Medical News Today: Flu Shot: Side Effects, Facts, Things to Consider

The flu is a respiratory illness caused by the influenza virus. Symptoms of the flu are typically more severe than a cold. They include fever, coughing, body aches, headache, and tiredness that last up to 2 weeks.

The flu can also be life-threatening in some cases. According to the Centers for Disease Control and Prevention (CDC), 200,000 people are hospitalized every year due to flu-related problems.

Young children, the elderly, pregnant women, and those with weak immune systems may be more likely to suffer dangerous complications.

Proper hand-washing and staying home when sick can help prevent the flu. But health experts say that for the best protection, most people should also get an influenza vaccine, or flu shot, every year.

What is the flu shot?

The flu shot helps the body’s immune system fight off the flu before a person gets sick.

It contains weakened or inactivate flu viruses that make the body think it is being infected without causing illness. These viruses tell the immune system to make special proteins called antibodies.

A woman having a vaccine.
The flu shot’s effectiveness depends on the age of the person and the strains of flu that are active that year.

The body stores these antibodies and can use them to fight off a future flu infection. As a result, a person who gets the shot may be able to avoid the flu completely, or only get a mild case.

Flu shot effectiveness

The effectiveness of the flu shot can vary widely from year to year and depends on two main factors:

  • The health and age of the person getting the shot
  • How well the shot matches the flu strains that are about that year

How health affects the flu shot

The flu shot seems to work better in adults and older children. People over the age of 65 tend to have weaker immune systems, and the shot may be less effective for them. Children under the age of 2 and people with long-term health conditions may also have a lower response to the shot and receive less protection.

Experts still say that the shot offers some protection and should be recommended for these groups, especially because they are most likely to suffer serious complications from the flu.

Matching the shot to the flu

Every year, new strains of the flu spread around the globe. There are hundreds of different strains, but flu shot manufacturers can only include 3 or 4 types in the shot each year.

Medical experts must narrow it down to the strains that are most likely to make people sick. A few months before flu season arrives, researchers study the flu strains that were most common the year before. They also look at strains that are spreading in other parts of the world. They use this data to predict which strains of flu will affect people during the upcoming flu season.

Sometimes, experts can accurately predict which strains of flu will spread, and the shot is considered a good “match.” When this happens, the shot offers more protection for those who get it. The 2011-2012 flu shot was a good match, and a study in Clinical Infectious Diseases states that it was 71 percent effective that year.

Other years, the shot may be a poor match. This happens when flu predictions are inaccurate or the virus changes before flu season begins.

Even when the virus is a poor match, however, the shot may still be helpful. During the 2014-2015 flu season, for instance, one of the viruses mutated, leading to a less effective flu shot match. It was also considered to be a particularly severe flu season.

Despite these problems, Open Forum Infectious Diseases report that the shot was 41 percent effective for younger people, and 56 percent effective for people age 65 and older.

Flu shot side effects

Although side effects are usually very mild, the flu shot can cause pain, redness, or swelling where the shot was given. A few people may also experience body aches or a low fever.

Hives on the skin.
The appearance of hives can signal an allergic reaction to the flu shot.

In rare cases, the flu shot can cause a severe allergic reaction. When this happens, it usually occurs within minutes or hours after the shot is given. The following are signs that require emergency treatment:

  • Wheezing
  • Swelling in the face
  • Hives
  • Trouble breathing
  • Feeling very weak or dizzy
  • Paleness

Because the viruses in the shot are weakened or inactivated, the flu shot cannot give someone the flu. However, it is possible to get the flu even after getting a flu shot. This may happen when a person is infected with a strain that was not in the shot, or if a person gets the flu before the shot has had time to take effect.

Those who get a flu shot can not only protect themselves but also those who may be most likely to get very sick or die from the flu. Babies younger than 6 months of age, people with long-term health conditions, and older adults may be less likely to get the flu when the people around them get the flu shot.

Are flu shots safe?

The CDC state that flu shots are safe and have a long history of safety behind them.

The shot is recommended for people age 6 months and older, with only a few exceptions.

