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BY MARGARITA CAMBESTNEW ERA STAFF WRITER

Exposure to second-hand smokehas steadily decreased over thelast 20 years, and the Centers forDisease Control and Preventioncredits that decline to a growingnumber of laws that ban smokingin workplaces and public spaces.

The District of Columbia and 26states have comprehensivesmoke-free laws, but Kentucky isnot one of them.

In the newest issue of the Ken-tucky Health Issues Poll, adultswere asked whether they favoreda statewide smoke-free law. Ken-tucky currently leaves the decisionto ban smoking in restaurants,bars, public spaces and work-places to municipalities and localgovernments. Sixty-five percent fa-vored a statewide smoke-free lawwhile 29 percent opposed it. Sixpercent had no opinion.

The poll has asked respondentstheir views on a comprehensivesmoke-free law annually since

2010, and support for the law hasconsistently increased since 2010with a clear relationship betweenpeople who oppose a statewideban and whether one smokes.Eighty-four percent of people whohave never smoked said they sup-port a smoke-free law. Seventy-

two percent of former smokerssupported it, and out of the 33 per-cent of responders who said theywere smokers, only 38 percentsupported a statewide ban.

Political-party identification, how-ever, didn’t seem to make much ofa difference in whether someone

supports smoke-free legislation, as69 percent of Democrats, 64 per-cent of Republicans and 57 per-cent of independents said theysupported a statewide smoke-freelaw.

Also in the newest poll, 75 per-cent of Kentucky’s working-ageadults said they were insured bysome means. Previous KHIP statis-tics suggested an increasedamount of adults were using publicinsurance, but 44 percent of thosepolled in 2013 said they rely onemployer-provided insurance, anincrease from 2008 to 2012, ac-cording to KHIP statistics. Re-search must still be done beforedeciding whether this is a tempo-rary shift or trend in the source ofhealth insurance for Kentuckyadults.

More than 25 percent of peopleage 18 to 64 are currently unin-sured with lower-income adultsmore likely to be among thosewithout insurance. An additional 8percent lapsed in their coveragesometime in the past year.

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Page 4

BY MARGARITA CAMBESTNEW ERA STAFF WRITER

Healthy living resolutionsrun rampant at the start of anew year.

This year is going to be dif-ferent, everyone tells them-selves. This is the year tomake that lifestyle change.

The end of winter loomsnear and that elusive bikinibody is once again up forgrabs. Maybe you want toeat better, exercise more,tone up, lose weight or quitsmoking.

Midway through the year,54 percent of people have al-ready given up their resolve,according to researchers atthe University of Scranton. Ofthat enthusiastic, resolution-making lot, 36 percent fail toeven make it through themonth of January. At the endof the year, only eight per-cent of people actually followthrough with those resolu-tions. What gives?

Carrie Davidson, a well-ness coordinator for Univer-

sity of Kentucky Human Re-sources, said that while thestatistics may be daunting,there may still be some lightat the end of the tunnel. Amyriad of fitness apps andstrategies may be just thepush some people need tomeet their goals this year.

Share on socialmedia for success

Just as support groupspositively reinforce goodchoices and help curb nega-tive choices, Davidson saidsocial media serves as rein-forcement for those that mayneed an extra push. Sharingon social media sites likeFacebook and Twitter maybe just the motivation someneed to stay on top of newgoals.

Although it doesn’t helpseasoned exercisers much,one of the main reasons a“sharing strategy” is effec-tive is the accountability fac-tor.

“Sharing on social media ismore effective for new exer-cisers or yo-yo exercisers,”

Davidson said. “And peoplethat don’t have it as a lifestylehabit.” Davidson said sea-soned exercisers aren’t asmotivated by sharing withothers because they usuallyalready know how to holdthemselves accountable.

But for new exercisers,after telling half of the office,friends and family that this isgoing to be “the year” noone really wants to be “theone” to fail.

Use fitness appsto reach goals

A list of UK approvedhealth and wellness appsputs RunKeeper and Map-MyRun at the top. Davidsonalso suggests apps likeCouch-to-5K for specific dis-tance goals and MyFitness-Pal for help on the diet side offitness.

“Most apps have a freeversion,” she said. “Try it. Ifyou like it, get the big onethat you pay for. It doesn’thurt.”

If you’re shooting for dis-tance running, apps that use

GPS to track mileage mayalso be helpful. Experts rec-ommend replacing runningshoes every 350 miles or so.The stored information onthese apps reminds you toreplace your shoes beforeyour joints do.

