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Oct. 10, 2022 — Getting a colonoscopy might not offer as many benefits as we previously thought about what is considered a gold standard in cancer screening, according to a surprising new study out of northern Europe. 

After a 10-year follow-up study of people who were invited to receive a colonoscopy, researchers compared their results to a group of people who did not get the cancer screening. The former group had only an 18% lower risk of getting colon cancer, and the procedure didn’t make much difference in colon cancer deaths, according to results published in The New England Journal of Medicine.

Colon cancer — the second leading cause of cancer in the U.S. and the third in the world — is commonly found in adults over age 50.

During a colonoscopy, doctors insert a small camera through your anus to examine your large intestine and rectum (AKA your colon).

“The absolute risks of the risk of colorectal cancer and even more so of colorectal cancer–related death were lower than those in previous screening trials and lower than what we anticipated when the trial was planned,” says Michael Bretthauer, MD, a gastroenterologist from the University of Oslo Department of Medicine in Norway, and lead researcher of the study.

If you hate colonoscopies, don’t start jumping with glee just yet. The study also had its flaws. 

Researchers invited about 28,000 people enrolled in a long-term Northern European healthy study to get a colonoscopy. A little less than half — 42% — (actually received it. 

“It’s hard to know the value of a screening test when the majority of people in the study didn’t get it done,” says William Dahut, MD, chief scientific officer at the American Cancer Society.

However, study patients who did undergo a colonoscopy had a 31% decrease in the risk of colorectal cancer, and cancer-related deaths dropped in half as compared to those who were not screened. This result points to the value of continued screening.

Getting a colon cancer screening is still the best method of prevention, says Karen Knudsen, PhD, chief executive officer at the American Cancer Society.

“The American Cancer Society recommends colorectal cancer screening, including colonoscopy, for adults beginning at age 45,” Knudsen says. “There’s no reason to change that direction. Recommended cancer screenings should be a routine part of good health.”

Click here for more information on colon cancer screening.

By Cara Murez HealthDay Reporter

HealthDay Reporter

MONDAY, Oct. 10, 2022 (HealthDay News) — At the height of the COVID-19 pandemic, more than 40% of Americans were untruthful about whether they had the virus or were ignoring safety precautions, a nationwide survey shows.

The December survey of 1,700 people found 721 respondents had either misrepresented their COVID status or failed to follow public health recommendations.

Folks ignored quarantine rules, told someone they were about to see that they had been taking more precautions than they actually were, and didn’t mention they might or did have COVID when they entered a doctor’s office. They were also untruthful about vaccination status, claiming they were vaccinated when they weren’t or that they were unvaccinated when they had taken the jab, the survey revealed.

The most common reasons for the lack of transparency were that people wanted to feel normal or to exercise personal freedom.

“COVID-19 safety measures can certainly be burdensome, but they work,” said co-author Andrea Gurmankin Levy, a professor of social sciences at Middlesex Community College in Connecticut.

Co-author Angela Fagerlin, head of population health sciences at University of Utah Health, said the survey raises concerns about how reluctance to truthfully report health status and adherence to masking, social distancing and public health measures could lengthen the pandemic and spread infectious diseases.

“Some individuals may think if they fib about their COVID-19 status once or twice, it’s not a big deal,” Fagerlin said in a University of Utah news release. “But if, as our study suggests, nearly half of us are doing it, that’s a significant problem that contributes to prolonging the pandemic.”

Respondents gave a variety of reasons for their deception. Among them: They didn’t think COVID was real or a big deal; they didn’t feel sick; they couldn’t miss work or stay home; they were following the advice of a public figure or celebrity; and finally, it was no one else’s business.
 

“When people are dishonest about their COVID-19 status or what precautions they are taking, it can increase the spread of disease in their community,” Levy said in the release. “For some people, particularly before we had COVID vaccines, that can mean death.”

