Category: Health Care Tips

The Government’s Tobacco Regulator Is About to Get Tough

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The Food and Drug Administration announced last week it was seeking public input on regulating menthol cigarettes, a necessary step toward banning or restricting sales. That’s the second major move since Mitch Zeller took the reins of the FDA’s Center for Tobacco Products in March. Zeller, who worked at the FDA in the 1990s, has been active in the public-health community for two decades and criticized the agency’s slow progress in the wake of the 2009 Family Smoking Prevention and Tobacco Control Act, which gave the FDA unprecedented authority to regulate tobacco products. Edited excerpts of his conversation with National Journal follow.

What are the big issues?

With all the progress that has been made over the last half century on tobacco use, it’s still the leading cause of preventable death and disease in this country. With over 440,000 people dying each year prematurely from tobacco use, we have over 300,000 kids becoming regular smokers every year. They’re not quite replacing those who are dying one for one, but three of every four smokers who die prematurely each year are being replaced. Every day, we have over 3,500 kids who light up for the first time. We have so much more work to do on this most urgent of public health issues, and our commitment to prevention is paramount.

What message works?

Don’t preach. Don’t lecture. Don’t just talk about the harms. Figure out a way to reach kids with an approach that will get their attention, that will make them more interested and more concerned, but that ultimately leaves the decision to them. But [help them] make that decision in a more informed, enlightened, self-confident way. We’re just in the research phase of the FDA commitment to public education; the first pieces of this campaign won’t start being unveiled until late in the year.

Last month, the FDA blocked four tobacco companies from introducing new products in the U.S.

Historically, in the unregulated marketplace, tobacco companies decided which new products were brought to market. For the first time, a science-based regulatory agency said some new products could come to market under the “substantial equivalence pathway” [proving they were no more harmful than products currently available], and some new products could not.

When is the decision on regulating electronic cigarettes coming?

When Congress passed the [Tobacco Control Act] four years ago, the initial grant of authority was only over cigarettes, roll-your-own tobacco, and smokeless tobacco. FDA intends to expand its regulatory authority over all products that meet the definition of a tobacco product. We’re getting closer to being able to do that.

How will new FDA regulations affect innovation in the tobacco market?

It’s hard to say. E-cigarettes seem to be an example of consumers voting with their pocketbooks, that they are open to new and more novel ways of getting their nicotine. If the day comes when we have a more fully regulated marketplace for nicotine products, FDA will be closer to what I call a “comprehensive nicotine regulatory policy” that could respond to what consumers may be saying, which is, “We’re interested in products that may pose less risk.”

What are your own benchmarks for success?

[Making] an investment in enforcement, an investment in science. We have a major commitment to public education, and this is going to start to unfold, mostly in 2014, with a focus on educating kids in a meaningful way. A researcher in the United Kingdom, Michael Russell, wrote in the 1970s that people smoke for the nicotine, but they die from the tar. FDA has an opportunity to create a comprehensive nicotine regulatory policy that recognizes that at the individual level, there’s a continuum of risk. Different products with how long does nicotine withdrawal last pose different levels of risk. And FDA now regulates the full spectrum of nicotine-delivering products, from conventional combustible cigarettes to medicinal nicotine products at the other end–the gum, the patch, the lozenge. Policy gets made at a population level, not at the individual level. But within this framework of a comprehensive nicotine regulatory policy, [we can drive] current cigarette smokers who are unable or unwilling to quit from the most harmful form of how much nicotine in a cigarette delivery to the least harmful form.

Any other reflections on your first few months on the job?

I’ve been struck by, even in the discussions with the tobacco industry, the candor that has been mostly present.

Were you a little hard on your predecessors about the speed of change?

Yes. There’s been a certain reality check that has occurred as I’m back inside of government, and I see what–because of the way the law and the rules work–the public just doesn’t see, which is, these things take time. But having said that, there is still an opportunity to try to move things through with some speed.

Lose weight this winter: Your easiest at-home workout

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Want to prevent winter weight gain? You don’t need fancy equipment or even a lot of time–just these six calorie-smoking moves from Denise Taylor, a personal trainer at Fitness by Design in New York City.

