Study: Women less able to suppress hunger than men

WASHINGTON – Faced with their favorite foods, women are less able than men to suppress their hunger, a discovery that may help explain the higher obesity rate for females, a new study suggests. Researchers trying to understand the brain's mechanisms for controlling food intake were surprised at the difference between the sexes in brain response.
Gene-Jack Wang of Brookhaven National Laboratory and colleagues were trying to figure out why some people overeat and gain weight while others don't.
They performed brain scans on 13 women and 10 men, who had fasted overnight, to determine how their brains responded to the sight of their favorite foods. They report their findings in Tuesday's edition of Proceedings of the National Academy of Sciences.
"There is something going on in the female," Wang said in a telephone interview, "the signal is so much different."
In the study, participants were quizzed about their favorite foods, which ranged from pizza to cinnamon buns and burgers to chocolate cake, and then were asked to fast overnight.
The next day they underwent brain scans while being presented with their favorite foods. In addition, they used a technique called cognitive inhibition, which they had been taught, to suppress thoughts of hunger and eating.
While both men and women said the inhibition technique decreased their hunger, the brain scans showed that men's brain activity actually decreased, while the part of women's brains that responds to food remained active.
"Even though the women said they were less hungry when trying to inhibit their response to the food, their brains were still firing away in the regions that control the drive to eat," Wang said.
Nora Volkow, director of the National Institute on Drug Addiction and a co-author of the paper, said the gender difference was a surprise and may be because of different nutritional needs for men and women, although she stressed that idea is speculative.
Because the traditional role of the female is to provide nutrition to children, the female brain may be hard-wired to eat when foods are available, she said. The next step is to see if female hormones are reacting directly with those specific parts of the brain.
"In our society we are being constantly being bombarded by food stimulus," she said in a telephone interview, so understanding the brain's response can help in developing ways to resist that stimulus.
Eric Stice, an expert on eating disorders at the Oregon Research Institute, called the findings provocative.
"I think it is very possible that the differences in hunger suppression may contribute to gender differences in eating disorders and that they are likely linked to gender differences in estrogen and related hormones," said Stice, who was not part of Wang's research team.
According to the Centers for Disease Control and Prevention, 35.3 percent of American women and 33.3 percent of men were considered obese in 2006.
Rosalyn Weller, a professor of psychology at the University of Alabama-Birmingham, said she was surprised by the results and "thought the dissociation between subjective reports of hunger and brain activation in women but not men was very interesting."
The results suggest that training in reducing food desires or in reacting to food cues could be effective treatments to combat obesity, said Weller, who was not part of the research team.
Weller was a co-author of a recent paper in the journal NeuroImage that studied women's brains when participants were shown pictures of food. They found that obese women had a much stronger reaction than normal-weight women in brain regions related to reward.
Wang noted that behavioral studies have shown that women have a higher tendency than men to overeat when presented with tasty food or under emotional distress.
This may result from differences in sex hormones, he said, and further research is planned to see if that is the case.
Alice H. Lichtenstein, an expert in eating behavior at Tufts University, called Wang's research "very interesting ... I hope to see more like it."
But, she added, a lot of different factors figure in what and when we eat.
"As we learn more about the different factors that go into making that decision we'll be better at helping people regulate" their eating, said Lichtenstein, who was not part of the research team.
Obesity has been increasing and Wang also suggested that another part of the reason is changes in society.
While food choices were seasonal and more limited for our ancestors, choices today are wider and the food is so tempting, he said.
"You go to the buffet, you see the food, you want it," Wang went on. "Some people go to the buffet, they don't eat so much, some do. There is something different in the people."
The study was funded by the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and by the General Clinical Research Center of Stony Brook University.
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MRSA rising in kids' ear, nose, throat infections

