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Tuesday, April 08, 2008

Benefits of Drinking Water Oversold?

Benefits of Drinking Water Oversold?

Researchers Say Evidence Is Lacking for Benefits of
Drinking 8 Glasses of Water a Day

By Kathleen Doheny
WebMD
Medical News
Reviewed by Louise Chang, MD

April 2, 2008 -- The health benefits of drinking water, at least for already
healthy people, may have been oversold, according to a new report. The findings
will likely disappoint water-bottle-toting Americans and relieve those who can
never seem to down those eight glasses of water a day, widely recommended for
our health.

But there is nothing magical about those eight glasses, at least when it
comes to proven health benefits, according to a new report. "There is no clear
evidence of benefit from drinking increased amounts of water," writes Stanley
Goldfarb, MD, professor of medicine at the University of Pennsylvania,
Philadelphia, and the senior author of an editorial on the topic in the
Journal of the AmericanSociety of Nephrology.

On the other hand, he adds, "There is also no clear evidence of lack
of benefit." There's a general lack of evidence either way.

Those doctors and others who have been recommending drinking eight glasses of
water aren't basing it on anything scientific, according to Goldfarb. He
concludes that most healthy people don't have to worry about drinking eight
glasses every day.

He emphasizes he is talking about healthy people with kidneys that function
well. And he points out that people who live in hot, dry climates do need to
drink more water to avoid dehydration, as do those who engage in vigorous
exercise.

(How much water do you drink each
day?
What other liquids? Talk with others on WebMD's Health Cafe message
board.)

Health Benefits of Drinking Water: Search for Evidence

Goldfarb was curious about where the longstanding recommendation about eight
daily glasses of water originated. "In my mind it wasn't that drinking this
extra water would hurt you, but that you might not have to."

So he combed through medical literature dating back to the early 1970s,
trying to find the science to back up the advice.

Turns out, there is no single study and no single outcome that led to the
recommendation becoming popular, he says. Somehow, it took on a life of its
own.

Goldfarb and his University of Pennsylvania colleague, Dan Negoianu, MD, next
examined some popular claims about the health benefits of drinking water, trying
in each case to find scientific evidence.

"We looked at the evidence of some of the so-called urban myths that have
grown up about drinking water," Goldfarb says.

Drinking lots of water is widely thought to help improve kidney function and
boost the clearance of toxins. One way it could do this, Goldfarb says, is by a
mechanism called glomerular filtration, a measure of the kidney's ability to
filter and remove waste products.

But in one study the researchers looked at, increased water intake by 12
young and healthy people actually decreased their glomerular filtration
rate. And in another study, the rate did not change over time during a
six-month period in which older men drank more water to try to improve bladder
function.

In other research, increased water intake was found to affect the clearance
of many substances by the kidneys, including sodium. But the studies don't prove
any sort of clinical benefit, Goldfarb says.


"What almost certainly happens is, any toxins the kidney is responsible for
excreting simply get diluted when the person is drinking a lot of water,"
Goldfarb says.


Claim No. 2: Drinking Water Helps Your Organs Work Better

Water is retained in various organs, so the thinking goes, and they work
better with more water in them.

But Goldfarb and Negoianu say how much water is retained varies with the
speed with which the water is taken in. If it's sipped, it's more likely to stay
in the body than when gulped.

Even so, they could find no studies documenting that increased water intake
helped the organs.


Claim No. 3: Drinking Water Reduces Food Intake and Helps You Lose
Weight

Drinking more water is widely encouraged to help weight loss, the theory
being that the more water you drink, the fuller you will feel and the less you
will eat. "The [medical] literature on this is quite conflicted," Goldfarb
says.


"Drinking before a meal might decrease intake [according to one study], but
another study found [it did] not."


Even so, Goldfarb calls this claim one of the most promising for further
study.


Claim No. 4: Drinking Water Improves Skin Tone


"From a quantitative sense, this doesn't make sense," Goldfarb says. The
water you drink will be distributed throughout the body. "Such a tiny part of it
would end up in the skin," he says.


"It turns out one small study showed there might be an increase in blood flow
in those who drink [a lot of] water, but no one has ever looked scientifically
[to see if it improves skin tone]."


Claim No. 5: Drinking Water Wards Off Headaches


Headache sufferers often blame water deprivation. But Goldfarb could only
find one study that looked at this. The study participants who boosted their
water intake had fewer headaches than those who did not, but the results were
not statistically significant, meaning they could have been chance findings



The report provides interesting -- and sometimes surprising -- information,
says David Baron, MD, a family physician and chief of staff at Santa Monica-UCLA
Medical Center & Orthopaedic Hospital, Calif., who reviewed it for
WebMD.


