SATURATED fat in red meat has long been linked to heart disease. But new research suggests it might not be the only culprit.
Bacteria in the intestines convert carnitine, a protein building block that's especially plentiful in beef, lamb, and venison, into compounds that speed up hardening and thickening of artery walls, according to a new study.
Generally, the redder the meat, the more carnitine it has. Although pork is considered a red meat, it doesn't have as much carnitine as beef, lamb and venison, and chicken and fish have even less.
Scientists behind the study, published in the journal Cell Metabolism, say their work suggests new targets for drugs to prevent and treat heart disease. And, they say, it raises concerns about the safety of dietary supplements that contain carnitine and a related compound.
The name “carnitine” comes from the Latin word for “meat” or “flesh.” It’s not considered an essential nutrient in food, because “we make all the carnitine we need on our own,” says study researcher Stanley Hazen, MD, PhD, of the Miller Family Heart and Vascular Institute at Cleveland Clinic. “Every cell in our body needs that carnitine,” which is essential for converting fats into energy, he says.
Studies have repeatedly shown a strong link between the amount of red meat people eat and their risk of dying of heart disease, Hazen says. But “the amount of cholesterol and fat in the red meat is not enough for the increased risk that’s observed,” he says. “There’s more to it than just the fat.”
The trillions of microorganisms -- mainly bacteria -- that live in the intestines help with nutrition and the immune system. They're as varied as the people they inhabit, due mainly to diet and genetics.
“When we feed ourselves, we’re feeding our microbes, too,” Hazen says. The more carnitine you eat, the more likely you'll have microbes in your gut that will convert it to the compounds that promote hardening and thickening of artery walls, he said.
“The bacteria in our gut serve as a giant bioreactor,” says Joshua Goldsmith, MD, PhD. He's a gastroenterology resident and post-doc fellow at the University of Michigan who was not involved in the new research. “They have an effect on us, and we have an effect on them.”
The new study, using mice, found that carnitine from the red meat is converted by gut microbes into a substance known as GBB. Then GBB is converted into compounds called trimethylamine (TMA) and TMAO, also by the gut microbes. All of that increases hardening of the arteries.
But give the mice antibiotics to wipe out their gut bacteria, and the level of GBB in their blood drops to near zero, Hazen’s team found.
It’s not that the other stuff is not important,” says Andrew Mendelsohn, PhD, referring to other cardiovascular risk factors. “It’s just that this also is important.” Mendelsohn, who was not involved with Hazen’s study, is president and research director of the Regenerative Sciences Institute in Sunnyvale, CA.
Hazen says his new study isn’t about red meat, but about a compound that is more common in red meat than in chicken or fish. "A logical thing would be to cut back eating the nutrient,” he says of carnitine. Although, he says, "We haven’t directly tested yet whether lowering TMAO in humans will lower cardiac risk.”
He was direct about taking dietary supplements containing carnitine or GBB. “Our data should sound an alarm that we need to look at the safety of long-term supplement exposure,” Hazen says.
Hazen and his collaborators last year published the first paper to examine how gut bugs, together with eating red meat, might play a role in raising the risk of plaque build-up in the arteries.
In that study, his team found that supplementing the diet of mice with carnitine changed the types of bacteria in their gut, leading to increased production of trimethylamine, which then converted into TMAO.
The researchers also measured blood levels of carnitine and TMAO in about 2,600 people being checked for heart problems. They found that those numbers predicted heart disease risk better than cholesterol levels.
PEOPLE who take calcium supplements could be increasing their risk of having a heart attack, according to researchers in Germany.
Calcium is often taken by older people to strengthen bones and prevent fractures.
But the study, published in the journal Heart, said the supplements "should be taken with caution".
Experts say promoting a balanced diet including calcium would be a better strategy.
The researchers at the German Cancer Research Centre, in Heidelberg, followed 23,980 people for more than a decade.
They compared the number of heart attacks in people who were taking calcium supplements with those who did not.
There were 851 heart attacks among the 15,959 people who did not take any supplements at all. However, people taking calcium supplements were 86% more likely to have had a heart attack during the study.
The researchers said that heart attacks "might be substantially increased by taking calcium supplements" and that they "should be taken with caution".
