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Health News
for 02/21/2010

(last updated 7:30am EST 02/21/2010)

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• Report: GSK Knew Avandia's Risks for Yea... Report: GSK Knew Avandia's Risks for Years
02/21/2010
Drug Maker GlaxoSmithKline Knew of Controversial Diabetes Medication's Risks Years Before They Were Public, Senate Finds (1 h ago)

• Video: Diabetes Drug a Heart Risk Video: Diabetes Drug a Heart Risk
02/20/2010
A new Senate report blames the diabetes drug Avandia for thousands of heart attacks. As Kimberly Dozier reports, calls to remove the deadly drug from the market have gone unheeded. (14 m ago)

• What to Seek, Avoid in Frozen Diet Meals What to Seek, Avoid in Frozen Diet Meals
02/20/2010
Expert from Health Magazine Stresses That Not All Such Items Are Created Equal (4 h ago)

• Video: Controlling Your Calories Video: Controlling Your Calories
02/20/2010
When you're watching your weight and don't have much time to prepare meals, what do you do? Chris Wragge speaks with Health Magazine's Frances Largeman-Roth about controlling calories. (5 h ago)

• Obamas' Personal Trainer Struts His Stuf... Obamas' Personal Trainer Struts His Stuff
02/20/2010
Cornell McClellan Demonstrates Boxing Moves He's Shown Barack and Michelle; He Says They Benefit Entire Body (6 h ago)

• March Madness Bargain: Vasectomies March Madness Bargain: Vasectomies
02/19/2010
Urologists Say Watching Basketball Tournament Good Way To Recover (1 d ago)

• Tobacco Fight Comes to Supreme Court Tobacco Fight Comes to Supreme Court
02/19/2010
Government Seeks $300 Billion from Industry for Deceptive Advertising; Companies Want Attacks on Profits Halted (1 d ago)

• Paralyzed Patient Can't Talk After All Paralyzed Patient Can't Talk After All
02/19/2010
Doctors Who Thought Belgian Man Was Communicating after 2 Decades in Vegetative State Now Say They Were Wrong (1 d ago)

• Foods to Cure the Winter Blues Foods to Cure the Winter Blues
02/19/2010
Dr. Jennifer Ashton: Certain Foods Can Help Lift Your Spirits! (1 d ago)

• Video: Mood Foods for Winter Blues Video: Mood Foods for Winter Blues
02/19/2010
Dr. Jennifer Ashton spoke to Harry Smith about why some foods to help your mood including oatmeal, milk and tea. (1 d ago)

• Medicare Private Plan Premiums Jump Medicare Private Plan Premiums Jump
02/19/2010
Latest Sign of Spiraling Health Care Costs Likely Fodder for Obama's Health Care Reform Foes (1 d ago)

• Video: Camel...It's What's for Dinner Video: Camel...It's What's for Dinner
02/19/2010
CBS News RAW: A traditional local restaurant in Dubai has tourists raving over the use of camel meat and milk in the cooking of various entrees and beverages there. (1 d ago)

• Denture Cream Overuse a Health Risk? Denture Cream Overuse a Health Risk?
02/18/2010
Glaxo Halts Production of Zinc-containing Denture Cream After Reports of Neurological Damage and Blood Problems in Consumers (2 d ago)

• FDA to Curb Use of Popular Asthma Drugs FDA to Curb Use of Popular Asthma Drugs
02/18/2010
Restrictions Issued on Drugs Used by Millions Because of Life Threatening Risk to Some (2 d ago)

• US Report: Health Premiums Could Skyrock... US Report: Health Premiums Could Skyrocket
02/18/2010
Health and Human Services Report Finds Double-Digit Increases Are being Sought by Insurers in Several States (2 d ago)

• Dems Near Plan to Pass Health Care Bill Dems Near Plan to Pass Health Care Bill
02/18/2010
White House, Congressional Democrats Are Preparing Proposal Which Could Pass Via Reconciliation in the Senate (2 d ago)