Some other helpful fitnessapps on the market includeCardioTrainer, an app thatrecords many different typesof activities, Fitsby, one thatallows you to bet your wayhealthy, and Zombies, Run!,a simulated outdoor zombiechase.

Cut the fatWhile some might see

this as a drastic change, cut-ting out negative influencersfrom your life may help youfight weight gain. Instagramand Pinterest are chock-fullof some of the unhealthiestdishes out there. Deleting orhiding users that post onlypictures of deep-fried Oreosis a start.

While anyone needing a“cheat meal” can find plentyof inspiration on either social

media platform, both ac-counts may also be used forgood.

“There are two groups (onPinterest),” she said. “Peo-ple who pin everything anddo nothing and people whoare really specific about whothey follow, what they postand do.”

Stay organizedAn electronic calendar

complete with alerts couldmake the difference be-tween success and failure.Sync your Google calendarson Android devices or useApple’s calendar on theiPhone. Both will get the jobdone. Davidson said planningworkouts as you’d plan ameeting makes it more likelythat they will be completed.

“You don’t take it off orbump it around and you say‘I’m sorry. I’m not available atthat time,’” she said. “It willlet you know, ‘hey, it’s timefor your workout’ and thenyou make a conscious deci-sion at that point whether ornot to exercise.”

BY MARGARITA CAMBESTNEW ERA STAFF WRITER

Americans have a problem withportion sizes, and Christian Countyresidents are not immune, said Lin-sey Ramage, a registered dietitian atthe Christian County Health Depart-ment.

With so many resolutions eachyear centering on healthy living, it's aperfect time to take a closer look atwhat and how we're eating, she said.Here are the dietitian's four tips onhow to finally stick to those resolu-tions this year. Bonus – you don'teven have to give up all the sweets.

Decrease portion sizeRamage said she first and fore-

most directs clients to track anddecrease their portion sizes. "Typi-cally our portions are much largerthan they should be." One way tosolve the problem of overloadedplates is serving on smaller platesto trick yourself into thinking you'regetting the same amount of food."If you're using a smaller plate

you're typically going to eat lessbecause there's less room on theplate."

At a restaurant, Ramage sug-gests asking for a takeout box tosave half the meal before you starteating. Avoiding sugary drinks –alcoholic and not – and skippingthe bread basket are also goodstrategies for safe meals awayfrom home.

Eat slowIt doesn't have to be Thanksgiving

every day, Ramage said. "Our brainneeds time to register that we'reeating and that we're full. Typicallywe eat really fast and by the endwe've stuffed ourselves but don'trealize that until we're done eating."

Slowing down might even allowyou to actually taste and enjoy dif-ferent types of fruits and vegeta-bles. Ramage said that while somepeople think healthy eating can beexpensive it doesn't have to be."Canned fruits and vegetable arejust as good. There's really no ex-cuse to not get your fruits and veg-

etables in," she said. "I do warnthem when they get the cannedfruits and vegetables to make sureit's no or low salt and in water, notin light or heavy, sweetened syrup."

Eat three meals a dayWhile some people might think

skipping meals to eat less overallis healthy, Ramage said it's defi-nitely not. "We need the energythroughout the day," she said.The dietitian suggests threeregular meals a day or fourto five small meals. "It'smuch easier on our bodybecause it has time to di-gest."

Follow the federalguidelines

You want to include all thefood groups into most ofyour meals, but the mainthing is watching yourserving sizes. Eatingall those food groupsmight seem like a lot

of food but if we're sticking to theserving sizes it's really not, and weare getting all the nutrients we need.Ramage said half of the plate shouldbe fruits and vegetables. Lean pro-tein should be included twice a week,and at least half the grains should be

whole grains. She also suggestsskim or one percent milk and

low-fat yogurt tomeet daily re-

q u i r e -ments ofdairy.

Tips for healthier eating in the New Year

PHOTO BY METRO CREATIVE CONNECTION

Using technology can help reach fitness goals

Page 5

NEW ERA STAFF REPORT

Jennie Stuart Medical Center isoffering the following free classesand events in February. Classesand events are updated frequently.For the most up-to-date listings ofthe hospital’s classes and events,go to the JSMC website atwww.jsmc.org

l 5:15 p.m. Feb. 3 – Supportgroup for spouses, caregivers andsurvivors of strokes and head in-juries at Cotthoff Learning Center,lower level of the Doctors Pavilionat JSMC. Call 270-885-7023.l 6-8 p.m. Feb. 6 – Free breast-

feeding class led by an registerednurse lactation consultant at theBoard Room, second floor ofJSMC, 320 W. 18th Street, Hop-kinsville. Reserve a seat by calling270-885-2888.l 4:30 p.m. Feb. 11 – Ramesh