For best results, do all six moves three to five times a week. Each one gets your heart pumping and works major muscle groups. The repetitions suggested are just a starting point; do more as your strength and stamina improve. Use these moves all winter long and greet spring in sleek shape!

1. USE WAIST CINCHER

  • a. Position yourself as shown with feet spread wider than hip-width apart. Tighten your abs and bend your left leg, keeping right leg straight, and bend from the waist to reach both arms to the floor at your left side.
  • b.&c. Slowly raise your upper body and arms overhead in a smooth, arching motion.
  • d. Bend your right knee and bring both hands to the floor at your right side. Repeat the movement on opposite side. Do 20 reps.

2 BUTT AND THIGH MASTER

  • a. Position yourself in a squat, with feet pointing slightly out. Tighten abs; place your hands on hips for balance. Make sure knees do not extend past your toes.
  • b. Leap straight up into the air, and land in the squat position. Do 15 reps.

3 BUTT BLASTER

a. Start with feet together as shown, knees bent and pointing to the right. Bend arms so they’re at waist height, and reach to the left. b. Jump straight up. c. As you come down, shift hips to the left, and land with knees bent and pointing to the left, arms reaching to the right. Do 15 reps.

4 FAT ATTACKER

  • a. Stand as shown, feet shoulder-width apart, arms by your sides.
  • b. Jump into a straddle stance–left leg in front, right leg in back. At the same time, scissor your arms–left arm in front, right one in back.
  • c.&d. Next, jump and reverse positions of both arms and legs. Keep your motions as smooth and flowing as possible. Repeat on opposite side. Do 15 reps.

5 LOWER-BODY TONER

  • a. Stand with feet hip-width apart. Bend knees into a squat and lean forward from the waist, keeping your back straight. Place hands on hips for balance.
  • b. Straighten legs and push your right leg behind you as high as you can without arching your back (think speed skating). Keep your right foot flexed. Return to squat, repeat on opposite side. Start with two or three 15-second sets; work up to 30-second sets.

6 BODY BUFFER

  • a. Stand as shown, feet about shoulder-width apart.
  • b. Squat down, placing hands flat on the floor alongside of or in front of your feet. (Let comfort be your guide.)
  • c. Jump and push both feet back, straightening your body into a push-up position. Jump and push both feet back to squat; stand up. Do 15 reps.

Treat your feet right

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You know it’s been a long winter when you go to put your best foot forward … and you don’t have one. A winter cooped up inside shoes makes for feet full of corns, calluses, aches, plantar fasciitis so you may need best shoes for plantar fasciitis. But if you put yourself on our foot-fitness program now, you can be sandal-ready this summer. If Cinderella’s stepsisters had heard about this program, one of them might have lived quite happily ever after in glass slippers, too.

IF THE SHOE DOESN’T FIT…

Those glass slippers bring us to our first point. Corns and calluses are made, not born. Both are caused by continual rubbing, which creates the hard, dry skin that builds up and causes trouble. The prime cause is wearing shoes just because they look great, even when they don’t fit right.

“It’s not just tight, pinching shoes that cause problems,” says New York podiatrist Terry L. Spilken, D.P.M., who works with, among others the Alvin Ailey American Dance Theatre. “Loose shoes can be just as bad for your feet, which slide around in them, creating the friction that ultimately leads to calluses and corns.”

The only difference between corns and calluses is shape: A corn is conical and compresses into the skin. Its shape concentrates the pressure on the area, making it more painful than a callus, which is flat.

“Realistically, I don’t expect every one to convert to properly fitting shoes. But at least I can make you aware of why you’re having the problem says Dr. Spilken. Shoes that fit right should support your foot without reshaping it. “You should have about one finger’s width between the shoes tip and your longest toe for some people this is their second toe),” says Dr. Spilken. The widest part of the shoe should correspond to the widest part of your foot.

A shoe store can only go so far in giving you sandal-pretty feet. When corns and calluses cause pain, go to a podiatrist. The doctor will examine you to determine what’s contributing to your foot problem. A corn on the top of a toe can hurt so much that you compensate by changing the way you walk. This, in turn, can create a whole new problem by putting too much pressure on your knee or hip. “You don’t want somebody to treat just a symptom,” says Dr. Spilken.

