FDA’s New Food Defense Tool Helps Stop Intentional Contamination
The U.S. Food and Drug Administration (FDA) has developed a new Food Defense Plan Builder tool to help owners and operators of food facilities create plans to minimize intentional contamination. While rare, intentional contamination, intentional contamination can be a serious public health problem. For example more than 40 people in Kansas became sick in 2009 when an employee put pesticide in salsa. Based on FDA’s food defense guidance documents, the tool uses a series of pointed questions to develop a customized food defense plan, including a vulnerability assessment; broad and focused mitigation strategies; and an action plan. Read more on food safety.

Text4baby Programs Gives Pregnant Women, Mothers Critical Information
The 2013 Text4baby State Enrollment Content will promote the mobile health tool while providing pregnant women with important information on their pregnancy and their child’s first year of life. By texting “BABY” (or “BEBE” for Spanish) to 511411, they will receive three free weekly text messages addressing issues such as labor signs and symptoms; prenatal care; developmental milestones; immunizations; nutrition; birth defect prevention; and safe sleep. The program is supported by more than 950 health departments, academic institutions, health plans, businesses and the U.S. Department of Health and Human Services. Under the contest, the states with the highest enrollment percentages will be recognized at the American Public Health Association Annual Meeting in Boston, Mass. in early November. Read more on maternal and infant health.

Citing High Cancer Risk, Angelina Jolie Undergoes Preventive Double Mastectomy
A mutated BRCA1 or BRCA2 gene makes a woman five times more likely to develop breast cancer in her life. On Tuesday in an op-ed in The New York Times, Angelina Jolie — who carries a “faulty” BRCA1 — announced she has undergone a double mastectomy to reduce her risk of developing the cancer. Her physicians had estimated an 87 percent risk of breast cancer and 50 percent risk of ovarian cancer. "I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer,” she wrote. “It is my hope that they, too, will be able to get gene tested." A woman with one of the faulty genes is at an average 60 percent risk of developing breast cancer; a woman without a mutated gene is at an average 12 percent risk. Today CNN anchor Zoraida Sambolin also announced she is getting a double mastectomy. Read more on cancer.

RWJF Obesity Report Details Tactics that Could Save Billions in Health Care Costs
The medical costs of the ongoing U.S. obesity epidemic could be as high as $210 billion annually, according to James S. Marks, Senior Vice President for the Robert Wood Johnson Foundation Health Group. The loss of economic productivity likely adds even more billions to the toll. However, increasing the Congressional Budget Office’s time frame for estimating the cost of legislation from 10 years to 75 years would greatly improve the battle against obesity by enabling us to better estimate the true costs—and savings—of health care and public health efforts. The Campaign to End Obesity estimates that over 75 years, obesity screening by physicians would save $44 billion, the S-CHIP childhood obesity demonstration project would save $41 billion, the U.S. Centers for Disease Control and Prevention’s diabetes prevention program would save $18.4 billion and Medicare part D weight-loss drug coverage would save $11.4 billion. Read the full report.

Citing Cancer Risk, FDA Proposes New Rules for Youth and Indoor Tanning
The U.S. Food and Drug Administration (FDA) is proposing that sunlamp products used for tanning be reclassified as a moderate risk device—up from a low risk device—and made to carry recommendations warning against their use by young people. The ultraviolet radiation from indoor tanning increases the risk of melanoma by 75 percent, according to the American Academy of Dermatology. “Using indoor tanning beds can damage your skin and increase your risk of developing skin cancer,” said FDA Commissioner Margaret A. Hamburg, MD. “The FDA’s proposed changes will help address some of the risks associated with sunlamp products and provide consumers with clear and consistent information.” Read more on cancer.

FDA Warns Pregnant Women of Migraine Drug Ingredient’s Risk to Children
Noting the link between the migraine medicine ingredient valproate and lower IQ scores in children, the U.S. Food and Drug Administration (FDA) is warning all pregnant women not to take medication containing the ingredient. "Valproate medications should never be used in pregnant women for the prevention of migraine headaches because we have even more data now that show the risks to the children outweigh any treatment benefits for this use," said Russell Katz, MD, director of the division of neurology products in the FDA's Center for Drug Evaluation and Research. FDA is also warning women who may become pregnant not to use valproate unless it is medically “essential” and that they make sure they are on effective birth control. Read more on maternal and infant health.