Dr Carrie Ruxton, from The Health Supplements Information Service which is funded supplement manufacturers, said: "Osteoporosis is a real issue for women and it is irresponsible for scientists to advise that women cut out calcium supplements on the basis of one flawed survey, particularly when the link between calcium, vitamin D and bone health is endorsed by the European Food Safety Authority."
The British Heart Foundation (BHF) said patients prescribed the supplements should keep taking their medication, but should also speak to their doctor if they were concerned.
Natasha Stewart, a senior cardiac nurse with the BHF, said: "This research indicates that there may be an increased risk of having a heart attack for people who take calcium supplements.
"However, this does not mean that these supplements cause heart attacks.
"Further research is needed to shed light on the relationship between calcium supplements and heart health. We need to determine whether the potential risks of the supplements outweigh the benefits calcium can give sufferers of conditions such as osteoporosis."
Ian Reid and Mark Bolland, researchers at the University of Auckland in New Zealand, said: "The evidence is also becoming steadily stronger that it is not safe, nor is it particularly effective.
"Therefore, the administration of this micro nutrient should not be encouraged; rather people should be advised to obtain their calcium intake from an appropriately balanced diet.
"We should return to seeing calcium as an important component of a balanced diet and not as a low cost panacea to the universal problem of postmenopausal bone loss."
A spokeswoman for the UK's Department of Health said it would consider the study carefully once the complete article had been published.
"The majority of people do not need to take a calcium supplement," she said.
"A healthy balanced diet will provide all the nutrients, including calcium, that they need. Good sources of calcium include milk and dairy foods, fortified dairy food alternatives, e.g. soya drink, and green leafy vegetables."
IF you've ever been constipated, you know how uncomfortable it can be. Although laxatives can provide a short-term fix, making certain lifestyle changes can help solve the problem for good. Below, medical experts weigh in on seven habits you should avoid to improve your digestive health.
1. Inactivity and Constipation
Lack of exercise not only causes weight gain and other health problems, it can also affect digestion. "Sedentary lifestyle is the thing that I would worry most about," says G. Richard Locke III, MD, gastroenterologist with the Mayo Clinic in Rochester, MN. No one knows exactly why, he says, but being inactive can cause constipation.
What you can do: "The best thing you can do to move your bowels is wake up, eat a real meal, and do some low-level activity," Locke tells WebMD. It doesn't have to be rigorous exercise, he says. Moving your body every day will improve your digestive health.
2. A Low-Fibre Diet Slows Digestion
Fibre is the material in plant foods that your body can't digest, and it's important for good digestion. "It goes through you and gives you something to form a stool around," says Locke. When you don't have enough fibre in your diet, stools can become small, dry, and hard.
What you can do: Eating more fibre adds bulk to stools, making them softer and easier to pass. To get more fibre in your diet, eat more fruits and vegetables, legumes and beans, and whole grains. A simple rule of thumb is to fill half your plate with fruits and vegetables at each meal. Also, always choose whole-grain breads and cereals and include one or two meals a week with beans or legumes. Gradually adding fibre to your diet (and be sure to drink plenty of water) will help prevent bloating and gas. Consider fibre supplements if the methods mentioned above don’t seem to help.
3. Not Drinking Enough Fluids Causes Constipation
When you're dehydrated, your body has less fluid available to keep stools soft. You can become dehydrated and not know it -- especially in hot weather.
"People don't really understand the symptoms of dehydration," says Faten Aberra, MD, MSCE, assistant professor of medicine at the University of Pennsylvania Health System. "It can be as simple as fatigue -- not necessarily this dying thirst to have water. It can be very subtle."
What you can do: You don't necessarily have to drink 6 glasses of water a day to prevent constipation, Aberra says. The key is to drink enough so you don't feel thirsty. You can also tell you're getting enough fluids if your urine is clear or light yellow. And it doesn't have to be water, juice is fine as long as you keep an eye on how many calories you take in, she says. Aberra also suggests limiting alcohol and caffeine because they can cause you to lose fluid through urination.
4. Junk Food and Your Digestive Health
When you eat junk food, you spend your calorie capital on foods that are low in fibre and nutrients and high in fat and sugar. And all that fat and too little fibre can cause digestive woes. "We know that fat tends to slow the gut down, because the gut is trying its best to get all the calories it can from fat," says Locke.