• Fat War Wages On in the Skies Fat War Wages On in the Skies
02/18/2010
Fat Folks' Activist Weighs in on Kevin Smith-Southwest Airlines Debacle, Says Everyone Uncomfortable on Planes (2 d ago)

• Official Warns Crib Makers on Safety Official Warns Crib Makers on Safety
02/18/2010
CPSC Chairman Says Government Will Use Its New Recall Powers (2 d ago)

• Trials Show Marijuana Eases Pain Trials Show Marijuana Eases Pain
02/18/2010
Report Funded by California Says First U.S. Clinical Trials in 20 Years Proves Pot's Benefits for Some Patients (2 d ago)

• Video: Confronting Fear in Virtual Reali... Video: Confronting Fear in Virtual Reality
02/18/2010
Phobias, such as the fear of flying, elevators or public speaking can disrupt people's lives. Dr. Jon LaPook talks with psychologist Robert Reiner about how to overcome these fears with the help of virtual reality. (2 d ago)

• Psychologists: We shrink Games anxiety Psychologists: We shrink Games anxiety
02/20/2010
If only Olympic competitors' fears really could be quelled by reading "Overcoming Anxiety for Dummies." (2 h ago)

• Health care drama headed to daytime TV Health care drama headed to daytime TV
02/20/2010
Coming soon to daytime television: America's long-running civic drama over how to provide better health care to more of its people without breaking the bank. (5 h ago)

• NYT: Diabetes drug harms heart, U.S. con... NYT: Diabetes drug harms heart, U.S. concludes
02/20/2010
NYT: U.S. government reports concluded that hundreds of people taking Avandia suffered heart attacks and heart failure, but some said the drug should remain available. (18 h ago)

• Best and worst natural cold and flu reme... Best and worst natural cold and flu remedies
02/19/2010
Sometimes even the most scrupulous germphobes and healthy people get sick anyway. (1 d ago)

• Viruses changed human evolution, study s... Viruses changed human evolution, study shows
02/19/2010
Italian scientists said on Friday they had found evidence of how viruses helped change the course of human evolution and said their discovery could help in the design of better drugs and vaccines. (1 d ago)

• Swine flu may be declared post-peak pand... Swine flu may be declared post-peak pandemic
02/19/2010
Flu experts will advise next week whether the world is in a post-peak phase of the H1N1 pandemic, signaling infections are falling in most countries but new waves may still occur, the World Health Organization said on Friday. (1 d ago)

• Sharp premium rise for Medicare private ... Sharp premium rise for Medicare private plans
02/19/2010
Millions of seniors who signed up for popular private health plans through Medicare are facing premium increases of 14 percent this year — another sign that spiraling costs are a problem even for those with solid insurance. (1 d ago)

• Are health costs driving U.S. the way of... Are health costs driving U.S. the way of Greece?
02/19/2010
The divide seemed too wide to bridge when the Senate voted on Christmas Eve on the Democrats' insurance reform bill. Msnbc.com fact-checks this claim — and more. (1 d ago)

• Sex addiction real — or excuse for cheat... Sex addiction real — or excuse for cheating?
02/19/2010
Tiger Woods’ shocking cheating admission and subsequent parade of alleged paramours has resulted in more than just unending fodder for the tabloids. The golf superstar has also given comfort to spouses who have long suspected their partners are incapable of fidelity. (1 d ago)

• Paralyzed Belgian patient can't talk aft... Paralyzed Belgian patient can't talk after all
02/19/2010
It was heralded as a medical miracle. After spending more than two decades in a coma, Rom Houben, a Belgian man in his mid-forties, was suddenly able to communicate, news reports trumpeted last November. (1 d ago)

• Life, interrupted: True cost of teen pre... Life, interrupted: True cost of teen pregnancy
02/19/2010
Nate Howell has about 76 days to adjust to his new reality. That is when he is due to become a parent with his 17-year-old girlfriend, Samantha Keith. While new research shows teen pregnancy is on the rise, couples like Nate and Samantha face individual struggles. (1 d ago)

• AIDS vaccine effects may wear off AIDS vaccine effects may wear off
02/19/2010
An AIDS vaccine that appears to have worked at least partly in Thailand may only temporarily protect patients, with the effects starting to wane after a year or so. (1 d ago)