The following people should talk to their doctor before getting the shot:

  • Those who are allergic to any ingredient in the flu shot
  • Anyone who had a severe allergic reaction to the flu shot in the past
  • Those who have had Guillain-Barré syndrome, a rare but severe paralyzing illness
  • People who are currently sick with an illness, such as a fever

Egg allergies and the flu shot

Most flu shots contain a small amount of egg protein. Egg-free shots are available for those with severe egg allergies. Studies have shown that people who are allergic to eggs can receive the flu shot without problems.

Pregnant women and the flu shot

The flu shot is safe and highly recommended for pregnant women. It can be given anytime during pregnancy. Pregnant women may be more likely to have serious complications of the flu due to a higher strain on the heart, lungs, and immune system.

A study in the New England Journal of Medicine suggests that the mother may pass some of the protection on to her unborn baby. Because babies cannot get the flu shot until they are 6 months old, this benefit may be helpful.

Types of flu shot

An older man having a vaccine.
Older adults may receive a high-dose version of the flu shot.

Flu shots are available in two doses: standard and high-dose. People under age 65 typically receive a standard dose vaccine. The high-dose version of the shot is recommended for people age 65 and older.

Most flu shots are trivalent, which means they contain three strains of flu. Newer vaccines are being developed with four strains, known as quadrivalent shots. Both are considered safe and effective, and the CDC recommend getting whichever type is available.

An intradermal shot is available for those who have a fear of needles. It uses a needle that is 90 percent smaller than the standard shot and is injected just under the skin instead of into the muscle. It is approved for people aged 18 to 64.

Although a nasal spray version of the flu shot has been available in recent years, a CDC vaccine advisory group reported that it is not effective and should not be used in the 2016-17 flu season.

When to get the flu shot

Experts recommend people get the flu shot as soon as it becomes available each fall. The shot takes 2 weeks to take effect, and flu season begins as early as October in some cases. But, people may still benefit from getting the flu shot later.

Flu season typically peaks in January or February. However, experts say getting the flu shot in the late winter and early spring months may still offer protection.

The flu shot is effective for about a year. This means people need a new shot to protect themselves each flu season, even if the strains in the shot are the same.

Written by Jennifer Berry

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Medical News Today: Flu Shot: Side Effects, Facts, Things to Consider

Infant formula: 7 steps to prepare it safely

Infant formula: 7 steps to prepare it safely

Are you measuring your baby’s infant formula correctly? Storing it properly? Keeping the utensils clean? To make sure, follow these seven steps.

By Mayo Clinic Staff

You’ve chosen your baby’s infant formula with care — but are you preparing it properly? Follow these steps to ensure proper nutrition and avoid food-related illness.

1. Check the expiration date

Look for an expiration or “use by” date on the formula container. If the expiration date has passed, you can’t be sure of the formula’s quality. Don’t buy or use outdated infant formula.

2. Wash your hands

Before preparing formula, wash your hands thoroughly with soap and water. Dry your hands well.

3. Prepare your bottle

Sterilize bottles, nipples, caps and rings before using them for the first time. You can boil the bottle and accessories in water for five minutes, use a microwave steam sterilizer bag or use a stand-alone electric steam sterilizer.

After the first use, there’s no need to sterilize your bottle and accessories. Wash these items with soap and water and allow them to air-dry. Bottle and nipple brushes can help you clean nooks and crannies. You can also use a dishwasher.

Aug. 24, 2016

References

  1. Kleinman RE, ed. Formula feeding of term infants. In: Pediatric Nutrition Handbook. 6th ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2009.
  2. Fluoride supplements. American Dental Association. http://www.ada.org/en/member-center/oral-health-topics/fluoride-supplements. Accessed Dec. 21, 2015.
  3. Overview: Infant formula and fluorosis. Centers for Disease Control and Prevention. Accessed Dec. 21, 2015.
  4. Lead: Water. Centers for Disease Control and Prevention. http://www.cdc.gov/nceh/lead/tips/water.htm. Accessed Dec. 21, 2015.
  5. FDA takes final step on infant formula protections. U.S. Food and Drug Administration. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048694.htm. Accessed Dec. 17, 2015.
  6. Jana LA, et al. Formula for success. In: Heading Home With Your Newborn: From Birth to Reality. 3rd ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2015.
  7. Zeratsky K (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 14, 2016.

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Boiling down the dietary guidelines

Boiling down the dietary guidelines

The dietary guidelines call for more veggies and less salt, fat and sugar. Here’s what that means for you.

