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In the doctor's lounge: Heart, diet, smoking, vaccines, old age

​This article first appeared in the St. Louis Beacon: July 22, 2008 - Flavonoid-rich Foods Improve Cardiac Risk Factors

Chocolate, soy and green tea get the green light while black tea gets blacklisted in an article published in the July American Journal of Clinical Nutrition.

These foods contain flavonoids, nutritional substances known to improve different cardiovascular risk factors. In this first study of its kind, researchers found that chocolate, soy and green tea intake had beneficial effects on risk factors like high blood pressure and cholesterol. Black tea, however, was found to raise blood pressure in this study.

But before you pitch your Earl Grey, remember that this is one study and further research on how best to individualize use of flavonoids to minimize risks and optimize health is still needed.

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Many People Unable to Recognize Need to Slim Down

Is a size 16 the new size 10? A study published online July 10 in the British Medical Journal points to yes.

The threshold at which overweight people see their weight as a problem has risen dramatically over the past eight years. "Despite media and health campaigns aiming to raise awareness of healthy weight, increasing numbers of overweight people fail to recognize that their weight is a cause for concern," the study reports

Eighty-one percent of overweight respondents to a 1999 survey correctly identified themselves whereas only 75 percent of those overweight did so in 2007.

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Perceived Access to Tobacco Predicts Youth Smoking

Teens who believe that they have easy access to cigarettes are more likely to become regular smokers, and especially so if they have friends who smoke, according to a study in the July/August issue of the Annals of Family Medicine.

"These findings suggest that youths who have peer smokers and perceive easy access may be at high risk for higher levels of smoking and may warrant greater attention in clinical and public health settings," the authors wrote.

While family physicians and pediatricians already routinely screen for risk behaviors, including tobacco use, the authors recommend also asking about the teens' perceptions of the accessibility of tobacco and exposure to peer smokers.

Parents may want to follow suit. as well.

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Importance of Adolescent Vaccines Highlighted

Also within the teen demographic this week, expert commentaries in the August issue of the American Journal of Preventive Medicine focus on how best to deliver vaccines recommended for this group.

Three vaccines are available that can prevent five serious diseases: meningococcal meningitis, human papillomavirus (which can lead to cancer) and a combination vaccine against tetanus, diphtheria and pertussis. Issues related to access and ability to consent to vaccination need to be addressed, according to the authors of the study. Improving educational efforts to reach teens and their caregivers was also seen as essential.

While vaccinations may be seen as controversial and can, like any medication, cause side effects, a decision not to immunize also involves risk.

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Older Patients May Not Voice Surgery Concerns

The elderly are often reluctant to fully disclose concerns they have about orthopedic procedures to their surgeons, according to a report in the July issue of the Journal of Bone & Joint Surgery.

Doctors and patients alike want the same thing: a positive outcome. Open lines of communication are paramount in delivering this result. The article recommends that orthopedic surgeons interview their patients intensively on their capacity to meet the demands of the surgery, including their finances and support from family members.

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This column by HealthDay's Dr. Cynthia Haines, Managing Editor of the Physician's Briefing news service, will run each week in the St. Louis Beacon.