What you can do: You don't have to give up favourite foods -- the trick is to come up with healthy substitutes. Instead of ordering pizza out, make your own with a store-bought whole-wheat crust topped by low-fat cheese and plenty of veggies. Replace the fast-food burger and fries with roasted sweet potato fries and turkey or black bean burgers on a whole-wheat bun.
5. OTC Supplements: A Surprising Cause of Constipation
Did you know that OTC supplements can affect your digestive health? Iron and calcium are the top two culprits according to Aberra.
What you can do: Eating balanced, healthy meals helps you get all the vitamins and minerals you need from food. However, that may not be enough for people with anaemia or for women looking to prevent bone loss. To counter the constipating effect of iron or calcium supplements, Aberra suggests a workaround. Try adding things to your diet that make you more prone to having bowel movements, such as prune juice and high-fibre foods.
6. Overusing Laxatives Can Cause Hard-to-Treat Constipation
Overusing stimulant laxatives can lead to dependence, says Ira Hanan, MD, associate professor of medicine at the University of Chicago Medical Centre. Using these laxatives every day can cause the colon to lose its ability to move things through, he says. Overusing enemas can have the same effect, so avoid using stimulant laxatives and enemas chronically. "They will eventually cause complete dependency and the constipation can be very hard to treat," he says.
What you can do: First of all, consider whether you really need laxatives. "A lot of people think that the daily bowel movement is the norm. We would consider anything from three bowel movements a week to three a day to be normal," Locke tells WebMD. If diet and exercise changes haven't helped, talk with your doctor about using fibre supplements. The problem with fibre for some people is that it may cause bloating and gas. Laxatives containing polyethylene glycol can also be used safely on a more regular basis, he says.
7. "Holding It" Is Bad for Your Digestion
Feel shy about using the office bathroom? Not a fan of public restrooms? You're not alone, according to Ellen Stein, MD. "A lot of people would prefer to go at home," says Stein, an assistant professor of medicine at Johns Hopkins Hospital in Baltimore, MD. Unfortunately, ignoring the urge is bad for your digestive health. "Holding or keeping things longer than you're supposed to can have a negative effect. The natural signals that you hear to tell you when you have to go can be extinguished," she says.
What you can do: Stein advises trying to find a place and time to have a bowel movement. For example, use the bathroom down the hall, rather than the one next to the boss's office.
GOT cellulite? So does just about every woman, no matter what size she is. Some men have it, too.
Some people make their peace with it, comfortable knowing that paparazzi aren't vying to take photos of them in a bikini any time soon. Others wage war against it. Half the battle is knowing what cellulite is and what your weapons are.
How Cellulite Is Like Your Couch
Cellulite is a little bit like upholstery, says Boston dermatologist Molly A. Wanner, MD. Picture pillowy fat attached to the skin by bands called septae.
In women, the septae pull straight down like a button on a cushion, making dimples. Men's septae come in at an angle, disguising them. Guys also have thicker skin than women, helping to hide their cellulite.
"There's no cure," says Neil Sadick, MD, a Manhattan dermatologist who recently reviewed the science behind some of the most popular treatments. "But there are definitely new things out there that can help."
Gaining weight can add to your cellulite by making your fat cells bigger. More fat under the skin can make your legs look lumpier.
Losing weight can reduce the look of cellulite, especially in women who have a lot of extra pounds to lose.
“If you have less fat, you're going to have less cellulite, potentially," Wanner says.
Weight loss isn't the right approach for everyone, though. For women who are already at a healthy weight, dropping a few pounds can loosen skin, making cellulite even more noticeable.
Caffeine and retinol are two ingredients in creams that aim to reduce cellulite.
In test tubes, caffeine and related ingredients shrink fat cells. Still, there's scant evidence that these treatments work when applied to the skin, according to recent research. Any improvement is likely to be temporary and minor.
The Personal Care Products Council, an industry trade group, declined to comment for this story.
Retinol may help boost the amount of collagen in the skin, making it thicker and more elastic. Thicker skin helps make cellulite less noticeable.
In one small study, a cream with .03% retinol improved cellulite when used for at least 6 months. The study found it increased skin thickness by an average of 2 millimetres on a treated leg compared to the skin on an untreated leg.
