Fresh Seafood Shouldn't Smell Fishy, Food Science Expert Says

If seafood is on the menu this holiday, there are a number of ways you can ensure that it's fresh and safe. A faint sea odor is normal, but fresh seafood should not smell "fishy," according to Kantha Shelke, an Institute of Food Technologists food science expert. Freshly cut fish, peeled crustaceans and shucked mollusks should be moist, not slimy or dry around the edges. Fresh fish should have clear, well-rounded eyes, not clouded, dry and sunken. The gills should be bright red, not darkened or slimy, and the fish should feel moist and springy instead of mushy, she added.

Fresh prawns, shrimp, lobster, soft shell crabs and rock shrimp should have a uniformly light-colored tail without any discoloration, Shelke said. Mollusks in the shell should be alive and hold tightly to their shells when handled and must come with either a "last sale date" or "date shucked." When buying fresh oysters, look for a natural creamy color within a clear liquid. It's best to buy fresh seafood the day you're going to eat it. If that isn't possible, properly store it in the fridge or freezer until it is prepared and cooked. Shelke offered the following storage tips:

* Fresh fish, shrimp, scallops, freshwater prawns, and lobster tails can be stored in tightly sealed storage bags or plastic containers and kept on ice in the refrigerator. Using this method, fresh scallops and crustacean tails will keep three to four days and fresh fish will keep five to seven days.

* Scallops, crustacean tails and fish can be frozen in water and stored in a freezer for four to six months. To thaw, leave them in the refrigerator overnight or you can place them under cold, running tap water immediately before you cook them.

* Live, hardshell mollusks can remain alive for a week to 10 days stored un-iced in the fridge, kept at 34 to 38 degrees Fahrenheit.

* Freshly shucked mollusks can keep for up to 10 days when packed in ice and stored in the refrigerator.

* Fresh softshell crabs can be stored up to two days if wrapped in plastic and packed in ice in the fridge. They can keep for up to six months when wrapped in several layers of plastic and stored in a freezer. It is important to thaw these overnight in the refrigerator only.

Black Smokers May Face Higher Death Risk Than Whites: CDC

A study conducted in Missouri suggests that smoking may be even more lethal for blacks than it is for whites. In fact, researchers say the smoking related death rate for blacks is nearly one-fifth higher than it is for whites in that state. The study was conducted by researchers at the Office on Smoking and Health at the U.S. Centers for Disease Control and Prevention. They analyzed data from 2003-2007 found that the average annual smoking-attributable death rate was 358 per 100,000 for blacks in Missouri and 286 per 100,000 for whites, a difference of 18 percent. That racial difference was larger among men than among women.

Blacks had a 26 percent higher smoking-related death rate for cancer and a 53 percent higher smoking-related death for circulatory diseases, but a 32 percent lower smoking-related death rate for respiratory diseases. Overall, smoking caused about a third of all cancer deaths, 15.3 percent of all circulatory disease deaths, and 46.5 percent of all respiratory disease deaths in Missouri between 2003 and 2007, according to the study. The findings appear in this week's issue of Morbidity and Mortality Weekly Report. Based on the data, the CDC says that "states should continue to implement population-wide tobacco control interventions that reach all racial groups."

Daily Pill Lowers Odds for Infection With HIV

A pill a day cut the risk of HIV infection by almost 44 percent in those at highest risk for contracting the virus, namely sexually active gay and bisexual men, a new study finds. The reduction in risk climbed to nearly 73 percent among study participants who took the pill, called Truvada, 90 percent of the time, the researchers added. Truvada is already available by prescription in the United States as a treatment for HIV-infected people.

The pill, which was tested in over 2,500 men at 11 sites in six countries worldwide, combines two HIV antiretroviral medications, emtricitabine (Emtriva) and tenofovir (Viread). Experts are hailing the results as a big step in the worldwide effort to combat the spread of the HIV virus, which infected some 2.7 million people worldwide in 2008. And it adds to other efforts to prevent spread, such as a topical gel containing tenofovir that was found last summer to be effective in preventing HIV infection in women in southern Africa.