Those most likely to engage in misrepresentation included all age groups under 60 and those with a greater distrust of science. About 60% of respondents said they had sought a doctor’s advice for COVID-19 prevention or treatment.

The study did not find an association between misrepresentation and political beliefs, party affiliation or religion.

Fagerlin said this survey asked about a broader range of behaviors compared to previous studies on this topic and included far more participants.

But the researchers said they could not determine if respondents answered honestly and the findings may underestimate how often people were dishonest about their health status.

“This study goes a long way toward showing us what concerns people have about the public health measures implemented in response to the pandemic and how likely they are to be honest in the face of a global crisis,” said co-author Alistair Thorpe, a postdoctoral researcher at University of Utah Health. “Knowing that will help us better prepare for the next wave of worldwide illness.”

The findings were published Oct. 10 in JAMA Network Open.

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19.

SOURCE: University of Utah Health, news release, Oct. 10, 2022

We know: You weren’t exactly thinking that fall fair food would be good for you. It’s not like you eat it every day. But if you’re tracking your nutrition, be forewarned: It’s going to set you back. 

Deep-Fried Diet Disasters

Food was no doubt served at festivals even before the nation’s first state fair, held in Syracuse, N.Y., in 1841. But it was in 1904, at the St. Louis World’s Fair, that fairgoers were introduced to the first real ”fast food” — hot dogs and ice cream cones that could be eaten as they walked, according to the statefairrecipes.com web site.

Since then, fair food has progressed way beyond caramel apples, corn on the cob, and nachos. There appears to be no end to what can be battered and deep fried — cookies, candy bars, cheese curds, macaroni and cheese, pralines, chocolate-covered strawberries, even cola (the last made with a cola-sweetened batter that’s deep fried and topped with cola syrup and powdered sugar). The Minnesota State fair, for one, boasts 54 varieties of food on a stick at this year’s fair.

Most nutrition databases don’t include fat and calorie values for such foods. But  you can count on these foods to have a shockingly high level of fat and calories.

”My educated guess is a serving of fried cola dough, whipped cream and Coke syrup on top is roughly 830 calories,” says Lona Sandon, assistant professor at the University of Texas Southwestern Medical Center. ”The fried macaroni and cheese is approximately 610 calories; the fried cheesecake in the ballpark of 500 calories; a fried praline will come in around 350 calories; and a tortilla-wrapped hot dog and cheese from the fryer about 550 calories.”

Here are more stats from the Calorie King web site, about fat and calories in food at the fair or festival:

• Fried Snickers (5 oz.): 444 calories and 29 grams (g) fat
• Fried Twinkie (2 oz.): 420 calories/34 g fat
• Funnel cake (1): 760 calories/44 g fat
• Twinkie Dog Sundae: 500 calories/14 g fat
• Cotton candy: 171 calories/0 fat
• Fried cheesecake (6 oz.): 655 calories/47 g fat
• Foot-long hot dog and bun: 470 calories/26 g fat
• Giant turkey leg: 1,136 calories/54 g fat

“Eating at a fair or festival can wreak havoc on your waistline because it is so easy to consume thousands of calories,” says Christine Palumbo, RD.

The Truth About Trans Fats

Common sense tells you to stay away from deep fried cheesecake. But even without trans fats, however, fried foods are not exactly low in calories or fat.

“Using trans fat-free cooking oil is certainly better. But no matter how you look at it, that doughnut is still a doughnut and it is still fried, and anytime you fry foods you pump up the fat and calories,” says Joan Salge-Blake, MS, RD, a spokesperson for the American Dietetic Association.

Fair Food Choices

You do have some healthier options.

“You can find healthier choices on the menus at the state fair,” says New-York based nutrition expert Bonnie Taub-Dix, MS, RD. “Look for fruits, vegetables, lean meats, pickles, corn on the cob (hold the butter).” 

