Is popcorn giving you heart disease?

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Oh, great. Just when you were starting to get a handle on your BPA exposure, scientists uncover a new one you should worry about. 

It’s called perfluorooctanoic acid (PFOA)—a chemical found in things like nonstick cookware, food wrappers, furniture, and even raincoats—and it’s been linked to cardiovascular disease, according to a new study. 

The kicker? A full 98 percent of us have PFOA in our bloodstreams. (Protect your body’s most important muscle with these tips to Strengthen Your Heart in 30 Days.)

Researchers from West Virginia University (WVU) School of Public Health, Morgantown, looked at the health data of 1,200 Americans and compared their PFOA serum levels with the incidence of heart disease. The results: The greater the amounts of PFOA in the bloodstream, the greater the risk of cardiovascular disease—regardless of factors like age, race, smoking, BMI, diabetes, and even hypertension. While previous research has linked PFOA to cardiovascular disease in animals, this is the first to look at PFOA’s heart effect on humans.

Scary? You bet. But more research needs to be done to determine the specific relationship between PFOA and cardiovascular disease. 

“We can’t yet be certain that PFOA causes heart disease,” says lead study author Dr. Anoop Shankar, chair of the department of epidemiology in the WVU School of Public Health. “The two could be related in another way, like people with cardiovascular disease tending to retain more PFOA in their blood.” (Minimize your exposure to harsh chemicals with these 19 Bizarre Home Remedies That Really Work.)

Still, PFOA’s track record isn’t exactly reassuring. Health watchdogs like the Environmental Working Group—which annually puts out the Dirty Dozen Foods You Should Eat Organic—cite research that suggests PFOA may be a human carcinogen, and previous research has linked the chemical to chronic kidney disease and high cholesterol in children and adolescents. It’s also a significant source of global chemical emissions—so much so that the EPA partnered with major manufacturers like DuPont and 3M to form the 2010/2015 PFOA Stewardship Program, which plans to eliminate PFOAs from the manufacturers’ products by 2015.
 

Until then, you can minimize your exposure to the chemical by steering clear of two of the biggest sources: nonstick cookware and packaged foods like microwave popcorn. According to the FDA, many popcorn bags contain especially high levels of PFOAs. (Popcorn addict? Avoid chemicals, calories, and sodium with these tips to prepare the perfect bowl of popcorn at home.)
 

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Skin Cancer Awareness Month: How to detect and prevent this deadly disease

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Skin cancer affects people of all ages and races, and it most often develops on the areas of a person’s skin most exposed to the sun.  It is the most common form of cancer diagnosed in the U.S., with more than 3.5 million diagnoses annually.  According to the American Cancer Society, skin cancer diagnoses equal more than the new diagnoses of breast, prostate, lung and colon cancers combined.  

There are three major types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma.  BCC is the most common form of skin cancer and most often occurs on the most sun-exposed areas of your body (i.e. face and neck).  It often appears as a pearly or waxy bump, or a flat, flesh-colored or brown scar-like lesion.  SCC also often occurs on sun-exposed areas of your body, but it presents as a firm, red nodule or a flat, scaly or crusty lesion.  

Melanoma, on the other hand, can develop anywhere on your body – even on skin that is not often exposed to the sun.  In men, it most commonly appears on the trunk, head or neck – and in women, the lower legs.  It often presents as a large brown spot with dark speckles; a mole that changes color, size or texture; a small lesion with irregular borders; or dark lesions on your palms, fingertips, soles or toes.  It is from these signs that the “ABCDEs of Melanoma” were developed:

A: Asymmetry of the mole.  If you were to draw a line across the mole, the two halves will be very different.

B: Borders of the mole are uneven.

C: Color varies throughout the mole.  This can include different shades of brown, tan, black or even red, blue or another color.

D: Diameter of the mole is greater than 6 millimeters (or the size of a pencil eraser); melanomas tend to be larger than benign moles.

E: Evolution of the mole, in size, shape, color, and texture can be indicative of melanoma.

It is estimated that one in five Americans will develop skin cancer, so the chance of you or someone you know developing skin cancer is more real than you may think.  Fortunately, there are some easy tips to help prevent skin cancer.  

