What is Worse? This or That?

What’s Worse, This or That?

by Sean Kenniff, MD 

What is worse: being obese or suffering from anorexia nervosa? 

Statistics show anorexia nervosa has the highest fatality rate of any psychological disorder. Up to twenty-percent of those affected will die from the condition if left untreated, and roughly three-percent die even with therapy. Obesity also kills, but much more slowly. The mortality rate for people suffering from anorexia nervosa is higher, and they tend to die at much younger ages when compared to an obese people of the same age. For an obese twenty-five-year old woman the risk of dying is around 0.1%.

What is worse for parents with children: Having a gun in the house, or a swimming pool in the backyard?

In the book Freakonomics by economist Steven Leavitt, statistical analysis reveals that having a swimming pool is roughly 100-times more risky than having a gun in the house. According to Leavitt there are 6-million residential swimming pools in the U.S., and more than 500 children drown in them each year-so roughly one child drowns for every 11,000 swimming pools. Meanwhile there are more than 200-million guns in the U.S., but fewer than 200 deaths in children under the age of ten are due to firearms. Simple math tells you that the risk of having a gun in the home is just 1-child death for every 1-million guns.

What is worse: smoking marijuana cigarettes, or smoking tobacco cigarettes?

This question appeared in an editorial in the British Medical Journal in 2003. From a legal point of view marijuana is certainly worse. But when it comes to your health tobacco cigarettes are a much bigger risk. Two large studies failed to find an increased risk of death associated with cannabis use. While there are plenty of carcinogens in marijuana smoke, people do not tend to chain-smoke the drug-so the overall exposure to those carcinogens is much less. And most marijuana smokers cease smoking the drug in early adulthood. Cigarettes pose a much larger personal and public health risk. However this conclusion comes with a caveat: perhaps the main reason people stop smoking marijuana after a certain age is because of its illegality. As we age we are less likely to commit these kinds of criminal activities. Decriminalization of marijuana may lead to more prolonged smoking and perhaps more deaths. But overall cigarettes are much worse. In the United States tobacco use contributes to roughly 1-in-5 deaths.

What is worse: being married and miserable, or happy and single? 

Research shows happily married couples live longer than singles, and the health benefit of being in a happy marriage is more profound for men than it is for women. People in positive marital relationships have lower blood pressures and reduced levels of stress hormones when compared to unhappily married couples. And a recent study from BYU researchers found unhappily married people have a higher blood pressure, and higher stress hormones than happy singles and happily married folks. So being unhappily married appears to pose the biggest risk to your health. But before you think about heading to divorce court, several studies have shown divorce can increase the risk of death. So try to make your marriage a happy one. 

It’s also important to mention that overall never-married people face the highest risk of death (unhappy and happy singles combined). A study published in 2006 found never-married people faced 5-times the risk of dying from infectious diseases, were 38-percent more likely to die from heart disease, and faced twice the risk of dying from an accident, homicide, or suicide.

What is worse: air pollution or being exposed to second-hand smoke?

Air pollution from industrial pollutants and motor vehicles accounts for 3% of all U.S. deaths according to an article in the European Respiratory Journal. A study from University of Southern California in 2007 found children living near a major highway (within 500 meters) were more likely to have asthma, other respiratory diseases, and were more likely to have reduced lung function and reduced lung growth. Living close to a busy highway has also been associated with an increased risk of heart disease and some cancers. Air pollution alone causes between 22,000 and 55,000 deaths each year in the U.S. according to government statistics, but the National Resources Defenses Council says air pollution is responsible for 64,000 deaths each year. Particulate matter and benzene are thought to be playing the largest role in causing the health problems. 20-million Americans live under air pollution that contains more than 32 toxins at levels 100 times higher than the EPA deems acceptable. The World Health Organization says worldwide there are 2-million deaths due to air pollution each year. So how does second-hand smoke compare? The American Cancer Society estimates exposure to second-hand smoke causes roughly 3400 lung cancer deaths and between 22,000 and 69,000 deaths from cardiovascular disease each year in the U.S. There are approximately 21-million American children (35%) living in homes where they are exposed to second-hand smoke. So the numbers turn out to be roughly the same.

Hangover a Highway Hazard

Are you driving with a ‘killer’ hangover?

By Sean Kenniff, MD 

  Most Americans are aware that drinking and driving is dangerous and often deadly. Alcohol is involved in roughly one-third of all U.S. traffic-related deaths; 36 people die each day and another 700 people are injured according to the CDC. But what happens the morning after a night of boozing? Recent studies suggest driving with a hangover is a hazard on the road. 

  The alcohol hangover is caused by a constellation of biological changes that occur during alcohol intoxication and its subsequent withdrawal. There is a rise in acetaldehyde in the bloodstream, along with hormonal fluctuations, dropping sugar levels, inflammation, dehydration, and abnormal cardiovascular activity. Under the influence of alcohol, sleep structure is also profoundly altered. All of this creates the typical hangover syndrome of headache, nausea, fatigue, muscle aches, thirst, shakiness, poor attention and difficulty with concentration. 