The most surprising finding, he says, was the lack of a scientific link found
between drinking a lot of water in order to eat less. "I thought [the suggestion
that] filling up your stomach with water might help lose weight makes sense," he
says.

The report isn't dismissing the need to drink a healthy amount of fluids, he
says. It simply showed no scientific basis to the recommendation to drink eight
glasses of water daily.


"There is a lot of individual variation" in exactly how much water or fluid
people need," he says.


Most of us, he says, are OK "by trusting our instincts" about how much to
drink. "If you have a normal heart, normal kidneys, and normal thirst mechanism,
it's not likely you will get dehydrated if there is a sufficient supply of
fluids available," he says, and drink when thirsty.


Drinking Water: A Placebo Effect?


Might drinking a lot of water make us think we feel better, look better, and
function better? Could there be a placebo effect to those eight daily
glasses?


"I'm certain there is," Goldfarb says. "The placebo effect is very
strong."


And if you're still convinced lots of water does your body good? No problem.
"People say they feel stronger and healthier if they drink more water," he
says. "That's fine. If they enjoy that benefit, so be it. [But] those who
don't feel that way shouldn't feel obligated to drink the eight glasses."

New Strength Training Advice for Kids

New Strength Training Advice for Kids


Get a Checkup First, Don't Overdo It, and Don't Start
Before Age 7, Says American Academy of Pediatrics

By Miranda Hitti
WebMD Medical
News

Reviewed by Louise Chang, MD



April 7, 2008 -- The American Academy of Pediatrics (AAP) has issued revised
guidelines on strength training for children and teens.


Teri McCambridge, MD, chair of the
AAP's Council on Sports Medicine and Fitness, says the revisions include more
specific recommendations about kids and teens who need further medical
evaluation prior to being cleared for strength training.


"The main groups include children with a prior history of childhood cancers,
uncontrolled hypertension
[high blood
pressure
], and congenital heart defects," McCambridge tells WebMD in an
email.


The revised guidelines also include a chart describing the different
certifications for strength trainers and the requirements required to get the
certifications. "We thought this was important because many health clubs are
designing strength training programs for children and we wanted parents to be
comfortable with their credentials," says McCambridge.


Overall, "we continued to emphasize that although strength training is safe
and effective in children and preadolescents, we continue to recommend playing
sports as the best way to improve skills and have fun," says McCambridge.


Here are other highlights from the guidelines, published in April's edition
of Pediatrics:



  • Don't start before kids are 7-8 years old. Kids' balance and posture don't
    mature until then.
  • Before starting strength training, kids and teens should get a medical
    checkup.
  • Follow proper techniques, with strict supervision by a qualified instructor.

  • Warm up for 10-15 minutes.
  • Strength-train for at least 20-30 minutes, then cool down for 10-15 minutes.

  • Address all major muscle groups, including the core muscles
  • Start with light weights and focus on technique.
  • Use control; don't slam the weights up and down.
  • Many strength-training machines are designed for adults; free weights may be
    a better option for kids.
  • Don't strength-train the same muscles every day. Two to three times per week
    is enough; more sessions may lead to injury.
  • When the child or teen can do 8-15 repetitions easily, add weight in 10%
    increments.

The AAP also recommends aerobic
exercise
, a healthy diet, and adequate fluid
intake.


Consistency counts, too. It takes at least eight weeks for strength training
to start showing results, and those results are lost about six weeks after
quitting strength training, according to the AAP.


The AAP doesn't support Olympic weight lifting in
kids and teens who are still growing, though McCambridge and colleagues note
several studies showing it to be safe.


Of course, the AAP condemns using anabolic steroids and other
performance-enhancing substances.

Thwart Genital Warts

Thwart Genital Warts: Don’t Sleep Around

Odds of Getting Genital Warts Increase With Number of
Sexual Partners, Study Shows
By Kelley Colihan
WebMD Medical
News
Reviewed by Louise Chang, MD

April 3, 2008 -- Nearly 6% of sexually active people surveyed reported that
they have been diagnosed with genital warts, with 25-to-34-year-old women reporting the
greatest percentage.

The National Health and Nutrition Examination Survey looked at 8,849 sexually
active men and women aged 18 to 59 from 1999 to 2004.

Ten percent of young women aged 25-34 reported being diagnosed with genital
warts (peak for women), compared with 6% of men aged 35-44 (peak for men).

More Sexual Partners, Higher Risk

The more sexual partners a person reported, the greater their chances of
having been diagnosed with genital warts.