Patel, MD, JSMC Radiation Oncol-ogy, will hold a Q&A session at theweekly cancer support group meet-ing of patients and family members

at Doctors Pavilion conferenceroom E, JSMC. No reservation re-quired.l 6 p.m. Feb. 18 – Weight-loss

surgery support group at DoctorsPavilion conference rooms A, B &C, JSMC. No reservation required.For more information, call 800-887-JSMC, ext. 4402.l Feb. 22, – Christian County

Heart Walk at Bradford Squaremall. For information, call theAmerican Heart Association at 270-205-0004. Registration begins at 8a.m., and the walk will start at 9a.m.l 5:30 p.m. Feb. 24 – Weight-

loss surgery informational seminarby Gerame Wells, MD, FACS, atCotthoff Learning Center, lowerlevel of the Doctors Pavilion atJSMC. Reserve a seat by calling800-887-JSMC, ext. 4402, or regis-ter online at jsmc.org.l 9-11 a.m. Mar. 1 – JSMC is a

sponsor of the YMCA’s HopDownthe Pounds finale at BradfordSquare mall. For information, callthe Y at 270-887-5382.

Jennie Stuart offers supportgroups, breast-feeding classes

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Diagnostic imaging (left) and blood draws (right), along with other lab services, arenow being provided by Jennie Stuart Medical Center in Guthrie. JSMC Guthrie Ex-press Lab and Medical Imaging is open 8 a.m. to 5 p.m. Monday, Tuesday and Thurs-day, at 10220 Dixie Beeline Highway in Guthrie, and is adjacent to GuthrieMD familyphysician practice. For more information, call 270-483-2517. SUBMITTED PHOTOS

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At the age of 12 to 15, manyyoung women are experiencingthe body and life changes that ac-company adolescence. It can bedifficult to imagine that breaststhat are just beginning to developmay contain cancer. But such isthe reality for some girls.

The majority of women who re-ceive a breast cancer diagnosis areover the age of 40. Experts atMonroe Carell Jr. Hospital at Van-derbilt University note that only 5percent of breast cancer cases arefound in women under the age of40. However, the hospital recentlytreated a 14-year-old girl whofound a lump and learned she hada rare form of breast cancer calleda phyllodes tumor. In 2009, a 13-year-old from Little Rock, Ark.found a quarter-sized lump in herright breast, while a 19-year-oldstudent at the College of New Jer-sey was diagnosed with cancerouscells and underwent a bilateralmastectomy.

Though such cases are rare, itbehooves teenage and adolescentgirls to familiarize themselves withthe disease and be mindful of theirbreast health.

Some organizations have in-creased breast cancer messagesfor young girls, and it is not uncom-mon to find young women partici-pating in runs and fundraisers forbreast cancer research. Some or-ganizations even conduct breastcancer workshops to educateyoung women about breast health.Dorothy Paterson of Texas, a for-mer Girl Scout leader who was di-agnosed with breast cancerherself, began conducting work-shops for Girl Scouts in 2007. Theidea isn’t to scare girls into believ-ing they have the disease, butrather to increase their awarenessof changes in their bodies that mayor may not be normal.

Some parents worry that educat-ing children about breast cancermay cause them to worry unnec-essarily, especially considering ayoung girl’s risk of developingbreast cancer is so minimal. How-ever, others see the importance inschooling girls early on about a dis-ease that is so common. Advo-cates of teaching young girls aboutbreast cancer often note that anyeffort to help save lives and pro-mote health is worthwhile.

Educating women about breast cancer

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Oral contraceptives have pre-vented pregnancies for decades.But some women take contracep-tives to help regulate menstrual pe-riod symptoms and to treat otherissues, including acne. Manywomen wonder if taking birth con-trol pills affects their risk of develop-ing breast cancer.

Anumber of studies indicatethat taking oral contraceptivesappears to slightly increasethe risk of developingcancer among youngerwomen, accordingto the NationalCancer Institute.However, dis-continuingoral con-traceptiveuse for 10years or morereturns risk levelsto normal. The MayoClinic notes that it is dif-ficult to weigh the effect ofbirth control pills on breast cancerrisk. Although some studies haveshown a link between the two,more recent studies do not show an

increased risk for breast cancerwhile taking birth control bills.