By Mayo Clinic Staff

In an environment that promotes high-calorie, nutrient-poor foods with a more sedentary lifestyle, too many Americans are regularly eating too many calories. Hence, the obesity epidemic and related health problems such as heart disease and type 2 diabetes.

The good news is that a large body of evidence shows that healthy-eating patterns and regular physical activity can help people achieve and maintain good health and reduce the risk of chronic diseases.

The recommendations

The 2015-2020 Dietary Guidelines for Americans provide five overarching recommendations:

  • Follow a healthy-eating pattern. A healthy-eating pattern and an appropriate calorie level will help you get the nutrition you need, achieve and maintain a healthy weight, and reduce your risk of chronic diseases.
  • Focus on variety, nutrient density and amount. To meet your nutrient needs and stay within your calorie limit, choose a variety of nutrient-dense foods across all food groups. Nutrient-dense foods include vegetables, fruits, whole grains, and fat-free or low-fat dairy products.
  • Limit calories from added sugars and saturated fats, and cut back on sodium. Follow an eating pattern that is low in added sugars, saturated fats and sodium.
  • Shift to healthier food and beverage choices. Choose nutrient-dense foods and beverages across all food groups in place of less healthy choices.
  • Support healthy-eating patterns for all. Everyone has a responsibility for supporting healthy-eating in all settings, such as at home, work or school, or wherever food is available.

What is a healthy-eating pattern?

A healthy-eating pattern is one that includes:

  • A variety of vegetables — dark green, red and orange, legumes (beans and peas), starchy and other
  • Fruits, especially whole fruits
  • Grains, at least half of which are whole grains
  • Fat-free or low-fat dairy, including milk, yogurt and cheese, and fortified soy beverages
  • A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds and soy products
  • Oils, including those from plants, and those that occur naturally in nuts, seeds, seafood, olives and avocados

The Healthy U.S.-Style is a dietary pattern designed to consider the types and proportions of foods Americans typically eat, but in nutrient-dense forms and appropriate amounts.

Recommended servings for U.S.-style eating patterns for 2,000 calories a day
Food group Servings
Source: U.S. Department of Health and Human Services, 2015
Vegetables 2 1/2 cups a day
Dark green 1 1/2 cups a week
Red and orange 5 1/2 cups a week
Legumes (beans and peas) 1 1/2 cups a week
Starchy 5 cups a week
Other 4 cups a week
Fruits 2 cups a day
Grains 6 ounces a day
Whole grains ≥ 3 ounces a day
Refined grains ≤ 3 ounces a day
Dairy 3 cups a day
Protein foods 5 1/2 ounces a day
Seafood 8 ounces a week
Meats, poultry, eggs 26 ounces a week
Nuts, seeds, soy products 4 ounces a week
Oils 27 grams a day
Limit on calories from added sugars, solid fats, added refined starches 270 calories a day (14% of total calories)

Aug. 23, 2016

References

  1. Dietary Guidelines for Americans, 2015-2020. U.S. Department of Health and Human Services. http://health.gov/dietaryguidelines/2015/guidelines. Accessed Jan. 7, 2016.
  2. Top 10 things you need to know about the 2015-2020 Dietary Guidelines for Americans. Office of Disease Prevention and Health Promotion. http://health.gov/news/dietary-guidelines-digital-press-kit/2016/01/top-10-things-you-need-to-know. Accessed Jan.7, 2016.

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Asthma in adults: Creating an asthma action plan

Asthma in adults: Creating an asthma action plan

Manage asthma by staying organized. Here’s help creating an adult asthma action plan.

By Mayo Clinic Staff

Maintaining good day-to-day asthma control is the key to keeping symptoms at bay and preventing asthma attacks. Having a written asthma action plan makes it easier for you to measure whether your asthma is under control — and it lets you know exactly what steps to take when it isn’t. Using an asthma action plan is especially important if you have moderate to severe asthma or you’ve had a serious asthma attack in the past. Here’s how to get started.

Creating your asthma action plan

Because asthma varies from person to person, you’ll need to work with your doctor to develop a plan that’s customized for you. Your action plan may include keeping a diary, and can help you:

  • Track asthma symptoms. The plan will help you keep tabs on asthma signs and symptoms and record when your symptoms interfere with daily activities, such as work, exercise or sleep.

