Health & Wellness: Spotlight on COPD
What is COPD ?
Chronic Obstructive Pulmonary Disease (COPD) is a devastating lung disease comprised of two major respiratory diseases – chronic bronchitis and emphysema
In 80% to 90% of cases, cigarette smoking is the principal underlying cause
COPD is Canada’s fourth leading cause of death
How Does COPD Develop?
Feeling of breathlessness at first generally thought to be due to age, being “out of shape”
People may experience:
Cough
Increased sputum
Chest colds or bouts of bronchitis that last for weeks
Breathlessness, wheezing
Difficulty with daily activities develops over time
What Can We Expect?
Approximately 5 million Canadians currently smoke
Almost 84% of Canadians over 35 years of age with self-reported COPD were or had been smokers (91% of men; 77% of women) and almost 40% of those were still smoking
In 2004–05, the average length of stay in hospital for individuals aged 55 and over with COPD was 9.6 days
COPD is increasingly becoming a women’s health issue: more women than men are being diagnosed with the disease
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Heart attack?
Don't drive - call 911
Making own way to ER may be fatal, study says
October 27, 2008
Sheryl Ubelacker
THE CANADIAN PRESS
Doctors have some simple advice for anyone with symptoms of a heart attack who needs to get to the hospital emergency room: leave the car in the garage and call 911.
Each year, thousands of Canadians experience the crushing chest pain and other telltale signs of a heart attack but choose to drive or be driven to their nearest ER instead of calling an ambulance. But doctors say that could be deadly.
"When it comes to heart attacks, every second counts," says Dr. Madhu Natarajan, a cardiologist at Hamilton Health Sciences. "The faster you get to the hospital, the faster you get treatment."
Natarajan presented a study to the Canadian Cardiovascular Congress in Toronto yesterday that found 40 per cent of people who went to the ER with heart attack symptoms had made their own way there.
Of the almost 500 patients studied, those who drove themselves or had a family member or friend take them were more likely to be younger, male, and with no history of heart disease.
"In general, people who are in the age range of 40 to 60 are more likely to drive themselves or find somebody to drive them to the hospital," Natarajan said in an interview.
"And also you see a lot of males between 50 and 70 who are married, their spouses drive them rather than them calling the ambulance."
He said people who come to hospital under their own steam can run into numerous delays – including traffic jams, difficulty finding the ER, lineups once they arrive and the time it takes to be triaged.
"We did see that people who came in by self (transport), their time to treatment was much longer," he said of the study.
And when it comes to a heart attack, there's an old saying that "time is muscle," meaning that heart cells can be irreparably damaged the longer they are starved of oxygen-rich blood. Calling 911 means quicker treatment: Paramedics are trained to recognize heart attack symptoms, can begin basic treatment and call ahead to prepare the ER.
Toronto Star |
LIST OF MAPLE LEAF RECALLED MEATS
Canadians are being told to dig through their fridges and freezers for any of the 220 Maple Leaf Foods products recalled by the Toronto-based company after test results
linked a plant in north Toronto to a nationwide listeriosis
Click here for a complete
list of recalled products (August 25, 2008)
Maple Leaf meat recall hits McDonald's, Mr. Sub

Health officials investigating whether
food poisoning, death are related
Aug 20, 2008 02:36 PM
Paola Loriggio
STAFF REPORTER
Public health officials are investigating whether an outbreak of food poisoning that killed one person is linked to contaminated cold cuts produced at a north Toronto plant.
Seventeen people, 13 of them in Ontario, have fallen ill since June in an outbreak of listeriosis, a food-borne disease caused by listeria bacteria. An Ontario resident died of the illness.
Officials at the Public Health Agency of Canada say they know little about the outbreak or its victims, but are investigating a connection with a meat recalled by Maple Leaf Foods, which supplies companies including McDonald's and Mr. Sub.
The strain of listeria monocytogenes involved in the outbreak is the same one found in the meat, but that doesn't mean the two are related, said agency spokesperson Philippe Brideau.