The variety of oral contraceptivesavailable perhaps plays a role in whystudies into the potential link be-

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as changing the mucus at the cervixto prevent sperm from entering. Atriphasic pill, in which the dose ofhormones is changed in threestages over the course of thewoman’s monthly cycle, seems tobe the biggest culprit in raisingbreast cancer risk.

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Breast cancer is the secondmost common cancer amongwomen, second only to lungcancer. One in eight women isexpected to develop breast can-cer in her lifetime, and a recentsurvey by the Society forWomen’s Health Researchfound that 22 percent ofwomen named breast cancer asthe disease they fear most. Thespecter of breast cancer makesit no surprise that women areeager to seek various ways toreduce their risks of developingthis potentially deadly disease.

Though cancer treatmentscontinue to evolve, there re-mains no cure for breast canceror any other types of cancer.However, there are steps menand women can take to reducetheir risks of developing breastcancer. In fact, the NationalCancer Institute says avoidingbreast cancer risk factors is thebest path to prevention.l Avoid exposure to radia-

tion. Repeated exposure to ra-diation therapy used to treatillnesses like Hodgkin’s diseasecan increase a person’s risk ofbreast cancer, particularly iftreatments begin at an earlyage.l Keep a healthy weight.

Obesity increases the risk ofbreast cancer, particularly inpostmenopausal women.Healthy eating and exercise canhelp women control theirweight while reducing theirrisks of developing breast can-cer and a number of other dis-eases. Scientists at The MayoClinic believe there is a link be-tween estrogen production infatty breast tissue and breastcancer.l Get your exercise. Exercis-

ing four or more hours a weekcan lower breast cancer risk.Exercise need not be heavy lift-ing at the gym. Any moderatephysical activity, from cycling to

walking, can be effective. Exer-cise decreases hormone levelsin the body that can impactbreast cancer risk. Some stud-ies indicate simply walkingbriskly for one to three hoursper week can reduce awoman’s breast cancer risk by18 percent.l Eat a low-fat diet. The

Women’s Intervention NutritionStudy from the National CancerInstitute found that the highestrate of breast cancer reductionwas among a group of women

who ate a low-fat diet.l Reduce alcohol consump-

tion. Various studies have indi-cated that women who drinkalcoholic beverages may de-velop cancer at a higher rate.Women who consume two tofive drinks daily have a greaterrisk of developing breast cancerthan those who abstain from al-cohol.l Weigh the risks of hormone

replacement therapy. There aremixed reviews on hormone re-placement therapy, or HRT, for

postmenopausal women. Theremay be a link between long-term HRT and breast cancer,particularly when estrogen andprogesterone are used in com-bination. Some doctors adviseestrogen-only hormone therapyfor women who have had a hys-terectomy.l Use of SERMs and aro-

matase inhibitors. Selective es-trogen receptor modulators, orSERMs, are drugs that act likeestrogen on some bodily tissuesbut block the effect of estrogenon other tissues. Aromatase in-hibitors decrease the amount ofestrogen made by the body.Women with a high risk of breastcancer may benefit from taking aSERM or aromatase inhibitor.l Increase fruit and vegetable

consumption. Carotenoids arecancer-protective pigmentsfound in a vast number of fruitsand vegetables. Researchers atNew York University foundwomen who had higher bloodcarotenoid levels had a signifi-cantly smaller risk of breastcancer than women with lowerlevels.l Go sparingly on antibiotics.

Only take antibiotics when theyare truly needed. New evidencesuggests that the more often awoman takes antibiotics, thehigher her breast cancer risk. Astudy of more than 10,000women found that women whotook antibiotics for the equiva-lent of about 25 prescriptionsover an average of 17 yearswhere twice as likely to de-velop breast cancer thanwomen who never took thedrugs.l Breastfeed your children.

Lactation can suppress ovula-tion and the body’s productionof estrogen, which has beenlinked to higher levels of breastcancer. Breastfeeding may dropa woman’s breast cancer riskby 4 percent.

Although there is no cure forcancer, there are a number ofdifferent ways women can re-duce their risks for breast can-cer.

How you can lower your risk of breast cancer10 quick, easy tips to turnthe odds in your favor

Regular exercise can help women lower their risk of developing breast cancer.

9

People around the world were shocked tolearn that actress and activist Angelina Jolieopted to have a double mastectomy in 2013 toreduce her risk of breast cancer. Jolie, who was37 years old at the time of the procedure, re-portedly learned that she carries a mutation ofthe BRCA1 gene, which sharply increases herrisk of developing breast cancer and ovariancancer. In addition, the actress has a family his-tory of cancer. Her mother, MarchelineBertrand, died of ovarian cancer in 2007 at theage of 56.

