BodySense Blog

Alzheimer's disease risks are gender specific

The risks of developing Alzheimer's disease differ between the sexes, with stroke in men, and depression in women, critical factors, according to a French study.

Dr. Karen Ritchie at La Colombiere Hospital in Montpellier and colleagues studied 6892 adults age 65 and older. At the start of the study between 1999 and 2001, none had dementia, but 42 percent were deemed to have mild cognitive impairment.

In all, just over 6.5 percent of those deemed to be cognitively impaired developed dementia over the next four years, whereas 37 percent returned to normal levels of functioning. In just over half, no change was seen.

Progression from mild cognitive impairment to dementia was more likely among those who were depressed and who were taking so-called anticholinergic drugs, which influence chemical signalling in the brain.

A variation in the ApoE gene -- a known risk factor for dementia -- was also more common among those whose mild cognitive impairment progressed to dementia.

But risk factors also differed between the sexes, the results showed.

Men with mild cognitive impairment were more likely to be overweight, diabetic, and to have had a stroke. Men who had had a stroke were almost three times as likely to progress.

Women with mild cognitive impairment, on the other hand, were more likely to be in poorer general health, disabled, suffering from insomnia and to have a poor support network.

Women incapable of performing routine daily tasks, which would allow them to live without assistance, were 3.5 times as likely to progress. And those who were depressed were twice as likely to do so.

Stroke was not a risk factor for progression to dementia in women.

According to the investigators, novel risk factors for impaired cognition were recent anesthesia, less consumption of caffeine, tobacco and alcohol, appetite loss, and in women, less use of hormone replacement therapy.

Reuters

Is There a Fat Gene?

You choose fruit instead of fries, put in your hour at the gym 3 times a week and take the stairs instead of the elevator. Yet those 10 or 20 extra pounds stubbornly refuse to disappear.

"Hey, it's not my fault," you'd like to say. "It's just the way I'm wired."

If only it were that simple. While it is true that your parents are partly to blame — if one or both is obese, you have a greater chance of being overweight¹ — genetics alone are not solely responsible for weight issues. Nor, it turns out, is there one specific genetic culprit.

"There are many different genes that regulate body weight," says Andrew S. Greenberg, M.D., director of the Obesity and Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University in Boston, Mass., and one of the world's foremost authorities on fat-cell metabolism.

According to Greenberg, scientists are still trying to get a better idea of the role that genes might play in weight gain. "We're at least 10 years away from finding more specific answers," he says.

In 1991, while a fellow at the National Institutes of Health (NIH) in Bethesda, Md., Greenberg and his colleagues made a groundbreaking discovery — a new protein within fat cells called perilipin.

"It coats the surface of fat that's stored in fat cells," he says. "And its level seems to regulate the breakdown of fat." The more perilipin in your fat cells, the more fat that gets stored rather than broken down.

"Probably a current estimate is 30 to 60% of weight gain is heredity," says Michael L. Goran, Ph.D., professor of preventive medicine, physiology and biophysics at the University of Southern California's (USC) Keck School of Medicine, and associate director of the medical school's Institute for Health Promotion and Disease Prevention Research.

To illustrate, he recalls a classic experiment in which identical twins with the same genes were overfed by the same amount. Certain twin pairs gained a lot of weight, while some pairs didn't gain at all. Within each twin pair, however, they gained about the same.

Of course, environment and lifestyle also greatly affect weight issues. "If you try to link when [the epidemic of] obesity started, there's a pretty good relationship to when cars became popular — around the '50s and '60s," says Robert Girandola, Ph.D., a USC associate professor of kinesiology, and a nutrition and obesity expert.

The advent of television just made us even more sedentary. And we're not getting any thinner. "Since 1990, the level of overweight people in the United States has gone from 51% to 65%," he says. "People are eating all day long. And, at the same time, our activity has gone down."

Our genetics are at odds with our diet and environment. "Essentially, the whole body is engineered to survive with limited nutrients," says Zhaoping Li, M.D., associate professor of clinical medicine at the University of California, Los Angeles, Center for Human Nutrition, and its director for clinical research. "And we're genetically built for being active 12 hours a day."

Since most of us are tied to our desks, Li recommends being as consciously active as possible — apart from a set exercise schedule.