  But does a hangover impair driving? 

  Using a car simulator, scientists from Brunel University in the U.K. tested the driving performance of eleven students before and after a night of heavy drinking. They found, when hungover, the students drove an average of ten miles per hour faster without realizing even it, and their traffic violations doubled. They drove erratically; swerving in and out of lanes, driving through red lights and stop signs, and even hitting an occasional pedestrian. 

  We shouldn’t be complacent the morning after, and driving ‘after the influence’ with a hangover can also be very dangerous. Graham Johnston of RSA, a British insurer, said in a press release. 

  It’s important to note all of these hungover students passed a breathalyzer examination before driving in the simulator. 

  Several other studies have documented similar impairments in psychomotor abilities during the hangover period, and more research is being conducted to confirm the findings. Time is the only cure for a hangover, along with drinking plenty of fluids and eating nutritious meals. So remember the next time you have a killer hangover call a cab, or take mass transit.

Pregnancy is Possible Any Time of the Month

   For many women, having sexual intercourse during menstrual bleeding carries a lower risk of conception than having sex during mid-cycle. But it is still quite possible to become pregnant during menstruation for several reasons.

   Most women ovulate during mid-cycle, around days 12-16 of a 28-day cycle. But some women, especially teenagers and young adults, have irregular ovulation. The egg for the following cycle can be released from the ovary during menstrual bleeding or a few days afterward. Since sperm can survive for five days or longer in the uterus that egg can be fertilized.

   Women with shorter menstrual cycles (21 days) and longer periods (7-days) may be most at risk for conceiving during her period. Women often mistake other causes of vaginal bleeding with menstrual bleeding and sexual activity results in pregnancy. In fact it’s normal for some women to ‘spot’ or bleed a little during ovulation-the most fertile time of the cycle.

   The best way to prevent pregnancy is of course through abstinence and the judicious use of contraceptive devices and drugs. Birth control pills are very effective, but condoms have an added benefit. Some studies have show the risk of transmitting and contracting a sexually transmitted disease is increased during menstrual bleeding. -Sean Kenniff, MD

Does ‘Carb-Loading’ Improve Athletic Performance?

  For generations, endurance athletes have practiced ‘carb-loading’, consuming large amounts of carbohydrates the night before the competition. Studies have found several different carb loading strategies can give athletes a competitive edge.

  During digestion carbohydrates are rapidly turned into glucose, a sugar that is the body’s primary and most immediate energy source. Excess glucose is then stored in the liver and muscles as glycogen. About four hours after a meal, the glycogen in the liver begins to break down and supply the body with glucose, but the glycogen in the muscle is reserved almost exclusively for muscle activity. By eating a high carbohydrate meal the night before a competition, athletes maximize the glycogen stores in their muscles, ensuring that the muscles will have enough glucose for strenuous activity.

  Studies have shown carb-loaded athletes perform better and their muscles do not fatigue as easily. However it is important to watch your calories. Excess calories of any kind have been shown to impair athletic performance. -Sean Kenniff, MD

Breast Cancer Risk: Does Size Matter?

 Large-breasted women are often concerned they could be facing an increased risk of breast cancer. Conversely, smaller-breasted women often assume they have less of a risk. But studies have shown there is no clear association between breast size and the risk of developing breast cancer. 

 The breast is primarily made up of two types of tissue: glandular tissue like the milk ducts and the mammary glands, and stromal tissue like fat and fibrous tissue. Breast cancer tumors usually arise from the glandular tissues. And while larger breasts can contain more glandular tissue than smaller breasts, breast size is largely a reflection of the amount of fatty tissue in the breast. Though some studies have shown a weak correlation between large breasts and breast cancer, most studies have not. 

 However there is some evidence that breast density could be a risk factor for breast cancer. Denser breasts have relatively less fatty tissue and more glandular tissues. While it is normal for young women to have dense breasts, many studies suggest women with increased breast density after menopause could be at a slightly increased risk of developing breast cancer. 

 It’s important to note that overweight and obese women often have larger breasts, and they also have a higher risk of breast cancer. But this is probably not related to increased breast size, but rather to the excess estrogen produced by fat cells in the body. -Sean Kenniff, MD

The Ten Most Effective Abdominal Exercises: #3 The Exercise Ball Crunch

  If you’re trying to tone your tummy, and want that washboard look, try these top ten abdominal exercises. Using electromyography (EMG) Dr. Peter Francis and his team from the Biomechanics Lab at San Diego State University measured abdominal muscle activity, and put some of the most commonly performed exercises to the test. They ranked them from most effective to least effective. The study was sanctioned by the American Council on Exercise (ACE). 

#3 The Exercise Ball Crunch 

  Dr. Francis found the most effective abdominal exercises combined continuous abdominal contraction and rotation of the torso. Overall the Bicycle Maneuver ranked #1 and the Captain’s Chair ranked #2 (see below). The Exercise Ball Crunch was the third most effective exercise for working the abs (it also finished #6 for working the oblique muscles). Here’s how to perform the Exercise Ball Crunch properly according to the ACE.