SLOUGH OFF PROBLEMS

For some people, calluses and corns have a biomechanical origin. They’re caused by the way a person walks naturally. For these people, that can be corrected with an orthotic (a shoe insert), says Dr. Spilken.

Regardless of whether a corn or callus is caused by bad shoes or a biomechanical defect, the number-one treatment when there’s pain is to cut away the problem area with a scalpel. Do not try to do this at home with your razor or scissors. You can cause extreme damage and infection. When done by a podiatrist, this is a safe and virtually painless procedure.

If your problem is only mild calluses that don’t hurt, or if you’re mainly interested in preventive maintenance, you can begin your foot fitness program at home or at a pedicurist’s. At home, don’t use anything harsher than a pumice stone to slough off dead, dry skin. “Spend five minutes soaking your feet to soften them before using a pumice stone to gently scour away dead skin,” says Dr. Spilken.

When you’re out of your bath or shower, or just before bed, massage a moisturizing cream into your feet. Begin doing this daily. After a few weeks, you may be able to reduce this to once a week and still be callus-free.

WAKE UP TIRED FEET

Imagine how sore your arms would be if you had to keep them in one position for a whole day… and they had to tote your whole body weight, as well. Sound tiring? It is for your feet. That’s why Dr. Spilken says that exercise and movement of the feet is vital. “By keeping the joints limber and with a good range of motion you can minimize the chances of having pain.

These two exercises can help you become footloose, if not fancy-free. (1) Sit with your toes on the ground and your heels off. Press into the floor and release. Repeat five times. (2) Take a minute or two a day and make circles in the air with your foot while sitting.

Another good pick-me-up for your feet is a soak in hot water at the end of the day. “The heat is terrific for getting the blood go and for relaxing the muscles,” explains Dr. Spilken. Then moisturize. Put some moisturizer in the palm of one hand and rest one foot on the opposite knee. With the heel of your hand, knead your foot, in a circular motion, from one end to the other. Knead the arch with your thumbs. Move along the soles and sides of your foot. Flex each toe back and gently rotate it. Tug it gently. Switch feet and repeat.

How to shave

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How you can avoid such a grisly fate–and how experienced shavers can get better results.

1 If this is your first time, or you haven’t shaved in a couple of weeks, use a beard trimmer to take your hair down as short as possible–just stubble on your legs.

2 Get into the shower and go through your normal washing routine. This way your skin gets warm and pliable, and the hair becomes soft. Never shave when you have goosebumps or you feel at all cold. That’s how you get razor burn.

3 Keep the shower running if you can step away from the direct stream (which otherwise will prematurely wash off shaving cream). If you can’t get out of the spray and the room is warm, turn the shower off, but keep a trickle of warm water running to clean the blade. If you can’t get out of the stream and the room is cold, turn your back to the water and do the best you can.

4 If you’re inexperienced or frequently cut yourself, apply a pre-shave oil to the problem areas. These are usually the ankles, the contours of the kneecaps, and the backs of your knees.

5 Apply shaving cream to your entire leg, from thigh to bottom of ankles. Ideally you use a shaving brush to apply it. A brush spreads the cream most easily and efficiently. A washcloth is next in preference, then your hands.

6 Start shaving. It’s okay to go against the grain, and it doesn’t matter if you shave from the thighs downward or ankle up. Just go slow and, around the problem areas, use short but smooth strokes. If you’re working in dim light, check for missed patches.

7 When you’re done, you’re not done. Rinse and look for spots you missed. Touch up the job. Repeat the process as necessary.

8 When you get out of the shower, use an alcohol-free moisturizer or aftershave balm. That will keep the legs from chafing. Swap out the blade after every two or three shaves.

Pet power!

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Puppies, kittens, birds, bunnies, ferrets, hamsters, snakes, lizards, fish–many people enjoy having pets. Are there health benefits to being a pet owner? What are the potential downsides? That’s all for you to find out!

* First, focus. Typing pets and health into a Web browser would probably yield mainly sites about keeping pets healthy. So narrow your topic for better results. Examples: pets and allergies, pets and Alzheimer’s disease, pets and grief. Sort through the sites you find to identify the trustworthy ones. Collect information relevant to your topic.