"Never stop moving around," she says. "Burn calories by cleaning the house yourself instead of hiring a maid. Walk around while you're on the phone. And," she adds, citing a 2005 Mayo Clinic study that monitored weight loss from fidgeting and other spontaneous movement, "if you can stand, don't sit."

Led by endocrinologist James Levine, M.D., the study tracked the body postures and movements of 20 people — 10 obese, 10 lean — at half-second intervals around the clock for a total of 10 days. On average, the obese subjects sat 150 minutes more per day than the lean subjects — which translated to 350 fewer calories being burned daily than the lean subjects.

But since losing weight didn't cause the obese subjects to spend more time standing, Levine concluded that their behavior was due to a brain chemical difference rather than a lack of motivation.²

This means that if you gain weight easily, you need to force yourself to park further away from the store or take a walk during your lunch hour. And, of course, eat less while making smart, healthful food choices. "Eat fruits, vegetables, lean proteins, very limited treats," Li recommends.

"Obesity is driven by acquired behavior," Goran says. "Unlike smoking, we have to eat. That's the irony and what makes it more challenging. Humans are designed to hunt for calories, and body fat is the only way that the body can store calories."

But our hunting days are long gone. In today's society — with drive-thru and delivery — we sit in our cars or houses, and the food comes directly to us.

Finding a balance between your weight goals and your lifestyle is key. And anyone who has tried to lose weight knows that's a difficult goal. "You can always exercise and eat less," says Greenberg, who's been studying fat genes for the past 15 years. "But in reality, people are busy, so it's not easy to do."

Revolution Health Group

Family Health History: What You Need to Know

You think your grandmother on your mom's side might have had breast cancer. Or maybe it was your aunt — and was it colon cancer?

When you're faced with a lengthy medical history form, tracing the roots of your family tree in your head in order to figure out exactly who had what and when can leave just about anyone scratching their head. That's where a complete family health history comes in handy.

A family health history of close relatives can serve as a sort of guide — a cheat sheet, if you will — to help you act as your own proactive health advocate to:

• assess your risks
• find out what you can start doing today to help decrease your chances of getting any chronic conditions that may run in your family

It seems simple enough. Yet according to a November 12, 2004, study in the journal Morbidity and Mortality Weekly (MMWR), only 30 percent of the nearly 4,500 people surveyed had actually made an effort to research their family health history (even though 96 percent believed that knowing was important).

What does it all mean?

According to the National Office of Public Health Genomics (NOPHG), a part of the U.S. Centers for Disease Control and Prevention (CDC), your family health history may indicate an increased risk if it shows diseases that:

• occur in two or more family members
• happened earlier than normal (for example, a decade or two before most people are diagnosed)
• don't often happen to a particular sex (like breast cancer in men)come in certain related combinations (like thyroid cancer and colon polyps, or colon and endometrial cancer, says the American Medical Association)

But genes aren't the only factors behind diseases that may be common from generation to generation — environment and lifestyle are often at play, too. So, even if conditions affecting family members aren't inherited, you may still be at risk if you've taken up their same habits.

If there's a pattern of certain diseases in your family, your doctor may refer you to a specialist or genetic counselor and/or recommend some preventive measures like:

• getting diagnostic or screening tests (like colonoscopies or mammograms) to detect diseases early on
• keeping an eye on potential problems (for example, high blood pressure or elevated cholesterol)
• making any necessary lifestyle changes (like watching what you eat, quitting smoking and exercising more)

Where to start?

To keep track of all your notes and information, use a family tree (aka pedigree) like the one on the National Society of Genetic Counselors' website. Or opt for a program like the U.S. Surgeon General's free customizable Web-based tool, My Family Health Portrait.

After jotting down your own past and present health information (as well as your kids'), Charles W. Smith, M.D., a board-certified family physician and the founder of the Little Rock, Ark.-based eDocAmerica.com site, says to ask both your mother and father: "What, if any, significant medical problems did you, your siblings (aunts and uncles) or your parents (my grandparents) have?"

Also talk to your siblings and then go back to other generations, recommends the National Society of Genetic Counselors. This includes nieces and nephews, aunts and uncles, cousins and grandparents on each side of the family. Use reunions and family get-togethers to your advantage.