  • Nearly 2% of people with one to two partners report having been diagnosed.
  • 3% of people with three to five partners report having been diagnosed.
  • 7.2% with six to 10 partners report having been diagnosed.
  • Nearly 11% of people with 10 or more partners report having been diagnosed.

More Diagnoses Among Whites


Whites were more likely to report having been diagnosed with genital warts
than African-Americans or Mexican-Americans:Â Â Â



  • Nearly 7% of whites reported having been diagnosed with genital warts
  • 4% of African-Americans reported having been diagnosed
  • 2 1/2% of Mexican-Americans reported having been diagnosed

Â


Uncircumcised Fared Better


Circumcision appeared to have an effect on rates of genital warts:



  • 4 1/2%Â of circumcised men reported having genital warts
  • 2.4% of uncircumcised men reported having genital warts

Â


Genital Warts: A Common STD


Genital warts, a common sexually transmitted disease in the United States,
are caused by the human papillomavirus (HPV). Researchers say more than 90% of
genital warts are brought on by two strains of HPV, types 6 and 11.


A vaccine to prevent these two strains of HPV (and two other strains) was
approved two years ago for girls and women aged 9 to 26 years old. The CDC
recommends that 11- and 12-year-old girls receive the vaccination, which is
given in three shots.


The vaccine is also recommended for girls and women aged 13 to 26 who haven't
completed vaccination already.


HPV Vaccine Controversy


Some 20 states have drawn up bills requiring that young women get the vaccine
(which is sold by the name Gardasil). That has generated controversy, with Texas
legislators shooting down the governor's bid to require all 11- and 12-year-old
girls to have the vaccine by September 2008.


The CDC says that about half of all sexually active women and men in the U.S.
will have a genital HPV infection at some time in their lives. Most HPV
infections are cleared by the body.


The survey appears in the April issue of Sexually Transmitted
Diseases.

Psoriasis: 7 New Genetic Clues

Psoriasis: 7 New Genetic Clues


Newly Discovered Genetic Variations May Make Psoriasis
More Likely, Study Shows

By Miranda Hitti
WebMD Medical
News
Reviewed by Louise Chang, MD
April 3, 2008 -- Scientists have discovered seven genetic variations linked
to psoriasis.

If confirmed in other studies,
those gene variants may make good targets for new psoriasis drugs, note the
researchers, who included Anne Bowcock, PhD, genetics professor at Washington
University School of Medicine in St. Louis.


"Common diseases like psoriasis are incredibly complex at the genetic level,"
Bowcock says in a news release. "Our research shows that small but common DNA
differences are important in the development of psoriasis. Although each
variation makes only a small contribution to the disease, patients usually have
a number of different genetic variations that increases their risk of psoriasis
and psoriatic
arthritis
."


Bowcock's team compared DNA from 223 psoriasis patients (including 91 with
psoriatic arthritis) and 519 people
without psoriasis, and also from two other large groups of people with and
without psoriasis.


Through those comparisons, the researchers identified seven genetic
variations linked to psoriasis and psoriatic arthritis and confirmed other
variations already linked to psoriasis.


One of the newly discovered variants is in a genetic region tied to four
other autoimmune diseases: celiac disease, type 1 diabetes, Grave's disease, and
rheumatoid
arthritis
.


Further studies are needed to confirm the findings, Bowcock and colleagues
note in the April 4 online edition of Public Library of Science
Genetics
.

Feed Your Heart Right

Feed Your Heart Right

WebMD Feature from "Shape" Magazine

By Kyle Shadix, R.D.

We’ve developed a day’s worth of delicious, easy
recipes that incorporate 15 heart-saving foods.

BREAKFAST


yogurt-orange
granola-parfait

Serves 4
Prep time: 5 minutes
Cook time: 0 minutes

2 cups plain lowfat yogurt
3 tablespoons honey
1 cup lowfat
granola
2 oranges, peeled and divided into segments


In a small bowl, combine yogurt and honey. Put a scoop of the mixture in the
bottom of an 8- to 10-ounce parfait glass. Follow with a scoop of granola and
another scoop of yogurt mixture. Top with orange segments and a sprinkle of
granola and serve.