"These results represent a major advance in HIV prevention research," Dr. Kevin Fenton, director of the National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention at the U.S. Centers for Disease Control and Prevention, said in a statement. "For the first time, we have evidence that a daily pill used to treat HIV is partially effective for preventing HIV among gay and bisexual men at high risk for infection, when combined with other prevention strategies. Given the heavy burden of HIV among gay and bisexual men, a new tool with potential additive benefit is exciting and welcome news."

For Teens, Privacy May Trump Health Care

If teens' desires for health care privacy aren't respected, their care could be compromised, a new study suggests. Teens are cautious about revealing sensitive information to health care providers for fear of being judged, and are reluctant to talk to unfamiliar or multiple medical staff, according to researchers at Cincinnati Children's Hospital Medical Center. The researchers conducted 12 focus groups for 54 teenagers and found that keeping health care information private was their most important issue. They also found that younger teens were more likely than older adolescents to want parental involvement.

In fact, some older adolescents said they might avoid a health care visit to prevent information being shared with their parents. Among the other findings:

* Teens of all ages said they would not discuss sensitive topics with health care providers if they thought the provider would judge them or "jump to conclusions."

* Younger teens said they did not have personal discussions with providers they didn't know or like, or if they believed the provider did not need to know the information.

* Only younger adolescents said they had concerns about violations of physical privacy.

* Kids with chronic illnesses better understood and accepted the need to share information with health care providers.

Doctors and other health care professionals need to make it as easy as possible for teens to share information, and need to respect their readiness or reluctance to disclose information, said lead author and adolescent medicine physician Dr. Maria Britto. "If the information isn't urgent, such as a routine health visit, providers may be better off waiting to ask sensitive questions until they know the teen better and can get better information once they've established trust," Britto said in a hospital news release.

Race Seems to Impact Rate of Kidney Function Decline

Among patients with kidney disease in the United States, certain racial/ethnic groups, including blacks and some Hispanics, get sicker faster than whites do, researchers have found. "Racial/ethnic differences are present early, before chronic kidney disease has been established," study co-author Dr. Carmen A. Peralta, of the University of California, San Francisco, said in a news release from the American Society of Nephrology. "The observed differences were not fully explained by traditional risk factors," which include cholesterol, weight, tobacco use, diabetes and high blood pressure, Peralta noted. The researchers reached their conclusions after examining the medical records of almost 5,200 adults in the United States whose kidneys initially worked normally.

Based on five years of follow-up data, the researchers used mathematical equations to estimate age-related changes in kidney function. The kidneys of blacks declined faster on an annual basis than those of whites, about 60 percent faster judging by one method, the study authors noted. Among Hispanic groups, kidneys declined faster among Dominicans, followed by Puerto Ricans. But other Hispanics, as well as Chinese Americans, didn't suffer from a faster rate of decline than whites. The research "reflects a new opportunity to study how to best identify persons at high risk and to investigate prevention strategies," Peralta said. The study was scheduled to be presented at the American Society of Nephrology's annual meeting, held this week in Denver.

Mental Illness Hit 1 in 5 U.S. Adults in Past Year

A new survey finds that 20 percent of U.S. adults over 45 million people experienced mental illness in the past year. Overall, 4.8 percent suffered serious mental illness, 8.4 million people had serious thoughts of suicide, 2.2 million made suicide plans, and one million attempted suicide, according to the 2009 National Survey on Drug Use and Health. Nearly 20 percent of adults with mental illness in the past year also had a substance abuse disorder, the report found. The rate was 25.7 percent for those with a serious mental illness about four times higher than the rate of 6.5 percent among people without a serious mental illness,

The survey, which included 67,500 adults nationwide, was released Thursday by the Substance Abuse and Mental Health Services Administration.

Among its other findings:

* Mental illness is more common among jobless people (27.7 percent) than among those with full-time jobs (17.1 percent).

* Women are more likely than men to experience mental illness 23.8 percent vs. 15.6 percent.

* Young adults had the highest rate of mental woes (30 percent) while those aged 50 and older had the lowest rate (13.7 percent).