The agency is asking victims to trace back what they have eaten in the past three months to see whether the outbreak is linked to the recalled cold cuts. It can take from two to 90 days for symptoms to appear, he said.
This morning, Maple Leaf Foods expanded a nationwide recall after bacteria was found in cold cuts produced at a Toronto plant that supplies companies including McDonald’s and Mr. Sub.
The Canadian Food Inspection Agency (CFIA) said the Maple Leaf meats – including sliced cooked turkey, roast beef, Bavarian smokes, corned beef, salami, ham and pepperoni – may be contaminated with the bacteria listeria monocytogenes.
The meats are sold under names including Schneiders, ML Sure Slice, Deli Gourmet, MSD, Burns, ML and FS. They include sliced turkey produced for McDonald’s and roast beef for Mr. Sub.
“These products have been distributed nationally, primarily to food service institutions such as restaurants, hospitals and nursing homes,” CFIA said in a statement. “In addition, these products may also be sold at retail and deli counters.”
None of the meat has been blamed for illnesses in humans, but “quite a large amount of product” is affected, said CFIA spokesperson Garfield Balsom.
In response, McDonald's has temporarily pulled the Turkey BLT sandwich from its Canadian menu, said spokesperson Louis Payette said.
Representatives of Mr. Sub and Maple Leaf could not be reached for comment this morning.
There are about 60 cases of listeriosis reported each year in Canada, but outbreaks are rare, Brideau said. About six have been reported since 1981, the first outbreak on record.
"It's not very common," he said. "It's not like salmonella. Most people have never heard about it."
Maple Leaf expanded the list of affected products after issuing a voluntary recall notice Sunday for two types of sliced beef sold under the Sure Slice name.
Although only a small batch products were found to contain listeria, Maple Leaf recalled dozens of products as a precaution and temporarily closed its Toronto plant to reassess food safety protocols there, according to a statement issued by the company.
Lists of the affected products are posted on the CFIA and Maple Leaf websites.
Consumers can also call Maple Leaf Consumer Foods at 1-800-568-5801 or CFIA at 1-800-442-2342 for more information.
Food contaminated with listeria monocytogenes may not look or smell spoiled. Consumption may cause listeriosis, a food-borne illness that can cause high fever, severe headache, neck stiffness and nausea.
Pregnant women, the elderly and people with weakened immune systems are particularly at risk. Infected pregnant women may experience only a mild, flu-like illness, however, infections during pregnancy can lead to premature delivery, infection of the newborn, or even stillbirth. |
Forget Viagra, eat watermelon

July 3, 2008
Betsy Blaney THE ASSOCIATED PRESS
LUBBOCK, Texas – A slice of cool, fresh watermelon is a juicy way to top off a barbeque and one that researchers say has effects similar to Viagra – but don't necessarily expect it to keep the fireworks all night long.
Watermelons contain an ingredient called citrulline that can trigger production of a compound that helps relax the body's blood vessels, similar to what happens when a man takes Viagra, said scientists in Texas, one of the top producers of the seedless variety in the U.S.
Found in the flesh and rind of watermelons, citrulline reacts with the body's enzymes when consumed in large quantities and is changed into arginine, an amino acid that benefits the heart and the circulatory and immune systems.
"Arginine boosts nitric oxide, which relaxes blood vessels, the same basic effect that Viagra has, to treat erectile dysfunction and maybe even prevent it," said Bhimu Patil, a researcher and director of Texas A&M's Fruit and Vegetable Improvement Center. "Watermelon may not be as organ-specific as Viagra, but it's a great way to relax blood vessels without any drug side effects."
Todd Wehner, who studies watermelon breeding at North Carolina State University, said anyone taking Viagra shouldn't expect the same result from watermelon.
"It sounds like it would be an effect that would be interesting but not a substitute for any medical treatment," Wehner said.