CHICAGO – Researchers say they found an "alarming" increase in children's ear, nose and throat infections nationwide caused by dangerous drug-resistant staph germs. Other studies have shown rising numbers of skin infections in adults and children caused by these germs, nicknamed MRSA, but this is the first nationwide report on how common they are in deeper tissue infections in the head and neck, the study authors said. These include certain ear and sinus infections, and abcesses that can form in the tonsils and throat.
The study found a total of 21,009 pediatric head and neck infections caused by staph germs from 2001 through 2006. The percentage caused by hard-to-treat MRSA bacteria more than doubled during that time from almost 12 percent to 28 percent.
"In most parts of the United States, there's been an alarming rise," said study author Dr. Steven Sobol, a children's head and neck specialist at Emory University.
The study appears in January's Archives of Otolaryngology, released Monday.
It is based on nationally representative information from an electronic database that collects lab results from more than 300 hospitals nationwide.
MRSA, or methicillin-resistant Staphylococcus aureus, can cause dangerous, life-threatening invasive infections and doctors believe inappropriate use of antibiotics has contributed to its rise.
The study didn't look at the severity of MRSA illness in affected children.
Almost 60 percent of the MRSA infections found in the study were thought to have been contracted outside a hospital setting.
Dr. Robert Daum, a University of Chicago expert in community-acquired MRSA, said the study should serve as an alert to agencies that fund U.S. research "that this is a major public health problem."
MRSA involvement in adult head and neck infections has been reported although data on prevalence is scarce.
MRSA infections were once limited mostly to hospitals, nursing homes and other health-care settings but other studies have shown they are increasingly picked up in the community, in otherwise healthy people. This can happen through direct skin-to-skin contact or contact with surfaces contaminated with germs from cuts and other open wounds.
But staph germs also normally live or "colonize" on the skin and in other tissues including inside the nose and throat, without causing symptoms. And other studies have shown that for poorly understood reasons, the number of people who carry MRSA germs is also on the rise.
Sobol said MRSA head and neck infections most likely develop in MRSA carriers, who become susceptible because of ear, nose or throat infections caused by some other bug. Symptoms that it could be MRSA include ear infections that drain pus, or swollen neck lymph nodes caused by pus draining from a throat or nose abcess.
Unlike cold and flu bugs, MRSA germs aren't airborne and don't spread through sneezing.
MRSA does not respond to penicillin-based antibiotics and doctors are concerned that it is becoming resistant to others.
The study authors said a worrisome 46 percent of MRSA infections studied were resistant to the antibiotic clindamycin, one of the non-penicillin drugs doctors often rely on to treat community-acquired MRSA. However, other doctors said it's more likely that at least some of infections thought to be community-acquired had actually originated in a hospital or other health-care setting, where MRSA resistance to clindamycin is common.
Dr. Buddy Creech, an infectious disease specialist at Vanderbilt University Medical Center, said the research "fits nicely" with smaller studies reporting local increases in MRSA head and neck infections.
"Every time someone looks, the rates of MRSA are going up and that's certainly concerning because it's a bug that can cause dramatic disease," Creech said.
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More recalls of peanut butter products announced

MILWAUKEE – Kellogg Co. said Monday federal authorities have confirmed that salmonella was found in a single package of its peanut butter crackers, as two grocers and General Mills Corp. recalled some of their products because of the scare.

Kellogg had recalled 16 products last week because of the possibility of salmonella contamination.

On Monday, the company based in Battle Creek, Mich., said the Food and Drug Administration confirmed contamination in a single package of Austin Quality Foods Toasty Crackers with Peanut Butter.

Food companies and retailers have been recalling products with peanut butter in them because of suspicion of contamination amid a salmonella outbreak that has killed at least six people and sickened more than 470 others in 43 states. At least 90 people have been hospitalized.

Also Monday, Midwestern grocer and retailer Meijer Inc. said it was recalling two types of crackers and two varieties of ice cream because of the possibility of salmonella contamination: Meijer brand Cheese and Peanut Butter and Toasty Peanut Butter sandwich crackers, and Peanut Butter and Jelly and Peanut Butter Cup ice cream.

Golden Valley, Minn.-based General Mills said in a news release Monday afternoon that it was recalling two flavors of snack bars: LARABAR Peanut Butter Cookie snack bars and JamFrakas Peanut Butter Blisscrisp snack bars. The company said the recall affected 15,000 cases and no illnesses have been reported. General Mills said the recall did not affect any other products it makes.