* Next, do some primary research. Have a pet yourself? Then you may have a head start. Otherwise, find a place in your community that relates to your topic. Maybe a nursing home welcomes therapy animals, or a veterinarian can tell you about fleas spreading from pets to humans. The firsthand anecdotes you gather by talking to people aren’t a substitute for studies and statistics, but they may help interest people in your topic.

* Take what you’ve learned, and try to educate people about it. Perhaps a pet store will display your poster about how to avoid catching a disease from a pet. Or maybe your newspaper will let you write an article on service animals. Use your imagination!

START HERE: These Web resources can help.

CDC Healthy Pets Healthy People

www.cdc.gov/healthypets

HealthLink BC

www.healthlinkbc.ca/healthfiles/hfile61a.stm

Delta Society

www.deltasociety.org

6 ways to get ready by summer

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Summer is here. Are you ready for it? As busy as our lives are, there’s a very good chance that you are like most of us, and the warm weather and all that comes with it has caught up with you, Never fear! The following are six tips to help you get ready for this incredible season of outdoor fun:

1 GIVE YOURSELF AN HONEST ONCE-OVER. Stand in front of a full-length mirror and look at yourself from head-to-toe–naked. Really. It may not be the easiest thing for you to do, but it’s important for you to assess your physical body. If you need to work on it, the time is now.

2 TEND TO YOUR SKIN. This is the season when bare becomes essential. That means you’d better pay attention to the skin you’re going to be showing. Have you been exfoliating and moisturizing? How do those elbows look in the light of day? What about your legs? Do you need to shave? And fellas, this includes you and your skin. Men commonly don’t use lotion on their bodies. Trust that nobody wants to see ashy skin when you put on those shorts.

3 EVALUATE YOUR WARM-WEATHER WARDROBE. Go through your closet carefully to see what you own for the season. Lay out outfits together as well as individual pieces. Try on everything to ensure that the clothing still fits you well and represents your style. Anything that doesn’t work, remove it from your closet. Give it away. Sell it on eBay. Don’t stash it farther into your closet.

4 REVIEW YOUR ACCESSORIES. What bags, shoes and jewelry do you have in your possession for the season? Match them with your outfits to see if you have what you need. And here’s another area where you may be able to show your generous side and give some of your goodies away. For the past few years, accessories for women have been key signature pieces. As the prices have skyrocketed, the desire for the next “it” accessory has become all the craze. Be mindful not to fall into that hole. Check what you’ve got before you go shopping.

5 MAKE A SHOPPING LIST. For women, key items for the season include floral dresses, navy and white ensembles, full circle skirts, enamel jewelry, wedge sandals and colorful, strappy stilettos. For ideas, visit neimanmarcus.com. For men, look to add argyle sweaters (argyleculture.com), skinny jeans and flat-front pants.

6 SELECT A SWIMSUIT. One of the toughest purchases per season is to select a swimsuit that looks just right on you. If you haven’t selected one yet, the pickings could be slim, so go now–with a buddy, if you dare. Appreciate a bit of control? The Miraclesuit offers just that with varying degrees of tummy control (miraclesuit.com). For modest swimwear, look for whole-pieces that have color emphasis where you want the eye to go, suits that are darker in camouflage areas, or you might want to consider tankinis. If you dare, go for a bikini. Just make sure it fits! Ready or not, summer is here. Enjoy!

Why am I eating a lot but losing a lot of weight?

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There’s no way for you to know without getting checked out in person. For an overview, though, we asked Dr. Yolanda Reid Chassiakos, clinical assistant professor of pediatrics at the University of California, Los Angeles. Besides rapid growth in the teen years, there are other possible reasons.

Problems with the thyroid are one common cause. That tiny organ in your neck is “the engine of the body,” according to Chassiakos. It can “speed up the metabolism and burn more fuel and calories, resulting in .”

Sometimes, infection can cause unintended weight loss by messing with the digestive system. So can enzyme deficiencies, rogue cells, hormone problems, and diabetes. “Certain medications, as well as legal and illegal drugs, can cause a teen to lose weight,” adds Chassiakos. And people worried about their weight, or other mental and emotional issues, may overestimate how much they’re eating.

So see your health provider. He or she will ask about your life, health, diet, and activity level, plus perform a physical exam and other tests. With a diagnosis, says Chassiakos, “medical treatment, nutritional coaching, or counseling can often help a teen regain desired weight–and good health.”