    You may also want to track how often you use a quick-acting inhaler, such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA, others), to ease symptoms.

  • Record peak flow readings. You may use a peak flow meter to track your asthma day to day. This simple hand-held device tests how well the lungs are working. Measurements that are lower than usual indicate that the lungs aren’t working as well as they should be. This is often the first sign that asthma is getting worse.
  • Assess asthma control. The action plan will give you a system for making sense of the information you record. Many asthma plans use a “traffic light” system of green, yellow and red zones that correspond to worsening symptoms. This system can help you quickly determine asthma severity and identify signs of an asthma attack.

    Some asthma plans use a symptoms questionnaire called the Asthma Control Test (ACT) to measure asthma severity over the past month.

  • Adjust medications. Your plan should say when you need to make medication adjustments based on the severity of your asthma symptoms. Asthma medications usually include long-term control medications, such as inhaled corticosteroids, and as-needed, quick-acting medications, such as inhaled albuterol. Make sure you understand what medications to use when, how to use them and what to expect.
  • Recognize and treat an asthma attack. Tracking symptoms daily and adjusting treatment accordingly improves asthma control and reduces the risk of having an asthma attack. But if symptoms do start to get worse quickly, follow the action plan’s instructions for using quick-acting medications or other steps to get your symptoms under control.
  • Know when to seek emergency care. Some asthma attacks can’t be managed at home. Use the action plan to recognize the signs of rapidly worsening asthma. If you use a peak flow meter, the action plan will also tell you when low peak flow readings signal that an asthma attack has become an emergency.
  • Avoid asthma triggers. The action plan may have a place for you to list your asthma triggers and notes on how to avoid them. These vary from person to person — examples include exercise, cold air, pollen, dust mites, mold, pet dander, gastroesophageal reflux disease (GERD), respiratory infections and smoke, including secondhand tobacco smoke.

Aug. 23, 2016

References

  1. Expert panel report 3 (EPR-3): Guidelines for the diagnosis and management of asthma. Bethesda, Md.: National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines. Accessed July 1, 2016.
  2. Asthma action plan. American Lung Association. http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/asthma/living-with-asthma/managing-asthma/create-an-asthma-action-plan.html. Accessed July 1, 2016.
  3. Bailey W, et al. What do patients need to know about their asthma? http://www.uptodate.com/home. Accessed July 1, 2016.
  4. Fanta CH. An overview of asthma management. http://www.uptodate.com/home. Accessed July 1, 2016.
  5. Asthma action plan. Asthma and Allergy Foundation of America. http://www.aafa.org/page/asthma-treatment-action-plan.aspx. Accessed July 1, 2016.
  6. Guidelines implementation panel report for expert panel report 3 — Guidelines for the diagnosis and management of asthma. Bethesda, Md.: National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines/implementation-panel-report-3. Accessed July 1, 2016.
  7. Bailey W, et al. Patient information: Asthma inhaler techniques in adults (Beyond the basics). http://www.uptodate.com/home. Accessed July 1, 2016.
  8. Fanta CH. Patient information: Asthma treatment in adolescents and adults (Beyond the basics). http://www.uptodate.com/home. Accessed July 1, 2016.

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Kindergarten readiness: Help your child prepare

Kindergarten readiness: Help your child prepare

Kindergarten readiness might be more important than you think. Find out how you can encourage your child’s development and school success.

By Mayo Clinic Staff

Your child is old enough to start kindergarten — but is he or she ready? Recognize the factors that might affect your child’s kindergarten readiness and what you can do to help him or her succeed in school.

Why is kindergarten readiness important?

Kindergarten marks the start of a child’s formal education. A child’s first school experiences can influence the way he or she relates to others for the rest of life. For example, success or failure at this stage can affect a child’s well-being, self-esteem and motivation. As a result, it’s important to make sure that when your child begins school he or she is developmentally ready to learn and participate in classroom activities.

How can I tell if my child is ready for kindergarten?

Most schools use cutoff dates — deadlines by which a child must be a certain age — to determine who’s eligible for a kindergarten class. Typically, a child must be age 5 before entering kindergarten. Age, however, isn’t the only way to measure a child’s kindergarten readiness.

