Sports safety: Not just child’s play

Playing sports offers plenty of fitness and other developmental benefits for kids, but injuries are common. Every year, more than 2.6 million U.S. children aged 19 and under are treated in the ER for sports- and recreation-related injuries.

If your child plays team sports, start by vetting the qualifications of the coaches.

A questionnaire-based study by the American Council on Exercise found common knowledge gaps among youth-sports coaches — many of whom are volunteers — in the areas of proper hydration, strength training, nutrition and concussions. For instance, many didn’t know about “second impact syndrome” — when a second concussion occurs before the first one has healed, a potentially fatal situation.

Make sure your kids learn and practice skills they need for their sport. Proper form helps prevent injuries. If your child isn’t in condition for the activity or is new to it, he or she needs to start slowly, ideally by preparing in the off-season for at least four weeks. Developing strong legs in particular will help protect knees and ankles.

Check that your young athletes have — and wear — properly fitted protective gear appropriate for their activity, such as helmets to prevent concussions, wrist guards, knee or elbow pads. And regularly check that the equipment is in good condition.

Wearing a helmet is a must for:

• Batting and running bases in baseball or softball.
• Playing a contact sport, such as football or hockey.
• Riding a bike, snowmobile or ATV.
• Skiing and snowboarding.
• Using inline skates, a skateboard or scooter.
• Horseback riding.

Also, pay attention to the weather. Kids need time to adjust to heat and humidity when playing outdoors to avoid both injury and illness. Make sure they drink the right amount of water and are dressed for the conditions.

More information

The U.S. Centers for Disease Control and Prevention has more detailed information for parents to help prevent a traumatic brain injury in kids of all ages.

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Heart Assn: Health benefits of soccer

As both a soccer mom and fanatic, Dr. Mercedes Carnethon knows why soccer is the world’s favorite sport.

It’s super easy to play.

“All it takes is a ball and a little bit of space,” said Carnethon, an epidemiologist.

With fervor rising as World Cup contenders knock each other out of the tournament, soccer enthusiasts are proudly wearing their fanaticism on their sleeves. And with good reason: Not only is soccer fun, it’s also good for you.

The obvious benefits are related to the aerobic activity generated on the field.

“It is a game of continuous running and with very little stopping,” said Carnethon, an associate professor of preventive medicine at Northwestern University in Chicago. “It also has anaerobic elements — that high intensity where you’re sprinting and then resting — you’re constantly moving.”

Sports researcher Peter Krustrup, who has spent more than 15 years studying the health benefits of soccer, said that recreational-level play and soccer-related exercise drills can help reduce cholesterol and blood pressure. Soccer also can help shift body composition by decreasing fat and increasing lean muscle.

And most of these benefits can take effect after just 12 to 16 weeks of training, he said.

Soccer is “a multipurpose sport” that combines endurance, strength and high-intensity interval training all at once, said Krustrup, a professor of sport and health sciences at the University of Southern Denmark.

“Basically, it takes the best of three worlds,” he said. “It’s as good as interval running, when it comes to the cardio training, and it’ as good as long-distance jogging or cycling, when it comes to endurance. It’s also as good as lifting weights when it comes to the musculoskeletal benefits.”

Another advantage soccer has over other sports is that it easily allows players of all skill levels and ages, said Krustrup, who has been researching older players, including some first-timers in their 80s. His findings discovered these older rookie players get the same type of health benefits as those who have played for decades.

Regular physical activity, whether from soccer or other types of exercise, can ease many of the underlying ailments people suffer from today, Carnethon said.

“Heart disease, diabetes and other chronic diseases don’t develop overnight. They develop after many years of accumulation of unhealthy lifestyle habits,” she said. “Another benefit [of soccer] is that it can be a lifelong sport.”

Soccer is often the entry into team sports for children, primarily because it’s inexpensive, it keeps them constantly active, and it requires less technical skills than a sport like basketball or baseball, Carnethon noted.

