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Does junk food at non-food stores add pounds?

Does junk food at non-food stores add pounds?

A new study shows that candy, soda and other junk foods are commonly sold at stores not traditionally associated with food — in a trend that researchers say may be contributing to the U.S. obesity problem.

The study, of more than 1,000 non-food retail stores across the U.S., found that 41 percent sold candy, soft drinks, chips and other sweet and salty snacks. The foods were most commonly placed at check-out counters, where they were “within arm’s reach” of impulsive buyers, the researchers report in the American Journal of Public Health.

Nearly all drug stores and gas stations in the study sold snack foods — as did a majority of general merchandise stores, hardware and garden stores and automobile repair shops.

Even some stores selling clothes, books or furniture offered customers a snack selection.

The problem, the researchers contend, is that this “ubiquity” of snack foods may tempt many people into buying calories that they otherwise would not.

And over time, those calories could add up to extra pounds, write Dr. Thomas A. Farley and colleagues at Tulane University School of Public Health in New Orleans.

A number of studies, the researchers note, have found that when people grab snacks throughout the day, they typically do not compensate by eating less at meals.

“This suggests that calories consumed through impulse purchases of snack foods will increase total daily (calorie) intake and thus contribute to weight gain,” Farley and his colleagues write in their report.

They estimate that if a person sees snack foods at retail stores twice per week, and ends up buying a typical product only 10 percent of the time, that would mean an extra 2,600 calories in a year. That, in turn, could translate to close to a pound of weight gain per year.

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More women having a healthy breast removed

how-to-get-rid-of-breast-cysts

More women having a healthy breast removed

A small but growing number of women with breast cancer are choosing to have the unaffected breast removed in an effort to prevent a recurrence, researchers reported Monday.

Using data from New York State hospitals, the researchers found that between 1995 and 2005, the prevalence of preventive mastectomy among women with a history of cancer in one breast more than doubled.

The procedure was performed in about 2 percent of all women diagnosed with breast cancer in 1995 and 1996 — rising to just over 4 percent by 2005.

In contrast, there was only a small increase in preventive mastectomies among women who had no personal history of breast cancer but were considered at risk because of a strong family history of the disease.

The findings suggest that while the number of preventive mastectomies performed each year in New York was small, the procedure is becoming more common, the researchers report in the journal Cancer.

The more marked increase among women with a history of breast cancer raises some concerns, senior researcher Dr. Stephen B. Edge, of the Roswell Park Cancer Institute in Buffalo, told Reuters Health.

The central issue, he explained, is that there is no evidence that removing the unaffected breast improves long-term survival.

While preventive mastectomy likely cuts the chances of cancer developing in the second breast, the ultimate impact on survival is a more complicated matter.

Edge noted that among women who are not at high genetic risk of breast cancer — about 95 percent of all breast cancer patients — the odds of developing cancer in the second breast are between 10 percent and 20 percent over 20 to 30 years.

So in deciding whether to have a preventive mastectomy, women need to consider the uncertain long-term benefits and the risk of complications — which include bleeding, infection and nerve damage.

“Women need to be carefully counseled on the issues of the risks of developing a second cancer, and the largely minimal or no impact this may have on their survival,” Edge said.

The study findings are based on data from hospital discharge records and the New York State cancer registry. Of the nearly 70,000 women who underwent mastectomies between 1995 and 2005, 9 percent — 6,275 women — had one for preventive reasons.

Of women having a preventive mastectomy, 81 percent had a history of breast cancer. The number of these procedures rose from 295 in 1995 to 683 in 2005.

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More women choose do-it-yourself births

12Jennifer Margulis, 40, of Ashland, Ore., delivered  daughter Leone Francesca at home Nov. 4 without medical help. More women are opting for unattended births.

More women choose do-it-yourself births

A growing number are having babies at home without medical help

Jennifer Margulis thinks birth should be a private party — no doctors or midwives invited. So when her daughter Leone Francesca was born at home last month, only Margulis and her husband, James, were in attendance.

“My husband and I were the only ones there when she was conceived,” says the 40-year-old writer from Ashland, Ore. “I thought we should be the only ones there when she was born.”

Margulis is part of a very small but growing number of women who are choosing to deliver their babies at home without the presence of health professionals. Some choose to have a husband or another family member help, while others opt to deliver their babies completely on their own.

The number of home births unattended by either a doctor or a midwife jumped by nearly 10 percent between 2004 and 2006, climbing from 7,607 unassisted births to 8,347 births, according to most recent figures from the National Center for Health Statistics. About 60 percent of the nearly 25,000 home births logged in 2006 were attended by midwives, a figure that experts expect will also rise.