For anyone who has ever had a mammogram, reminded someone to have a mammogram or sported anything pink for breast cancer awareness month, the New York Times has a thought-provoking article well worth reading. The author battled breast cancer twice and raises the interesting and controversial question of whether the uber-awareness campaign about breast cancer led to more mammograms than were necessary. The author argues that mammograms can result in early treatment—which comes with its own risks—but ultimately doesn’t save many lives. Studies cited show many women died despite early detection and many others, who underwent years of treatment for breast cancer, might never have been bothered by their breast tumors at all.  

The article arrives on the heels of a study in the journal Cancer that found that the proportion of women undergoing screening for breast cancer every year did not change after the U.S. Preventive Services Task Force advised that there was not enough evidence to support routine mammograms for women in their 40s.

Otis Brawley, chief medical officer of the American Cancer Society, weighed in on the Times article on the ACS Press room Blog and agreed that it is recommended reading: “This is a powerful and important article, one I believe every breast cancer advocate, and frankly even advocates for prostate and other cancers, should read,” wrote Brawley. “ It lays out the challenge that lies before us in reducing death and suffering from breast cancer, while demonstrating the challenge that we in public health face in how to accurately and truthfully administer information.”

>>Read the article.

Mammography Rates Remained Steady After Change in Guidelines
The proportion of women undergoing screening for breast cancer every year did not change after U.S. Preventive Services Task Force released recommendations saying there wasn't enough evidence to support routine mammograms for women in their 40s, according to a new study published in the journal Cancer. In 2009, the Task Force changed their recommendations to state that women aged 50 to 74 should have a mammogram every other year, and screenings for women under age 50 should be evaluated by each woman with her doctor, according to individual risk factors. "When there are conflicting versions of guidelines, providers may err on the side of screening," said David Howard, a health policy researcher from Emory University in Atlanta, in an interview with Reuters. Read more on cancer.

Latest HIV Vaccine Study Halted
The National Institutes of Health halted a study testing an experimental HIV vaccine after an independent review board found the vaccine did not prevent HIV infection and did not reduce the amount of HIV in the blood. The trial, started in 2009, is the latest in a series of failed HIV vaccine trials, according to Reuters. The halted study included more than 2,500 volunteers in 19 U.S. cities. Study populations included men who have sex with men and transgender people who have sex with men. Read more on HIV.

CDC's Food Safety Report Card: Some Foodborne Illnesses Spiked in 2012
The Centers for Disease Control and Prevention (CDC) recently released the "nation’s annual food safety report card," and it shows that 2012 rates of infections from two types of foodborne bacteria—campylobacter and Vibrio—have increased significantly when compared to a baseline period of 2006-2008, while rates of most others have not changed during the same period. The data are part of the Foodborne Diseases Active Surveillance Network report. Campylobacter infections have been linked to tranmission in many foods, including poultry, raw milk and produce. These infections were at their highest level since 2000, up 14 percent since 2006-2008. Vibrio infections, often associated with raw shellfish, were up 43 percent.

“The U.S. food supply remains one of the safest in the world,” said CDC Director Tom Frieden, MD, MPH. “However, some foodborne diseases continue to pose a challenge. We have the ability, through investments in emerging technologies, to identify outbreaks even more quickly and implement interventions even faster to protect people from the dangers posed by contaminated food.” Read more on food safety.

Experts Debate Expected Changes to ADHD Diagnosis
Medical experts are at odds as to what to ultimately expect from the predicted changes to the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 will be released in May by the American Psychiatric Association. The broadened criteria should increase the number of people diagnosed with ADHD in part by expanding the age time frame for the onset of symptoms. "In the current version, it's seven years,” James Norcross, MD, a child and adolescent psychiatrist at the University of Texas Southwestern Medical Center at Dallas. “That will be changed to 12 years in the DSM-5, which may make things easier for adults and adolescents, because they'll be able to better recall some of the challenges that may have occurred." Norcross said the changes are positive overall. However, Allen Frances, MD, chair of the task force for the DSM-4 and former chair of psychiatry at Duke University School of Medicine in Durham, N.C., worries the new criteria will serve to increase the unnecessary use of stimulant medications. "We're already overdiagnosing ADHD,” he said. “Almost 20 percent of teen boys get the diagnosis of ADHD, and about 10 percent of boys are on stimulant drugs. We don't need to make it easier to diagnose ADHD.” Read more on mental health.