By having a preventive mastectomy, Jolie re-duced her breast cancer risk from 87 percent to5 percent, according to an op-ed piece she au-thored in The New York Times. Jolie is not theonly well-known actress to opt for a preventivemastectomy, as fellow thespian Christina Ap-plegate had a similar procedure in 2008 afterlearning she had a mutation of the BRCA1gene. These highly publicized cases have leftmany women wondering if a preventive mas-tectomy is something they should consider.

BRCA stands for “breast cancer susceptibilitygenes,” a class of genes known as tumor sup-pressors, says the National Cancer Institute.Mutations in these genes have been linked tohereditary breast and ovarian cancer. A person’srisk of developing breast and/or ovarian canceris greatly increased if he or she inherits a harm-

ful mutation in BRCA1 or BRCA2. Mutations inthese genes could also put a person at in-creased risk for other cancers.

Genetic tests can check for mutations inBRCAgenes. During such a test, a blood sampleis taken, and if a mutation is found, a personmay get genetic counseling and work with adoctor to develop a plan of action. It is important

to note that not all people with a genetic muta-tion will get breast cancer or ovarian cancer.The National Cancer Institute’s “SEER CancerStatistic Review” states a woman who has in-herited a harmful mutation in BRCA1 or BRCA2is about five times more likely to develop breastcancer than a woman who does not have sucha mutation.

Although there is no surefire way to deter-mine if a person with a mutated gene will de-velop breast cancer, many women who areconsidered high risk opt for a preventive mas-tectomy to reduce their risk. Women who havea family history of breast cancer, have receivedpositive results from gene testing, have alreadyhad cancer in one breast, or have dense breaststhat make testing difficult may want to get apreventive mastectomy.

The decision to get a preventive mastectomyis not one to take lightly. Many breast centersare staffed with breast-health specialists, ge-netic counselors, breast surgeons, and recon-structive surgeons who can help patients makethe best decision. Second opinions are stronglyrecommended for women considering a pre-ventive mastectomy.

Women should understand the options avail-able to them if they have an extremely elevatedrisk of breast cancer or ovarian cancer.

Preventive mastectomy can reduce risk of breast cancer

Preventive mastectomy is an option for women who areat a very high risk for breast cancer.

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Medical professionals often warnthat snack foods can be unhealthy,upsetting dieting plans and causinga person to consume more caloriesthan is recommended. While anumber of snack foods, particularlysnacks that are laden with satu-rated fats, sodium and many calo-ries, can be detrimental to yourhealth, there are plenty of healthysnacks available to men andwomen who know where to look.

“Self” magazine reports Ameri-cans consume 26 percent of theircalories at times other than break-fast, lunch and dinner. Many fit-ness plans actually recommendregular snacking as part of a “graz-ing” mentality. Grazing, or eatingseveral small meals per day ratherthan three large ones, can helpkeep metabolism primed and readyto burn calories. Grazing also en-ables a person to avoid overeatingat any particular meal. But grazingon the wrong foods can be coun-terproductive. That’s why selectingthe right snacks is important.l Aim for snacks that are 100

calories or less. One-hundred calo-rie snacks can help you fill you up

and stave off hunger pangs. Whilethere are plenty of prepackaged100-calorie snacks available, youcan easily make your own snackpacks by being conscious of nutri-tion labels. Measure serving sizesof healthy foods into separate con-tainers so you’re less likely to eat

more than is necessary.l Fill up on fruits and vegeta-

bles. Produce can make a healthysnack because it is generally lowin calories, which means portionsizes will be larger than otherhigh-calorie foods. Many fruitsand vegetables are packed with

vitamins and other nutrients,which are needed to keep a bodyhealthy. Many also make goodsources of fiber, which can helpyou feel satiated longer betweenmeals.l Choose foods with healthy

fats. Not all fats are bad. Monoun-saturated and polyunsaturatedfats lower total cholesterol andbad cholesterol in the blood.Sources of good fats includenuts, olive oil, avocado, salmon,soy, and sunflower oil. Skip foodsthat have high levels of saturatedfats, which are mainly found inanimal products. Trans fats areperhaps the worst fats to eat, asthey are produced by hydrogena-tion to give them a longer shelflife. Avoid foods that contain hy-drogenized oils.l Opt for snacks that mimic the

texture of unhealthy snacks. Some-times you may crave somethingcrunchy or a particular comfortfood. Choose a crunchy wholegrain cereal over potato chips. Ifyou desire a cool, creamy treat,frozen yogurt has much fewer calo-ries than ice cream.