* Overall, only 37.9 percent of adults with mental illness received mental health services.

* While the use of mental health services was highest among those with serious mental illness (60.2 percent), 4.4 million adults with serious mental illness in the past year did not receive the services they needed.

"Too many Americans are not getting the help they need and opportunities to prevent and intervene early are being missed," SAMHSA Administrator Pamela S. Hyde said in an agency news release. "The consequences for individuals, families and communities can be devastating. If left untreated mental illnesses can result in disability, substance abuse, suicides, lost productivity, and family discord. Through health care reform and the Mental Health Parity and Addiction Equity Act we can help far more people get needed treatment for behavioral health problems," she said.

FDA Expected to Ban Caffeinated Alcohol Drinks

The U.S. Food and Drug Administration was set to rule Wednesday on the safety of caffeinated alcoholic beverages that have reportedly left dozens of young adults sick or hospitalized. The announcement comes amid a growing backlash against so-called energy drinks that mix caffeine and alcohol, even though such beverages are becoming increasingly popular with college students and even children. The drinks are regularly consumed by 31 percent of 12- to 17-year-olds and 34 percent of 18- to 24-year-olds, the U.S. Centers for Disease Control and Prevention estimates.

New York Sen. Charles Schumer, who has supported a ban on the drinks that are marketed under such names as Four Loko and Joose, reported Tuesday on his Web site that the FDA would outlaw the products because they are an "unsafe food additive to alcoholic beverages." Schumer, a Democrat, also said the Federal Trade Commission planned to notify manufacturers that "they are engaged in the potential illegal marketing of unsafe alcoholic drinks." Meanwhile, the maker of Four Loko said Tuesday that it would remove caffeine and other stimulants from its four different flavors of alcoholic drinks.

Four Loko has up to 12 percent alcohol in a 23.5-ounce can, according to published reports. Four Loko's manufacturer, Chicago-based Phusion Projects, insists that the drinks are safe. But, in a statement posted on the company's Web site, it said it was removing the caffeine "after trying unsuccessfully to navigate a difficult and politically charged regulatory environment at both the state and federal levels." The company said it doesn't agree that mixing caffeine and alcohol is inherently unsafe.

Gene Therapy Shows Potential Against Heart Failure

By substituting a healthy gene for a defective one, scientists were able to partially restore the heart's ability to pump in 39 heart failure patients, researchers report. "This is the first time gene therapy has been tested and shown to improve outcomes for patients with advanced heart failure," study lead author Dr. Donna Mancini, professor of medicine and the Sudhir Choudhrie professor of cardiology at Columbia University College of Physicians and Surgeons in New York City, said in a university news release.

"The therapy works by replenishing levels of an enzyme necessary for the heart to pump more efficiently by introducing the gene for SERCA2a, which is depressed in these patients. If these results are confirmed in future trials, this approach could be an alternative to heart transplant for patients without any other options," she added. Mancini presented the results Monday at the annual meeting of the American Heart Association (AHA) in Chicago. The gene for SERCA2a raises levels of the enzyme back to where the heart can pump more efficiently. The enzyme regulates calcium cycling, which, in turn, is involved in how well the heart contracts, the researchers said.

"Heart failure is a defect in contractility related to calcium cycling," explained Dr. Robert Eckel, past president of the AHA and professor of medicine at the University of Colorado Denver. The study authors hope that, if replicated in larger trials, the gene therapy treatment could actually delay or obviate the need for heart transplants in patients with heart failure. "There are a lot of treatments for heart failure but at some point patients stop responding and then the prognosis is poor," said Dr. Rita Redberg, AHA spokeswoman and professor of medicine at the University of California, San Francisco. After that, the only option is a transplant.

Omega-3 Supplements Won't Fight Irregular Heartbeat

Omega-3 fatty acid supplements don't cut back on recurrences of atrial fibrillation, a type of irregular heartbeat that can cause stroke, new research suggests. "We now have definitive data that they don't work for most patients with AF," said Dr. Peter R. Kowey, lead author of a study appearing in the Dec. 1 issue of the Journal of the American Medical Association that is also scheduled to be presented Monday at the American Heart Association's annual meeting in Chicago. "Although we can't exclude the possibility of efficacy in sicker AF patients, it would be hard to believe that it would work in that population and not in healthier patients. So for practical purposes, yes, the end of the line in AF."