Ask everyone about:

• heart disease (the leading killer of both men and women in the United States)
• cancer (breast, colon, lung, ovarian, prostate, etc.)
• diabetes (type 1 and 2)
• osteoporosis
• stroke
• high blood pressure (hypertension)
• Alzheimer's disease
• seizure disorders
• kidney disease
• asthma and significant allergies
• serious mental health disorders (like depression and bipolar disorder)
• mental retardation
• substance abuse problems (alcohol or drugs)
• birth defects
• learning problems
• vision or hearing loss

Get specifics about the type of disease (for example, the kind of cancer or diabetes), how conditions were treated, whether diseases were well-controlled and whether there were any complications, Smith says.

Also find out more details about family members, such as:

• date and place of birth
• at what age they were diagnosed with certain conditions
• at what age certain family members died and the cause of death
• ethnic origin (because some hereditary conditions are more prevalent in particular ethnicities)
• lifestyle — eating, exercising, smoking, drinking or drug habits

If you were adopted, talk to your birth parents, your adoption agency or your state's health and social services agency to find out about accessing your biological parents' legal or medical records, says the NOPHG.

Putting it in perspective

Your family health history is not a death sentence or an absolute prediction of your future fate. Even if one or more of your immediate family members has or had a serious disease doesn't mean that you'll get it, too.

"I spend lots of time assuring women that they really aren't at significantly greater risk because their Dad's mom had breast cancer — and reassuring them that increased risk means only that," says Vivian M. Dickerson, M.D., the executive medical director of women's health at Hoag Hospital in Newport Beach, Calif., and past president of the American College of Obstetricians and Gynecologists (ACOG).

"The best thing about knowing your risks is that you can do things to reduce those risks — things that you might have just skipped if you were less aware," she says. "Knowledge is power and prevention beats cure any time!"

Revolution Health Group

A New Level Of Mastery

Coming Full Circle

Life is a circular journey through our issues and processes, and this is why things that are technically new often seem very familiar. It is also why, whenever we work to release a habit, change a pattern, or overcome a fear, we often encounter that issue one last time, even after we thought we had conquered it. Often, when this happens, we feel defeated or frustrated that after all our hard work we are still dealing with the same problem. However, the reappearance of a pattern, habit, or fear, is often a sign that we have come full circle, and that if we can maintain our resolve through one last test, we will achieve a new level of mastery in our lives.

When we come full circle, there is often the feeling that we have arrived in a familiar place, but that we ourselves are somehow different. We know that we can handle challenges that seemed insurmountable when we began our journey, and there is the feeling that we might be ready to take on a new problem, or some new aspect of the old problem. We feel empowered and courageous to have taken on the challenge of stopping a pattern, releasing a habit, or overcoming a fear, and to have succeeded. At times like these, we deserve a moment of rest and self-congratulation before we move on to the next challenge.

Coming full circle is like stepping into a clearing where, for a moment, we can see where we came from and where we are standing at the same time. Remembering that we will be tested again is important, but it’s also important to pause and take a look at the ground we’ve covered, honoring our courage, our persistence, and our achievement. Then we can begin the next leg of our circular journey with a fuller understanding of where we are coming from.

DailyOM

'Low glycemic' diet helpful in diabetic youth

In children and adolescents with type 1, or insulin-dependent, diabetes, consumption of a low glycemic index diet may improve blood sugar control, according to results of a National Institutes of Health-sponsored study.

Glycemic index, or GI, refers to how rapidly a food causes blood sugar to rise. High-GI foods, like white bread and potatoes, tend to spur a quick surge in blood sugar, while low-GI foods, such as lentils, soybeans, yogurt and many high-fiber grains, create a more gradual increase in blood sugar.

Dr. Tonja R. Nansel of the National Institute of Child Health and Human Development and colleagues tested the effects of high GI and low GI meals on blood sugar levels using continuous blood sugar monitoring in 20 type 1 diabetics who were between the ages of 7 and 16 years.

The findings, reported in the journal Diabetes Care, suggest that a low GI diet can improve blood sugar control "to a clinically meaningful degree above that obtained by careful carbohydrate counting and contemporary insulin regimens," Nansel noted in comments to Reuters Health.