Dietitians also offer these tips:

• Don’t arrive hungry. Eat before you go so you can limit your food to a few treats instead of grazing on food all day long.
• Go early in the morning, when you may be less likely to be enticed by the aromas of food.
• Drink plenty of water and stay hydrated.
• Check out all the offerings first, then choose three items to enjoy over the course of the day.
• Ask for an extra plate and share your food choices. 

The real problem with fair and festival food, dietitians say, is mindless eating. That’s what happens when you’re walking and talking. Before  you know it, that food on a stick has disappeared.

“It is better to find a place to sit down, enjoy the food, eat it slowly so you can recognize when you are full,” Palumbo says.

What about all the steps you log as you walk all day at the fair or festival? Unfortunately, it’s not likely to counteract the fried food calories. So if you’re going to indulge, just factor that in.

You might think of mucus – the runny, goopy, or gummy stuff you sneeze out, sniff in, and cough up – as something pesky you never seem to have a tissue for. It might not be sexy, but mucus is one of your body’s biggest defenders.

This slippery, sometimes sticky fluid comes from the mucus membranes that line your respiratory tract – your nose, mouth, larynx, trachea, and lungs. Mucus provides moisture for the air we breathe and lubricates your respiratory tract. “Mucus serves a protective function in capturing debris, allergens, dust, and pathogens such as viruses and bacteria, which can then be shuttled out of the body,” says Ken Yanagisawa, MD, president of the American Academy of Otolaryngology-Head and Neck Surgery.

Mucus Color Meanings

You’ve likely noticed mucus shows up in a range of colors and textures when you’re sick, sniffly, or congested, or have a condition like a sinus infection. Though mucus color isn’t enough to always diagnose illness or a certain condition, it can point you in the right direction.

And even if you don’t notice it, mucus is always there.

Thin and clear. It’s the sniffly stuff that appears with allergies. Mostly water, yet packed with dissolved salts, proteins, and antibodies, clear mucus also can mean your body’s in healthy mode. Your nasal tissues constantly churn it out. Most of it slyly slips down the back of your throat and dissolves in your stomach without you knowing it.

White. Your nose might be stopped up. The swollen tissues in your nasal passages slow down mucus flow, while moisture loss thickens it and makes it cloudier. This type of mucus ripens conditions for a cold or a sinus infection.

Yellow.  A cold or infection may be building up steam. Your mucus can take on a yellow tint when your white blood cells race to the scene of an infection to try and fend it off.

Green. Dead white blood cells can make your mucus green and gunky. Your immune system’s on high alert. Call your doctor if it doesn’t improve in 10 to 12 days, or if you have a fever. If you have sinusitis, which is a bacterial infection, your doctor likely will order antibiotics to clear it up.

Brown. You might have gotten a big whiff of something like dirt. Brownish mucus could also be tinged with old blood.

It’s rare, but in chronic lung diseases like bronchiectasis or cystic fibrosis, bacteria in your lungs can cause inflammation and bleeding that turn you mucus a dark brown.

What’s key to remember is that yellow, green, or brown mucus all can signal bacterial or viral infections.

Red. A red or pinkish tinge might mean a little harmless blood from, say, blowing your nose often or something riling up your nasal lining. In some cases, “Red mucus – or bloody scabs – can be due to blood from nosebleeds, or bleeding from a polyp or even a tumor,” Yanagisawa says.

Black. You might be breathing in debris that’s clumping up in your nose. Lots of dust or cigarette smoke can blacken mucus, too. And though rare, it also can be a sign of a fungal infection. If you have a weakened immune system, check in with your doctor.

Knowing what mucus colors can mean can help, but it all comes down to what’s normal for your body. So pay attention, Yanagisawa advises. “Any discoloration or alteration in consistency which is abnormal for your body should be monitored closely, and if persistent, should warrant a call or visit with your doctor.”

Mucus Management

The key to dealing with mucus is to ID its source. For example:

Allergies or colds. This thin, clear, watery mucus can be treated with antihistamines. Be mindful if you have a prostate disorder, though. Nasal steroid sprays can give relief, too. If you have glaucoma, you’ll need to be cautious with both of these treatments.