• Gene test can identify bits of cancer in... Gene test can identify bits of cancer in blood
02/19/2010
A personalized blood test can tell whether a patient's cancer has spread or come back, offering a better way to see if treatments are working, U.S. researchers said on Thursday. (1 d ago)

• Placebos may have biological effect on b... Placebos may have biological effect on body
02/19/2010
When it comes to the placebo effect, it really may be mind over matter, a new analysis suggests. (1 d ago)

• Fighting swine flu fatigue with weird ma... Fighting swine flu fatigue with weird marketing
02/19/2010
Some clinics now are practically begging people to get vaccinated, in a dramatic shift from just a few months ago when people stood in long lines and waited to get the scarce vaccine. (1 d ago)

• Opinion: Disability-free world may not b... Opinion: Disability-free world may not be better place
02/18/2010
Opinion: Genetic testing of parents and, in some cases, embryos, means fewer are born with Down syndrome and cystic fibrosis, but it also raises some difficult ethical challenges. (2 d ago)

• Birth weight on the decline in the U.S. Birth weight on the decline in the U.S.
02/18/2010
Reversing a trend of nearly five decades, birth weight in the U.S. may be on the decline, according to a new study. (2 d ago)

• Warning issued on 4 widely used asthma d... Warning issued on 4 widely used asthma drugs
02/18/2010
The government is taking steps to curb use of some long-acting asthma drugs used by millions, issuing safety restrictions Thursday to lower a life-threatening risk that asthma could worsen suddenly. (2 d ago)

• Vaginal birth can be OK after several C-... Vaginal birth can be OK after several C-sections
02/18/2010
Women who attempt vaginal childbirth after having several babies by cesarean section may not have a greater risk of complications than women who've had only one prior C-section, a new study suggests. (2 d ago)

• Drug could prolong men’s sexual staying ... Drug could prolong men’s sexual staying power
02/18/2010
Not since Viagra has a prescription medication held so much potential to affect the sex lives of American men. Here's why that could hurt you. (2 d ago)

• Genetic test to classify tumours Genetic test to classify tumours
02/19/2010
News reports on this technology are based n a press release from Dr Victor Velculscu and colleagues at John Hopkins University. Their press release discusses forthcoming research that will be presented at a US conference and published in a medical journal next week. In the research the scientists made use of new genome sequencing techniques to look for large changes in the DNA released by tumour cells. The aim of the research was to say whether these tests could be used to detect specific biological markers for cancer in each patient’s blood. How was the research performed? The study compared six sets of cancerous and normal tissue from patients with colon or breast cancer. The researchers scanned all of the DNA in each sample and looked for DNA rearrangement, repetition or deletions of DNA sequences They also checked whether DNA sequences had the correct ordering, orientation or spacing. The researchers then amplified the levels of normal and tumour DNA in the blood in order to determine whether these tests were sensitive enough to detect the presence of rearranged tumour DNA in these samples. They found that in one patient they could use this technique to detect that not all of their tumour had been removed during surgery. What is the theory behind this blood test? This news story is based on research that has studied the genetic profile of patients with cancer in order to develop individualised blood tests that may help doctors to tailor patient’s cancer treatments. One of the properties of tumours is that they can differ from normal tissue in the amount of different types of protein that they produce. They can also vary in their genes and the proteins that are produced on the surface of different tumours, even between patients with the same type of cancer. These genes and proteins may determine how effective a particular cancer treatment will be in destroying the cancer cells and preventing them from spreading. The genetic changes in tumours can be small changes in the sequence of genes but are also though to include changes in large sections of DNA. In these large changes whole sections of DNA may be repeated, deleted or in the incorrect order. Currently CT scans are used to visually detect the presence or absence of tumours after treatment. However, very small tumours may not be detectable by this method. As tumours release small quantities of their DNA into the bloodstream it may be possible to devise a blood test that will chemically measure the presence of abnormal DNA. Theoretically, measuring this tumour DNA in the blood may also make it possible to monitor whether a treatment has been effective in destroying fully destroying a tumour. Will this research lead to personalised cancer care? It is already established that changes found in specific genes of tumours can govern how the tumour responds to different types of cancer treatment. This is preliminary research shows potential to use this property aid detection of the cancerous cells that may persist after treatment. However, the researchers would need to assess the technology in a larger number of patients with different types of tumours in order to how well the blood test can predict the presence or absence of a tumour. This would be especially true in smaller tumours that may be harder to detect or remove. Another potential problem would be the cost of any tests developed from this research: the technology currently used to examine the patient’s genes is currently more expensive than CT scans, estimated to be in the region of $5,000 per patient. Also, as preliminary research this technology does not appear to have assessed how strongly large DNA changes affect a tumour’s response to treatment. Therefore, it is too early to say that doctors are close to being able to provide made to measure cancer treatments based on the genetic make-up of an individual’s tumour. However this development may be an important early step in that direction. Links To The Headlines Press release: Eurekalert Press release: John Hopkins University Links To Science Personalised blood tests for cancer 'could soon transform the way the disease is treated' . The Daily Telegraph, February 19 2010 The cancer holy grail: DNA test will allow doctors to create personalised treatments for patients . February 19 2010 Cancer's genetic fingerprint allows doctors to personalise treatment . The Guardian, February 19 2010 New blood test detects whether a cancerous tumour is responding to therapy . The Times, February 19 2010 Blood test offers hope to cancer sufferers . The Independent, February 19 2010 (1 d ago)