It was not immediately clear how many packages of Kellogg crackers had been tested, if more tests were being made on other products or if some had already been found not have salmonella, Kellogg spokeswoman Kris Charles said. A spokesman for the FDA said the agency was not providing any new information Monday, a federal holiday.

The government on Saturday had advised consumers to avoid eating cookies, cakes, ice cream and other foods containing peanut butter until health officials learn more about the contamination.

Most peanut butter sold in jars at supermarkets appears to be safe, officials said.

Officials have been focusing on peanut paste and peanut butter made at Peanut Corp. of America's plant in Blakely, Ga.

On Sunday, Peanut Corp. expanded its own recall to all peanut butter and peanut paste produced at the Blakely plant since July 1.

The company's peanut butter is not sold directly to consumers but it is distributed to institutions and food companies. The peanut paste, made from roasted peanuts, is an ingredient in cookies, cakes and other products sold to consumers.

Meijer, based in Grand Rapids, said in a news release Monday it was issuing its recall because makers of its products had announced possible contamination. The products are sold in Meijer stores and gas stations in Michigan, Ohio, Indiana, Illinois and Kentucky.

Late Monday, grocer Kroger Co. recalled Private Selection Peanut Butter Passion Ice Cream sold in select stores, also because of the possibility of contamination. The Cincinnati-based company said the product was sold at stores named City Market, Fred Meyer, Fry's, King Scoopers, QFC and Smith's in 11 states, primarily in the West. The company said the ice cream was not sold in its namesake Kroger stores or any other retailers it operates. No illnesses have been reported.

The recall last week by Kellogg, the world's largest cereal maker, affected products including Keebler Soft Batch Homestyle Peanut Butter Cookies, Famous Amos Peanut Butter Cookies and Keebler Cheese & Peanut Butter Sandwich Crackers. Charles said the recall affected more than 7 million cases of its products.

Kellogg Chief Executive David Mackay said the company would evaluate its processes "to ensure we take necessary actions to reassure consumers and rebuild confidence in these products."

Salmonella, a bacteria, is the most common cause of food poisoning in the U.S., causing diarrhea, cramping and fever.

Also on Monday, Abbott Nutrition recalled three products because of the possibility of salmonella contamination: ZonePerfect Chocolate Peanut Butter bars, ZonePerfect Peanut Toffee bars and NutriPals Peanut Butter Chocolate nutrition bars. The Columbus, Ohio-based company said the items were sold in the U.S., Mexico, New Zealand and Singapore.

Over the weekend, Little Debbie maker McKee Foods Corp. of Collegedale, Tenn., issued a voluntary recall of its peanut butter crackers because of possible contamination.

Other companies issuing recalls recently include Midwest supermarket chain Hy-Vee Inc. of West Des Moines, Iowa, Perry's Ice Cream Co. of Akron, N.Y., and the South Bend Chocolate Co. in Indiana. Ralcorp Frozen Bakery Products, a division of St. Louis-based Ralcorp, recalled several brands of peanut butter cookies it sells through Wal-Mart stores.

Some companies were quick to assure their customers their products were fine and they were not involved in the investigation. Russell Stover Candies Inc., maker of Russell Stover and Whitman's, said Monday it does not use ingredients from Peanut Corp. ConAgra Foods Inc., maker of Peter Pan peanut butter, said Saturday it was not involved in the investigation and neither the Omaha, Neb.-based company nor its suppliers use ingredients from Peanut Corp.

Peter Pan and other peanut butter produced by ConAgra were linked in 2007 to a salmonella outbreak that sickened more than 625 people in 47 states. The company traced the contamination to a leaky roof and faulty sprinkler head at its Georgia plant.