“Part of preventing these chronic diseases that develop over decades is maintaining a healthy lifestyle from youth, even from late toddlerhood on,” she said. “For many, soccer can help build the mindset of a healthy lifestyle from a young age.”

Pierre Barrieu, the sports performance director for the Major League Soccer team LA Galaxy, said another benefit soccer provides is the tremendous mental boost that accompanies the built-in camaraderie.

“This is a game designed to be played with a team. Not many sports are played 11 to 11, so there’s a social aspect in soccer that you may not find in some other sports,” he said.

Soccer is such an all-around healthy sport that even simply watching from the stands can require a level of endurance, Barrieu said.

“When you go to stadiums, the fans are the ones bringing the atmosphere. They are incredibly active. There is no kiss cam. There is no dance cam,” he said. “If you watch the games at the World Cup, the fans are the ones out there on their feet. They are sweating, some as much as the players in the game.”

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Cost keeps many from getting hearing aids

 A hearing aid can set you back as much as $7,000, and that’s the main reason more Americans don’t use one, a new study finds.

The report also suggests that many people are too embarrassed to wear one.

No matter the reason, it’s troubling, one study author said, because poor hearing can hurt people in many ways.

“Unaddressed hearing loss can affect one’s psychosocial, physical and cognitive [brain] health,” said study lead author Dr. Michael McKee.

“Furthermore, hearing loss is tied with unemployment and reduced incomes, so by not addressing the hearing loss, it is possible that those who are unable to acquire hearing aids will be made even worse off down the road,” he added.

McKee is an assistant professor of family medicine at the University of Michigan.

Only about one-third of hearing-impaired Americans over age 55 use a hearing aid, the study found. Use of the devices is even less common among older blacks, Hispanics, people with less education and the poor.

“In many cases, these groups were less than half as likely to use hearing aids compared to those with higher wealth, education and whites,” McKee noted.

Hearing aids cost anywhere from $2,000 to $7,000 out of pocket. Most insurance — including Medicare — doesn’t cover them.

By their 50s, roughly three in 10 Americans experience hearing loss. That rises to 45 percent among those in their 60s; nearly 70 percent among 70-year-olds; and nearly 90 percent among octogenarians.

To track hearing aid use, the researchers reviewed data from a survey of 35,000 men and women aged 55 and older, all of whom reported hearing loss. In-depth interviews were conducted with 21 patients.

The interviews found that cost, lack of insurance coverage, vanity or stigma were common reasons for not using hearing aids. The participants also cited a lack of attention to hearing loss by their primary care provider and worries about finding a trustworthy audiologist.

Just 15 percent of respondents in their late 50s said they used hearing aids, compared with 57 percent among those in their late 80s, the findings showed.

Hearing aid use also differed by race, the investigators found. About 40 percent of white patients used hearing aids, compared with about 18 percent of black patients, and 21 percent of Hispanics.

Education gaps were evident, too. Over 45 percent of study participants who had gone to college wore a hearing aid, compared to less than 29 percent of respondents who hadn’t finished high school.

Among the poorest respondents, about one-quarter wore a hearing aid compared to nearly half of the highest earners.

That said, hearing-impaired military veterans between 55 and 64 were twice as likely to use a hearing aid than their non-vet peers. Why? Because veterans benefits often cover the cost.

Still, Jackie Clark, president of the American Academy of Audiology, said that although price is an obstacle, it’s not the only problem.

“The reason people are averse to hearing aids is pretty complex, multi-dimensional and culturally influenced,” Clark said.

Moreover, the science of hearing is still relatively young, she noted. It took off only after World War II, when many veterans returned with hearing harmed by exposure to exploding bombs.

“I often like to remind people that it took over 100 years for the adoption of eye glasses to attain good vision,” Clark said.

It was only once good eyesight became an indispensable feature of modern life that “the glasses industry went from almost non-existent to almost complete uptake,” Clark added.

So what can be done to encourage broader acceptance of hearing aids?

Besides ensuring that insurance covers their cost, McKee said people need to be reminded about how helpful hearing aids could be.