Snack foods can be healthy with smart choices

While a number of snack foods can be detrimental to your health, there are plenty ofhealthy snacks options available to health-conscious people.

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BY LINDSEY TANNERAP MEDICAL WRITER

CHICAGO – Young teens aren’texactly embracing the government’sLet’s Move mantra, the latest fitnessdata suggest.

Only 1 in 4 U.S. kids aged 12 to 15meet the recommendations – anhour or more of moderate to vigor-ous activity every day.

The results are based on about800 kids who self-reported their ac-tivity levels and had physical examsas part of the 2012 National YouthFitness Survey.

Government researchers won’tcall the results disappointing, butlead author Tala Fakhouri of the Cen-ters for Disease Control and Preven-tion said, “There’s always room forimprovement.”

The CDC released partial resultsWednesday from the fitness survey,which involved kids aged 3 to 15.Other results from the same surveyare pending and include fitness databased on more objective measuresincluding treadmill tests.

Fakhouri said the nationally repre-sentative results provide useful infor-

mation for initiatives that aim to in-crease kids’ fitness, including theLet’s Move anti-obesity campaignlaunched by first lady MichelleObama in 2010.

Kids in the survey reported onwhich physical activities they didmost frequently outside of schoolgym class – basketball for boys andrunning for girls.

While few met guidelines estab-

lished in 2008 for activity that raisesthe heart rate and makes youbreathe harder, most said they did atleast an hour of exercise at thatlevel during the previous week.Overall, about 25 percent said theygot an hour of that kind of exerciseevery day

Obese kids were less active thannormal-weight girls and boys. Over-weight girls were slightly less active

than normal-weight girls, but levelswere similar among overweight andnormal-weight boys.

“It’s definitely very concerning tosee that our kids are engaging insuch a limited amount of physical ac-tivity each day when we are still bat-tling” an obesity epidemic, said Dr.Stephen Pont, an Austin, Texas, pe-diatrician and chairman of the Amer-ican Academy of Pediatrics’ sectionon obesity.

Data suggest obesity may havedecreased slightly among some kidsbut the overall rate for children aged2 to 19 is 17 percent, or about 12.5million obese kids.

Pont said schools can do more tohelp by not cutting recess and givingkids more time for physical activity.

Recent national data on kids’ fit-ness levels is limited. A 2009-10CDC survey involving kids ages 6 to11 found about 70 percent met thephysical activity guidelines, althoughlevels dropped off among older kidsin that age group. The results camefrom parents, who may be inclinedto over-report how active their kidsare because of “social desirability,”the researchers said.

Just 1 in 4 young teens meet US fitness guidelines

Central and Mirror Lake Middle School cross-country runners, wearing pink for breastcancer awareness, climb the final hill of a cross-country race in October at KincaidPark in Anchorage, Alaska.PHOTO BY THE ASSOCIATED PRESS

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BY LAURAN NEERGAARDAP MEDICAL WRITER

WASHINGTON – Talk about mindover matter: A quirky new study sug-gests patients’ expectations canmake a big difference in how theyfeel after treatment for a migraine.

Boston researchers recruited 66migraine patients in an attempt toquantify how much of their pain reliefcame from a medication and howmuch was due to what’s called theplacebo effect, the healing power ofpositive belief.

More than 450 headaches later,they reported Wednesday that it’s im-portant for doctors to carefully choosewhat they tell patients about a pow-erful medicine – because the mes-sage could help enhance its benefits,or blunt them.

“Every word you say counts, notonly every gram of the medication,”said Harvard professor TedKaptchuk, who led the new studywith a team at Boston’s Beth IsraelDeaconess Hospital.

Here’s how it worked. First, the pa-tients who suffer regular migrainesagreed to forgo pain relievers for sev-eral hours during one attack, record-ing their symptoms for comparisonwith later headaches.

Then for each of their next six mi-graines, the patients were given a dif-ferent pill inside an envelope with adifferent message. Sometimes theywere told it was an effective migrainedrug named rizatriptan, a positivemessage. Other times they were toldit was a placebo, a dummy pill, sug-gesting no benefit. Still other timesthey were told the pill could be eitherone, a neutral message.

Sometimes the doctor’s mes-sage was true – they weretold they got rizatriptanand they reallydid. Some-times it wasfalse be-cause re-searchers had

secretly switched the pills.Of course the real migraine drug

worked far better than the dummypill. But remarkably, people whoknew they were taking a placebo stillreported less pain than when they’dleft their migraine untreated, the re-searchers found.