First, wear at least SPF 30 sunscreen and protective clothing (e.g. long sleeve shirts, pants, wide-brimmed hats, sunglasses, etc.) every day – even on cloudy days.  Reapply your sunscreen every two to three hours, especially if you are swimming or sweating.  Seek shade during the sun’s harshest hours: between 10 a.m. and 4 p.m.  

Second, avoid tanning, tanning beds and sun burns.  Also, be watchful for any new or changing spots on your skin.  If you do see any spots that are new, have changed, are itchy or are bleeding, see your dermatologist immediately. Not all changes are caused by skin cancer, but it’s always best to speak with your dermatologist.  Early detection affords you the greatest likelihood of successful treatment.

Dr. David B. Samadi is the Vice Chairman of the Department of Urology and Chief of Robotics and Minimally Invasive Surgery at the Mount Sinai School of Medicine in New York City. He is a board-certified urologist, specializing in the diagnosis and treatment of urological disease, with a focus on robotic prostate cancer treatments. To learn more please visit his websites RoboticOncology.com and SMART-surgery.com. Find Dr. Samadi on Facebook.

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Lyme disease rates rise in northern US

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  A deer tick.Nikon Small World

Lyme disease is shifting northward within the U.S., with cases in northern states on the rise while cases in southern states decline, a new study says.

Between 1992 and 2007, there were significant increases in Lyme disease rates in 21 states, while 14 states showed a significant decrease, and 15 states showed no significant change, according to the study.

Most of the states that showed increases in the tick-borne disease were northern states, including most states in New England, along with Virginia, Ohio, and Pennsylvania, and states across the northern Midwest, including Michigan, Illinois, Wisconsin, Minnesota and North Dakota.

States that showed decreases in Lyme disease rates over the study period were mainly in the Southeast, such as Georgia, Louisiana, Mississippi, Tennessee and Kentucky, but drops were also seen in California, Oregon and Wyoming.

"Our findings are consistent with the hypothesis that increases in Lyme disease incidence in recent decades are attributable at least in part to the effects of climate change," the researchers wrote.

Studies have suggested that warming temperatures at northerly latitudes allow the Ixodes ticks, which carry the bacteria that cause Lyme disease, to migrate northward. Meanwhile, rates of the disease may be decreasing in southern states as warmer temperatures there allow an expansion of lizard populations from farther south. Lizards are "dead-end hosts" of the Lyme disease bacteria, meaning they do not transmit the disease to humans.

Lyme disease is also being reported in parts of Canada previously thought to be too cold for the ticks, the study said.

The researchers at the University of Toronto used data on Lyme disease rates from the Centers for Disease Control and Prevention (CDC). They took into account factors beyond latitude that can affect a state's rate of Lyme disease, such as how much of its population lives in rural areas and the growth of its suburbs.

To prevent tick bites, the CDC recommends using repellents that contain 20 percent or more DEET, avoiding areas that are wooded or have high grass, and showering soon after returning from the outdoors.

The new study was published April 16 in the journal CMAJ Open.

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The big ticker: Heart disease

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Clench your fist—that’s about the size of your heart. Located in the center of your chest, the heart beats about one hundred thousand times a day, pumping five to six quarts of blood per minute.

Once the blood receives oxygen from the lungs, the heart sends the blood from the aorta through the arteries and into the capillaries, which are smaller, thinner blood vessels. Then, once the capillaries have brought oxygen and nutrients to every cell in the body, the blood is redeposited into the veins, and from there it goes back to the heart for the cycle to begin again.

So what we have here is a plumbing system essentially, a smart pump with different connecting parts that circulates blood throughout the body. The heart itself is made up of four chambers—the two up top are called the atria, the two on the bottom are called the ventricles—connected by a set of valves. And the whole system is set in motion, or beats, thanks to the electrical impulses sent out by a small bundle of specialized cells in the right atrium that act as the heart’s natural pacemaker, causing the muscles of this organ to contract and relax.

Any malfunction of this blood pump is known as heart disease, of which one of the most common types is coronary artery disease. It is the No. 1 killer of both men and women in the United States killing more nearly half a million Americans each year.