The nitric oxide can also help with angina, high blood pressure and other cardiovascular problems, according to the study, which was paid for by the U.S. Department of Agriculture.
More citrulline – about 60 per cent – is found in watermelon rind than in the flesh, Patil said, but that can vary. But scientists may be able to find ways to boost the concentrations in the flesh, he said.
Citrulline is found in all colours of watermelon and is highest in the yellow-fleshed types, said Penelope Perkins-Veazie, a USDA researcher in Lane, Okla.
She said Patil's research is valid, but with a caveat: One would need to eat about six cups of watermelon to get enough citrulline to boost the body's arginine level.
"The problem you have when you eat a lot of watermelon is you tend to run to the bathroom more," Perkins-Veazie said.
Watermelon is a diuretic and was a homeopathic treatment for kidney patients before dialysis became widespread.
Another issue is the amount of sugar that much watermelon would spill into the bloodstream – a jolt that could cause cramping, Perkins-Veazie said.
Patil said he would like to do future studies on how to reduce the sugar content in watermelon.
The relationship between citrulline and arginine might also prove helpful to those who are obese or suffer from type-2 diabetes. The beneficial effects – among them the ability to relax blood vessels, much like Viagra does – are beginning to be revealed in research.
Citrulline is present in other curcubits, like cucumbers and cantaloupe, at very low levels, and in the milk protein casein. The highest concentrations of citrulline are found in walnut seedlings, Perkins-Veazie said.
"But they're bitter and most people don't want to eat them," she said.
thestar.com
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Ignorance is not bliss

Avoiding prostate tests because you're afraid of hearing bad news could be deadly mistake
Paul Irish - Toronto Star
Don't be an ostrich!
You know who you are. Are you the guy who hides his head in the sand refusing medical tests or examinations because he's scared he may be sick?
As ridiculous as it sounds, there are a lot of those frightened birds out there.
Colin Graham, 74, admits he had a touch of the ostrich in him.
But he still had enough sense to listen to his doctors – and he's glad he did.
In early 2005, Graham's family doctor felt an irregularity in his prostate gland while performing a digital rectal exam.
He sent Graham to Sunnybrook's Odette Cancer Centre for a PSA test, which proved normal.
But because of other factors – Graham's age and the facts that cancer runs in his family and his prostate gland was irregular – Sunnybrook doctors determined he had a high risk of having prostate cancer.
A biopsy proved them right, and the prostate was removed.
"I didn't feel the slightest bit sick ... I didn't know I had it," Graham says. "Men should take full advantage of anything that will help them detect the cancer. My PSA was normal, but look what happened."
Dr. Robert Nam, a urological oncologist at Sunnybrook, was able to detect Graham's prostate cancer thanks to a nomogram, which classified him as a high-risk patient even though his PSA levels were normal.
A nomogram is a statistical model that determines the threat of cancers or disease based on known risk factors.
Sunnybrook's model – called the Prostate Cancer Risk Calculator – takes just minutes to determine the level of risk, based on age, family history, ethnicity, urinary symptoms, PSA, free/total PSA ratio and rectal exam results.
It's the first nomogram to use all known risk factors for prostate cancer, and has already proven to be more reliable than conventional cancer screening.
Nam says a PSA test may not detect smaller cancers, but once other markers are taken into account, the nomogram can identify patients at a high enough risk to warrant a biopsy. Although he says the PSA number will always be important, it is more useful when used in context with as much information about the patient as possible.
To see how the nomogram works, go to the website at prostaterisk.ca and click on the link to the risk calculator. However, it is best used in consultation with a family doctor.
Sunnybrook researchers based the nomogram on 3,108 Canadian men (all of whom had abnormal PSA values or rectal exam results), along with another group of 408 volunteers with normal PSAs.
All of the men underwent prostate biopsies.
Of the main group, 42 per cent were diagnosed with prostate cancer.
Of the 408 with normal PSAs, 24 per cent were diagnosed with prostate cancer.