• Push for more stable vaccines Push for more stable vaccines
02/19/2010
“Scientists at Oxford University have found a way of keeping vaccines stable without refrigeration,” the BBC has reported. The news is based on research on using two special membranes to dry the viral particles used in vaccines in order to keep them stable when stored at warm temperatures. Normally these viral substances cannot stand warmer atmospheres for more than a few weeks, which means they need to be kept refrigerated. The new techniques tested were shown to increase the shelf life of viral substances by several months, meaning they could help reduce the practical problems faced by vaccination programmes in the developing world. This is potentially a very useful development as it offers the hope that doctors will be able to distribute vaccines more easily in the rural areas of developing countries where refrigerated storage for vaccines can be problematic and costly. This will be of particular importance for the distribution of any HIV and malaria vaccines that may be developed, as these illnesses are very common in some hot, remote parts of Africa. Where did the story come from? Dr Robert Alcock and colleagues from Cambridge Biostability Ltd, the University of Oxford and Nova Bio-Pharma carried out this research. The study was funded by a grant from the Grand Challenges in Global Health initiative of the Bill and Melinda Gates Foundation. The study was published in the peer-reviewed medical journal, Science Translational Medicine. This study was covered in detail by the BBC. What kind of research was this? Many vaccines work by using a weakened form of a live virus. Injecting someone with the vaccine triggers the immune system into creating antibodies that protect against the full-strength virus. Some vaccines are made by injecting only part of viral DNA into the body. This DNA is contained within a ‘vector’, a substance that will to allow viral proteins to be produced inside the body. The body’s immune system will then make antibodies against these proteins so that if the person is exposed these proteins on the real virus they will already be protected. Vaccines are not very stable and need to be stored cold. Keeping vaccines refrigerated is estimated to account for up to 14% of the cost of a vaccine. There are also important practical implications of the need to refrigerate vaccines in some developing countries. These areas often have the greatest need for immunisation but lack the reliable electricity supply needed to store vaccines. Many scientists are trying to develop new vaccines for malaria, tuberculosis and HIV, but the authors of this paper say there must also be moves to make these vaccines more stable at higher temperatures in order to increase the overall efficiency of vaccination programmes. In this laboratory study, the researchers looked at whether they could make vaccines more stable in warmer conditions. They based their research on a type of chemistry involving different types of sugars, suggesting that these sugars would stabilise the vaccine molecules. Theoretically, combining the viral molecules with sugars immobilises them and prevents any chemical reaction that might break down the vaccine. What did the research involve? The researchers used two viral vaccine vectors, called AdHu5 and MVA, both of which are unstable at warm temperatures. Viral vectors are typically used in vaccine development to carry genetic material into cells so that they develop proteins on their surface similar to proteins found on the infectious virus. In this way, the body is given the ability to produce an immune response that will protect it against future infections. Scientists are currently conducting clinical trials on prototype viral vector-based vaccines against malaria, HIV-AIDS, tuberculosis and influenza. The researchers looked at how stable the