A study funded by Johnson & Johnson that tested an unnamed anti-cellulite cream with active ingredients including caffeine and retinol found that the cream reduced the size of the stomach, thighs, and upper arms slightly more than a placebo gel when both were used twice daily for 12 weeks.
A treatment for cellulite called endermologie uses rollers and suction to knead the skin, improving circulation.
Treatments last for 10 to 45 minutes and are typically repeated twice weekly for several months. A package of 10 to 12 sessions runs $1,000 and up.
Despite the hefty price, Wanner and Sadick say there's little evidence that it works against cellulite.
At the Doctor's Office
Wanner says a "dizzying" number of machines are available through doctors' offices that promise to treat cellulite without surgery.
Some cellulite machines, such as Vela Smooth, Venus Freeze, Thermage, and Accent XL, use radio wave energy. Others, including Smooth Shapes and Zerona, use lasers. A newer group of machines, such as the Acoustic Wave Therapy system, uses high intensity sound waves.
Lasers and radio waves work by applying heat. The heat is meant to firm and thicken skin, and it may help melt some of the bulging fat underneath. Acoustic waves aim to break up the septae bands that pull down on the skin, creating dimples.
Most of these technologies require multiple treatments. The cost can range from $1,500 to $5,000, depending on how many times you go and which technology you choose.
How much improvement can you expect?
Wanner says even using the best technologies, "about 25% to 50% of people may see an improvement of 25% to 50%, which may diminish over time."
FOR nearly 30 years, HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome) have been shrouded in myths and misconceptions. In some cases, these mistaken ideas have prompted the very behaviours that cause more people to become HIV-positive. Although unanswered questions about HIV remain, researchers have learned a great deal. Here are the top ten myths about HIV, along with the facts to dispute them.
Some 33 million people now live with HIV, worldwide. How did we get here?
Myth No. 1: I can get HIV by being around people who are HIV-positive.
The evidence shows that HIV is not spread through touch, tears, sweat, or saliva. You cannot catch HIV by:
· Breathing the same air as someone who is HIV-positive
· Touching a toilet seat or doorknob handle after an HIV-positive person
· Drinking from a water fountain
· Hugging, kissing, or shaking hands with someone who is HIV-positive
· Sharing eating utensils with an HIV-positive person
· Using exercise equipment at a gym
You can get it from infected blood, semen, vaginal fluid, or mother's milk.
Myth No. 2: I don't need to worry about becoming HIV positive -- new drugs will keep me well.
Yes, antiretroviral drugs are improving and extending the lives of many people who are HIV-positive. However, many of these drugs are expensive and produce serious side effects. None yet provides a cure. Also, drug-resistant strains of HIV make treatment an increasing challenge.
Myth No. 3: I can get HIV from mosquitoes.
Because HIV is spread through blood, people have worried that biting or bloodsucking insects might spread HIV. Several studies, however, show no evidence to support this -- even in areas with lots of mosquitoes and cases of HIV. When insects bite, they do not inject the blood of the person or animal they have last bitten. Also, HIV lives for only a short time inside an insect.
Myth No. 4: I'm HIV-positive -- my life is over.
In the early years of the disease epidemic, the death rate from AIDS was extremely high. But today, antiretroviral drugs allow HIV-positive people -- and even those with AIDS -- to live much longer, normal, and productive lives.
Myth No. 5: AIDS is genocide.
In one study, as many as 30% of African-Americans and Latinos expressed the view that HIV was a government conspiracy to kill minorities. Instead, higher rates of infection in these populations may be due, in part, to a lower level of health care.
Myth No. 6: I'm straight and don't use IV drugs -- I won't become HIV-positive.
Most men do become HIV-positive through sexual contact with other men. However, about 16% of men and 78% of women become HIV-positive through heterosexual contact.
Myth No. 7: If I'm receiving treatment, I can't spread the HIV virus.
When HIV treatments work well, they can reduce the amount of virus in your blood to a level so low that it doesn't show up in blood tests. Research shows, however, that the virus is still "hiding" in other areas of the body. It is still essential to practice safe sex so you won't make someone else become HIV-positive.
Myth No. 8: My partner and I are both HIV positive -- there's no reason for us to practice safer sex.
Practicing safer sex -- wearing condoms or using dental dams -- can protect you both from becoming exposed to other (potentially drug resistant) strains of HIV.