Further evaluation of the nomogram is underway, through a multi-institutional cross-Canada study group of another 5,000 men.
"In addition to helping men avoid unnecessary biopsies, the risk calculator better detects prostate cancer at an earlier, more curable, stage," Nam says.
"And it helps identify high-risk patients who may need to make immediate dietary and lifestyle changes and need repeat biopsies."
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Shower curtain health warning
PVC vinyl leaching pollutants into air, study finds
June 13, 2008
Huixia Sun
STAFF REPORTER
Some shower curtains may be hazardous to your health, according to a new study released yesterday.
As many as 100 harmful chemicals are released into the air from PVC shower curtains, posing risks to human health and the environment, says the study, released jointly by the U.S.-based Center for Health, Environment and Justice, Canada-based Environmental Defence, and the Canadian Environmental Law Association (CELA).
Researchers purchased polyvinyl chloride (PVC) shower curtains from five American retailers. In laboratory tests they were found to contain chemicals including volatile organic compounds (VOCs), phthalate, organotins and metals. Several chemicals found in the curtains are considered a human health concern under the Canadian Environmental Protection Act, but are not regulated, according to the report.
Toxic chemical off-gassing may contribute to respiratory problems, and damage the liver, central nervous and reproductive systems, said the report, titled "Volatile vinyl: the new shower curtain's chemical smell."
Pregnant women and children are particularly vulnerable, and heat or humidity can increase the release of chemicals, said the report.
"Not only are vinyl products contaminating our indoor air, but they release toxic dioxins during manufacturing and incineration," said Theresa McClenaghan, CELA's executive director. "The federal government has a window of opportunity to proactively regulate these chemicals with a major bill before Parliament to amend the federal Hazardous Products Act."
Environmental Defence and CELA are urging Ottawa to ban PVC in shower curtains and calling on manufacturers and retailers to switch to safer products such as cotton shower curtains. They are also urging expanded labelling rules. .
Responding to the study yesterday, a council of the Canadian Plastics Industry Association denied that the chemicals in the curtains were dangerous to consumers.
"Just because a chemical has been detected does not mean that it's harmful," said the director of the Vinyl Council of Canada, Marion Axmith, in a news release.
Calling the report "simple scaremongering," she said vinyl shower curtains had been in use "for decades with no reported incidents of harm."
With files from Nick Kyonka
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Toronto Star
Middle-aged spare tire
linked to Dementia

THE CANADIAN PRESS
Carrying a spare tire on the abdomen is known to significantly boost the risk for diabetes and cardiovascular disease, but new research suggests excess belly fat in middle-age also may contribute to Alzheimer's and other forms of dementia later in life.
In fact, a long-term study of more than 6,000 people found that those with the highest amount of abdominal fat in their 40s had about triple the risk of developing dementia than those with the lowest amount of fat around their mid-sections.
Having a bulging belly boosted the risk of dementia regardless of whether participants had normal weight overall or were overweight or obese, as measured by body mass index (BMI), said principal investigator Rachel Whitmer, a research scientist at Kaiser Permanente, a non-profit U.S. health plan that conducted the study.
Furthermore, the increased risk of Alzheimer's and other dementias existed independently of other health conditions, including diabetes, stroke and heart disease – and the effect did not vary by race or gender, Whitmer said from Oakland, Calif.
The study, published Thursday in the journal Neurology, found that those who were overweight by BMI standards and also had a pot belly were 2.3 times more likely to develop dementia than people with a normal weight and abdominal profile, she said.
Those who were both obese and big around the middle were 3.6 times – or a whopping 260 per cent – more likely to develop dementia than those of normal weight and belly size. That compares to an 80 per cent higher risk for people who were overweight or obese but without so-called beer gut.
"So there's two messages here," Whitmer said. "The first message is that if you are normal (weight) and you have a large belly, your risk for dementia was about the same as those who were overweight or obese who didn't have a large belly."