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Texas girl gets new heart; sis awaiting transplant

DALLAS – A 7-year-old girl received a new heart Monday, more than eight months after she and her older sister were put on the transplant list because of the same rare ailment.
Their mother said Shayde Smith is relieved now that her sister Emily has received a transplant. "She's still nervous about it, but she said that now that Emily's made it through, she knows she will," Natalie Van Noy said.
The girls have restrictive cardiomyopathy, which means the heart doesn't relax between pumps and doesn't fill properly with blood. The condition can cause blood clots or death.
Emily was a higher priority for transplant than 9-year-old Shayde because she had more symptoms, including wheezing spells and her lips, toes and fingertips turning blue when she got cold.
Van Noy said Emily's hands and feet are now warm. "She looks awesome," her mother said.
The girls' condition is rare, with less than one-in-a-million children diagnosed, said Dr. Kristine Guleserian, the pediatric cardiothoracic surgeon who led the team operating on Emily at Children's Medical Center Dallas. Without a transplant, the chance of survival is 40 to 50 percent one to two years after diagnosis.
Restrictive cardiomyopathy doesn't have a known cause. It seems to run in families, but the condition hasn't yet been proven to be genetic.
While it isn't rare for siblings to need transplants, it is rare that they would need them at the same time, said Pam Silvestri, a spokeswoman for Southwest Transplant Alliance, one of the organ donation agencies across the country that provides organs to transplant hospitals.
The girls are from the Boyd area, about 30 miles northwest of Fort Worth.
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Girl in China critically ill with bird flu

BEIJING – A 2-year-old girl in northern China has tested positive for bird flu and is in critical condition — the second case of human infection in a month.

The girl fell ill on Jan. 7 in central Hunan province and was taken to a hospital by her grandparents four days later after she returned home to Shanxi province, the Health Ministry said in a notice on its Web site late Saturday.

Tests confirmed she was infected with the H5N1 bird flu virus, it said. It did not say how the girl, surnamed Peng, was infected or what she was doing in Hunan.

"The patient is in critical condition, and the health department of Shanxi province is sparing no efforts" to save the girl, the notice said.

All the people who had close contact with the girl were under medical observation, the ministry said, and no one else has been found ill.

The case comes at a worrisome time for authorities as tens of millions of people are on the move between cities and rural hometowns for Chinese New Year, which begins on Jan. 26. The Agricultural Ministry has said it will step up checks before the holiday.

China, which raises more poultry than any other country, has vowed to aggressively fight the virus.

A spokeswoman for the World Health Organization in Beijing said it was informed of the case and was staying in close contact with the Health Ministry.

Earlier this month a 19-year-old woman died from the bird flu virus in a Beijing hospital after contact with ducks in a market in a neighboring province, the first death from bird flu since February last year. The WHO said the case did not appear to signal a new public health threat.

Health officials worry the H5N1 virus could mutate into a form that could spread easily among people.

According to the latest WHO tally, bird flu has killed 248 people worldwide since 2003, including 21 in China. The young girl brings the total number of cases in the country to 32.

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High risk medical devices escaped close review

WASHINGTON – Some medical devices for sensitive uses, from certain hip joints to a type of defibrillator, have won government approval without a close scientific review, congressional investigators said Thursday.

Although Congress ordered the Food and Drug Administration years ago to resolve the issue, the agency approved 228 medical devices without a full scale review from 2003-2007, the Government Accountability Office said in a report.

Some devices approved under the less rigorous process have been recalled because of malfunctions and other problems, according to the consumer group Public Citizen. One device was an external defibrillator to assist heart attack victims.

The report comes as the FDA's Center for Devices and Radiological Health is the subject of allegations that scientists were pressured to approve medical machinery against their professional judgment. Nine FDA scientists wrote the Obama transition team last week complaining that a "corrupted" review process is putting public health at risk.

The allegations are a separate matter from the concerns raised in Thursday's report. But taken together, they probably will raise the level of congressional scrutiny over the FDA's medical devices branch.

"GAO's investigation confirms my concerns that the approval process for medical devices is woefully inadequate," said Rep. Frank Pallone, who heads the House Energy and Commerce Committee's health panel. "For years, Congress has required high-risk medical devices to undergo stringent premarket review, but GAO's findings show that is simply not happening in every case."

Pallone, D-N.J., said he intends to hold hearings on the FDA's oversight of medical devices. The GAO did not look into whether any patients were harmed as a result of devices that got less government scrutiny.

The root of the problem seems to be that the FDA never fully carried out the intent of a decades-old change in the law.