two viral vectors were by storing them at different temperatures and then also tested how infective they were by measuring the immune response they elicited in vaccinated mice. Vaccines are usually dried for storage then reconstituted in liquid for injection. Two sugars, sucrose and trehalose, are commonly used as stabilising agents in vaccines because they can protect the live vaccine from breaking down. This research tested an alternative technique where the viral vectors were slowly dried using a glass fibre or polypropylene membrane at room temperature. The researchers then tested if these dried vaccines could be reconstituted easily and whether they were as effective as traditional cold-stored vaccines. Finally, they looked at the infective properties of the membrane-dried viral vectors under different storage conditions, as viral vectors need to remain infective in order to create immunity in the body. What were the basic results? The researchers found that the viral vector AdHu5 was not infectious, and therefore ineffective, when stored at 37˚C or 45˚C for one week. The MVA viral vector was stable at these temperatures for about a month. The researchers found that MVA could be dried without using membranes and still retain its infectivity when reconstituted, even if it was dried without the sugar stabilisers. However, AdHu5 needed to be dried with the sugar stabilisers in order to remain infective. Adding sugars to AdHu5 preserved its full infectivity after reconstitution. The researchers also found that AdHu5 could be stored for up to six months and at temperatures up to 45˚C if dried on a glass fibre membrane with the sugar stabilisers. Drying on a polypropylene membrane allowed it to be stored for six months at temperatures up to 25˚C. The MVA viral vector could be stored for up to 12 months at 37˚C. At 45˚C this viral vector was stable for at least four months, but by 12 months it had lost its infectivity. The stability of MVA did not differ on either membrane. How did the researchers interpret the results? The researchers suggest that the new technique can make viral vectors stable for four to six months at temperatures up to 45˚C. They say that the doses deposited onto membranes in their proof-of-concept study were close to those that are used in a clinical setting. The researchers propose that an attachment containing the membrane with the dried vaccine could be fitted to the end of a standard syringe as part of an all-in-one, ready-to-inject vaccine delivery device. The liquid in the syringe would reconstitute the viral vector in the attachment to create a complete vaccine for immediate injection. They suggest that this technology may “allow low-tech distribution routes in rural areas, potentially enabling better penetration of disease prevention measures in resource-poor settings”. Conclusion This was a proof-of-concept study that showed that viral vector stability at warm temperatures could be increased by slowly drying vaccines suspended in sugar stabilisers onto special filter-like membranes. This study was performed with model viral vectors that can have DNA inserted into them to make them work as vaccines for specific diseases. Further work is needed to characterise the effect of the technique on the storage conditions needed for vaccines used for specific diseases. This development is potentially very useful as it may lead to improvements in the availability and effectiveness of vaccination programmes in areas of the world with fewer resources. Links To The Headlines Scientists raise fresh hopes for fridge-free vaccines . BBC News, February 19 2010 Links To Science Alcock R, Cottingham MG, Rollier CS et al. Long-Term Thermostabilization of Live Poxviral and Adenoviral Vaccine Vectors at Supraphysiological Temperatures in Carbohydrate Glass . Sci Transl Med 17 February 2010: Vol. 2, Issue 19, p. 19ra12 (1 d ago)