When trying to determine if your child is ready for kindergarten, don’t worry about whether or not he or she has mastered specific skills. Instead, consider his or her readiness to learn. How well is your child able to communicate and listen? Is your child able to get along with other children and adults? Use your own intuition as a parent and consult your child’s doctor, preschool teacher and any other child care providers for useful, objective information about your child’s development and readiness for school.

Keep in mind that some schools also require children to take a teacher-administered kindergarten readiness test to evaluate their abilities relative to other children of the same age. Not all educators believe these individual, in-class readiness tests for kindergarten students is an appropriate use of time and resources.

Aug. 23, 2016

References

  1. Kliegman RM, et al. Middle childhood. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed July 29, 2016.
  2. Harris LL. School readiness for children in the United States. http://www.uptodate.com/home. Accessed July 29, 2016.
  3. Moreno MA. School readiness. JAMA Pediatrics. 2013;167:784.
  4. Flannery ME. Kindergarten readiness tests wasting valuable teaching time. neaToday. http://neatoday.org/2015/01/15/kindergarten-readiness-tests-wasting-valuable-teaching-time/. Accessed Aug. 2, 2016.
  5. National Association for the Education of Young Children (NAEYC), et al. Technology and interactive media as tools in early childhood programs serving children from birth through age 8. NAEYC. http://www.naeyc.org/content/technology-and-young-children. Accessed Aug. 2, 2016.
  6. Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 2, 2016.

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Fitness program: 5 steps to get started

Fitness program: 5 steps to get started

Are you thinking about starting a fitness program? Good for you! You’re only five steps away from a healthier lifestyle.By Mayo Clinic Staff

Starting a fitness program may be one of the best things you can do for your health. Physical activity can reduce your risk of chronic disease, improve your balance and coordination, help you lose weight — and even improve your sleep habits and self-esteem. And there’s more good news. You can start a fitness program in only five steps.

1. Assess your fitness level

You probably have some idea of how fit you are. But assessing and recording baseline fitness scores can give you benchmarks against which to measure your progress. To assess your aerobic and muscular fitness, flexibility, and body composition, consider recording:

  • Your pulse rate before and immediately after walking 1 mile (1.6 kilometers)
  • How long it takes to walk 1 mile or 400 meters, or how long it takes to run 1.5 miles (2.41 kilometers)
  • How many half situps, standard pushups or modified pushups you can do at a time
  • How far you can reach forward while seated on the floor with your legs in front of you
  • Your waist circumference, just above your hipbones
  • Your body mass index

2. Design your fitness program

It’s easy to say that you’ll exercise every day. But you’ll need a plan. As you design your fitness program, keep these points in mind:

  • Consider your fitness goals. Are you starting a fitness program to help lose weight? Or do you have another motivation, such as preparing for a marathon? Having clear goals can help you gauge your progress and stay motivated.
  • Create a balanced routine.

    The Department of Health and Human Services recommends getting at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, or a combination of moderate and vigorous activity.

    For example, try to get about 30 minutes of aerobic exercise on most days of the week. Also aim to incorporate strength training of all the major muscle groups into a fitness routine at least two days a week.

  • Start low and progress slowly. If you’re just beginning to exercise, start cautiously and progress slowly. If you have an injury or a medical condition, consult your doctor or an exercise therapist for help designing a fitness program that gradually improves your range of motion, strength and endurance.
  • Build activity into your daily routine. Finding time to exercise can be a challenge. To make it easier, schedule time to exercise as you would any other appointment. Plan to watch your favorite show while walking on the treadmill, read while riding a stationary bike, or take a break to go on a walk at work.
  • Plan to include different activities. Different activities (cross-training) can keep exercise boredom at bay. Cross-training using low-impact forms of activity, such as biking or water exercise, also reduces your chances of injuring or overusing one specific muscle or joint. Plan to alternate among activities that emphasize different parts of your body, such as walking, swimming and strength training.
  • Allow time for recovery. Many people start exercising with frenzied zeal — working out too long or too intensely — and give up when their muscles and joints become sore or injured. Plan time between sessions for your body to rest and recover.
  • Put it on paper. A written plan may encourage you to stay on track.