FDA Releases Violations on Several Dozen Compounding Pharmacies
Yesterday the U.S. Food and Drug Administration (FDA) released a list of violation reports for 28 of the 31 drug compounding pharmacies it’s inspected since April. The safety of drugs produced at compounding pharmacies came into question last year after the Framingham, Massachusetts-based New England Compounding Center was linked to a meningitis outbreak that caused 39 deaths and 656 cases of illness in 19 states. Found violations range from “inappropriate clothing for sterile drug processing to insufficient testing for contaminants,” according to Reuters. Still, FDA reiterated its stance that it needs more increased regulatory authority when it comes to compounding facilities. Last month Commissioner Margaret A. Hamburg, MD, proposed the FDA be given greater authority to oversee high-risk sterile compounding facilities that distribute drug products in advance of or without receiving a prescription. Read more on prescription drugs.

USPSTF: Limit Oral Cancer Screenings to Patients with Signs, Symptoms
Primary care physicians should limit oral cancer screenings to adult patients who actually show signs or symptoms of the condition, according to new draft recommendations from the U.S. Preventive Services Task Force (USPSTF). "The evidence shows that it is difficult to detect oral cancer and that the evidence is not clear whether oral cancer screening improves long-term health outcomes among the general adult population or among high-risk groups," said Jessica Herzstein, MD. "We need more high-quality research on whether screening tests can accurately detect oral cancer and if screening adults for oral cancer in primary care settings improves health outcomes." Tobacco and alcohol are both major risk factors for oral cancer. The task force also recommended physicians take into account patient wishes, medical histories and other expert opinions when making decisions. Read more on cancer.

FDA Budget Includes Funds for Food, Medical Product Safety Improvements
The U.S. Food and Drug Administration’s (FDA) requested $4.7 billion budget will include funds to support the Food Safety Modernization Act and to help ensure the safety of medical products. However, the budget will also include a $15 million cut related to human drug, biologics and medical device programs. “Our budget increases are targeted to strategic areas that will benefit patients and consumers and overall strengthen our economy,” said Margaret A. Hamburg, M.D., Commissioner of Food and Drugs. “Through the good work of the FDA, Americans will receive life-saving medicines approved as fast as or faster than anywhere in the world, confidence in the medical products they rely on daily, and a food supply that is among the safest in the world.” Read more on food safety.

Study: No Link Between Fertility Drugs, Increased Ovarian Cancer Risk
There is no link between fertility drugs and an increased risk of ovarian cancer, according to a new study in the journal Fertility and Sterility. While previous studies have suggested a connection, Albert Asante, MD, lead author of the study and a clinical fellow in the division of reproductive endocrinology at the Mayo Clinic, said the results show that “women who need to use fertility drugs to get pregnant should not worry about using these fertility drugs." The study looked at the medical information of approximately 1,900 women who participated in an ovarian cancer study at the Mayo Clinic. Approximately 13 out of every 100,000 women will develop ovarian cancer in their lives. Read more on cancer.

Unemployment Stress Can Lead to Severe Cardiovascular Troubles
The stress and anxiety of unemployment can cause both immediate and long-lasting cardiovascular problems. There’s even a possibility of something called “broken heart syndrome.” "In a very stressful situation, you can actually get a severe release of adrenaline and sympathetic nerve discharges that cause the heart to beat irregularly," said John Higgins, MD, a sports cardiologist at the University of Texas Health Science Center in Houston, according to HealthDay. In the most severe cases this can lead to heart attack. However, Kavitha Chinnaiyan, MD, director of cardiac imaging at Beaumont Hospital in Royal Oak, Mich., said steps can be taken to reduce the damage. "We know from studies that behaviors such as meditation, yoga and tai chi work specifically to reduce our response to stress," she said, noting that meditation in particular “helps you see your choices and have a clearer perspective of what to do next. Stress may still be around us, but meditation gives us a better ability to cope with it." Learn more on the connection between stable employment and health in an INFOGRAPHIC.