• Fumes from frying steak probed Fumes from frying steak probed
02/18/2010
“Frying meat on a gas hob may increase your risk of cancer,” according to the Daily Mail. This news story is based on research that attempted to estimate the concentrations of potentially harmful chemicals that professional chefs are exposed to from the fumes of cooking steak. This research looked at the gases produced by frying and not how breathing these fumes affected health or cancer risk. While the researchers found that certain harmful chemicals were produced, these were well within the established limits of safe environmental exposure. Although the chemicals found in these fumes may be carcinogenic in high concentrations, this study alone does not provide sufficient evidence to prove that fumes from cooking steak increase the risk of cancer in humans. Where did the story come from? This study was carried out by Dr Ann Kristin Sjaastad and colleagues at the Norwegian University of Science and Technology. The study was funded by the Norwegian Foundation for Health and Rehabilitation and published in the peer-reviewed journal Occupational and Environmental Medicine. Although The Daily Telegraph and the Daily Mail stated that the amounts of the chemicals produced during cooking were within safety limits, this fact was not adequately emphasised in their reports and their coverage tended to sensationalise the story. This research looked at the chemical composition of cooking fumes. It did not look at the health consequences of exposure to the chemicals produced by cooking, as could be assumed from reading the media reports. What kind of research was this? This was a laboratory study looking at the chemicals found in the fumes from cooking steak. The researchers wanted to see if the fumes contained any harmful chemicals and what concentrations of these chemicals a cook would be likely to inhale. The researchers say that previous research has shown that some chemicals found in cooking fumes can have effects on cells in culture, suggesting that they may be carcinogenic. The chemicals that they were particularly interested in were polycyclic aromatic hydrocarbons (PAH), which have been found in the fumes from different types of cooking oil. The researchers explain that the International Agency for Research on Cancer (IARC) has recently classified the fumes from high-temperature frying as ‘probably’ cancer-causing to humans. They also highlight the results of a 1986 study that reported an increased risk of respiratory tract cancer in cooks and bakers. The researchers say that although there is “limited evidence” from studies in humans that emissions from high-temperature frying are carcinogenic, animal experiments have provided “sufficient evidence” to suggest that there is a link. What did the research involve? The researchers cooked 400g beefsteaks in either margarine or soya bean oil. The margarine used contained soya bean oil, rapeseed oil, coconut oil, palm oil and vitamins A and D. The first steak was cooked for 15 minutes, and after a 25-minute break the next steak was fried. The researchers repeated the process five times. Steaks were either cooked on a gas or electric hob. The kitchen had an area of 19 square metres and was fitted with an extractor hood. Air samples were taken by drawing air into a sampling tube with a fixed flow rate that was attached to the shoulder of the person frying the steak. This experimental process was designed to mimic the exposure a chef would regularly experience in a restaurant kitchen, and not the type of exposure experienced in a home kitchen. What were the basic results? The researchers could only detect one type of PAH, a chemical called naphthalene. Naphthalene is commonly known as the primary ingredient of traditional mothballs. The concentrations of naphthalene in cooking fumes were 0.15 to 0.27 millionths of a gram per square metre. The researchers reported that the environmental exposure limit for PAHs in Norway is 40 millionths of a gram per square metre. The researchers found that there were also various types of other chemicals called alkanals and alkanels in the fumes. These varied in concentration depending on whether the beef was cooked on an electric or a gas stove, with a greater amount generally found in the cooking fumes of steak cooked on a gas stove. They did not report if the two stoves cooked the meat at different temperatures. They also found that cooking on a gas stove produced a greater number of ultrafine particles in the air than cooking on an electric stove. How did the researchers interpret the results? The researchers concluded that the measured levels of total particles and PAHs that were likely to have been breathed in by the cooks were well below the occupational exposure limits set in Norway. They say that there are no defined limits for alkanals and alkanels. Conclusion This research looked at the chemical composition of cooking fumes produced when cooking steaks. The researchers set up their laboratory so that they could mimic the environment and length of exposure that a professional chef would regularly experience in a restaurant kitchen, and not a household setting. As such it should be regarded as preliminary laboratory research, which will need to be judged in the context of other studies looking directly at how these fumes affect health. Although this study showed that some potentially dangerous chemicals were generated, these were well within the safe limits of exposure. Other chemicals produced have no established safe level. This will need to be examined through additional research. The differences that the researchers observed in the chemicals produced when cooking on a gas compared to an electric stove are likely to be due to the different temperatures at which the steak was cooked. A limitation of the study was that these temperatures were not measured. This study did not directly measure the health effects of cooking fumes, and overall it does not provide evidence that exposure to the fumes from cooking steak is bad for your health. Links To The Headlines Frying steak on gas hob 'may increase risk of cancer' . The Daily Telegraph , February 18 2010 The 'cancer risk' of frying steak on a gas hob . Daily Mail , February 18 2010 Links To Science Sjaastad AK, Jørgensen RB and Svendsen. Exposure to polycyclic aromatic hydrocarbons (PAHs), mutagenic aldehydes and particulate matter during pan frying of beefsteak . Occupational and Environmental Medicine ; Published online February 17 2010 (2 d ago)