“Public announcement programs highlighting the benefits of addressing your hearing loss could help,” he said. “We need to engage celebrities who wear hearing aids to show that having one does not make one appear uncool or less able.”

McKee and his colleagues reported their findings in a recent issue of The Gerontologist.

More information

There’s more on seniors and hearing loss at the U.S. National Institute on Deafness and Other Communication Disorders.

SOURCES: Michael McKee, M.D., M.P.H., assistant professor of family medicine, University of Michigan, Ann Arbor; Jackie Clark, Ph.D., president, American Academy of Audiology, and clinical professor, School of Behavioral & Brain Sciences, University of Texas at Dallas/Callier Center; May 21, 2018, The Gerontologist

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Men, not careers, prompt women to freeze eggs

Women who choose to have their eggs frozen aren’t necessarily putting off having children because they’re laser-focused on their careers, new research suggests.

It’s more likely that a lack of a stable, fulfilling relationship is what’s behind those decisions, the Yale study authors found.

The study of 150 women undergoing egg freezing in the United States or Israel found that 85 percent of the women didn’t have a partner. Of those who did have a partner, they reported that their partner wasn’t ready or refused to have children, or the relationship was new or uncertain.

“The portrayal of egg-freezing women as selfish ‘careerists’ is incorrect,” said study author Marcia Inhorn, a professor of anthropology at Yale.

“Most of these women are successful professionals, but they’ve been looking for committed relationships and have been unable to find them. Thus, partnership problems, not career planning, is by far the main reason for egg freezing at the present time,” she said.

Elective egg freezing is a relatively new technology that uses a process to fast-freeze the eggs. In 2013, around 5,000 egg-freezing cycles were performed in the United States. In 2018, it’s predicted that number will be about 76,000, the researchers said.

Dr. Tomer Singer is director of the egg freezing program at Northwell Health Fertility in Manhasset, N.Y. He said the several-week process begins with hormone shots to stimulate and ripen the eggs, and then a trigger shot when it’s time to retrieve the eggs.

During the egg retrieval, the patient receives light sedation. The doctor uses ultrasound to guide the retrieval, which is done through the vagina so no incision is needed. Singer said the procedure takes about 15 to 20 minutes, and usually the woman can go home about an hour later.

Each cycle of egg retrieval costs about $5,000 to $15,000, depending on the center, Singer said. The cost of the drugs adds another $2,000 to $6,000. And, storage of the eggs costs between $500 and $1,000 a year after the first year, he added.

Insurance often won’t pay for egg freezing. However, Singer said some large companies are choosing to offer it as an option to their employees.

It’s not yet clear what the optimal number of eggs to freeze is. The researchers said that based on the data that’s available now, it appears that women under 35 might want to freeze 10 to 12 eggs. They recommend that women over 35 freeze about 20 eggs for the best chance of getting pregnant later.

Singer said that each cycle of egg freezing can result in between three and 30 eggs, though between five and 20 is more typical. He added that the doctor can usually estimate with a blood test or transvaginal ultrasound how many eggs they’ll be able to retrieve. That means women can decide to go ahead with egg retrieval or not that cycle, saving money if it looks like only a few eggs will be retrieved.

The women in the survey were between the ages of 29 and 42. But Inhorn said most — 73 percent — were between 35 and 39.

The women in the United States were mostly from the East Coast (Boston to Washington, D.C.) and the San Francisco Bay Area. In Israel, the women were mainly from Tel Aviv and Haifa, Inhorn said.

Choosing to freeze eggs because of career planning was the least common option chosen by women who didn’t have a partner.

The researchers noted little difference in reasons for freezing eggs between the women in the United States and Israel. But Inhorn noted that it’s possible that women’s reasons for freezing eggs in other countries may be different.

Singer said the findings mirror what he’s been seeing in practice. “It’s becoming more routine for women to come in because they can’t find a partner, or they’re not so comfortable with where they are in their relationship. They may not be so quick to think they’ll find Mr. Right soon, and egg freezing gives women options. It’s a back-up option,” he explained.