Smaller, Frequent Meals Help Kids Keep Weight Off
Smaller, more frequent meals can help kids ward of overeating and obesity, according to several new studies in the journal Pediatrics. One study found that simply using smaller dishware—thus forcing smaller portions—meant kids ate less; they found that adult-sized dishware led first-graders to take 90 calories more of food. Researchers also found kids who ate more often were 22 less likely to be overweight. "The results are very interesting and confirm our expectations that the impact of plate size on adults in the laboratory also apply to children," said Thomas Robinson, MD, a childhood obesity researcher at Stanford University, according to Reuters. "This study provides very important preliminary evidence that using smaller dishware may help reduce children's energy intakes." Read more on obesity.

Low-calorie Drinks Increasingly Popular for Kids
While sugary drinks remain popular, low-calories drinks are also gaining more and more consumers, according to a new study in the journal Pediatric Obesity. Researchers at the University of North Caroline (UNC) found both that consumption of calories from sweetened drinks was down and consumer of low-calorie drinks was up over a 10-year period. The findings were especially significant for kids. "The food industry is trying many ways to reduce the caloric content of foods and beverages," said Barry M. Popkin, PhD, W.R. Kenan Jr. Distinguished Professor of Nutrition at UNC's Gillings School of Global Public Health. "We are increasingly seeing them replace caloric sweeteners with low-calorie sweeteners. This trend has particularly emerged in the last three to four years as U.S. concern about obesity, diabetes and other complications of consuming excessive sugary high-calorie beverages has increased." Read more on nutrition.

Missed, Delayed Mammograms Increase Death Risk for Older Women
Older women with misses or delayed mammograms are significantly more likely to die from breast cancer, according to new research to be presented at the annual meeting of the American Association for Cancer Research. Researchers found “that 23 percent of women who had their last mammogram five or more years before being diagnosed with breast cancer had advanced cancer, compared with 20 percent of those who had a mammogram six months to a year before their diagnosis,” according to HealthDay. Increased time between mammograms also significantly increased the risk of death from cancer for women age 75 and older. Researchers said more study is needed to examine the connection. "It is possible that the differences in the relationship between screening interval and [death] in older versus younger women may be related to the more aggressive nature of the tumors in younger women, which might obliterate the effects of more screening,” said Michael Simon, MD, leader of the breast multidisciplinary team at the Barbara Ann Karmanos Cancer Institute in Detroit. “Other reasons may include differences in cancer treatment, information that was not available for this [group] of women.” Read more on cancer.

CDC: Distracted Driving a Major Danger in U.S., Younger Populations
About 69 percent of U.S. drivers talk on their phone while behind the wheel and approximately one in three use text messaging or email, according to a new study from the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report. The rates were higher than those seen in several European countries. The study also found that younger men and women were, on average, more likely to engage in the risky behavior. No significant difference in behavior between men and women was found. “Everyone, of every age and generation, has the ability to make a decision to drive distraction-free,” said Linda C. Degutis, DrPH, MSN, director of CDC’s National Center for Injury Prevention and Control. “It’s especially risky for young, inexperienced drivers—who are already extremely vulnerable to crashes—to be distracted when they are behind the wheel. Answering a call or reading a text is never worth a loss of life.” Read more on safety.

High-fat Dairy Foods Increase Breast Cancer Survivors Change of Death
Breast cancer survivors who consume high-fat dairy foods are at higher risk of dying of cancer than those who consumer little or none of the food type, according to a new study in the Journal of the National Cancer Institute. Researchers found that they were at a 49 percent higher risk of death. High-fat dairy foods include ice cream, butter and certain kinds of cheeses. While the risk in absolute terms is a 12 percent risk of dying of breast cancer, researchers said this “modest” increase justifies the relatively easy lifestyle change of cutting out high-fat dairy foods. Read more on cancer.

National Salmonella Outbreak in Kids Linked to Type of Frog
A 2008-2011 outbreak of Salmonella Typhimurium in kids has been linked to African dwarf frogs kept as pets, according to a new study in the journal Pediatrics. There were 376 cases in 44 states and 29 percent of the cases led to hospitalizations, though no one died. Most victims were less than 10 years old. The researchers said too few parents are aware of the salmonella risk from reptiles and amphibians, which require diligent handwashing and careful maintenance of their habitats. Children under age 5 are at especially high risk and should have no contact with African dwarf frogs or their environments. Read more on infectious disease.