This study, the largest of its kind, looked at patients with AF who were otherwise healthy. "We cannot say there is any convincing evidence of a role for omega-3 in the prevention of atrial fibrillation," added Dr. Ranjit Suri, director of the Electrophysiology Service and Cardiac Arrhythmia Center at Lenox Hill Hospital in New York City, who was not involved with the trial. The study was funded by GlaxoSmithKline. Omega-3 fatty acids, which are found in fatty fish such as salmon and albacore tuna, had showed some promise in preventing heart disease in earlier trials. Of the total 663 outpatient participants, 542 had paroxysmal atrial fibrillation, which appears suddenly and resolves on its own, and 121 had persistent atrial fibrillation, which needs treatment.

Participants were randomized to receive either a placebo or 8 grams of omega-3 supplements daily for the first week, followed by 4 grams a day for the remaining 23 weeks of the trial. The doses used in the study are available only by prescription and are "higher than doses previously published in studies," said Dr. Robert Block, a cardiologist and assistant professor of community and preventive medicine at the University of Rochester Medical Center. At the end of six months, 46 percent of those in the placebo group and 52 percent of those taking omega-3 supplements experienced recurrences. The numbers of paroxysmal AF patients in the placebo and treatment groups who had AF recurrences were about equal, the investigators found.

CPR Guidelines May Lower Out-of-Hospital Death Rate

When implemented, the American Heart Association's 2005 guidelines on cardiopulmonary resuscitation (CPR) can dramatically boost survival rates among people being treated outside a hospital setting, according to an expert report. A case report on the effectiveness of the new guidelines is scheduled to be presented Saturday at the AHA's annual meeting in Chicago by Dr. Michael Dailey, an associate professor of emergency medicine at Albany Medical College. Dailey also serves as medical director of emergency medical services (EMS) for the town of Colonie, N.Y., population 80,000. He said that local implementation of the AHA directives beginning in 2006 translated into a quadrupling of survival rates in his community over a three-year period.

Adoption of the guidelines took many forms, including the expansion of CPR training along the lines of the AHA's "CPR Anytime" format. Since 2005, about 200 Colonie residents a year have been trained in CPR, Dailey said. In addition, the town has embraced other AHA suggestions, such as the use of impedance threshold devices, faster deployment of mechanical CPR devices, bringing down emergency response times by upwards of a full minute, a commitment to performing two minutes of CPR before applying defibrillation, and favoring a period of high quality CPR prior to application of advanced airway placement and IV access. Also, as of 2009, once in the hospital, resuscitated patients in comas have received therapeutic hypothermia, he added. Since 2005, Colonie has also opened three Level One cardiac arrest centers.

'Stop Smoking' Ads That Target Emotions Seem to Work Best

Television ads that encourage people to quit smoking are most effective when they use a "why to quit" strategy that includes either graphic images or personal testimonials, a new study suggests. The three most common broad themes used in smoking cessation campaigns are why to quit, how to quit and anti-tobacco industry, according to scientists at RTI International, a research institute. The study authors examined how smokers responded to and reacted to TV ads with different themes. They also looked at the impact that certain characteristics such as cigarette consumption, desire to quit, and past quit attempts had on smokers' responses to the different types of ads.

"While there is considerable variation in the specific execution of these broad themes, ads using the 'why to quit' strategy with graphic images or personal testimonials that evoke specific emotional responses were perceived as more effective than the other ad categories," lead author Kevin Davis, a senior research health economist in RTI's Public Health Policy Research Program, said in an institute news release. Davis and his colleagues also found that those who had less desire to quit and those who had not tried quitting in the past year had significantly less favorable responses to all types of smoking cessation ads. The same was true, to a lesser extent, for smokers with high levels of cigarette consumption.