• Happy people, healthy hearts? Happy people, healthy hearts?
02/18/2010
“Being happy is a great way to keep your heart healthy,” reported the Daily Express . The newspaper quoted doctors who said that we should all have more fun to help avoid heart attacks. The 10-year study assessed a range of symptoms, such as depression, hostility and anxiety, in almost 2,000 men and women. The participants were recorded in videotaped interviews and scored on their joy, happiness, excitement and contentment on a five-point happiness scale. For each point higher up the scale a person was placed, their risk of developing heart disease dropped by 22%. It is plausible that happier people are healthier. However, the effect demonstrated in this study was quite small compared to traditional modifiable risk factors, such as smoking, blood pressure or bad cholesterol. Modifying each of these factors can independently reduce the risk of heart disease by more than a third, and the combined effect of improving them together is much greater. In comparison, the one-point improvement on the happiness scale used here produces a relatively small, but probably still important, decrease in risk. Where did the story come from? This research was carried out by Dr Karina W Davidson and colleagues from the Center for Behavioral Cardiovascular Health at Columbia University Medical Center in New York. The study was supported by multiple grants from the National Institutes of Health (NIH), National Center for Research Resources and NIH Roadmap for Medical Research in the US. The paper was published in the peer-reviewed medical journal European Heart Journal . Many newspapers reported this story and interpreted the science fairly. All of them emphasised the benefits of a range of positive emotions. Some, including The Times , also quoted commentators, who said that this study does not prove ‘cause and effect’ and who recommended keeping established risk factors, such as smoking, blood pressure and cholesterol, under control. What kind of research was this? This was an analysis of data from a prospective cohort study conducted in Nova Scotia, Canada. The study aimed to see if positive emotions are linked to a lower risk of coronary heart disease (CHD). The researchers adjusted for several known heart risk factors and followed the population surveyed for up to 10 years. Only those who had completed the happiness questionnaires could be included in the analysis, and the five-point happiness scale was only recorded at the start of the study. It is possible that this could have led to inaccuracies in the estimate of the degree of benefit that happiness gives. What did the research involve? The researchers explain that previous studies have found a link between positive emotions and improved survival, immune function and lower risk of diabetes and hypertension. They say that negative emotions, such as anger, hostility and depression, are linked to a higher risk of a new episode of CHD. The Canadian Nova Scotia Health Survey looked at the health of men and women aged 18 and older in 1995 and followed them for the next 10 years. The main outcome of interest was heart disease and death. The researchers used hospital discharge codes or death certificates to assess new fatal or non-fatal cases of heart disease. They said that Nova Scotia has a universal healthcare insurance system and the computerised recording of health records is near complete. Only residents who had attended the first clinic session and completed the structured interview were included. Anyone who had had a hospital discharge diagnoses of CHD in the five years before the start of the study was excluded. The participants’ sex, age, total cholesterol, HDL cholesterol, blood pressure, history of diabetes and cigarette smoking were recorded at the beginning of the study, and a nurse measured their weight and height. From the collected data, the researchers took the records of 1,739 participants (862 men, 877 women) for analysis from the 5,576 original records in the survey. The researchers then used a range of interview scales to score emotions: Depressive symptoms were measured on the Centers for Epidemiological Studies-Depressive Symptoms (CES-D) Scale, using 17 items from a 20-item self-reporting scale. Hostility was assessed with the Cook-Medley Hostility Scale, which involved 50 true or false items commonly used to assess self-reported hostility. Anxious symptoms were assessed using the Trait-subscale of the State-Trait Anxiety Scale, a 20-item test that describes symptoms of anxiety (such as, I worry too much over something that really does not matter). Positive affect (happiness) was scored using video of a 12-minute structured interview designed to be stressful. In the interview, researchers assessed how participants expressed emotions and stress reactions. Positive affect is a rating of the degree to which participant express positive