Aug. 20, 2016

References

  1. Your guide to physical activity and your heart. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/resources/heart/obesity-guide-physical-active-html. Accessed Aug. 9, 2016.
  2. Starting an exercise program. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00416&return_link=0. Accessed July 29, 2016.
  3. Physical activity and health: The benefits of physical activity. Centers for Disease Control and Prevention. http://www.cdc.gov/physicalactivity/basics/pa-health/index.htm. Accessed July 29, 2016.
  4. Overcoming barriers to physical activity. Centers for Disease Control and Prevention. http://www.cdc.gov/physicalactivity/basics/adding-pa/barriers.html. Accessed July 29, 2016.
  5. 2008 Physical Activity Guidelines for Americans. U.S. Department of Health and Human Services. https://health.gov/paguidelines/guidelines/. Accessed Aug. 9, 2016.
  6. The adult fitness test. President’s Challenge Program. https://www.adultfitnesstest.org/testInstructions/aerobicFitness/index.php. Accessed Aug. 9, 2016.
  7. Laskowski ER (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 10, 2016.

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Medical News Today: Notion of 'healthy obesity' further challenged

The concept of metabolically healthy obesity – obese individuals who may not be at an increased risk for metabolic complications – has been the subject of much debate over the past 15 years, with some scientists questioning if it even exists. New evidence published in Cell Reports provides further evidence against the existence of a healthy obese state.
[obese woman exercising]
“Healthy obesity” is a term used to describe obese individuals who remain free from type 2 diabetes and other disorders.

Obesity is one of the most visible, yet most neglected public health problems, with an escalating global epidemic of overweight and obesity reaching many parts of the world.

Around 600 million people worldwide are affected by obesity, with the condition significantly increasing the risk of heart disease, stroke, type 2 diabetes, osteoarthritis and some cancers.

Evidence supporting the link between obesity and metabolic and cardiovascular diseases has accumulated since the 1940s. However, experts began to question in the 1970s and 80s the extent to which obesity increases the risk for these disorders.

Furthermore, studies in the late 90s and early 2000s found that not all obese individuals experienced a greater risk of metabolic and cardiovascular complications, and, in fact, they displayed a relatively healthy metabolic and cardiovascular profile, hence the term “metabolically healthy obesity.”

Difference between healthy and obese participants

While no universally accepted criteria exist to define metabolically healthy obesity, a potential hallmark of the condition is a high sensitivity to insulin, a hormone that promotes uptake of blood glucose into cells to be used for energy.

Estimates suggest that up to 30 percent of obese individuals are metabolically healthy and, as a result, may not need as much intervention to prevent obesity-related complications.

Mikael Rydén, of the Karolinska Institutet in Stockholm, Sweden, and colleagues examined the responses to insulin in 15 healthy participants and 50 obese subjects who were enrolled in a gastric bypass surgery clinical study.

Biopsies of abdominal white fat tissue were obtained at the start and end of a 2-hour period of insulin and glucose received by intravenous infusion. Based on the glucose uptake rate, 21 obese individuals were classified as insulin sensitive, and 29 classed as insulin resistant.

Analysis of white fat tissue samples revealed a clear difference between healthy participants and insulin-sensitive and insulin-resistant obese individuals.

In response to insulin stimulation, white fat tissue from both obese groups showed almost identical abnormal patterns of gene expression, which were not influenced by cardiovascular or metabolic risk factors such as waist-to-hip ratio, heart rate, or blood pressure.

Obesity changes gene expression in fat tissue

The researchers uncover that obesity – rather than other common risk factors – is likely the principle factor affecting metabolic health.

“Our study suggests that the notion of metabolically healthy obesity may be more complicated than previously thought, at least in subcutaneous adipose tissue,” says Rydén.

“There doesn’t appear to be a clear transcriptomic fingerprint that differentiates obese subjects with high or low insulin sensitivity, indicating that obesity per se is the major driver explaining the changes in gene expression,” he adds.

Study limitations include that gene expression profiles were only examined in white fat tissue and not other types of fatty tissue or other organs. Also, all obese participants were due to go through bariatric surgery, suggesting the finding may only apply to obese individuals at the severe end of the scale.

Overall, the study finds that white fat tissue samples from obese individuals classified as either metabolically healthy or unhealthy show almost identical, abnormal changes in gene expression in response to insulin stimulation.

