New moms NYC Marathon win stirs debate
Fri, 09 Nov 2007 00:28:41 GMTBy LINDSEY TANNER, AP Medical Writer
CHICAGO - For bleary-eyed new moms, the image of Paula Radcliffe celebrating her astonishing New York marathon victory just nine months after giving birth is more than slightly surreal. There she was, one sinewy arm holding a baby, the other victoriously waving a British flag, ribs visible beneath a washboard-flat torso, not an ounce of visible fat on her sleek body.
"Running whilst preggers? Winning 9 months after? Yo!" read one blog comment. "She is phenomenal and a role model to all new Mums!" said another.
Radcliffe's triumph Sunday, running 26.2 miles in two hours, 23 minutes just 291 days after childbirth, inspires equal amounts of awe and envy. But it also highlights a medical debate about just how gung-ho women should be about exercise during pregnancy and afterward.
Some doctors believe women used to rigorous exercise can continue it at least early in pregnancy and resume soon afterward, but that this is not the time for inactive women to suddenly decide they want to try a marathon. Their advice is often that it's OK to continue what you're used to, but don't push it.
Other doctors are "pretty nervous about women exercising during pregnancy" and advise against, said Dr. Linda Szymanski, a Johns Hopkins obstetrician and exercise specialist.
The problem is, guidelines are vague and there's not much research, she said.
Most medical advice on the topic is based on "pretty poor evidence," and there's even less data on the effects in highly trained athletes, Szymanski said. "It's a really tough area."
Running a marathon requires several months of training and long-distance running most days. The intensity is rigorous for those hoping to win.
Radcliffe ran throughout her pregnancy and has said her husband's help made training afterward easier. The British runner also has said she resumed training too soon after a long and difficult labor. She suffered a stress fracture at the base of her spine that sidelined her in May for eight weeks.
Still, the 33-year-old women's marathon world record-holder is a seasoned pro who won six previous marathons. So for her, running during pregnancy and afterward made sense, said Dr. Alan Peaceman, chief of maternal-fetal medicine at Northwestern University's Feinberg School of Medicine in Chicago.
Kristen Chase of Atlanta, who had a baby son two days after Radcliffe's daughter was born in January, was a several-times-weekly jogger before pregnancy. She said her doctor told her she could start exercising again when her son was six weeks, "but not to do anything strenuous."
That would definitely rule out training for a marathon — not that Chase was contemplating it.
"New moms are extremely tired, so the prospect of getting on a treadmill or even running outside at six weeks when your children — at least my children — aren't sleeping through the night" seems unimaginable, said Chase, who also has a 3-year-old daughter.
Except for women who have had a Caesarean section, which takes longer to heal, most women are ready to resume prior activity levels by eight weeks post-baby, Peaceman said.
"It's good to get back to the level that you were at prior to pregnancy, so for elite athletes, there's no reason they can't resume training," he said.
Pregnancy causes physical changes that both help and hinder athletic performance. Increased blood flow could be beneficial. But the girth from a swelling belly can change a woman's gait and make her feel off balance. Also, joints and ligaments become more lax, which can raise the risk for injury, Szymanski said.
Some doctors, including the American College of Obstetricians and Gynecologists, discourage most women from bouncy or high-impact workouts during pregnancy and urge them to take it easy at first after giving birth because some body changes linger.
The group says some lower-impact activities are generally safe during pregnancy, even for beginners, including swimming and walking. Marathon running isn't listed.
Admirable as it is, Radcliffe's triumph isn't unprecedented. Other elite long-distance runners have won races soon after having babies, including Norway's Ingrid Kristiansen, who won the 1983 Houston marathon within five months of giving birth.
It still seems way out of reach for moms who aren't athletes. Says Marsha Takeda Morrison, a Los Angeles blogger whose children are 9 and 11, "It's been 3,285 days since I last gave birth and I get winded just walking to the refrigerator."
Mont. sees rise in youth drug abuse rate
Fri, 09 Nov 2007 00:28:10 GMTBy AMY BETH HANSON, Associated Press Writer
HELENA, Mont. - A new report says the rate of substance abuse among Montana youth is much higher than the national average. The state is using that information to target federal money to change attitudes about drinking and driving and binge drinking.
The Addictive and Mental Disorders Division of the Department of Public Health and Human Services will soon be awarding $9.86 million in federal grant money to agencies and community groups who have plans to "change societal norms," said Jackie Jandt.
The projects receiving the grants will look at laws and their enforcement, public perception, education and policies relating to drinking and driving and binge drinking.
"If we don't have that public perception that it's not OK to drink and drive," things won't change, Jandt said Wednesday. "We're going to teach them the skills to changes within their community."
A survey of Montana high school students shows 38 percent admitted binge drinking within the past 30 days, above the national average of 28 percent. The rate among American Indians in Montana is higher, with 45 percent admitting binge drinking, which is defined as having five or more drinks on one occasion.
Montana students are more likely than their peers in other states to drive when drinking or ride in a car with someone who has been drinking, the report says, based on the Prevention Needs Assessment and the Youth Risk Behavioral Surveillance Survey.
The PNA is an anonymous school survey conducted with 8th-, 10th- and 12th-graders during even years. The Youth Risk survey includes school-based surveys of representative samples of 9th through 12th grade students and are conducted every two years.
Surveys show 37 percent of all students acknowledged having ridden in a car driven by someone who had been drinking within the past 30 days, compared to the national average of 30 percent. Among American Indians, 46 percent said they rode in a car driven by someone who had been drinking within the past month.
One-fifth of Montana high student students said they had driven a car while drinking within the past month, compared to the national average of 12 percent.