Medical devices include everything from tongue depressors to silicone breast implants and pacemakers. In 1976, Congress set up a three-tiered classification system for devices.

Manufacturers of low-risk devices such as bandages and reading glasses could get cleared by notifying the FDA before going to market. High-risk devices such as pacemakers and heart valves would have to go through tighter scrutiny, and their manufacturers were required to provide evidence of safety and effectiveness. Devices classified as high-risk tended to be ones that are implanted in the body or could spell the difference between life and death.

An exception was carved out for new versions of high-risk devices already on the market.

Manufacturers could get approval by convincing the FDA that these devices were "substantially equivalent" to their precursors. In 1990, Congress ordered the FDA to end the practice, but it has continued even as generations of technology have come and gone.

The report urged the FDA to promptly resolve the problem, either by carrying out full reviews or reclassifying some devices as lower risk, if appropriate.

The FDA acknowledged the problem, but has not set a timetable for resolving it. "In general, we agree with the conclusions and recommendations," said spokeswoman Karen Riley. "We are considering legal and procedural options to accomplish this objective."

The GAO report found that two-dozen distinct types of devices approved without close scrutiny, including metal hip joints, external defibrillators, and electrodes for pacemakers.

"It all adds up to less-than-rigorous device review, and it's placing tens of thousands of Americans at risk," said Peter Lurie, deputy director of Public Citizen's health research group.

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FDA pledges openness on gene-altered products

WASHINGTON – Federal health officials Thursday pledged a new, open process for approving drugs and foods from genetically engineered animals.
Consumer groups complained the policy won't do enough to tell people if they're eating gene-altered animals and fails to protect the environment. They urged the incoming Obama administration to reconsider it.
Genetic engineering, already widely used for crops, is on the threshold of producing animals that can grow faster or even yield drugs that treat human illnesses. Although the potential benefits — and profits — are huge, many individuals have qualms about manipulating the genetic code of other living creatures.
In issuing its long-awaited final policy, the Food and Drug Administration said it will not allow any products from genetically engineered animals to be sold without first submitting them to scrutiny by independent advisers at a public meeting. The government will allow exceptions for research animals, such as lab rats, and the FDA will post those on its Web site.
Genetically engineered — or GE — animals are not clones, which the FDA has already said are safe to eat. Clones are exact copies of an animal. With GE animals, their DNA has been altered to produce a desirable characteristic.
"We will not approve any application until we are convinced of the safety and effectiveness," said FDA biotechnology expert Larisa Rudenko, who has been working on the complex issue since 1989. "The public should rest assured that we are not going to be rushing any decisions."
But consumer groups said the FDA's policy will not require all genetically engineered foods to be labeled as such. And they said the government has not done enough to examine the potential impact of genetically engineered animals on the environment, particularly if some escape and begin to mate with animals in nature.
"They are completely ignoring consumers' overwhelming desire for labeling," said Michael Hansen, a senior scientist with Consumers Union, publisher of Consumer Reports. FDA officials said genetically engineered foods will be labeled if they are different in some important way from natural foods, for example, no-fat filet mignon.
The FDA also failed to require a cradle-to-grave tracking system for genetically engineered animals, said Gregory Jaffe, who heads the biotechnology project at the Center for Science in the Public Interest. He's particularly concerned about animals that are not supposed to enter the food supply chain.
"The FDA has made some small but important changes to increase the transparency of this process," said Jaffe. "It helps, but the devil is in the details."
While not calling for a repeal of the FDA policy, Jaffe urged the incoming Obama administration to work with Congress on a new law that specifically addresses the genetic engineering issue. The FDA based its policy on older laws that apply to animal drugs.
Drugs and foods from GE animals will become increasingly common in the next five to ten years. For example, an FDA advisory committee last week considered approval of an anti-clotting drug produced from the milk of GE goats. The scientific advisers concluded that the drug — ATryn — appears to be safe and effective. A final FDA decision is pending. And a Massachusetts company hopes to win FDA approval this year for a faster-growing salmon.
The biotechnology industry welcomed the FDA's announcement.
"This system will ensure the products made available through this science will go through a rigorous and transparent review process before being approved for the marketplace," said Barbara Glenn, a senior scientific adviser with the Biotechnology Industry Organization.
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DVD teaches autistic kids what a smile means