Myth No. 9: I could tell if my partner was HIV-positive.
You can be HIV-positive and not have any symptoms for years. The only way for you or your partner to know if you're HIV-positive is to get tested.
Myth No. 10: You can't get HIV from oral sex.
It's true that oral sex is less risky than some other types of sex. But you can get HIV by having oral sex with either a man or a woman who is HIV-positive. Always use a latex barrier during oral sex.
NEARLY everyone has days when they feel sleepy. But for some people, excessive sleepiness actually gets in the way of daily work, child care, and even leisure activities. This is known as hypersomnia, recurrent sleepiness that makes people want to nap repeatedly, even at work.
Not surprisingly, the problem of daytime sleepiness usually starts at night. Even missing just a few nights’ sleep, or not getting enough uninterrupted sleep, can slow you down and sour your mood.
Poor sleep habits are often the cause of daytime sleepiness. Before you go through any more groggy and crabby days, try these 12 ways to improve night time sleep and avoid daytime sleepiness.
That may sound obvious, but many of us succumb to shaving an hour or two off our sleep time in the morning or at night to do other things. Most adults need seven to nine hours a night, and teenagers usually need a full nine hours. Block out eight or nine hours for sleep every night.
“Reserve your bed for sleep and sex,” says Avelino Verceles, MD, assistant professor at the University of Maryland School of Medicine and director of the school’s sleep medicine fellowship. “You shouldn’t read, watch TV, play video games, or use laptop computers in bed.” Don’t do your bills or have heated discussions in bed either. They may leave you sleepless.
People who have problem sleepiness are often advised to go to bed and get up at the same time every day, including on weekends. But randomly setting an ideal bedtime can lead to more frustration if you suffer from insomnia and already have trouble falling asleep, says Barry Krakow, MD, medical director of Maimonides Sleep Arts and Sciences Ltd. in Albuquerque, N.M., and author of Sound Sleep, Sound Mind: 7 Keys to Sleeping Through the Night.
Instead, Krakow suggests starting out by setting a wake-up time only. “Stick by that for the first few weeks or even months to establish a rhythm,” he says. “That process of always getting up at the same time helps to anchor the circadian rhythm. And if you do that and have a bad night, you’ll also to be sleepier the next bedtime.”
Another approach to getting into a consistent schedule is to try going to bed 15 minutes earlier each night for four nights. Then stick with the last bedtime. Gradually adjusting your schedule like this usually works better than suddenly trying to go to sleep an hour earlier.
Regular mealtimes, not just regular sleep times, help regulate our circadian rhythms. Eating a healthy breakfast and lunch on time -- rather than grabbing a doughnut and coffee in the morning or a late sandwich on the run -- also prevents energy deficits during the day that will aggravate your sleepiness. Plan to finish eating meals two to three hours before bedtime.
Regular exercise (30 minutes a day on most days) offers multiple benefits for sleep. Exercise, especially aerobic exercise, generally makes it easier to fall asleep and sleep more soundly.
Exercise also gives you more daytime energy and keeps your thinking sharp. And if you exercise outside in daylight, you get still more benefits. Sleep experts recommend 30 minutes of exposure to sunlight a day because daylight helps regulate our sleep patterns. Avoid exercising within three hours of bedtime.
7. De-clutter your schedule
“If you don’t think you can allow seven or eight hours for sleep, then you need to look at your schedule and make some adjustments,” says Verceles. “Move some activities from night time to early evening or from early to late morning.” Try to eliminate tasks that aren’t really important. Getting enough sleep at night will help you function better during your remaining activities.
8. Don’t go to bed until you’re sleepy
If you go to bed when you’re just tired, you probably won’t be able to fall asleep, Krakow says. “Distinguish between the feeling of sleepiness and being tired. Get into bed when you’re sleepy -- eyes droopy, you’re drowsy, you feel like you’re nodding off. It’s a very different kind of feeling.”
9. Don’t nap late in the day
Late afternoon napping can make daytime sleepiness worse if because it can interfere with night time sleep.
10. Create a relaxing bedtime ritual
A relaxation routine before bedtime can help you separate from the day -- especially from activities that are over-stimulating or stressful, making it difficult to sleep. Try meditation, soaking in a hot bath, listening to soothing music, or reading a book. A cup of herbal tea or warm milk can also be soothing, but skip those if they cause you to wake at night to go to the bathroom.