"When consuming the low GI diet, blood glucose (sugar) levels were in the target range 66 percent of the time compared to 47 percent of the time when consuming the high GI diet," she explained. "This difference was statistically significant."

When consuming the low GI diet, study subjects also demonstrated significantly lower daytime average blood sugar levels compared to the high GI diet and fewer blood sugar excursions.

"It is plausible" based on the results of this study, Nansel said, "that a low glycemic index diet may reduce the dose of insulin required while improving blood sugar control.

Reuters

ADHD and Vitamins

Vitamins that may be helpful

Some children with ADHD have lowered levels of magnesium. In a preliminary, controlled trial, children with ADHD and low magnesium status were given 200 mg of magnesium per day for six months.¹⁵ Compared with 25 other magnesium-deficient ADHD children, those given magnesium supplementation had a significant decrease in hyperactive behavior.

In a double-blind study, children with ADHD who received 15 mg of zinc per day for six weeks showed significantly greater behavioral improvement, compared with children who received a placebo.¹⁶ This study was conducted in Iran, and zinc deficiency has been found to be quite common in certain parts of that country. It is not clear, therefore, to what extent the results of this study apply to children living in other countries.

In a double-blind study, supplementation with L-carnitine for eight weeks resulted in clinical improvement in 54% of a group of boys with ADHD, compared with a 13% response rate in the placebo group.¹⁷ The amount of L-carnitine used in this study was 100 mg per 2.2 pounds of body weight per day, with a maximum of 4 grams per day. No adverse effects were seen, although one child developed an unpleasant body odor while taking L-carnitine. Researchers have found that this uncommon side effect of L-carnitine can be prevented by supplementing with riboflavin. Although no serious side effects were seen in this study, the safety of long-term L-carnitine supplementation in children has not been well studied. This treatment should, therefore, be monitored by a physician.

A deficiency of several essential fatty acids has been observed in some children with ADHD compared with unaffected children.^{18 19} One study gave children with ADHD evening primrose oil supplements in an attempt to correct the problem.²⁰ Although a degree of benefit was seen, results were not pronounced. In a 12-week double-blind study, children with ADHD were given either a placebo or a fatty-acid supplement providing daily: 186 mg of eicosapentaenoic acid (EPA), 480 mg of docosahexaenoic acid (DHA), 96 mg of gamma-linolenic acid (GLA), 864 mg of linoleic acid, and 42 mg of arachidonic acid. Compared with the placebo, the fatty-acid supplement produced significant improvements in both cognitive function and behavioral problems.²¹ No adverse effects were seen. In a preliminary trial, supplementation with approximately 400 mg of flaxseed oil and 25 mg of vitamin C, each twice a day for three months, was associated with an improvement of symptoms in children with ADHD.²²

In a preliminary study of women in Italy, iodine deficiency severe enough to cause hypothyroidism during pregnancy was associated with an increased risk of ADHD in their children.²³ Women who are contemplating pregnancy or who are pregnant should get adequate amounts of iodine in their diet and should discuss with their healthcare provider whether iodine supplementation is appropriate.

Iron status, as measured by the serum ferritin concentration, was significantly lower in a group of children with ADHD than in healthy children. Ferritin levels were below normal in 84% of the children with ADHD, compared with 18% of the healthy children.²⁴ Since iron deficiency can adversely affect mood and cognitive function, iron status should be assessed in children with ADHD, and those who are deficient should receive an iron supplement. In a case report, a young boy with both ADHD and iron deficiency showed considerable improvement in behavior after receiving an iron supplement.²⁵

B vitamins, particularly vitamin B6, have also been used for ADHD. Deficient levels of vitamin B6 have been detected in some ADHD patients.²⁶ In a study of six children with low blood levels of the neurotransmitter (chemical messenger) serotonin, vitamin B6 supplementation (15–30 mg per 2.2 pounds of body weight per day) was found to be more effective than methylphenidate (Ritalin®). However, lower amounts of vitamin B6 were not beneficial.²⁷ The effective amount of vitamin B6 in this study was extremely large and could potentially cause nerve damage, although none occurred in this study. A practitioner knowledgeable in nutrition must be consulted when using high amounts of vitamin B6. High amounts of other B vitamins have shown mixed results in relieving ADHD symptoms.