“The findings suggest that vigorous health interventions may be necessary for all obese individuals, even those previously considered to be metabolically healthy. Since obesity is the major driver altering gene expression in fat tissue, we should continue to focus on preventing obesity.”

Mikael Rydén

“Insulin-sensitive obese individuals may not be as metabolically healthy as previously believed,” says Rydén. “Therefore, more vigorous interventions may be necessary in these individuals to prevent cardiovascular and metabolic complications,” he concludes.

Future studies by the team will concentrate on tracking study participants after bariatric surgery to determine whether the associated weight loss normalizes gene expression responses to insulin. Additionally, Rydén and his collaborators will investigate particular genes linked to improved metabolic health in these people.

Learn how the duration a person is overweight or obese can increase the risk of several cancers.

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Medical News Today: Anemia may raise risk of death for stroke patients

Older adults who have had a stroke may be at greater risk of death if they have anemia. This is the conclusion of a new study published in the Journal of the American Heart Association.
[Anemia definition and blood]
For older stroke patients, anemia may increase their risk of death.

Stroke affects more than 795,000 Americans each year, and it is a leading cause of long-term disability in the United States.

Around 87 percent of all strokes are ischemic, whereby the artery that supplies oxygen-rich blood to the brain becomes blocked. When an artery in the brain leaks or ruptures, this is known as hemorrhagic stroke.

According to the research team – including senior author Dr. Phyo Myint of the University of Aberdeen in the United Kingdom – many patients who have experienced stroke have anemia.

Anemia is a condition characterized by low levels of circulating red blood cells or hemoglobin, which causes a reduction in the amount of oxygen that is transported to the body’s organs and tissues.

Signs and symptoms of anemia include fatigue, headache, pale skin, dizziness, shortness of breath, coldness in the hands and feet, and chest pain.

While anemia can affect any age group, pregnant women and older adults are at increased risk for the condition.

For their study, Dr. Myint and colleagues set out to investigate how anemia may impact risk of death following stroke.

Twofold risk of death for stroke patients with anemia

The researchers analyzed the data of 8,013 adults of an average age of 77, all of whom had been admitted to the hospital with acute stroke between 2003-2015.

The team looked at how participants’ levels of hemoglobin – a protein in red blood cells that carries oxygen – and incidence of anemia influenced their risk of death in the year after their stroke.

Fast facts about stroke

  • Each year, stroke kills around 130,000 Americans
  • It is the fifth leading cause of death in the U.S.
  • Stroke costs the U.S. around $34 billion every year.

Learn more about stroke

On hospital admission for stroke, the researchers found that around 25 percent of patients had anemia, and this increased their risk of death over the following year.

Among patients who had ischemic stroke, the risk of death was increased twofold for those with anemia, compared with ischemic stroke patients who did not have anemia. Hemorrhagic stroke patients who had anemia were at 1.5 times greater risk of death.

Furthermore, the researchers found that higher hemoglobin levels among patients were associated with poorer stroke outcomes and increased risk of death, particularly in the first month after stroke.

This finding, the team says, suggests that both low and high hemoglobin levels may raise stroke patients’ risk of death.

The researchers’ findings were further confirmed with a systematic review of 20 studies – involving almost 30,000 patients – that looked at the link between anemia and stroke outcomes.

Overall, the authors say their research highlights the importance of anemia prevention, diagnosis, and treatment for stroke patients.

“One example of an intervention might be treating the underlying causes of anemia, such as iron deficiency, which is common in this age group,” says co-author Raphae Barlas, also of the University of Aberdeen.

“As the study has convincingly demonstrated, anemia does worsen the outcome of stroke, so it is very important that we identify at-risk patients and optimize the management.”

Raphae Barlas

Read how a major red blood cell discovery could lead to new treatments for anemia.

See the article here:

Medical News Today: Anemia may raise risk of death for stroke patients

Caregiving: Tips for long-distance caregivers

Caregiving: Tips for long-distance caregivers

Long-distance caregiving poses unique challenges. Find out what you can do to help your loved one from afar — and how to make the most of personal visits.

By Mayo Clinic Staff

If you live an hour or more away from a loved one who needs care, you might wonder what you can do to help. Start by understanding options for long-distance caregiving, ranging from coordinating services to providing respite for a primary caregiver.

What is long-distance caregiving?