11. Avoid "nightcaps"
People often think that alcohol helps sleep, but it actually robs you of deep sleep, which is essential for feeling well rested. When the effects of alcohol wear off during the night, you’ll probably be wide awake again.
12. See a sleep specialist
Daytime sleepiness can be caused by sleep disorders. If you are excessively sleepy consistently during the day even when you sleep well or if you fall asleep without warning during daily activities, you may have a sleep disorder such as narcolepsy or sleep apnoea, a breathing problem that occurs during sleep. According to Krakow, undiagnosed and untreated sleep disorders are probably the greatest cause of daytime fatigue and sleepiness.
Problem sleepiness can also be caused by certain illnesses and medications. And mental conditions such as depression, posttraumatic stress disorder, and anxiety are very commonly linked to sleep problems.
A sleep specialist can design a treatment program for you that treats the underlying sleep disorder and helps you develop better sleep habits and attitudes though cognitive behavioural therapy. Sometimes it takes a combination of medication and behavioural therapy to eliminate daytime sleepiness, but it can be done.
DID you have to go and do it all the time? The technical name for your problem is frequent urination. In most people the bladder is able to store urine until it is convenient to go to the toilet, typically four to eight times a day. Needing to go more than eight times a day or waking up in the night to go to the bathroom could mean you're drinking too much and/or too close to bedtime. Or it could signal a health problem.
Causes of Frequent Urination
Frequent urination can be a symptom of many different problems. When frequent urination is accompanied by fever, an urgent need to urinate, and pain or discomfort in the abdomen, you may have a urinary tract infection. Other possible causes of frequent urination include:
Diabetes: Frequent urination is often an early symptom of both type 1 and type 2 diabetes as the body tries to rid itself of unused glucose through the urine.
Pregnancy: From the early weeks of pregnancy the growing uterus places pressure on the bladder, causing frequent urination.
Prostate problems: An enlarged prostate can press against the urethra (the tube that carries urine out the body) and block the flow of urine. This causes the bladder wall to become irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination.
Interstitial cystitis: This condition of unknown cause is characterized by pain in the bladder and pelvic region. Often, symptoms include an urgent and/or frequent need to urinate.
Diuretic use: These medications that are used to treat high blood pressure or fluid buildup work in the kidney and flush excess fluid from the body, causing frequent urination.
Stroke or other neurological diseases: Damage to nerves that supply the bladder can lead to problems with bladder function, including frequent and sudden urges to urinate.
Less common causes include bladder cancer, bladder dysfunction, and radiation therapy.
Often, frequent urination is not a symptom of a problem, but is the problem. In people with overactive bladder syndrome, involuntary bladder contractions lead to frequent and often urgent urination, meaning you have to get to a bathroom right now -- even if your bladder is not full. It may also lead you to wake up once or more during the night to use the bathroom.
Diagnosing the Cause of Frequent Urination
If urinary frequency interferes with your lifestyle or is accompanied by other symptoms such as fever, back or side pain, vomiting, chills, increased appetite or thirst, fatigue, bloody or cloudy urine, or a discharge from the penis or vagina, it's important to see your doctor.
To diagnose the cause of frequent urination, your doctor will perform a physical exam and take a medical history, asking questions such as the following:
· Are you taking any medications?
· Are you experiencing other symptoms?
· Do you have the problem only during the day or also at night?
· Are you drinking more than usual?
· Is your urine darker or lighter than usual?
· Do you drink alcohol or caffeinated beverages?
Depending on the findings of the physical exam and medical history, your doctor may order tests, including:
Urinalysis: The microscopic examination of urine that also involves a number of tests to detect and measure various compounds that pass through the urine
Cystometry: A test that measures the pressure inside of the bladder to see how well the bladder is working; cystometry is done to determine if a muscle or nerve problem may be causing problems with how well the bladder holds or releases urine.
Cystoscopy: A test that allows your doctor to look at the inside of the bladder and urethra using a thin, lighted instrument called a cystoscope
Neurological Tests: Diagnostic tests and procedures that help the doctor confirm or rule out the presence of a nerve disorder
Ultrasonography: A diagnostic imaging test used to visualize an internal body structure
Treatment for Frequent Urination
Treatment for frequent urination will address the underlying problem that is causing it. For example, if diabetes is the cause, treatment will involve keeping blood sugar levels under control.