While do-it-yourself deliveries are still uncommon, many doctors and midwives consider them dangerous. Risks can range from hemorrhage in the mother to problems with the baby’s oxygen supply during delivery.

“Most births are not complicated but when something goes wrong, everything happens very quickly and things can go downhill very fast,” says Donna Strobino, a professor and deputy chair in the department of maternal and child health at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

“If you look at data from developing countries where unattended births are more common, you see a higher rate of infant and maternal mortality with unattended births than with hospital births.”

Even among healthy women with no clear risk factors, life-threatening complications can arise suddenly, says Dr. Hyagriv Simhan, an associate professor of obstetrics and gynecology and chief of maternal-fetal medicine at the Magee-Womens Hospital of the University of Pittsburgh Medical Center. “There are lots of women who experience unpredictable bad events,” Simhan says.

Shauna Schoenborn, a stay-at-home mom from Imperial, Mo., and other advocates of unassisted birth aren’t swayed by doctors’ warnings. To them, pregnancy and delivery are natural processes that the medical establishment has turned into disease that must be managed.

After giving birth to her first baby in the hospital, Schoenborn, 31, chose to have her next four children at home — by herself. Although her husband was in the house during the births, he didn’t help with the deliveries.

“My hospital births were very managed,” says Schoenborn. “I wanted privacy and to be free of internal exams. I wanted to give birth in an upright position and they want you to lie down. I feel birth is an instinctive process and in the hospital they treat women like they’re broken and birth like an illness.”

‘I know my body’
Schoenborn also chose not to have prenatal care from a medical professional. That meant no internal exams and no ultrasounds to check for twins and fetal development. “I would know if I was carrying twins,” Schoenborn says. “I know my body.”

For Margulis, the biggest problem in the hospital — and even at home with a midwife — was interference with “normal” labor. When a pregnant woman enters the hospital, Margulis says, she’s signing on for a host of unnecessary interventions, including multiple internal exams, a greatly increased likelihood of receiving the drug oxytocin to speed delivery and also of a Caesarean section.

Margulis’ first baby was born in a hospital and the next two were at home with a midwife. Margulis wasn’t happy with either experience and decided she wanted more control over the process.

After researching the do-it-yourself option, she felt assured the birth process is “safer than taking a shower.”

Margulis cited a recent Canadian study that found giving birth at home with a midwife was about as safe for babies and moms as in a hospital, with the rate of newborn deaths about two per 1,000 for planned home births. The rate of C-sections was a few percentage points higher in hospitals.

However, the women in the studies were very healthy, had no risk factors, and had small-sized babies, says Dr. Harish M. Sehdev, an assistant professor of clinical obstetrics and gynecology and director of labor and delivery at Pennsylvania Hospital in Philadelphia. Hospitals generally have much higher C-section rates because they treat a variety of new moms, including those who are overweight, have big babies and have lots of risk factors like diabetes and high blood pressure.

In addition, one in 20 women who had chosen to give birth at home ended up delivering in the hospital. “And those were the low-risk women,” Sehdev adds.

More important, says midwife Pamela Kane, Margulis is “comparing apples and oranges.” The studies cited by Margulis are looking at home births with midwives present, not unattended births, which are more risky because you don’t have a trained professional nearby who can spot the early warning signs of a serious problem, says Kane, a certified nurse midwife at Pennsylvania Hospital.

And while women like Margulis and Schoenborn may not like being put on a birthing schedule, experts say there are reasons doctors choose to intervene with oxytocin or a C-section if the labor isn’t progressing fast enough. Among them is the risk of damage to the musculature of the pelvic floor if women strain too long, says Sehdev.

When those muscles are damaged, it weakens the moorings that hold the uterus, the bladder and the bowels in place. The impact of that may not be seen till women hit their 50s and 60s, when the organs can unexpectedly drop down into the vaginal canal.

The choices women make might change if they saw the catastrophes that nobody likes to talk about, says Sehdev. “I’ve known women who lost their babies because the baby got stuck and they couldn’t get to the hospital fast enough,” he explains.

Those realities have affected the way Augustine Colebrook looks at unattended births. Colebrook had three children on her own before going back to school to become a midwife so that she could help with births herself.

“I struggle with myself wondering if I would have another kid unattended, after being a midwife for almost 10 years,” says the 33-year-old from Ashland, Ore., who consulted with Margulis during pregnancy. “I think I probably would — it was a life-changing experience. But I’m not sure.”

Margulis, however, says she finally experienced the kind of birth she wanted.

“It was absolutely incredible, a totally empowering experience,” she said. “When you give birth by yourself, you realize how powerful and strong your body is.”

Linda Carroll is a health and science writer living in New Jersey. Her work has appeared in The New York Times, Newsday, Health magazine and SmartMoney.

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