"These findings suggest that smokers clearly differ in their reactions to cessation-focused advertising based on their individual desire to quit, prior experience with quit attempts and, to a lesser degree, cigarette consumption. These are important considerations for campaign creators, designers and media planners," Davis said. The study, published online in the journal Tobacco Control, used data from 7,060 adult smokers in New York State who took part in an online survey. On Wednesday, the U.S. Food and Drug Administration announced a new "comprehensive tobacco control strategy" that would include not only graphic photos on packs of cigarettes, but bold statements such as "Smoking Will Kill You."

High Cholesterol in Middle Age May Not Raise Dementia Risk for Women

For years, doctors have been saying that keeping your cholesterol levels in check as you age is good for your brain as well as your heart, but a new study suggests the connection between cholesterol and dementia later in life isn't quite so clear-cut. After more than 1,400 Swedish women followed for 32 years, Johns Hopkins researchers found that those with high cholesterol at mid-life were at no greater risk of developing Alzheimer's and other types of dementia than women with lower levels. In addition, the women whose cholesterol levels decreased the most from middle to older age were 2.5 times more likely to develop dementia than those whose levels increased or stayed the same.

Both cell and animal studies have suggested that high cholesterol contributes to Alzheimer's disease, the researchers noted, but they stressed that the relationship between cholesterol and dementia may vary over a lifetime. "Our findings highlight how risk factors can change over the course of a person's life span," said Michelle M. Mielke, an assistant professor of psychiatry at Hopkins and lead author of the study, which was published online Nov. 10 in the journal Neurology. "My biggest worry is that people will look at these results and decide that cholesterol doesn't matter, but that's not what we're saying," Mielke added.

"We know that high cholesterol is a very strong risk factor for cardiovascular disease and still needs to be treated with diet, exercise and possibly medication." Mielke added that it was unclear why a decline in cholesterol levels in old age was linked to a higher risk of dementia, but said it might be an early part of the disease process. "As people start to develop symptoms, they often forget to eat and start losing weight, and that may be why their cholesterol goes down." For the study, Mielke and her colleagues examined data from the Prospective Population Study of Women, which began in 1968 and consisted of 1,462 Swedish women between the ages of 38 and 60.

Childhood Abuse Linked to Diabetes Risk in Adult Women

Women who were victims of childhood abuse may be at increased risk of developing diabetes in adulthood, new findings suggest. Researchers surveyed 67,853 U.S. nurses and found that 54 percent reported physical abuse and 34 percent reported sexual abuse before age 18. Moderate and severe physical and sexual abuse were associated with a 26 percent to 69 percent increased risk of type 2 diabetes in adulthood. "Much, although not all, of this association is explained by the greater weight gain of girls with a history of abuse.

The weight gain seems to start in teenage years and continues into adulthood, increasing the risk of diabetes," lead author Janet Rich-Edwards, director of developmental epidemiology at Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital in Boston, said in a Center for Advancing Health news release. But she added that weight gain explained only 60 percent of the association, "implying that the experience of abuse gets incorporated into the body through other mechanisms, as well." Further research is needed to understand the link between childhood abuse and diabetes, the study author added.

"One theory is that abused women develop disordered eating habits as a compensatory stress behavior, leading to excess weight gain," Rich-Edwards said. "Another theory suggests that child abuse may increase levels of stress hormones that later cause weight gain and insulin resistance, characteristic of diabetes." The study appears online and in the December print issue of the American Journal of Preventive Medicine. "Child abuse can leave an enduring imprint on health in adulthood," Rich-Edwards said in the news release. "We hope to alert clinicians to the possible role of abuse in the histories of some patients that they see with pre-diabetes and diabetes. We also need to help families prevent child abuse, and we need to learn the best ways to reduce the long-term health burden that it imposes."

Number of Uninsured American Adults Hits Record High

Nearly 50 million Americans have gone without health insurance for at least part of the past year up from 46 million people in 2008, federal health officials reported Tuesday. Those people included not only those Americans living in poverty, but an increasing number of middle-income people, according to a report from the U.S. Centers for Disease Control and Prevention. "The bottom line is that uninsurance of young and middle-class adults increased by 4 million people from 2008 to the first quarter of 2010," CDC Director Dr. Thomas R. Frieden said during a news conference Tuesday.

