Friday, May 04, 2007
Fit Buddies update
As Dr. Sanjay Gupta's 2007 Fit Nation Tour heads to Denver, Colorado, for the weekend, the CNN Fit Buddies are working to improve their eating and workout habits. Here's an update from the third week of the weight-loss and fitness challenge. Read about their successes and pitfalls every Friday here on the Paging Dr. Gupta blog.

CNN correspondent Ed Lavandera:

Bare with me a moment as I crunch some numbers. I've worked in four different cities the last nine days. Take those nine days and multiply by three meals per day and that equals 27 total meals. Eighteen of those 27 meals I've eaten on the road.

I suspect there are a lot of you who live out of a suitcase. This is the biggest challenge for me. I'm getting better at making smart choices when I read through a restaurant menu but it's tough. I don't like sitting in a restaurant on the road for several hours. Often I just want to order the quickest and easiest item on the menu so I can get out of there. This might sound crazy to some of you but ordering the right food requires a lot of "brain energy" for me. More than anything, it's a mental challenge for me. When you're tired, cranky and wrapping up a 15- hour work day taking the extra time to find the healthiest option is a chore.

CNN Domestic director of coverage Stacia Deshishku:

Long before I joined the Fit Buddies bandwagon, I planned a girl's trip to Jazzfest in New Orleans. Therefore, last weekend was a challenge for me to stay on track with my eating and exercise. There is simply no city like New Orleans - especially when it comes to eating and drinking! The weekend had high points as well as its share of low ones. On the one side, I really thought about my food choices. At the fest, instead of etouffee and fried bread, I opted for salad and sushi. Instead of sitting all afternoon, I walked around and around the fairgrounds. I racked up 30,000 steps on my pedometer! On the downside, I did partake in some of the Big Easy's most famous delicacies - hurricanes and beer! The "old" me would have fallen off the wagon and not gone back to the gym. But the "new" me privately looked forward to Monday's grueling workout with someone who could help me refocus on the task at hand.

This week's lesson: cheating doesn't have to spell the end! Just make the best choices possible at the moment, don't get discouraged and jump back on the bandwagon ASAP!

CNN Medical News producer Matt Sloane:

As I sit on a plane ready to takeoff to the next Fit Nation stop in Denver, I'm reflecting on last week's stop - New Orleans. I don't have to tell you that it's a city of excess, or about how many poor choices I made because Stacia already has covered the temptations.

The plan was to get back to town, get back on the wagon with my eating and working out, and just regard last weekend as a "speed bump" of sorts on the road to fitness.

You know what they say about plans. With only 2 1/2 days in Atlanta before leaving again, it seemed there were things that needed more immediate attention than my diet. My house was a mess, my dog was lonely, my chain link fence needed to be finished, and I had a ton of prep work to do for the Denver trip.

Guess what? No workouts this week. We're heading to a Cinco de Mayo festival in Denver, but I promised myself, Robert and my girlfriend that I would eat well and keep the drinking to one margarita with an old buddy of mine. Here's hoping my will power is stronger than the allure of authentic Mexican food!

Fitness trainer Robert Dothard:

We all knew this stuff was going to happen - that there would be bumps in the road to fitness for each of you. But I encourage you to keep the faith and workout and make good-for-you food choices. There will always be set backs and challenges. So what do you? First, refocus - remember why you started this fitness journey in the first place (odds are those reasons still exist). Second, educate yourself on healthy eating, fitness and exercise. Lastly, and you could see this coming, take different ACTION. For example, over the next week, I would love to see a lot fewer nutrition and exercise log entries start with: "I was bad"... "I caved and had XYZ"... and of course the final type of entry... a selection from the library of excuses we all have!

Next week let's re-start - not to dismiss all the work you have done so far - I mean you have inspired me to lose 10 lbs and 1 percent body fat since we started, but to keep us all from leaning on old habits like an athlete clings to his or her glory days.
Thursday, May 03, 2007
Paying for your life
Every year, around 6,000 people learn they have ALS or Lou Gehrig's disease. That may seem like a small number, unless of course you are one of those people, or love one of those people. It is an awful disease that robs people of strength in their extremities and then relentlessly marches toward the center of the body, eventually causing paralysis of the throat muscles and diaphragm. There is no cure, and once diagnosed, people are essentially handed a death sentence.

Unfortunately, there has been little progress made in the treatment of this disease. Many believe that is because there are few incentives to investigate and develop medications, because of the small number of potential beneficiaries. Unlike other neurodegenerative problems, such as MS, there are fewer clinical trials for ALS, and investigators have greater difficulty securing funding. That could be why so many more advances have been made with MS. To be fair, ALS is considered an "orphan disease," and because of that there are some federal incentives to reduce the cost of drug development. Many researchers, though, say it is not enough.

This morning, we told the story of an investigator who decided to get creative. He went to his own patients and suggested that they pay to be a part of a clinical trial. He didn't require payment, but he explained that the trial was in jeopardy without more money. We followed one patient who gave $4,500 and another patient who thought it was wrong to pay and gave nothing. Both say that ultimately, they were treated fairly and even had some benefit from the medications.