emotions, whether verbally, in their behaviour (such as smiling) or in the tone of responses (such as cheerful). After the end of the interview, the tapes were coded from one (no positive affect expressed) to five (extreme positive affect) by 23 certified coders. What were the basic results? The researchers adjusted their results for traditional risk factors, including age, sex, blood pressure and cholesterol, and for negatives affects such as depression and hostility. They found that the rate of new episodes of CHD was 22% lower for a one-point increase in the positive affect score (adjusted hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.63 to 0.96). When the researchers compared people with high happiness scores to those with lower scores, they found that those with higher scores were reportedly more likely to be female, less likely to be current smokers, and more likely to have lower total cholesterol, blood pressure, levels of hostility and anxious symptoms. The researchers say that this “suggests that higher levels of positive affect are related to better overall health”. How did the researchers interpret the results? The researchers say that, in this large randomly selected sample, increased positive emotions (happiness) were associated with a reduced risk of new heart attacks over 10 years, even after adjustment for depressive symptoms, hostility and anxiety. According to the researchers, the prospect that increasing happiness is associated with a decrease in the risk of heart disease is an exciting, but untested, theory that needs further research. Conclusion This study tested a theory that many people already accept without any strong evidence: that being happy is good for the heart. This research appears to show a link between happiness and heart disease, at least in the context of recorded interviews as an assessment of happiness. The researchers warn that better heart health may simply be related to better overall health in people who are happy. Some other limitations are also mentioned: As the information on cardiovascular risk factors was only measured at the start of the study, some misclassification is likely. Some people may have developed high blood pressure or started smoking during the 10 years of follow-up. As the electronic records did not exist before 1990, it is technically possible that some participants who experienced CHD events more than five years before the study could have been included in the analysis if they had denied or forgotten about their past heart disease. As this was an observational study, the researchers say that they cannot rule out the possibility that factors they did not measure or did not fully adjust for could have caused the effect thought to be due to happiness. They say that the participants selected for the study were generally younger, female and less hostile than the participants who were excluded from the analysis. They say that it is “possible that our results may be at least partially accounted for by a selection bias”. Overall, this study provides useful data and illustrates the way that happiness can be measured relatively objectively in studies of emotions. The link between happiness and heart disease is not completely clear and the wide confidence intervals in the statistical analysis suggest that, if the selection bias is taken into account, the effect of happiness may be quite small. It is plausible that happier people are healthier. However, the actual effect demonstrated in this study was quite small, compared with traditional modifiable risk factors, such as smoking, blood pressure or bad cholesterol. Modifying each of these factors can independently reduce risk by more than a third, and the combined effect of improving them together is much greater. In comparison, the one-point improvement on the happiness scale used here produces a relatively small, but probably still important, decrease in risk. Links To The Headlines Happiness wards off heart disease, study suggests. BBC News, February 18 2010 Good mood helps keep heart disease at bay. Daily Mirror , February 18 2010 Happiness may be good for your heart: research. The Daily Telegraph , February 18 2010 Happy and enthusiastic people less prone to heart disease, say researchers. The Times , February 18 2010 Happiness reduces risk of heart disease, research finds. The Guardian , February 18 2010 Optimists 'are less likely to get heart disease'. Daily Mail , February 18 2010 Being happy is the key to living longer. Metro, February 18 2010 Feeling happy? Then you’ve just added years to your life. Daily Express, February 18 2010 Links To Science Davidson KW, Mostofsky E and Whang W. Don't worry, be happy: positive affect and reduced 10-year incident coronary heart disease: The Canadian Nova Scotia Health Survey. European Heart Journal February 17 2010 (advance access published online) (2 d ago)

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