What's more, the number of people without insurance for a year or more increased from 27.5 million in 2008 to 30.4 million in the first quarter of 2010, Frieden said. "That's an increase of 3 million of chronically uninsured adults." These findings debunk two myths about health insurance, Frieden said. "The first myth is that it's only the poor who are uninsured. In fact, half of the uninsured are over the poverty level," he said. "The second myth is that it's only healthy people who are uninsured and that young healthy people make a choice not to have health insurance. In fact, more than two out of five individuals who are uninsured at some point during the past year had one or more chronic diseases," he said.

During the past 10 years, the number of U.S. adults without insurance for at least part of the year has risen an average of 1.1 million people a year, and about half are middle-income adults, according to the report. People without health insurance are more likely to skip medical care because of cost. This can lead to poorer health, higher long-term health care costs and early death, the report said. Uninsured adults with chronic medical problems are three times more likely to skip medical care, compared to those with insurance. For instance, more than 40 percent of people without insurance who suffer from diabetes, high blood pressure or asthma skipped getting care due to costs, the report found.

Diabetes Drugs Might Lower Risk of Lung Cancer

Researchers report that drugs used to treat diabetes may indeed both prevent and contain lung cancer. The findings, being presented Tuesday at the annual meeting of the American College of Chest Physicians in Vancouver, back up preliminary data that some diabetes medications might protect against tobacco-induced lung cancer. "Patients who did not develop lung cancer had a much higher chance of taking one of these medications than those who did develop lung cancer," said study author Dr. Peter Mazzone. "And those who did develop lung cancer were much less likely to have seen that cancer spread outside the chest and more likely to survive longer with one of these drugs."

Both metformin and the class of drugs known as thiazolidinediones (which includes Avandia and Actos) are used by tens of millions of Americans. A mouse study published in September found that metformin was associated with up to a 73 percent reduction in the number of tumors mice developed when they were given a common carcinogen found in tobacco. The mice had been genetically engineered to be susceptible to this kind of tumor. Epidemiological studies in humans have found similar effects. Metformin was originally marketed as Glucophage, but is now available as an inexpensive generic.

For this study, Mazzone and his colleagues reviewed and compared electronic medical records on 225 diabetics with lung cancer with a similar number of diabetic patients who did not have lung cancer, although both groups shared other risk factors such as age, smoking history and gender. "Forty-one percent of those with lung cancer had taken one of these medications at some point prior to developing the cancer, and 96 percent of all the controls had taken one of these medications in diabetic treatment," reported Mazzone, director of the lung cancer program at The Respiratory Institute at the Cleveland Clinic in Ohio.

Eating Peanuts While Pregnant May Raise Child's Allergy Risks

Women who eat peanuts during pregnancy may be putting their babies at increased risk for peanut allergy, a new study suggests. U.S. researchers looked at 503 infants, aged 3 months to 15 months, with suspected egg or milk allergies, or with the skin disorder eczema and positive allergy tests to milk or egg. These factors are associated with increased risk of peanut allergy, but none of the infants in the study had been diagnosed with peanut allergy. Blood tests revealed that 140 of the infants had strong sensitivity to peanuts. Mothers' consumption of peanuts during pregnancy was a strong predictor of peanut sensitivity in the infants, the researchers reported in the Nov. 1 issue of the Journal of Allergy and Clinical Immunology.

"Researchers in recent years have been uncertain about the role of peanut consumption during pregnancy on the risk of peanut allergy in infants. While our study does not definitively indicate that pregnant women should not eat peanut products during pregnancy, it highlights the need for further research in order to make recommendations about dietary restrictions," study leader Dr. Scott H. Sicherer, a professor of pediatrics at Jaffe Food Allergy Institute at the Mount Sinai School of Medicine in New York City, said in a journal news release. Sicherer and his colleagues recommended controlled, interventional studies to further explore their findings. "Peanut allergy is serious, usually persistent, potentially fatal, and appears to be increasing in prevalence," Sicherer said.