"Now, if you are overweight or obese and you have a large belly, your risk really goes up."
"So this really nicely shows that the effect of the large belly was above and beyond the effect of body mass index and, in particular, the magnitude of the effect of the large belly got greater as you weighed more."
The study involved 6,583 people in northern California, aged 40 to 45, who had their abdominal fat measured between 1964 and 1973 and whose health records were followed over time. An average of 36 years later, when participants were in their 70s, 16 per cent had been diagnosed with dementia.
Whitmer said the kind of fat that settles in the belly, known as visceral fat, has a different makeup and actions in the body than the type of fat packed on elsewhere, called subcutaneous fat.
"And fat biologists know, that visceral fat, it is more lively, it is more toxic, it is more metabolically active," said Whitmer. ``It secretes a lot of hormones and inflammatory compounds."
While only speculating, she suggests one or more of these inflammatory substances may be able to cross into the brain and cause damage – just as they may do to blood vessels and organs like the heart and pancreas.
"It's not a causal study, it's not a mechanistic study," she said. "But I think our findings suggest there is a pathway going on that is something intrinsic to that belly size, to that belly fat, because we did take into account other diseases that are highly correlated with belly size and highly correlated with dementia."
Dr. Jean-Pierre Despres, a specialist in obesity and cardiovascular disease at Laval University, said he is not surprised to see a relationship between excess abdominal fat and dementia.
"Obviously this is an association and you don't want to speculate too much on the mechanism behind such associations," Despres said Wednesday from Quebec City.
"But if you think about the consequences of abdominal obesity, of having fat at the wrong place, we know that having too much abdominal fat is associated with what I call a minestrone soup of abnormalities, increasing the risk of Type 2 diabetes, but also increasing the risk of cardiovascular disease."
"Now I'm learning today that on top of the risk of heart disease, the risk of diabetes, this is one more complication to add to the expanding list, which makes this extremely interesting," said Despres, who was not involved in the study.
While more research is needed to pin down exactly how having a paunch might affect the brain, he said the study provides more evidence that having fat in the wrong place is detrimental to health.
"It's not a matter of how fat you are, it's where the excess fat is located," said Despres, noting that a portly girth (roughly more than 94 centimetres in men and 80-plus centimetres in women) and elevated blood fat (triglycerides) suggests a build-up of visceral fat.
Dr. Cheryl Wellington, an associate professor of pathology and laboratory medicine at the University of British Columbia, called the Neurology paper a "landmark study that strengthens the connection between metabolic disturbances and the onset of dementia."
"What is really important about studies like this is that it actually provides people with things that they can do to help lessen their risk of dementia in old age," she said from Vancouver.
"Taking good care of yourself in midlife is probably the biggest thing that you can do to preempt dementia as much as possible later. So when you're in your 30s and 40s and 50s, make sure you've got diet and exercise under control."
Whitmer agreed that having too much visceral fat may be risky, but the good news is it's a risk that can be modified.
"It is actually less stubborn than the subcutaneous fat, so you can get rid of that fat with exercise and with diet." thestar.com
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Two stand-outs for those seeking pre-summer tan

April 12, 2008
Peggy MacKenzie
TORONTO STAR
Here comes the sun and I say it's time to get our tan on. Literally. No frying for us under a sun lamp or following the sun in our backyards. With the self-tanning products on the market, broiling on the beach to achieve that bronze look is so passé.
Self-tanning products are safe, Toronto dermatologist Dr. Cheryl Rosen writes in an email, "as long as people don't rely on them to be sunscreens." All the self-tanning products warn consumers to put sunscreen over top of the tanner if going out into the sun. Other things to keep in mind:
If you're sensitive to smells, take a sniff at the store. Some had no smell while others lasted throughout the day.
All tanners warn to spread evenly but sparingly over knees, knuckles, toes and ankles. This is easier to do in theory.