Healthnotes

Nurturing techniques to improve learning and attention

The following are suggestions for nurturing your child to help improve his or her learning and attention.

• Give frequent physical contact. Touch and hold your baby as much as possible during the first 6 months of his or her life. You will not spoil your baby. Your baby needs frequent physical contact to grow and develop.
• Limit exposure to television as much as possible before age 2. When your child is age 2 and older, one hour or less of TV a day is plenty. Make sure the programs your child watches are appropriate for his or her age.
• Choose age-appropriate toys, and provide a safe play environment. Toys that stimulate the brain are recommended, such as books, blocks, and puzzles. Use a playpen or gate to ensure the play area is safe from potential hazards, such as stairs or pets.
• Encourage your child to play. Find some time each day to play with your child. Choose games and play activities that encourage conversation, such as reading and board games. Also, allow your child some time to play alone.
• Make sure your child gets enough sleep and rest each day. Don't interrupt your child's sleep unless it is necessary. You may want to use soft music to help your child relax; some people suggest playing soft music that does not contain words for 30 minutes each day.
• Encourage your child to eat healthy foods and to develop healthy eating habits. Limit the amount of sugar and fat in your child's diet. Also, don't allow your child to have juices, sports drinks, or soda pop before a meal.

Healthwise

 

Adaptive Equipment

and

Sensory Tools

Practitioner's Corner -- About Kids and Attention Disorders

Attention deficit hyperactivity disorder (ADHD) in children can be quite challenging for the entire family: Kids who have it have a hard time concentrating, and their kinetic energy tends to exhaust everyone around them. The conventional approach to treatment relies primarily on stimulant drugs like Ritalin, but at our integrative clinic we try to use gentler therapies whenever appropriate.

Before starting down any treatment path, though, it's crucial to have your child thoroughly assessed. (The best place to do this is at a child development center that's part of a children's hospital or academic medical center.) Lots of kids who are thought to have an attention disorder actually turn out to be suffering from depression, anxiety, or a learning disability; when these problems are treated, the symptoms that looked like attention problems often clear up.

An assessment will also pinpoint the particular subtype of attention disorder a child has, so you can tailor treatment accordingly. In the hyperactive form of ADHD, impulsive and hyperactive behavior are the biggest symptoms. Another form, marked by an inability to focus, often doesn't emerge until adolescence. Most children, however, suffer from a combined version of the disorder, which usually shows up between the ages of seven and 11.

Here are some of the questions we're most frequently asked about attention disorders.

Q: My eight-year-old son has been diagnosed with attention deficit hyperactivity disorder. Is there any chance that changing his diet will make a difference?

A: There have been quite a few "gold standard" studies supporting the idea that for certain kids, dietary changes can be a big help.

One type of diet (known as oligo- antigenic) is fairly radical; it eliminates ingredients that are thought to provoke allergies, including dairy, gluten, refined sugars, dyes, preservatives, and additives. A theory as to why this might make a difference has to do with a phenomenon called leaky gut syndrome. Normally, the intestinal lining serves as a good filtering system for proteins like those that trigger allergies. But in some people, the gut seems to have a sort of "leak" that allows these proteins to get into the bloodstream. At that point the immune system reacts, and this can contribute to behavioral problems.

The pure form of this diet is very restrictive and can be difficult to stick to. It allows only two types of meat (lamb and turkey), two types of starches (rice and potatoes), two types of vegetables (cabbage and carrots), and two fruits (apples and bananas).

A more practical approach might be to test potentially troublesome foods one at a time. Eliminate dairy, say, for three weeks to see if any significant changes occur. For most people, this approach is pretty doable, and there's very little downside to trying it.

As a general guideline, I'd also suggest giving the child unprocessed and organic foods, to avoid contributing any additional toxic load to the body.

Q: My daughter has the inattention form of ADHD. Are there any mind-body therapies that might help her focus?

A: Certain forms of relaxation can be very useful. Kids can learn to do diaphragmatic breathing and muscle relaxation, which they can use on their own to help themselves calm down and concentrate better.

Meditation can be helpful, too, but the child would need to practice it on a daily basis to get any lasting benefit.