Coronary artery disease, also known as coronary heart disease, is a narrowing and obstruction of the coronary arteries, which are responsible for bringing oxygen and nutrients to the heart itself. As early as your teen years, fat deposits begin to develop in some of these arteries, and as time goes by, the fat deposits build up, ultimately creating an obstruction that begins to decrease the amount of blood to the heart and cause an inflammation as the artery tries to heal itself.

Over time the fat deposits in the arteries begin to harden, and you begin to get deposits of small platelets that compound the obstruction. All of this can lead not only to a significant narrowing of the arteries, but to blood clots that may either obstruct the artery or get dislodged and create further obstructions elsewhere in the plumbing system.

One of the consequences of this narrowing or total obstruction of the coronary artery is ischemia, which occurs when there is an insufficient supply of oxygenated blood for the heart muscle. Any activity—eating, excitement, or changes in temperature—can make the problem worse.

One of the most common symptoms of ischemia is angina, which is a discomfort, heaviness, pressure, numbness, or squeezing feeling in the chest. Sometimes it is mistaken for indigestion or heartburn. It is usually felt in the chest, but it can also migrate to the arms, especially the left shoulder. Other symptoms include shortness of breath, irregular heartbeats or palpitation, a very fast heartbeat, nausea, and sweating. If this ischemia is not corrected, if it lasts more than 30 minutes and does not get better, a heart attack may result.

In a heart attack, the heart muscle begins to fail, either through a very erratic electrical stimulation called an arrhythmia or by stopping altogether. It is important to recognize these symptoms because early intervention could save your life.

A doctor can tell you if you have coronary artery disease by discussing your symptoms, especially shortness of breath, taking your medical history, and looking at your risk factors, in particular, smoking, cholesterol, blood pressure, and sugar control. There are a host of diagnostic tests your doctor can do, such as an electrocardiogram (ECG or EKG); an exercise stress test; an ultrafast CAT scan, which looks for calcium deposits in your coronary artery; and cardiocatheterization, which can help determine the degree of obstruction of the artery.

If you are diagnosed with coronary artery disease, treatment is threefold. The first has to do with lifestyle changes, like quitting smoking, starting to exercise, and keeping to a low-fat, low-sodium, low-cholesterol diet.

The second aspect of treatment is medication, which may be needed to get your heart working more effectively. Other medication will be prescribed to reduce the cholesterol.

The third aspect of treatment has to do with procedures to help improve the blood flow through the coronaries. One possibility is a balloon angioplasty, in which a small balloon-tipped catheter is inserted into the coronary arteries and then inflated to open up the clogged artery. Another possibility is placing a small, metal stent inside the artery to keep it open and improve blood flow.

A heart bypass operation takes place when total replacement of the piece of the coronary that is obstructed becomes necessary.

Plumbing Vs. Electrical Problems

Other types of cardiac disease have nothing to do with obstruction of the coronaries but with the way the electrical system of the heart works. Sometimes the specialized cells that electrically stimulate the heart become dysfunctional, and you can develop an arrhythmia, where the heart beats either too slowly, too quickly, or out of sync. These conditions can be diagnosed with an electrocardiogram, and sometimes medications alone can help to regulate the rhythm.

Another common problem is heart failure. This occurs when the heart can no longer effectively pump all the blood that it receives. Heart failure affects about five million Americans, and it’s the leading cause of hospitalization of people older than 65. Many times, heart failure is due to prior damage caused by coronary artery disease, or by arrhythmias that have weakened the function of the heart. Ultimately, heart failure creates a backlog of pressure into the lungs, and people with heart failure tend to have difficulty breathing. Depending on the cause of the heart failure, different medications are available for treating it.

The valves of the heart are another source of heart problems. The valves can be damaged at birth or through infection. Abnormal or infected valves can interfere with normal blood flow and heart function and can lead to major cardiac disease. Surgery may be needed to replace the valves.

Sometimes the lining of the heart may be infected, a condition called pericarditis. If this membrane is inflamed, the heart may not beat properly. Valve abnormalities, arrhythmias, and heart failure all have a common symptom—shortness of breath or difficulty catching your breath. If you have this problem, see a cardiologist to get the correct diagnosis and treatment.

The heart is a remarkable organ. It is the core of life, and its beat is central to your survival. Keeping it in prime working order is of paramount concern.

Dr. Manny Alvarez

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