Nutrition score per serving (1 cup):
174 calories, 1 g fat (5% of
calories), 0 g saturated fat, 39 g carbs, 4 g protein, 2 g fiber, 117 mg
calcium, <1 mg iron, 89 mg sodium


LUNCH


flaked-salmon salad
with black beans


Serves 4
Prep time: 15 minutes
Cook time: 10–20 minutes


12 ounces boneless salmon fillet
2 cups broccoli florets
1 15.5-ounce
can black beans, drained and rinsed
1 cup grape tomatoes, halved
Salt and
pepper to taste
4 cups torn assorted salad greens (trimmed, washed, and
dried)
1 bunch fresh basil leaves
2 carrots, peeled and shaved into long
strips


FOR THE VINAIGRETTE
1 tablespoon extra-virgin olive oil
1/4 cup bottled
fat-free vinaigrette
Juice of 1 large lemon, plus more to taste, if
necessary
1 teaspoon Dijon mustard


Preheat oven to 400°F. Place the salmon in a small roasting pan. Cook for 10
to 20 minutes, depending on the thickness of the fish (plan on 10 minutes per
inch), or until an instant-read thermometer registers 140°F. Remove salmon from
oven and set aside. Once salmon cools, flake into bite-size pieces with a
fork.


Meanwhile, bring a 2-quart saucepan filled with water to a boil. Add broccoli
and boil for 1 minute, or until broccoli turns bright green. Pour into a
colander and rinse under cold running water. Shake to remove as much water as
possible and place broccoli in a large bowl.


Make vinaigrette by whisking olive oil, fat-free vinaigrette, lemon juice,
and Dijon. Toss broccoli with the vinaigrette. Set aside. In another bowl,
combine salmon, black beans, and grape tomatoes. Season with salt and pepper, if
desired.


Divide salad greens and basil on four plates. Top with broccoli and salmon
mixture, garnish with shaved carrots, and serve.


Nutrition score per serving (2 1/2 cups):
293 calories, 11 g fat
(33% of calories), 2 g saturated fat, 29 g carbs, 23 g protein, 10 g fiber, 126
mg calcium, 3 mg iron, 628 mg sodium


DINNER


pork tenderloin with
spiced cherry compote


Serves 4
Prep time: 3 minutes
Cook time: 10 minutes


1 16-ounce pork tenderloin
1 tablespoon chopped
fresh rosemary
Salt
and pepper to taste
Cooking spray



FOR THE COMPOTE
1 cup cold orange juice
1 teaspoon cornstarch
1 cup
dried tart cherries, divided
1 teaspoon ground cayenne pepper


Preheat oven to 400°F. Sprinkle
pork with rosemary, salt, and pepper. Spritz an ovenproof skillet with cooking
spray. Over medium heat, sear the pork on all sides, about 2 minutes or until
browned. Place skillet in the oven.


Meanwhile, in a food processor, pulse orange juice, cornstarch, half the
cherries, and cayenne pepper. Place mixture in a large heavy saucepan and add
remaining cherries. Cook over medium heat until the mixture boils and thickens,
about 1 minute. Remove pan from heat and let sauce cool in pan.


Roast pork about 10 minutes, or until an instant-read thermometer inserted
into center registers 155°F. Let sit 5 to 10 minutes, then slice into
medallions. Divide among four plates. Spoon sauce over pork and serve.


barley-almond pilaf


Serves 4
Prep time: 5 minutes
Cook time: 40 minutes


1 teaspoon olive oil
1 small onion, finely chopped
3/4 cup pearl
barley
2 cups low-sodium chicken broth
1 bunch scallions, sliced
Salt
and pepper to taste
1/4 cup toasted almonds, crushed


Heat olive oil in a medium-size heavy saucepan over medium heat. Add onion
and sauté until translucent, about 5 minutes. Add barley and stir constantly for
2 minutes. Pour chicken broth into the pan with the barley and bring to a boil.
Reduce heat to low and cover. Cook until barley is almost tender, about 25
minutes. Add scallions, stir, and cover the pan again. Cook 3 minutes.


Remove pilaf from heat and let stand 10 minutes; season with salt and pepper.
Garnish with toasted almonds and serve.


garlic sautéed
swiss chard


Serves 4
Prep time: 5 minutes
Cook time: 5 minutes


3 large garlic cloves
2 teaspoons olive oil
2 large bunches Swiss
chard, well-washed, drained, and spun dry, coarse stems discarded
Salt and
pepper to taste


Slice garlic into thin strips and set aside. In a large heavy skillet, heat
olive oil over medium-high heat until hot but not smoking. Add garlic and sauté
until lightly browned, about 1 minute. Remove garlic slices from pan and
set aside.


Add Swiss chard to garlic-infused oil and sauté for about 3 minutes. Using
tongs, flip chard and continue cooking 2 minutes, or until chard is wilted but
still bright green.


Season with salt and pepper, toss in garlic, and serve.


Nutrition score per serving (4 oz. pork, 1/4 cup compote, 3/4 cup
barley, 1 cup Swiss chard):
503 calories, 14 g fat (25% of calories), 2 g
saturated fat, 74 g carbs, 23 g protein, 12 g fiber, 102 mg calcium, 4 mg iron,
141 mg sodium

R