The treatment for overactive bladder should begin with behavioral therapies, such as:
· Bladder retraining: This involves increasing the intervals between using the bathroom over the course of about 12 weeks. This helps retrain your bladder to hold urine longer and to urinate less frequently.
· Diet modification: You should avoid any food that appears to irritate your bladder or acts as a diuretic. These may include caffeine, alcohol, carbonated drinks, tomato-based products, chocolate, artificial sweeteners, and spicy foods. It's also important to eat high-fiber foods, because constipation may worsen the symptoms of overactive bladder syndrome.
· Monitoring fluid intake: You should drink enough to prevent constipation and over-concentration of urine, but you should avoid drinking just before bedtime, which can lead to nighttime urination.
· Kegel exercises: These exercises help strengthen the muscles around the bladder and urethra to improve bladder control and reduce urinary urgency and frequency. Exercising pelvic muscles for five minutes three times a day can make a difference in bladder control.
Treatment may also include drugs such as Detrol LA, Ditropan, Enablex, Oxytrol, Myrbetriq, Sanctura XR, Tofranil, and Vesicare. Oxytrol for women is the only drug available over the counter.
There are other options for those that do not respond to lifestyle changes and medication. The drug Botox can be injected into the bladder muscle causing the bladder to relax, increasing its storage capacity, and reducing episodes of leakage.
Several types of surgery are also available. The least invasive involve implanting small nerve stimulators just beneath the skin. The nerves they stimulate control the pelvic floor and the devices can manipulate contractions in the organs and muscles within the pelvic floor.
A MEDITERRANEAN diet may be a better way of tackling obesity than calorie counting, leading doctors have said.
Writing in the Postgraduate Medical Journal (PMJ), the doctors said a Mediterranean diet quickly reduced the risk of heart attacks and strokes.
And they said it may be better than low-fat diets for sustained weight loss.
Official NHS advice is to monitor calorie intake to maintain a healthy weight.
Last month NHS leaders stressed the need for urgent action to tackle obesity and the health problems that often go with it.
The PMJ editorial argues a focus on food intake is the best approach, but it warns crash dieting is harmful.
Signatories of the piece included the chair of the Academy of Medical Royal Colleges, Prof Terence Stephenson, and Dr Mahiben Maruthappu, who has a senior role at NHS England.
They criticise the weight-loss industry for focusing on calorie restriction rather than "good nutrition".
And they make the case for a Mediterranean diet, including fruit and vegetables, nuts and olive oil, citing research suggesting it quickly reduces the risk of heart attacks and strokes, and may be better than low-fat diets for sustained weight loss.
The lead author, cardiologist Dr Aseem Malhotra, says the scientific evidence is overwhelming.
"What's more responsible is that we tell people to concentrate on eating nutritious foods.
Inspired by traditional cuisine of countries such as Greece, Spain and Italy, the Mediterranean diet has long been associated with good health and fit hearts.
Typically, it consists of an abundance of vegetables, fresh fruit, wholegrain cereals, olive oil and nuts, as well as poultry and fish, rather than lots of red meat and butter or animal fats.
"It's going to have an impact on their health very quickly. We know the traditional Mediterranean diet, which is higher in fat, proven from randomised controlled trials, reduces the risk of heart attack and stroke even within months of implementation."
The article also says adopting a Mediterranean diet after a heart attack is almost three times as effective at reducing deaths as taking cholesterol-lowering statin medication.
The authors argue the NHS is in a "key position" to set a national example by providing healthy food in hospitals and by ensuring doctors and nurses understand the evidence.
Prof Stephenson says the service can exert a powerful influence, for good or ill.
"Our hospitals and surgeries are the frontline for delivering health, it's nothing more than common sense then that we should be leading by example.
"We wouldn't dream of letting people drink alcohol or smoke in any healthcare environment, so I find it incomprehensible that we facilitate and sometimes actively promote food and drink that in some ways cause as many problems. And although some positive steps have been taken on the food given to patients in hospital, their visitors and staff also deserve better."
Public Health England is reviewing the dietary advice conveyed in the "eatwell plate" - which is used across the UK for guidance on what food to eat. Its recommendations include calorie-counted recipes to help achieve a healthy weight.