Kids who receive regular massages often show decreases in hyperactivity and impulsivity. In one study, parents were trained to massage their children, and that worked very well. Biofeedback, in which children learn to control their heart rate or muscle tension, is worth trying, too. To find a good practitioner, your best bet is to check with a child psychologist, behavioral pediatrician, or pediatric nurse-practitioner who specializes in this area.

Q: I've heard neurofeedback can help kids with attention disorders. What exactly is it, and does it really work?

A: It's a new type of biofeedback that trains kids to control their brain waves. There's mounting evidence that it's both helpful and safe, and kids tend to be very good at it. It's like a video game for the body. The practitioner places electrodes on the child's scalp, and the child learns to control the brain waves -- in real time -- by watching them on a computer screen. Many kids with ADHD are deficient in beta waves, the high-frequency brain waves involved in thinking. And they tend to have too much theta wave activity, which happens when the mind is disorganized and not well focused. One training strategy works to decrease theta wave activity and increase beta waves.

The only downside is the time it takes -- usually 30 to 50 sessions of training are required before a child is fully trained. Since insurance typically doesn't pay for it, it can be expensive.

This is something you'll want to do with the guidance of a well-trained professional. Your best bet is to find someone credentialed by the Biofeedback Certification Institute of America.

Q: Are there supplements that can calm a child with ADHD?

A: Yes. There's some evidence to support the theory that kids with ADHD are missing normal levels of key vitamins and nutrients, particularly zinc and essential fatty acids. Studies have shown that when you replenish these nutrients, some kids definitely do better. So I like to recommend a good high-potency multivitamin that contains trace minerals, along with 1,000 to 1,500 milligrams per day of omega-3 fatty acids, preferably the DHA and EPA forms. These supplements are safe, and any parent of a child with ADHD would do well to consider them. There are several good EFA supplements made specifically for children; I like DHA Junior, from Nordic Naturals, and Coromega, from ERBL.

One herb you hear a lot about is ginkgo biloba, which may help kids function better by increasing blood flow to the brain. I haven't seen specific research on this, but holistic child psychiatrists often use it. Another commonly used herb is lemon balm, which is thought to have a calming effect and to ease restlessness. These herbs won't work for all kids with ADHD, but they're certainly worth trying.

Q: How much time should I give alternative approaches before putting my child on Ritalin?

A: It depends on the severity of the disorder. If it's the mild-to-moderate form, and the child is keeping up in school, you could give the complementary approach three to six months. During that time, you'll need to track the child's progress carefully with school professionals and the child's doctor.

If a child is more severely affected, I'd begin with the conventional treatment, then start adding in the complementary approaches. Long term, you'll want to try to make a gradual transition to the complementary therapies.

Alternative Medicine Magazine

If My Child Has Asthma, Can We Keep Our Pet?

Only about 10% of the general population has pet allergies, but at least 30% of people with asthma are allergic to animals. So if your child has asthma, it's a good idea to consider whether your pet could be producing allergens that are triggering asthma symptoms.

Contrary to popular belief, your animal's fur probably isn't the culprit. But animal dander (skin flakes), saliva, urine, and feathers can cause allergic reactions. Though pet hair itself isn't the problem, an animal's fur can collect dust mites, pollen, mold, and other allergens. And any animal that lives in a cage (from birds to gerbils) will produce droppings that can attract mold and dust mites.

You may hear people say that certain breeds of dogs or cats, particularly those that don't shed, don't trigger their asthma, but all warm-blooded animals give off these allergens and are capable of causing an allergic reaction.

If you're wondering whether your child is allergic to your pet, it might be a good idea to have him or her tested for allergies. If your child turns out to be allergic to your pet, you'll have to decide whether you'll keep it or find a new home for the animal. The best course is to remove the pet from your home, though this isn't usually the easiest or happiest solution. Your child, other kids in the family, and even adults in the family may have a tough time with this decision.

In some cases, your child's doctor may say that it's OK to keep your pet if your child receives medicine or allergy shots. If you go this route, you'll also want to take measures at home to limit your child's exposure to the animal, such as keeping the pet out of your child's bedroom and play areas. Hard as this is to enforce, try to teach your child not to hug or kiss the animal. Vacuum and dust regularly and avoid rugs and wall-to-wall carpeting, especially in your child's room.