Inhorn presented the findings Monday at the European Society of Human Reproduction and Embryology meeting in Barcelona. Findings presented at meetings are typically viewed as preliminary until they’ve been published in a peer-reviewed journal.

More information

Learn more about egg freezing from the American College of Obstetricians and Gynecologists.

SOURCES: Marcia Inhorn, Ph.D., William K. Lanman, Jr. professor of anthropology and international affairs, Yale University, New Haven, Conn.; Tomer Singer, M.D., director, reproductive endocrinology, Lenox Hill Hospital, and director, egg freezing program, Northwell Health Fertility, Manhasset, N.Y.; July 2, 2018, presentation, European Society of Human Reproduction and Embryology meeting, Barcelona

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Medical Marijuana a Hit With Seniors

Seniors are giving rave reviews for medical marijuana.

In a new survey, those who turned to it for treating chronic pain reported it reduced pain and decreased the need for opioid painkillers.

Nine out of 10 liked it so much they said they’d recommend medical pot to others.

“I was on Percocet and replaced it with medical marijuana. Thank you, thank you, thank you,” said one senior.

Another patient put it this way: “It [medical marijuana] is extremely effective and has allowed me to function in my work and life again. It has not completely taken away the pain, but allows me to manage it.”

Study co-author Dr. Diana Martins-Welch said, “The impact of medical marijuana was overwhelmingly positive. Medical marijuana led them to taking less medications overall — opioids and non-opioids — and they had better function and better quality of life.” Martins-Welch is a physician in the division of geriatric and palliative medicine at Northwell Health, in Great Neck, N.Y.

The biggest complaint the researchers heard about medical marijuana was the cost. “It’s an out-of-pocket expense. Insurance doesn’t cover it because it’s federally illegal,” Martins-Welch explained.

As for unwelcome side effects, Martins-Welch said sedation was what she heard about the most. “A lot of people don’t like feeling sleepy,” she said.

It’s also important to work with your doctor to find the right dose, since pain experts say that too little or too much doesn’t ease pain.

Thirty-one states have some type of medical marijuana law on the books, according to the National Conference of State Legislators.

“Every state has its own laws, like what a qualifying condition is. There are a lot of differences. And you can’t take a product from one state and cross another state line,” Martins-Welch said.

According to federal law, medical marijuana is still illegal in the United States. “There are legal fears. Some practitioners worry that the DEA [U.S. Drug Enforcement Administration] might come after them,” she added.

Medical marijuana is different than just picking up some pot and smoking it.

“The goal with medical marijuana is to find the dose that gives a therapeutic benefit without a high, or slowing reaction time or causing sedation,” Martins-Welch said. “To find that right dose, we start low and go slow.”

In fact, it’s important to work with a doctor because there’s a “therapeutic window” with THC, the active component in marijuana that causes the high, according to Dr. Mark Wallace, a board member of the American Pain Society.

If you get a dose that’s within that window, the pain is relieved. If you get too little, you won’t get pain relief, and if you go over the therapeutic window, pain is actually worsened, Wallace explained.

The study included a 20-question survey of nearly 150 seniors who had used medical marijuana for chronic pain. The seniors had received their medical marijuana from dispensaries in New York or Minnesota.

The average age of the seniors was 61 to 70, and 54 percent were female. Many (45 percent) used a vaporized oil in an e-cigarette device. Twenty-eight percent used a medical marijuana pill.

Twenty-one percent said they used medical marijuana daily, while 23 percent said they used it twice a day. Another 39 percent said they used it more than twice a day, the researchers noted.

About half the time, medical marijuana had been recommended by a doctor. One-quarter of the seniors decided to try medical marijuana at the urging of a friend or family member. Almost all — 91 percent — would recommend medical marijuana to someone else.

When asked how medical marijuana affected their pain levels, the seniors reported going from a 9 (on a pain scale of zero to 10) down to 5.6 a month after starting the medical marijuana.

Wallace said he’s seen many positive results from the use of medical marijuana in his patients.

