidemiology.

During follow-up of about 27 years on average, 640 of the participants (358 men) died from heart disease and another 293 (122 men) died from stroke.

Compared with participants' with the highest vitamin D, those with the lowest had 25 percent higher risk of dying from heart disease or stroke, Kilkkinen noted in an email to Reuters Health.

There was a "particularly striking association" between vitamin D levels and stroke deaths, the researcher noted, in that having the lowest vitamin D seemed to confer "twice the risk," compared with having the highest vitamin D.

Allowing for age, gender, and other demographic factors, plus alcohol intake, smoking, physical activity, and season in which vitamin D levels were obtained did not significantly alter these associations.

In this study, vitamin D levels were "substantially lower" than levels thought to be sufficient, and "somewhat lower" than those reported in previous studies in other European and American populations.

However, there is no "absolute consensus" as to what the optimal range of vitamin D should be, the investigators note. Also, it's not known whether low vitamin D actually causes increased risk for heart disease or stroke. Clearly, further study is needed, they conclude.

SOURCE: American Journal of Epidemiology, October 15, 2009

Curry Compound Kills Cancer

A molecule found in a curry ingredient can kill esophageal cancer cells in the laboratory, suggesting it might be developed as an anti-cancer treatment, scientists said on Wednesday.

Researchers at the Cork Cancer Research Center in Ireland treated esophageal cancer cells with curcumin -- a chemical found in the spice turmeric, which gives curries a distinctive yellow color -- and found it started to kill cancer cells within 24 hours.

The cells also began to digest themselves, they said in a study published in the British Journal of Cancer.

Previous scientific studies have suggested curcumin can suppress tumors and that people who eat lots of curry may be less prone to the disease, although curcumin loses its anti-cancer attributes quickly when ingested.

But Sharon McKenna, lead author of the Irish study, said her study suggested a potential for scientists to develop curcumin as an anti-cancer drug to treat esophageal cancer.

Cancers of the esophagus kill more than 500,000 people across the world each year. The tumors are especially deadly, with five-year survival rates of just 12 to 31 percent.

McKenna said the study showed curcumin caused the cancer cells to die "using an unexpected system of cell messages."

Normally, faulty cells die by committing programed suicide, or apoptosis, which occurs when proteins called caspases are 'switched on' in cells, the researchers said.

But these cells showed no evidence of suicide, and the addition of a molecule that inhibits caspases and stops this "switch being flicked' made no difference to the number of cells that died, suggesting curcumin attacked the cancer cells using an alternative cell signaling system.

U.S. researchers said in 2007 they had found curcumin may help stimulate immune system cells in the Alzheimer's disease.

© 2009 Reuters. All rights reserved. Republication or redistribution of Reuters content, including by caching, framing or similar means, is expressly prohibited without the prior written consent of Reuters.

Diet and Exercise May Prevent Diabetes

People on the brink of developing diabetes who get a lot of support and encouragement to diet and exercise can turn things around and avoid the disease, U.S. researchers said on Wednesday.

"Millions of people could delay diabetes for years and possibly prevent the disease altogether if they lost a modest amount of weight through diet and increased physical activity," said Dr. Griffin Rodgers, director of the National Institute of Diabetes and Digestive and Kidney Disease. MORE>>>>>>>>>>

Fiber Keeps Diseases at Bay

Insoluble dietary fiber, or roughage, not only keeps you regular but also plays a vital role in the immune system, keeping certain diseases at bay, say Australian scientists.

The indigestible part of all plant-based foods pushes its way through most of the digestive tract unchanged, acting as a kind of internal broom. When it arrives in the colon, bacteria convert it to energy and compounds known as "short chain fatty acids." These are already known to alleviate the symptoms of colitis, an inflammatory gut condition.

Similarly, probiotics, and prebiotics, food supplements that affect the balance of gut bacteria, reduce the symptoms of asthma and rheumatoid arthritis, also inflammatory diseases. Until now, no one has understood why.

Doctoral student Kendle Maslowski and professor Charles Mackay from the Garvan Institute of Medical Research made new sense of such known facts by describing a mechanism that links diet, gut bacteria and the immune system. They demonstrated that GPR43, a molecule expressed by immune cells and previously shown to bind short chain fatty acids, functions as an anti-inflammatory receptor, MORE>>>>>>>>>

Fewer Televisions Help Dieters

What's the secret of success of people who lose lots of weight and keep it off for many years? A new study suggests predictable factors like exercise and control over eating play a role, but so do factors in the home like fewer TVs and more exercise equipment. MORE>>>>>>>>>>>>

MOBILE USE IS LINKED TO BRAIN TUMOURS

LONG-term mobile phone users could face a higher risk of developing cancer in later life, according to a decade-long study.

The report, to be published later this year, has reportedly found that heavy mobile use is linked to brain tumours.

The survey of 12,800 people in 13 countries has been overseen by the World Health Organisation.

Preliminary results of the inquiry, which is looking at whether mobile phone exposure is linked to three types of brain tumour and a tumour of the salivary gland, have been sent to a scientific journal.

The findings are expected to put pressure on the British Government – which has insisted that mobile phones are safe – to issue stronger warnings to users.

Green Tea Reduces Risk of Dying from Pneumonia

Drinking green tea continues to show health benefits, particularly among women, hints a new study from Japan.

Drinking five or more cups a day cut the risk by "47 percent in Japanese women," but not Japanese men, Ikue Watanabe, from Tohoku University Graduate School of Medicine in Sendai, Japan noted in an email to Reuters Health.