Unfortunately, such measures may not be enough - because animal allergens are airborne, heating and ventilation systems will spread allergens throughout the house, even if the pet is confined to one room. Keeping the pet in the yard may not be a total solution either because some allergens will eventually be carried in on clothing.

If you decide to keep your pet, it might also be a good idea to:

• Buy an air cleaner. HEPA air cleaners can really help, especially for cat allergies. Vacuums are available with HEPA filters as well.
• Keep your child away from the cat's litter box, and place the box away from air vents.
• Have someone other than your child wash and brush your pet every week (this is advisable for cats as well as dogs).
• Encourage everyone in the family to wash their hands after playing with your pet.
• Keep your pet out of the child's bedroom and away from rugs and upholstered furniture. You may need to shut the doors to certain rooms or use baby safety gates to keep cats and dogs out.

If you have a bird, gerbil, or other small caged animal, keep the cage in a room other than your child's bedroom. Make sure the pet stays in its cage at all times, and clean the cage daily - without your child's assistance. You'll also want to let your child's teacher know about your child's allergies if there's a caged pet in the classroom.

If you do decide to find another home for your pet, be sure to talk to your child about his or her feelings. You'll want to assure your child it's not his or her "fault" - and make sure siblings don't blame the child. Losing a pet, even if it is only to another home, may be difficult for everyone in the family. If your child has his or her heart set on a new pet, your best bets are a turtle, lizard, snake, or fish. (But be cautious because certain reptiles carry Salmonella bacteria.)

Remember, too, that even if you remove the pet from your home, you may not see improvements in your child's asthma symptoms for a while. After a pet is removed from the home, it can take up to 6 months to reduce the allergen levels to those of a home without pets. Even if the pet is removed, your child may still need to use the asthma or allergy medications that he or she used previously.

When your child is invited to a house with a pet, he or she should take any prescription allergy medicine before going and should (as always) bring along his or her asthma rescue medication as well.

KidsHealth

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Healthy Habits to Maintain Weight Loss

I know that many of you are familiar with self help books that tell you about the habits of successful people. This is a new twist to that concept. Recently the National Weight Control Registry published their analysis of 5,500+ people who lost at least 30 pounds and kept it off for at least one year. An interesting fact about this group of people was that 77% of them were women! And indeed these women maintained their weight loss for an average of six years and 13% kept the weight off for more than ten years. 45% lost weight on their own through diet and exercise, although a few used diet alone. Exercise alone was the method for 1% which is not surprising as exercise alone is usually unsuccessful. So, how did these women do it? Well, here are eight habits of highly successful "biggest losers":

1.   Eat a low calorie, low fat diet; the women took in, on average, 1385 calories per day and many used meal substitutes such as drinks, bars, etc.

2.  Exercise vigorously to use up an average of 2500 calories per week; tables are available to help you learn how many calories you can burn doing various activities.

3.  Weigh yourself often; almost 75% weighed themselves at least weekly - many weighed themselves daily

4.  Limit diet variety; keep fewer different types of food in the house, at the office, etc. Ever wonder why Jelly Beans and M&M's are multicolored? Because women eat more out of a full jar that contains multicolored candy than a jar that contains only one color! Decreasing the variety of food available seems to decrease the desire to eat.

5.  Eat consistently; over 50% ate the same way on weekends and holidays as they did on ordinary week days.

6.  Eat breakfast; this was the daily habit of 78% of our big losers. Studies show that the metabolism kicks in and stays higher in folks who eat a low calorie, low fat breakfast that is balanced with both carbs and protein.

7.  Limit TV!!! 62% of those who succeeded in losing weight and keeping it off watched less than 10 hours of TV per week.

8.  Limit fast food!!! Successful losers ate fast food less than one time per week. If you have to consume fast food, choose the healthy alternatives containing fresh ingredients and watch the portion size. Best to avoid it altogether whenever possible

Well, were you surprised by any of these? Usually people are the most surprised by the admonition to eat breakfast. They also find the number of calories to be very challenging - but it is doable. And we all know that even losing 10 to 15% of your body weight can reduce the risk of diabetes and heart disease. And yet 1/3 people in the US are obese and 1/2 are overweight.

VivianDickersonMD