Jandt said the campaign against binge drinking and drinking and driving needs to be similar to the one that addressed heart disease as a top killer 30 years ago. She said it is now widely known that to help prevent heart disease people need to exercise regularly, eat a healthy diet and not smoke.
Other survey results included in the 2007 Kids Count Data Book show nearly one-quarter of Montana high school students acknowledge using marijuana at least once within the past 30 days, equal to the national average, while use among American Indians is 37 percent.
Ten percent of Montana high school students and 17 percent of American Indian high school students say they've used methamphetamine at least once in their lifetime, compared to 8 percent nationally.
Forty-four percent of Montana students in grades 8-12 say they have smoked a cigarette at least once in their life while 22 percent say they've used smokeless tobacco. Among American Indians, 70 percent say they've smoked at least once while 35 percent say they've used smokeless tobacco.
Fourteen percent of Montana high school students say they've used smokeless tobacco within the past 30 days, compared to 7.6 percent nationwide.
Ohio lawmakers push autism coverage bill
Fri, 09 Nov 2007 00:27:42 GMTCOLUMBUS, Ohio - Fully insured health plans would be required to cover diagnosis as well as treatment for autism under an Ohio House bill advocates say would expose autistic children to early treatment that will benefit them the rest of their lives.
The proposal, which has bipartisan sponsors, is modeled after the two-month-old mental health parity law that requires health insurance providers to cover certain psychological conditions. Currently, many health plans cover the diagnosis of autism but not treatment.
"I just feel like taxpayers shouldn't have to pick up the tab," said Tamara Heydt, a mother of two autistic children, 9-year-old Gavin and 11-year-old Garrett. "My insurance should have to pay for it. Insurance companies pay for other neurological disorders. I feel like it's discrimination."
The family spent $60,000 on treatment in one 18-month period.
The Heydts were able to stave off bankruptcy because her children qualified for Medicaid waivers after their diagnosis. The family is insured through Medical Mutual of Ohio.
Joseph Gibbons, director of government relations for Medical Mutual, said his company doesn't cover autism treatment and doesn't believe any employer who buys insurance has ever asked for the coverage.
Insurance industry officials want more details about the House bill, which is being sponsored by Republican Rep. Jon M. Peterson and democratic Rep. Ted Celeste, both of suburban Columbus. Insurance officials are concerned the bill would lead to more mandates based on a disease or health condition.
"Each individual has the belief that their cause is the one that the government needs to find the solution to," said Kelly McGivern, president of the Ohio Association of Health Plans. "We believe employers who buy policies should make the decision."
Continuing treatments, involving such things as speech therapy, a psychologist working on socialization skills and home health aides, aren't covered, said Jacquie Wynn, director of the Center for Autism Spectrum Disorders at Nationwide Children's Hospital. Autistic children, she said, need 30 hours to 40 hours of intervention a week.
Wynn said 30 percent of families who come to the center for treatment leave because they can't afford it.
"There's a cost savings in the reduction of aggressive behavior or the self-care skills they learn," she said. "With short-term, early intervention in their early years, you see the payoff in their lifetime."
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Information from: The Columbus Dispatch, http://www.dispatch.com
Pill slimly raises cervical cancer risk
Fri, 09 Nov 2007 01:38:56 GMTBy MARIA CHENG, AP Medical Writer
LONDON - Women taking the birth control pill have a slightly higher risk of cervical cancer, but that risk disappears a decade after they stop taking it, scientists say.
International researchers reported Friday in the British medical journal The Lancet that women who took the pill for at least five years had nearly double the cervical cancer risk of women who had never taken the pill.
But that risk is small and outweighed by the fact that the pill reduces the threat of other forms of cancer, The Lancet report said.
In developed countries, women up to the age of 50 who have never used oral contraceptives have a 3.8 in 1,000 risk of developing cervical cancer. That rises slightly to 4 in 1,000 for women who use the pill for at least five years, and 4.5 in 1,000 for those who use it for a decade.
In developing countries, taking oral contraceptives raises the risk of cervical cancer from 7.3 in 1,000 to 8.3 in 1,000.
"The bottom line is that this is a very small risk," said Dr. Debbie Saslow, director of breast and gynecological cancer at the American Cancer Society. Saslow was not linked to the study.
Cervical cancer cases typically affect women in their 30s — when many may be on the pill.
Previous research has linked the pill to cervical cancer, but the Lancet study appears to show for the first time that this connection is temporary. Ten years after women stop taking oral contraceptives, their risk for cervical cancer is virtually the same as that for women who never took them.
The research was led by Dr. Jane Green of Cancer Research UK's epidemiology unit at the University of Oxford.
Green and colleagues examined data from 24 studies worldwide, including 16,573 women with cervical cancer and 35,509 without it. The study was funded by the World Health Organization, the International Agency for Research on Cancer and Cancer Research UK.
Experts are not sure why oral contraceptives — which contain estrogen and progestagen — might increase the cervical cancer risk. The contraceptives also are thought to raise the chance of breast cancer, which may be triggered in part by hormone imbalances.
But those same hormones can protect against other cancers such as ovarian and womb. And unlike cervical and breast cancer, there is no way to screen for ovarian or womb cancer.
"The small increases in risk for cervical and breast cancers are outweighed by reduced risks for ovarian and womb cancer," Green said in a statement.
Doctors said that as long as women are routinely screened for cervical cancer, the increased odds that come with the birth control pill should not cause concern. If detected early, cervical cancer is potentially curable.
"Fear of cervical cancer should not be a reason to avoid use of oral contraception," wrote Peter Sasieni of Queen Mary University of London, in an accompanying commentary in The Lancet.