Over-the-counter (OTC) decongestants can help too, but take care using them, says Yanagisawa. They can trigger heart palpitations or speed up your heart rate. Meanwhile, nasal decongestant sprays like oxymetazoline (Afrin) can open up your nasal passages and help you breathe better for a while, but they don’t get rid of mucus. If you use a nasal decongestant for more than 3 days in a row, the congestion can come back and trigger a cycle that’s hard to break. Also:

• Prescription nasal antihistamines can help when OTC meds don’t do the trick. The bitter taste can put some people off, though.
• OTC expectorants that contain guaifenesin (Mucinex, Robitussin) help break up mucus in your chest and keep your airways moist.

“For children, there are a number of nasal aspirators which can be utilized to suction out nasal secretions and mucus safely and effectively,” Yanagisaw notes.

Nose, sinus, or throat infections. These typically trigger green or yellow mucus. “This is best treated with antibiotics if bacteria are the culprit,” he says.

If the mucus comes from gastroesophageal reflux disease (GERD), the best treatment is meds such as a histamine-2 receptor blocker, such as famotidine. A proton pump inhibitor such as omeprazole may also work. Cutting out certain foods, including chocolate, spicy foods, citrus, and drinks with caffeine or red wine can help, too.

Maintaining Mucus Health

“Mucus is normal and of vital importance in the proper functioning of our respiratory tract,” Yanagisaw says.

To keep things moving right:

• Drink lots of fluids to stay hydrated.
• Use nasal saline mists or sprays to maintain moisture.
• Try a humidifier and steam in colder weather.
• Flush out excess mucus and nasal secretions with a nasal and sinus irrigation device like a neti pot.

Oct. 10, 2022 – Microplastics have been detected in human breast milk for the first time, according to a new study published in Polymers.

While more studies are needed, the researchers said, they said they were worried about the potential health effects on babies.

“The proof of microplastics’ presence in breast milk increases our great concern for the extremely vulnerable population of infants,” Valentina Notarstefano, PhD, one of the study authors at the Universita Politecnica della Marche in Italy, told The Guardian.

“It will be crucial to assess ways to reduce exposure to these contaminants during pregnancy and lactation,” she said. “But it must be stressed that the advantages of breastfeeding are much greater than the disadvantages caused by the presence of polluting microplastics.”

The research team analyzed breast milk samples from 34 healthy mothers, which were taken a week after giving birth in Rome. Microplastics were detected in 26 of the samples, or 76%.

The researchers recorded how much food and drink the mothers consumed that used plastic packaging as well as their use of personal hygiene products with plastic. But they found no link with the presence of microplastics in breast milk, which suggests that the widespread presence of microplastics in the environment “makes human exposure inevitable,” the study authors wrote.

The research team also found microplastics in human placentas in 2020, The Guardian reported. Other studies have found microplastics in human blood, cow’s milk, and polypropylene bottles that are often used to bottle-feed babies. Although previous studies have noted the toxic effects of microplastics in human cell lines, lab animals, and marine wildlife, the effects in living humans are still unknown.

In the latest study, the researchers found microplastics were made up of polyethylene, polypropylene, and polyvinyl chloride, which are found in plastic packaging. The team couldn’t analyze particles that were smaller than 2 microns, but they said even smaller plastic particles were likely present in the breast milk.

The research team couldn’t identify the risk factors linked to microplastics in breast milk. But Notarstefano advised pregnant women to pay attention to the food and drinks they consume in plastic packaging, clothes made with synthetic fabrics, and cosmetics that contain microplastics. 

“Studies like ours must not reduce breastfeeding of children, but instead, raise public awareness to pressure politicians to promote laws that reduce pollution,” she said.