Pneumonia risk seems to be reduced even by drinking small amounts of green tea.

Drinking as little as one cup or less of green tea per day was associated with 41 percent less risk of dying from pneumonia among Japanese women, the investigators found.


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Ban on fast-food eateries is no fat cure, study says

A regulation banning the establishment of new fast-food restaurants in South Los Angeles is unlikely to curb obesity rates, according to a study by researchers at Santa Monica think tank Rand Corp.

Concerned about high levels of obesity, the lack of traditional grocery stores and a proliferation of fast-food eateries, the Los Angeles City Council approved a moratorium on new fast-food restaurants in one of the poorest sections of the city last year. It has extended the ban through March of next year.

"We argue that the premises for the ban were questionable," Roland Sturm and Deborah Cohen write in today's online edition of the journal Health Affairs.

The study was based on InfoUSA business data and a survey of 1,480 Los Angeles County residents. It was funded by the National Institutes of Health, with no financial support from the fast-food industry, Sturm said.

Contrary to "conventional wisdom," the density of fast-food chain restaurants per capita is actually less in South Los Angeles than in other parts of the city, said Sturm, a Rand senior economist.

"If you look at it per 100,000 residents, the area is not overrun with McDonald's," Sturm said. "The story about fast-food chains does not hold up."

Though the authors noted that obesity takes a "disproportionate toll on minority populations, especially among African American and Hispanic youth" who live in South Los Angeles, limiting the type of restaurants that move to the area isn't likely to solve the problem.

Policy choices such as forcing restaurants to print calorie and nutrition information on their menus and reducing the availability of snack food and sodas is likely to be more effective in combating obesity than restricting the areas where fast-food establishments can open, Strum said.

One outside nutrition expert was not surprised by the findings.

"What we know already, and this study confirms, is that people living in poor inner-city areas do not have easy access to healthful, affordable food, especially fresh food. Lack of food access is highly correlated with diet-related health conditions," said Marion Nestle, nutrition professor at New York University.

Though she doesn't object to the type of moratorium Los Angeles enacted, Nestle said there are plenty of other things the city can do "to encourage more healthful food consumption in low-income areas." She said cities could start with improving nutrition and nutrition education in schools as well as encouraging farmers markets, fruit-and-vegetable carts and community gardens.

Patricia Williams, a McDonald's franchise owner with nine restaurants in Southern California, including South Los Angeles, said, "There are some neighborhoods in South Los Angeles that would probably benefit from a McDonald's. So the moratorium should be looked at on a case-by-case basis."

Almost 26% of the residents of South Los Angeles are considered obese, according to the study. That compares with about 18% of the residents of Los Angeles County who live in higher-income neighborhoods, the study's authors wrote.

They found that the far wealthier West Los Angeles has 29 fast-food chain establishments, 14 small food stores and 10 large supermarkets per 100,000 residents. South Los Angeles, by comparison, has 19 fast-food chain restaurants, 58 small food stores and three large grocery stores.

The authors said those data were at odds with "media reports about an over-concentration of fast-food establishments" in South Los Angeles.

Among those reports, the study cited a chart that accompanied a July 30, 2008, story in The Times. The chart said fast-food establishments represented 45% of all restaurants in South Los Angeles. That was a higher percentage than in any other section of the city.

Doug Smith, The Times' director of computer-assisted reporting, who analyzed the data, said the different findings arose from the newspaper study's including small independent restaurants with seating for 10 or fewer people. The Rand study focused primarily on fast-food chains -- leading to a smaller count.

Councilman Bernard C. Parks, whose 8th District includes part of the area where the moratorium is in force, took exception to the Rand report.

"Anybody who in the year 2010 thinks they can compare South Los Angeles to West Los Angeles is going to be faulty. You just can't make comparisons between the two communities," said Parks, who is a proponent of the ban.

He said his 8th District desperately needed more sit-down restaurants, supermarkets and other sellers of fresh food and produce.

"We are the most underserved community in L.A. for everything but fast food. There are a parade of people who have to leave the 8th District to purchase their basic food and household needs," Parks said.

South Los Angeles is often labeled a "food desert" because of its lack of large traditional grocery stores that are the typical source of healthful foods such as fresh fruit and vegetables.

However, the study found no difference in fruit and vegetable consumption between residents of South Los Angeles and people in other areas. Likewise, there was no difference in the proportion of people who participate in 300 minutes of exercise or more per week.

Residents of both West and South Los Angeles tend to eat out about 3.5 times a week, though South Los Angeles residents are more likely to obtain food from a food cart or truck rather than a sit-down restaurant, the study said. South Los Angeles residents also were likely to watch more television.

The Rand researchers attributed the greater likelihood of South Los Angeles residents to be obese to their consuming more snacks and sodas than people who lived in other areas.

"Snacks usually don't come from a restaurant," Sturm said. "They typically come from stores and vending machines."

jerry.hirsch@latimes.com

Driving Convertibles Is Bad for Hearing

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Cruising down the highway with the top of your convertible down may feel great, but it can also permanently damage your hearing. A new study recorded noise levels in convertibles being driven at 50 to 70 mph on a par with construction sites and nearing the volume of an ear-pounding pneumatic drill. Wind noise, driving speed, road surface and traffic congestion all contributed to the ear-splitting volume. Consistent readings were recorded in the 88 to 99 decibel range with the noise level rising as speed increased. Repeated exposure to sounds over 85 decibels are widely recognized to raise the risk of permanent hearing loss. MORE>>>>>>>>>>