The surprise: Patients’ reports ofpain relief more than doubled whenthey were told the migraine drug wasreal than when they were told, falsely,that it was a fake, the team reportedWednesday in the journal ScienceTranslational Medicine.

In fact, people reported nearly asmuch pain relief when they took aplacebo that they thought was thereal drug as they did when they took

the migrainedrug whilebelieving itwas a fake.K a p t c h u k

said that effectprobably isn’t

purely psychological,saying the ritual oftaking a medicationmay trigger somesubconscious mem-

ory that could leave people feelingbetter even if they knew they’d takena fake drug.

Scientists have long known thatsome people report noticeable im-provements in pain and certain othersymptoms when they’re given aplacebo, which can be a sugar pill orsham surgery or some other benignintervention. Some studies even havedocumented that a placebo actuallycan spark a biological effect.

But scientists don’t know why theplacebo effect works or how to har-ness its potential benefit.

The new research is an interestingattempt to answer some of thosequestions, at least for one kind ofpain, said Dr. Mark Stacy, vice deanfor clinical research at Duke UniversityMedical Center, who wasn’t involvedwith the work. And learning howmuch of an impact it makes couldhelp design better studies of newdrugs, to ensure the phenomenondoesn’t skew the results, he added.

For now, it shows “the power ofpositive thinking may be helpful intaking care of your migraine,” hesaid.

Study: Thinking positive helps migraine drug workPlacebo effect doubles effectiveness of medicine

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Page 13

BY LAURAN NEERGAARDAP MEDICAL WRITER

WASHINGTON – Sure yourliver or kidney could save some-one’s life. But would you donateyour hands, or your face? Signingup to become an organ donor mayget more complicated than justchecking a box on your driver’s li-cense.

The government is preparing toregulate the new field of hand andface transplants like it does stan-dard organ transplants, givingmore Americans who are disabledor disfigured by injury, illness orcombat a chance at this radicalkind of reconstruction.

Among the first challenges is de-ciding how people should consentto donate these very visible bodyparts that could improve some-one’s quality of life – without de-terring them from traditionaldonation of hearts, lungs and otherinternal organs needed to savelives.

“Joe Blow is not going to knowthat now an organ is defined asalso including a hand or a face,”said Dr. Suzanne McDiarmid, whochairs the committee of the UnitedNetwork for Organ Sharing, orUNOS, that will develop the newpolicies over the next few months.

Making that clear to potentialdonors and their families is critical– “otherwise we could underminepublic trust,” said McDiarmid, atransplant specialist at the Univer-sity of California, Los Angeles.

“The consent process for thelife-saving organs should not, mustnot, be derailed by a consentprocess for a different kind oforgan, that the public might thinkof as being very different from do-nating a kidney or a heart or aliver,” she added.

These so-called “reconstructivetransplants” are experimental, andrare. The best estimates are that27 hand transplants have been per-formed in the U.S. since 1999, andabout seven partial or full facetransplants since 2008, said Dr.Vijay Gorantla, medical director ofthe University of Pittsburgh recon-structive transplant program.

But they’re gradually increasingas more U.S. hospitals offer thecomplex surgeries, the DefenseDepartment funds research intothe approach for wounded veter-ans – and as transplant recipients

go public to say how the surgerieshave improved their lives.

“These hands are blessed handsto me,” said Lindsay Aronson Ess,30, of Richmond, Va., who re-ceived a double hand transplant in2011. She had lost her hands andfeet to a life-threatening infectionin 2007.

Until now, deciding who quali-fies for a hand or face transplant,and how to find a match and ap-proach a potential donor’s familyall have been done on an informal,case-by-case basis.

There has been no way to tellwhich hospitals’ techniques workbest and how patients ultimatelyfare. There have been reports oftwo deaths related to face trans-plants in other countries, andsome transplanted hands have hadto be amputated. Patients musttake lifelong anti-rejection medica-tions that put them at risk of infec-tions, cancer and other sideeffects.

In July, government regulationsgo into effect making hand andface transplants subject to thesame strict oversight by UNOS,which manages the U.S. transplantprogram, as heart or kidney trans-

plants. They’re part of a new defi-nition of “organ” that also includesother body parts that doctors oneday might transplant – from feetto voice boxes, maybe even theuterus. Unlike corneas, heartvalves and other simpler tissuesthat are regulated by the Food andDrug Administration, these are allcomplex mixes of blood vessels,nerves, muscles and other tissues.