It does raise a larger issue. Should patients with a terminal diagnosis be asked to pay to participate in a clinical trial or is that ethically questionable? Should we as a society do more to support funding for rare diseases, such as ALS? What are your thoughts?
Wednesday, May 02, 2007
Is melamine changing your diet?
For the past two months, pet owners have been wondering whether they were feeding their cats and dogs food that might kill them. That's because the Food and Drug Administration found melamine and melamine-like products in various pet foods. The official death toll for animals is still at 17, and the Food and Drug Administration says it has received reports of thousands more.

Melamine is normally used to make plastics, building supplies and is also used in fertilizer - it was found in wheat gluten imported from China. Cyanuric acid, is a compound similar to melamine, normally used in swimming pool supplies, was found in rice protein, also imported from China. 153 different pet products have been recalled, and it was thought to be an animal problem. However, that changed in the past week, when we learned that the contaminated products had made their way into the human food supply.

Now we know that almost 3 million chickens and at least 350 hogs may have consumed animal feed mixed with this tainted pet food, and these chickens and pork products have made their way into the supermarkets and on to people's dinner tables.

But the FDA tells us they "believe the likelihood of illness after eating pork from hogs [and chickens] that were fed the contaminated product would be very low." You may be wondering, how they can be so sure? The FDA says it's all about "dilution."

I spoke with Dr. Michael Payne, a University of California-Davis toxicologist, who explained that the only studies that show how dangerous melamine can be to animals were done with pure melamine. Those studies found melamine to be 15-35 times LESS toxic than caffeine.

However, pets tend to eat the same pet food day after day, so if the food they eat is tainted, they're more likely build up a concentration and get sick from it. People are different. We eat a variety of foods. First of all, not every meal we eat includes chicken or pork. So here's how the FDA explains it:

Pet food with melamine is already considered diluted (not pure melamine). When the tainted pet food is mixed with the animal feed, it's diluted again. When the chickens or pigs eat the animal feed, and we consume the product, it's diluted another time. And when we digest the food, it's diluted again.

That's why they are comfortable telling us that the risk to humans is minimal.

Have you changed your eating habits based on this latest news? Are you concerned about the possibly having consumed tainted chicken or pork?
Tuesday, May 01, 2007
Doctors & drug companies
I'm back today after being away for a little while. I was out spreading the word about "Chasing Life," a CNN special and an accompanying book. Thanks to many of you, the book is a New York Times and national best seller. I hope all of you get a chance to chase life. I decided to write the book after the birth of my first daughter, and now I truly practice what I preach. While I never really thought about mortality, I do know that I want to be around as long as possible, and I believe this book could help us all.

On my first day back, I'm reporting about the cozy relationship between the pharmaceutical industry and doctors, based on a new survey published in the New England Journal of Medicine. I was surprised to learn that 94 percent of physicians have some sort of relationship with the pharmaceutical industry. That means just about every physician that cares for you has interacted with the industry in some way. Most of the time (83 percent), the relationship is based on food and beverages provided to doctors, such as a catered lunch. Another popular icebreaker (78 percent) is free drug samples, and about a third of the time the relationship involves money-- actual payments to doctors for consulting services or for lectures.

Breaking it down even further, the survey found that family practitioners are most likely to meet with representatives from the pharmaceutical industry, and cardiologists are most likely to accept payments. Doctors at hospitals and clinics were less likely to meet with the drug companies than physicians in solo practice.

So, what does this all mean for you? On one hand, an argument can be made that these drug representatives help educate doctors about new medications and therapies. That certainly could be in your best interest. Others argue that relationships, ANY relationships, between doctors and the pharmaceutical industry are unscrupulous and should be questioned. Where do you come down on this issue? Again, keep in mind- as it stands now, more than nine out of 10 doctors interact with the pharmaceutical industry in some way.
Monday, April 30, 2007
What is in the best interest of the dying?
There are few things sadder than seeing a child with a tube up his nose. When Catarina Gonzales first showed me video she had shot with her camera phone of her little boy, Emilio, my heart broke for them both. Emilio is Catarina's life, and soon, Emilio will die. The 17-month-old suffers from Leigh's disease, a rare genetic disorder that's destroying his central nervous system. Emilio can't hear, see or eat without help.

Emilio is spending his final days in the Pediatric Intensive Care Unit at Austin Children's Hospital in Texas. A ventilator keeps him alive. Doctors say they can't help him. In fact, they believe the ventilator is prolonging Emilio's suffering. The hospital, which is run by the Catholic church, believes the ethical thing to do is to stop life support and let Emilio die. In Texas, that's permissible. Under a law signed by then-Gov. George W. Bush, a hospital can cease life support if it is deemed "medically inappropriate".

But Catarina says it's not her son's time. She is suing the hospital. The two sides have been in and out of court, with the next hearing scheduled for May 8. Catarina contends the hospital is "trying to play God by saying who lives or dies." She says that Emilio isn't in pain and that he responds to her touch. In the meantime, Catarina is by Emilio's side day and night. She spends hours on her cell phone, trying to find another hospital to take her son. But so far, she's had no luck.

In some ways, Emilio's situation is the same one thousands of American families face every day. When death is near, what is in the best interest of the dying? Should doctors have the final say or the family?
Get a behind-the-scenes look at the latest stories from CNN's chief medical correspondent, Dr. Sanjay Gupta, and the CNN Medical Unit producers. They'll share news and views on health and medical trends -- info that will help you take better care of yourself and the people you love.
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