Long-distance caregiving can take many forms. From afar, you might:

  • Provide emotional support to a primary caregiver
  • Coordinate services for a loved one, such as arranging for household help or in-home care, and follow up to make sure there are no problems
  • Manage a loved one’s medical bills or records
  • Make yourself available for medical visits

You might also arrange to stay with your loved one while his or her primary caregiver takes time off or goes on vacation.

How can I keep on top of my loved one’s care from long distance?

You can take many steps to be an effective long-distance caregiver. For example:

  • Schedule a family meeting. Gather family and friends involved in your loved one’s care in person, by phone or by video chat. Discuss your goals, air feelings and divide up duties. Appoint someone to summarize the decisions made and distribute notes after the meeting. Be sure to include the loved one in need of care in the decision-making process.
  • Get organized. Compile notes about your loved one’s medical condition and any legal or financial issues. Include contact numbers, insurance information, account numbers and other important details.
  • Research your loved one’s illness and treatment. This will help you understand what your loved one is going through, the course of the illness, what you can do to prevent crises and how to assist with disease management. It might also make it easier to talk to your loved one’s doctors.
  • Keep in touch with your loved one’s providers. In coordination with your loved one and his or her other caregivers, schedule conference calls with doctors or other health care providers to keep on top of changes in your loved one’s health. Be sure to have your loved one sign a release allowing the doctor to discuss medical issues with you — and keep a backup copy in your files.

    You may also be able to log into your loved one’s medical records online to see test results, medications, after-visit summaries and more. Medical office staff members can tell you if they offer electronic medical records and how to request permission.

    Bear in mind that your loved one will make final health care decisions unless he or she has named a medical power of attorney. This is a type of advance directive — written, legal instructions regarding preferences for medical care. A medical power of attorney (health care proxy) makes health care decisions when a patient cannot.

  • Ask your loved one’s friends for help. Stay in touch with your loved one’s friends and neighbors. Ask your loved one who he or she would prefer to come around on a regular basis, and ask those people to regularly check in on your loved one. They might be able to help you understand what’s going on with your loved one on a daily basis.
  • Seek professional help. If necessary, hire someone to help with meals, personal care and other needs. A geriatric care manager or social worker also might be helpful in organizing your loved one’s care. Contact your Area Agency on Aging for help finding local resources.
  • Plan for emergencies. Set aside time and money in case you need to make unexpected visits to help your loved one. Consider inquiring about taking unpaid leave under the Family and Medical Leave Act.
  • Stay in touch. Try sending your loved one digital movies of yourself. Send cards. Set a time each day or week for phone calls or video chats with your loved one.
  • Aug. 17, 2016

    References

    1. A guide to taking care of yourself. Family Caregiver Alliance. https://www.caregiver.org/print/151. Accessed July 26, 2016.
    2. Working successfully with home care services. Family Caregiver Alliance. https://www.caregiver.org/caregiver-working-successfully-home-care-services. Accessed July 26, 2016.
    3. Tips for the long-distance caregiver. AARP. http://www.aarp.org/relationships/caregiving-resource-center/info-09-2010/pc_tips_for_long_distance_caregiver.html. Accessed July 26, 2016.
    4. Long-distance caregiving: Questions and answers. National Institute on Aging. https://www.nia.nih.gov/health/publication/long-distance-caregiving/introduction. Accessed July 26, 2016.
    5. Long-distance caregiving. Alzheimer’s Association. https://www.alz.org/care/alzheimers-dementia-long-distance-caregiving.asp. Accessed July 26, 2016.
    6. Takahashi PY (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 1, 2016.
    7. A patient’s guide to the HIPAA privacy rule. U.S. Department of Health and Human Services. http://www.nextstepincare.org/uploads/File/consumer_HIPAA.pdf. Accessed July 26, 2016.
    8. 4 tips for long-distance caregivers. AARP. http://blog.aarp.org/2016/01/21/amy-goyer-technology-helps-long-distance-caregivers/. Accessed July 26, 2016.
    9. Advance care planning: Ensuring your wishes are known and honored if you are unable to speak for yourself. http://www.cdc.gov/aging/pdf/advanced-care-planning-critical-issue-brief.pdf. Centers for Disease Control and Prevention. Accessed Aug. 2, 2016.

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Caregiving: Tips for long-distance caregivers