LONDON – It wasn't until Jude met Jenny that the 3-year-old autistic boy understood what happy people look like. Jenny, a green trolley car with a human face, had a furrowed brow when her wheel buckled and she got stuck on a track. But after being rescued by friends, she smiled broadly — and that's when something clicked for little Jude Baines.
"It was revelatory," his mother, Caron Freeborn told AP Television News in Cambridge, England. Before watching the video, Jude didn't understand what emotions were and never noticed the expressions on people's faces, even those of his parents or younger brother.
Jenny's adventures are part of a DVD for autistic children released this week in the United States called The Transporters.
The DVD teaches autistic children how to recognize emotions like happiness, anger and sadness through the exploits of vehicles including a train, a ferry, and a cable car.
It is the brainchild of Simon Baron-Cohen, director of the Autism Research Centre at Cambridge University. He also happens to be a cousin of Sacha Baron-Cohen, the comedian behind the characters Ali G, the aspiring rapper, and Borat, the crass Kazakh reporter.
Baron-Cohen first became interested in autism in the 1980s while teaching autistic children. "Why should social interaction be so difficult for a child who has very good skills in other areas like memory or an attention to detail?" he wondered.
About a decade ago, Baron-Cohen suggested that autism — which is much less likely to afflict girls — might be an extreme version of the typical male brain. Men tend to understand the world via patterns and structure, whereas women are more inclined to understand emotions and sympathize with others.
Autism, Baron-Cohen believes, is a condition where people perceive systems and patterns while remaining almost oblivious to other people and their feelings.
To help autistic children understand emotions, Baron-Cohen and his team use eight track-based vehicles in their DVD. The vehicles have human faces grafted onto them, making focusing on human features unavoidable. The video was financed by the British government.
"To teach autistic children something they find difficult, we needed an autism-friendly format," Baron-Cohen said. Autistic children are particularly drawn to predictable vehicles that move on tracks like trains and trams. For years, parents of autistic children have noted their children's attachment to Thomas the Tank Engine.
"Autistic children are often puzzled by faces, so this video helps focus on them in a way that makes it very appealing and soothing," said Uta Frith, an emeritus professor of cognitive development at University College London, who was not involved in developing the video.
Frith said the DVD was a way for autistic children to learn social skills the way other children might learn math or a foreign language.
In a small study of 20 autistic children between ages 4 and 7, Baron-Cohen and colleagues found that autistic children who watched the video for at least 15 minutes a day for one month had caught up with normal children in their ability to identify emotions.
But Baron-Cohen cautioned that while autistic children might be able to recognize emotions better after watching the DVD, that would not necessarily change their behavior at home or on the playground.
"This is not some kind of miracle cure," he said. "It just shows that if you have the opportunity to practice these social skills, you can improve."
Other experts said the video was not a replacement for working and playing with real people.
"You can't just park your child in front of this for hours and go to the other room," said Catherine Lord, director of the Autism and Communication Disorders Center at the University of Michigan. "This will hopefully start interactions or play sequences that kids can then play with real people."
When the DVD was released in Britain in 2007, Baron-Cohen and colleagues distributed 40,000 copies free to families with an autistic child or to doctors working with them.
The DVD sells for $57.50 and includes interactive quizzes and a booklet for parents and teachers. It is available online at http://us.rd.yahoo.com/dailynews/ap/ap_on_he_me/storytext/eu_med_autism_video/30590580/SIG=110i30vfm/*http://www.thetransporters.com. Half of the profits go to autism charities and research, and the other half goes to Changing Media Development, the company Baron-Cohen launched with colleagues.
Similar videos have been produced, but Lord said those have struggled to capture children's attention. In Baron-Cohen's study, some parents reported that their children watched the DVD hundreds of times within a month.
Freeborn said The Transporters DVD has made a "massive difference" for Jude and their family.
"(Jude) now understands what disgusted is, which is quite important if you have a younger brother," she said.
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