The rules mean potential recipi-ents will be added to the UNOSnetwork, for matching of donatedhands and face tissue that are theright tissue type and compatiblefor skin color, size, gender andage. Transplants and their out-comes will be tracked.

Before then, the UNOS commit-tee will have to decide such thingsas who’s first on the waiting list,and what special expertise a trans-plant center needs.

Then there’s the consent chal-lenge. Some specialists say peopleshould receive a list of body partswhen they first sign an organdonor card – to specify exactlywhat they do and don’t want do-nated at death.

“Ethically it is the right thing to

do so the potential donor has achoice,” said Pittsburgh’sGorantla, who is closely watchinghow UNOS will tackle this issue.

But UNOS committee bioethicistRobert Veatch of Georgetown Uni-versity said until now, next-of-kinhave decided on donating a lovedone’s face or hands, because pre-viously registered organ donorsprobably had no idea that was anoption. That’s even though somestate laws preclude family fromoverriding a relative’s pre-death de-cision to donate organs or tissues.

“Some people who would bewilling to consent to a kidneymight get a little squeamish abouta face,” he said.

The government projected fewerthan two dozen people might beplaced on a waiting list for handand face transplants each year. ButSusan Stewart of Association ofOrgan Procurement Organizationssaid ultimately, it will increasethese transplants because findinga match will be easier.

Hand recipient Ess – the patientvoice on the UNOS committee –also wants to ensure potential re-cipients are fully informed of therigors and risks.

UNOS to oversee hand, face transplants like organs

Double hand transplant recipient, Lindsay Aronson Ess, works on her dexterity during a physical therapy session on Dec. 20 inRichmond, Va. PHOTO BY THE ASSOCIATED PRESS

Page 14

Finding time to exercise is no small feat formany men and women. Obligations at home andat the office can make it hard to fit in a workout, afamiliar quandary for men and women with multi-ple commitments.

Though it's not always easy to fit in a workoutwhen juggling multiple responsibilities, men andwomen must consider the responsibility they havewith regard to maintaining their physical and men-tal health. The United States Department of Healthand Human Services advises that healthy adultsget at least 150 minutes a week of moderate aer-obic activity or 75 minutes a week of vigorous aer-obic activity, and that such activity should bespread out over the course of the week. In addi-tion, the DHHS also advises that healthy adults in-clude strength training exercises in their workoutregimens at least twice a week. Such a workoutschedule can improve both physical and mentalhealth, making it easier for men and women tohandle their hectic schedules.

While such recommendations may seem man-ageable, many men and women still feel as ifthere's just not enough time in the day for themto incorporate a daily exercise regimen. The fol-lowing are a few ways such men and women canfind time for fitness.l Take a walking lunch. Many professionals

have heard of a "working lunch," but thosestrapped for time to exercise might want to take awalking lunch instead. Rather than sitting at yourdesk or in your favorite booth at a nearby restau-

rant on your lunch hour each day, consider squeez-ing in some time to walk during those 30-60 min-utes you normally spend eating or catching up onoffice gossip with coworkers. lExercise in the morning. Research has shown

that men and women who exercise in the morn-ings exercise on a more consistent basis thanthose who exercise later in the day, including after

leaving the office at the end of the workday. l Prepare meals ahead of time. If working out

in the morning simply won't work out for you, thenconsider planning meals in advance so you canfree up time between the office and dinner eachnight. For example, slow cookers and crockpotsmake it possible to start making dinner in the earlymorning and require little or no effort once you ar-rive home in the evening. l Work while you workout. Smartphones and

tablets have made it easier than ever to get workdone while you're away from work. This includesgetting some work done while you're getting inyour weekly recommended aerobic activity on thetreadmill, elliptical machine or exercise bike. l Get off the couch. Many men and women

prefer to unwind on the couch as they catch up ontheir favorite television shows and movies. Butsuch unwinding should not come at the expenseof working out. Much like catching up on work atthe gym, you also can catch up on your favoriteshows and movies while at the gym. Many smart-phones and tablets now have apps that allowusers to access subscription streaming services,so users who can't find time to exercise shouldtake advantage of such apps and watch their fa-vorite shows and movies from the treadmill in-stead of the couch.

Finding time to exercise can be difficult, buteven the busiest men and women have severaloptions at their disposal as they attempt to makefitness a bigger priority in their lives.

Finding time for fitness a challenge, but doable

Taking a walk while you eat your lunch is a good way tosqueeze in some extra exercise.

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