Judge Strikes Down N.Y. City’s Sugary Drink Limit; Bloomberg to Appeal
“The loopholes in this rule effectively defeat the stated purpose of this rule,” wrote State Supreme Court Justice Milton Tingling when striking down New York City’s 16-ounce limit on sodas and other sugary drinks just hours before it was set to go into effect. He also called the law “arbitrary and capricious.” Still, Mayor Michael Bloomberg says he expects to win on appeal. “As far as we have come, there is one public health crisis that has grown worse and worse over the years, and that is obesity," he said at a news confernce. "Five thousand people will die of obesity this year in New York. The best science tells us that sugary drinks are a cause of obesity." Read more on obesity.

NFL, GE Partner in $60M Effort to Study and Prevent Brain Injuries
The National Football League and General Electric Co have announced a $60 million partnership to advance research into brain injuries while also developing new technologies to help limit injuries to athletes. It includes $40 million for research into imaging technologies and $20 million for researchers and businesses working on injury prevention, identification and management. The NFL has faced multiple lawsuits related to concussions, including a class action on behalf of 4,000 former players. "We're trying to do this with the best minds anywhere in the world," said GE Chairman and CEO Jeff Immelt at a news conference. Each year, U.S. emergency rooms see about 173,000 temporary brain injuries related to sports and recreation in people age 19 and under, according to the U.S. Centers for Disease Control and Prevention. Read more on injury prevention.

Ovarian Cancer Patients Who Don’t Receive Recommended Treatment More Likely to Die in 5 Years
Ovarian cancer patients who do not received the treatment recommended by the National Comprehensive Cancer Network (NCCN) clinical practice guidelines—or as many as two-thirds of patients—have a 30 percent greater risk of dying within five years, according to new findings to be presented at the annual meeting of the Society of Gynecologic Oncology. The study found that low-volume hospitals that treat fewer ovarian cancer patients are less likely to follow the treatment guidelines. "The high-volume hospitals, which did 20 or more cases a year, and high-volume physicians, which did 10 or more a year, were significantly more likely to administer treatment that was adherent to NCCN guidelines," said Robert Bristow, MD, director of gynecologic oncology at the School of Medicine of the University of California, Irvine. According to the American Cancer Society, in the United States, approximately 22,000 new cases of ovarian cancer are diagnosed each year and 15,000 women die from the disease. Read more on cancer.

Breast Cancer in Young Women May Be Up Slightly in Past Several Decades
Advanced breast cancer in women ages 25 to 39 may have increased since 1976, according to a new report in The Journal of the American Medical Association. In 2009 there were about 2.9 advanced cased per 100,000 younger women, up from 1.53 per 100,000 in 1976. The researchers say further study is needed to verify the numbers. In the mean time, they recommend that young women see a doctor if the notice lumps or other early indicators, and not simply assume they are too young to develop breast cancer. Read more on cancer.

Cohabitating Same-sex Couples Report Worse Health than Married Heterosexuals, Possibly Tied to Discrimination
Stress and discrimination may be the reason that cohabitating same-sex couples report generally worse health than do married heterosexuals, according to a new report in the Journal of Health and Social Behavior. The study looked at how the individuals describe their health, not at their health records. The same-sex male couples were 61 percent more likely to report poor or fair health and same-sex female couple were 46 percent more likely. "Research consistently suggests that 'out' sexual minorities experience heightened levels of stress and higher levels of discrimination, and these experiences may adversely affect the health of this population," said Hui Liu, lead author and an assistant professor of sociology at Michigan State University. "It may also be that same-sex cohabitation does not provide the same psychosocial, socioeconomic and institutional resources that come with legal marriage, factors that are theorized to be responsible for many of the health benefits of marriage." Read more on LGBT issues.

Poll: 1 in 5 Americans Know a Victim of Gun Violence
One in five Americans—and 4 in 10 black Americans—know a victim of gun violence, according to the latest Kaiser Health Tracking Survey. The poll measured personal experience and concerns about firearms. About 42 percent of Americans are worried about being the victim of gun violence, with racial and ethnic minority groups more likely to be concerned. About 75 percent of Hispanics, 62 percent of black Americans and 30 percent of white Americans say they are worried. Read more on violence.