By Steve Feldman, MD, as told to Kendall Morgan

For the last 29 years, I’ve specialized in treating patients with psoriatic disease, a chronic immune condition that includes psoriasis. I’ve been involved in studies where new drugs are being tested and in the development of new treatment guidelines. There were changes and new developments in treatment right from the beginning. There’ve been various topical treatment options, oral drugs, and then, more recently, the development of biologic treatments.

Biologics have revolutionized the management of moderate to severe psoriasis and other psoriatic conditions including psoriatic arthritis, but they also can cost tens of thousands of dollars per year. I’ve done a lot of research into these costs, and what I came to realize is that it’s hard to know how much any particular patient actually will pay for a particular drug. That’s because of contracts with insurers and other programs. So, keep in mind that the retail price of a drug isn’t an accurate reflection of how much you (or your insurer) will pay.

Still, these costs can be intimidating. I’ve had patients who lost their insurance not come to see me because they felt they couldn’t afford it. But there are lots of ways to get to low-cost or even free medications for those who can’t afford it otherwise. Health insurers often will specify which drugs they’re willing to pay for. If you don’t have insurance coverage, you might actually have more treatment options, not fewer. Many drug companies offer financial assistance through special support programs. You can look into financial assistance through nonprofit or government organizations, too. There may be a process involved, but you should never assume that treatment is out of reach simply based on your income or insurance status. Even if you think your household income is too high, you still might qualify for financial assistance or price breaks. It never hurts to ask.

If your symptoms are mild, you can save on costs even before you go to see a doctor. For mild psoriasis on the face or other sensitive parts of the body, for example, you can try over-the-counter treatments such as hydrocortisone ointment. It’s a relatively weak topical, but it may be strong enough. Topical tars can be messy and smelly, but they also can be effective if you’ll use them. Scalp psoriasis is common, and over-the-counter medicated shampoos can be useful there. Also, getting sun on psoriasis is a good way of treating it. We do phototherapy in the office, and that’s costly. But just spending time in the sun can make your psoriasis symptoms better.

When you go to the doctor, finding one who takes your insurance will keep your copays lower. If the doctor prescribes medications, I recommend going to GoodRx.com to see what the medicines cost at different pharmacies and what breaks are available. Even generics can be expensive, so it’s always a good idea to check and compare prices first. Sometimes there can be vast differences between pharmacies. Check if the medication is one that your insurer will cover.

If your doctor recommends phototherapy (also called ultraviolet light) treatments, these can cost a lot less than many of the biologic medications used for severe psoriasis. But, depending on your insurance coverage, it may actually cost you more in copays. As an alternative, see if you can find a tanning bed at a gym or somewhere else in your community. Oftentimes it’s possible to get unlimited access for a low monthly fee. It’s a good idea to talk with your doctor about any treatment you use, but home phototherapy, sunlight, and tanning beds can be reasonable ways of reducing costs even if your psoriasis is severe.

Another thing patients with psoriatic disease can do if they are doing well on a drug taken every 2 weeks is to try taking it every 3 or 4 weeks instead and see what happens. It might work to stretch the dosing this way, and that can lower the cost. However, if your prescription copay is low anyway, this may not affect your cost all that much. It’s best to let your doctor know if you are adjusting your medications and spreading the doses out this way, as it could make it more likely the treatment will stop working over time. This said, there are now lots of treatment options, so I don’t worry about this as much as I used to.

Keep in mind that you will need to see a specialist to get these prescription medications. Your primary care doctor most likely won’t have access to biologics. When you choose a specialist, make sure they have experience treating psoriatic disease and let them know about any financial concerns you have. I give patients my phone number and tell them that if they get to the pharmacy and the drug costs a lot, they can call me and see if there’s an alternative treatment or a financial assistance program available to lower the cost. I’ve seen too many patients who blindly filled a high-cost prescription when there was a way to pay less. I’ve also seen too many patients suffer by delaying needed treatment.

This doesn’t need to happen. There are many steps you can take, and help is available to lower your costs while ensuring that you get the treatment and care you need.