Dr Alison Tedstone, the chief nutritionist at Public Health England, said there was no single silver-bullet solution.
"Government advice is to eat plenty of bread, rice, potatoes, pasta and other starchy foods, plenty of fruit and vegetables; and some milk and dairy products, meat, fish, eggs, beans and other sources of non-dairy protein.
"Foods high in salt, fat and sugar should be eaten less often and in small amounts. If you are currently overweight you will need to eat less to achieve a healthy weight and be active as part of a healthy lifestyle."
The chairman of the National Obesity Forum, professor David Haslam, welcomed the article.
"A calorie is not just a calorie and it is naive for anyone to think the complex hormonal and neurological appetite systems of the body respond to different substances in the diet in identical fashion."
He said banning fast food outlets in hospitals would be a "legal minefield" given the extended contracts in existence. But he said healthy nutrition programmes could be put in place - as has happened in other big organisations - to counter what he called their "sinister effect".
THE worldwide cost of obesity is about the same as smoking or armed conflict and greater than both alcoholism and climate change, research has suggested.
The McKinsey Global Institute said it cost £1.3tn, or 2.8% of annual economic activity - it cost the UK £47bn.
Some 2.1bn people - about 30% of the world's population - were overweight or obese, the researchers added.
They said measures that relied less on individual responsibility should be used to tackle the problem.
The report said there was a "steep economic toll", and the proportion could rise to almost half of the world's population by 2030.
The financial costs of obesity are growing - for health care and more widely in the economy. By causing illness, obesity results in working days and output lost.
The researchers argued that a range of ambitious policies needed to be considered and a systemic rather than piecemeal response was essential.
"These initiatives would need to draw on interventions that rely less on individual responsibility and more on changes to the environment," the report said.
If the right measures were taken there could be long-term savings of £760m a year for the UK's National Health Service, it added.
The initiatives assessed in the report include portion control for some packaged food and the reformulation of fast and processed food.
It said these were more effective than taxes on high-fat and high-sugar products or public health campaigns. Weight management programmes and workplace fitness schemes were also considered.
The report concluded that "a strategy of sufficient scale is needed as obesity is now reaching crisis proportions".
The rising prevalence of obesity was driving the increase in heart and lung disease, diabetes and lifestyle-related cancers, it said.
Dr Alison Tedstone, chief nutritionist at Public Health England (PHE), said: "The report is a useful contribution to the obesity debate. PHE has consistently said that simple education messages alone are not enough to tackle obesity."
Dr Tedstone said obesity required action across national and local government, industry and society as a whole, and there was "no single silver bullet solution".
The report was produced by McKinsey Global Institute, the business and economics research arm of consultancy firm McKinsey & Company.
THE Bill and Melinda Gates Foundation has pledged $5.7m towards a programme to increase production of experimental Ebola treatments in Guinea and other affected countries.
The programme will focus on treatments derived from the blood of survivors.
The foundation also said the grant would be used to evaluate new experimental drugs.
More than 5,000 people have died in the current Ebola outbreak - almost all of them in West Africa.
There is currently no licensed treatment or vaccine for the Ebola virus. Hospital treatment is based on giving patients fluids to stop dehydration and antibiotics to fight infections.
There are, however, several experimental vaccines and drug treatments for Ebola under development, but these have not yet been fully tested for safety or effectiveness.
The medical charity Medecins Sans Frontieres is to start clinical trials of some of these treatments in West Africa in December.
The foundation, run by former Microsoft boss Bill Gates and his wife Melinda, said that it would work with several private partners to develop convalescent plasma treatments.
The treatments would used blood donated from Ebola survivors who had been screened for diseases.
The liquid plasma from the blood, containing disease-fighting antibodies, would then be isolated and given directly to patients.
The remaining blood could then be returned to the donor, allowing them to donate blood at a faster rate than before.
Dr. Papa Salif Sow, an infectious diseases expert working with the foundation, said that the programme would work with governments to "to rapidly identify and scale up potential lifesaving treatments".
"The Gates Foundation is focusing its R&D investments on treatments, diagnostics, and vaccines that we believe could be quickly produced and delivered to those who need them if they demonstrate efficacy in stopping the disease" he said.