1. Sit on the ball with your feet flat on the floor.

2. Lie back on the ball until your thighs and torso are parallel to the floor.

3. Cross your arms over your chest, or place them lightly behind your head. Do not pull on your neck.

4. Contract your abdominals raising your torso no more than 45 degrees.

5. Move your feet closer together to work your obliques.

6. Repeat sets of 12-20 repetitions.

  Check the Healthapalooza.com Special Reports section tomorrow when we will reveal the exercise that ranked #4 in the study. -Sean Kenniff, MD

The Ten Most Effective Ab Exercises: #2 The Captain’s Chair

  If you want washboard abs this summer, you might want to try the ten exercises most likely to give them to you. Dr. Peter Francis from the Biomechanics Lab at San Diego State University measured abdominal muscle activity with electromyography (EMG) devices, and put some of the most commonly performed exercises to the test, ranking them from most effective to least effective. The study was sanctioned by the American Council on Exercise (ACE).

#2 The Captain’s Chair

  Dr. Francis found the most effective abdominal exercises combined continuous abdominal contraction and rotation of the torso. Overall the Bicycle Maneuver ranked #1 (see below), but the ‘Captain’s Chair’ finished a close second and it strengthened both the abdominal and oblique muscles the best. Here’s how to perform the exercise properly according to the ACE.

     1. Stabilize your upper body by gripping hand holds.

     2. Lightly press your back against the back pad.

     3. Slowly lift your knees to your chest, then return legs to starting.

     4. The motion should be controlled and deliberate, not fast or jerking.

Check the Healthapalooza.com Special Reports section tomorrow when we will reveal the exercise that ranked #3 in the study. -Sean Kenniff, MD

The Ten Best Abdominal Exercises: #1 The Bicycle Crunch

  Want to know the most efficient way to getting those washboard abs? So did Dr. Peter Francis from the Biomechanics Lab at San Diego State University. Measuring muscle activity with electromyography (EMG) Dr. Francis studied several of the most commonly performed exercises and ranked them from best to worst. The study was sanctioned by the American Council on Exercise (ACE). 

#1 The Bicycle Crunch

  Dr. Francis found the most effective abdominal exercises combined continuous abdominal contraction and rotation of the torso. The Bicycle Maneuver, sometimes called the ‘Bicycle Crunch’ topped the list. Here’s how to do it properly according to the ACE.

• 1. Lie on your back and lace your fingers behind your head.
• 2. Bring your knees toward your chest and lift BOTH shoulder blades off the ground.
• 3. Do not pull on your neck.
• 4. Straighten your left leg while simultaneously turning your upper body to the right, bringing the left elbow towards the right knee.
• 5. Alternate sides in a ‘bicycling’ motion for 12-16 repetitions.

  Check the Healthapalooza.com Special Reports section tomorrow when we will reveal the exercise that ranked #2 in the study. -Sean Kenniff, MD

Having a Mid-Life Crisis in Your Thirties? It’s a ‘Thrisis’

  Men in a mid-life crisis are easy to spot. They’re Botox-blasting, cash-flashing, tanning, toning, wig-wearing late-forty-somethings driving sporty cars and cruising for sporty younger women. But today psychologists are seeing a new phenomenon; an early mid-life crisis that strikes both men and women equally, and in their thirties–It’s called a ‘thrisis’.

   Dr. Mitchell Spero, a licensed psychologist and director of Child and Family Psychologists, says people in the throes of a full-blown thrisis usually fall into two main camps.

“There are those who have had a prolonged adolescence by going to school and entering the workforce later in life,” Dr. Spero says, “and then there are those who had children earlier in life, maybe even too young, and now they are dealing with marital stress or divorce.”

   Spero says combine years spent in college, grad school, with the current economic downturn and adolescence has extended into the early twenties. That leaves many thirty-somethings struggling for independence while they’re still entangled in the parental safety net.

   “They want to be independent, but they are actually pseudo-independent. Their parents still must help them out in some way,” he says. For many that is a source of great internal frustration and it is easy to come unbalanced.

   “People in their thirties are often trying to balance child rearing, career advancement, all the financial pressures, leaving your parents, and in some cases losing a parent — at the same time,” Dr. Spero says.

   Unlike a mid-life crisis, where the angst is driven by the ghost of glory-days past, those in a thrisis worry about an uncertain future and unsatisfied expectations.      

   “Adjust expectations for yourself and for others, and don’t forget to adjust the time frame,” Dr. Spero says, “It’s OK to accomplish some of these things in your forties. Live in the present without blaming those of the past.” -Sean Kenniff, MD

-Dr. Sean Kenniff is a neurologist and health journalist in Miami.

-Dr. Mitchell Spero can be reached at Child + Family Psychologists at 954-587-7520, or 954-349-2777, or visit his website www.childandfamilypsychologists.org