“The geriatric population is my fastest-growing patient population. With medical marijuana, I’m taking more patients off opioids,” he said.

“There’s never been a reported death from medical marijuana, yet there are 19,000 deaths a year from prescription opioids. Medical cannabis is probably safer than a lot of drugs we give,” Wallace said.

Medical marijuana can also stimulate appetite, Martins-Welch said, which is a “godsend for cancer patients,” though extra eating may not be a welcome side effect for everyone.

Martins-Welch said it’s best to discuss potential drug interactions with your doctor, but it’s usually OK to mix marijuana and opioids. She said she’d caution against mixing medical marijuana with alcohol.

The study findings were presented recently at the American Geriatrics Society meeting in Orlando, Fla. Studies presented at meetings are typically viewed as preliminary until they’ve been published in a peer-reviewed journal.

More information

Learn more about medical marijuana from the U.S. National Institute on Drug Abuse.

SOURCES: Diana Martins-Welch, M.D., physician, department of medicine, division of geriatric and palliative care medicine, Northwell Health, Great Neck, N.Y.; Mark Wallace, M.D., board member, American Pain Society, and professor, anesthesiology, University of California, San Diego, and program director, UCSD Center for Pain Medicine; May 3, 2018, presentation, American Geriatrics Society meeting, Orlando, Fla.

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Occupational Exposure Limits for Heat Stress Often Exceeded: CDC

Based on recommendations from the U.S. Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health and the American Conference of Governmental Industrial Hygienists, occupational exposure limits for heat stress are exceeded in most recorded cases of outdoor occupational heat-related illness, according to research published in the July 6 issue of the CDC’s Morbidity and Mortality Weekly Report.

Aaron W. Tustin, M.D., from the Occupational Safety and Health Administration (OSHA) in Washington, D.C., and colleagues retrospectively reviewed 25 outdoor occupational health-related illnesses (14 fatal and 11 non-fatal) investigated by the OSHA from 2011 to 2016. Personal risk factors were assessed for each incident, and the wet bulb globe temperature (WBGT), workload, and acclimatization status were estimated.

The researchers found that in all fatalities and eight of 11 non-fatal illnesses, heat stress exceeded exposure limits. For the same 25 cases, a Heat Index screening threshold of 85 degrees Fahrenheit could identify potentially hazardous levels of workplace environmental heat when WBGT was unavailable. Six fatalities occurred when the Heat Index was <91 degrees Fahrenheit.

“Whenever heat stress exceeds occupational exposure limits, workers should be protected by acclimatization programs, training about symptom recognition and first aid, and provision of rest breaks, shade, and water,” the authors write.

Abstract/Full Text

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Disordered eating behaviors up for overweight young adults

Young adults at a weight status classified as overweight or obese have increased prevalence of disordered eating behaviors (DEBs), according to a study published online June 11 in the Journal of General Internal Medicine.

Jason M. Nagata, M.D., from the University of California in San Francisco, and colleagues examined the prevalence of eating disorders and DEBs using cross-sectional data obtained from Wave III of the National Longitudinal Study of Adolescent to Adult Health for young adults ages 18 to 24 years.

The researchers found that 48.6 percent of the 14,322 young adults in the sample were at a weight status classified as overweight/obese. Those at a weight status classified as overweight/obese reported a higher rate of DEBs than young adults at a weight status classified as underweight/normal weight (females: 29.3 versus 15.8 percent; males: 15.4 versus 7.5 percent). After adjustment for all covariates, the odds of engaging in DEBs were increased for females versus males (odds ratio, 2.32), Asian/Pacific Islanders versus whites (odds ratio, 1.66), homosexual or bisexual versus heterosexual (odds ratio, 1.62), high school or less versus more than high school education (odds ratio, 1.26), and obesity versus normal weight (odds ratio, 2.45).

“The high prevalence of DEBs particularly in young adults at a weight status classified as overweight or obese underscores the need for screening, referrals, and tailored interventions for DEBs in this population,” the authors write.

 Explore further: Binging, purging and fasting more common in overweight, obese young adults

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