They also warn you about ruining your clothes if you don't wait long enough for the product to dry. All tanners varied wildly on drying time.
Vicky, at the Shoppers Drug Mart at Union Station, says to exfoliate before applying the tanners and moisturize after (if needed).
We tested legs for this column but some of the tanners advertise that they're for the whole body, including faces. Check the label to make sure.
All five of Test Drive's pasty-white testers complained there weren't enough instructions even though an error in application has serious consequences to your body and clothes.
All the tans were intact after shaving, although the Marcelle tester found the tan "bled" a little onto the razor but there was no change in the colour on her legs.
To the bronzed beauties in the photo – Gale, Deb, Libby and Jane – a big thank you. I was also a tester.
Clarins Self-Tanning Instant Gel
   Cost: $35
Size: 125 mL
Drying Time: 15 to 20 minutes
Moisturizer: Yes.
Scent: Yes. Pleasant
Libby had a lot of time to contemplate this gel after the first application. She read the minimal instructions, washed her hands and nails thoroughly after use, and then waited for three hours while it dried. "I think I applied it with too heavy a hand," she jokes, since the product normally dries in under 20 minutes. "It smells wonderful – like every Clarins product I've ever used," she says, adding that this tanner was even a great moisturizer. "(It) got rid of the alligator-skin look my legs usually have all winter." She liked the colour and, unlike the rest of us, there were no splotches after her first try.
Roc Minesol Bronze Self-tanning lotion
Johnson & Johnson
  
Cost: $19
Size: 100 mL
Drying Time: 30 minutes
Moisturizing properties: Yes
Scent: Yes. Pleasant
Jane used this lotion six times over the two weeks before the last photo shoot and her legs have the look she normally has in the summer. She waited a minimum of one hour before getting dressed but had to dodge her dog who tried for a quick ankle lick. The minimal instructions made it difficult "to determine how, how much, and where to apply." The white lotion was a good consistency and coated evenly with almost no aroma. Dry skin areas, though, absorbed it quickly and then developed a yellowish hue. Immediately after applying, Jane noticed a slight tingling sensation and a slight "suntan lotion" smell that was clean and fresh. That's when the dog moved in. Like Clarins and Biotherm, a rounded tablespoon was enough for one application. It absorbed well, with no stickiness.
Neutrogena Build-a-Tan
  
Cost: $13.99
Size: 200 mL
Drying Time: 5 minutes.
Moisturizing properties: Yes.
Scent: Yes. Unpleasant chemical smell that lasted all day.
I used this lotion daily for five days before the last photo shoot and every other day for two weeks before that. The colour appeared natural to me, not orangey, and does slowly build over time. Applying the lotion was easy from the pump but, because I feared having a two-toned result on my ankles and knees, I applied sparingly on those areas and still created that look anyway. To ensure even coverage, you'd have to use this product for at least a week before showing your legs to the world. I found it reassuring that the tan built over time, since there's too much room for error with an instant tan. The drying time was minimal and, to check if the colour bled, I wore white socks and never noticed any colour on them. This tanner was the cheapest of the lot but worked very well once I got into the swing of it. Now that I've stopped for three days, however, my tan isn't as even.
Biotherm Sun Tan Gel Beautiful Legs
 
Cost: $30
Size: 150 mL
Drying Time: 45 minutes
Moisturizer: No.
Scent: Yes. A "chemical" smell
Gale likes that the gel is bronze-coloured for application, since it was easy to see the coverage against her white legs. After one application, she did see a slight bronze colour, but also streaks. Getting the product to "feather" or fade on Gale's feet was hard and she had a "start" line that looked unnatural. The colour darkened after the second application and the streaking was minimized. Her knees were another hard area to tan: "I had two large circles of dry skin." When the tanner dried, Gale's skin "felt a little tight, like it contracted when it dried. I had to moisturize big time." The odour was neither pleasant nor unpleasant, but it did have a "chemical" smell. Gale wished there was an insert "explaining if it would stain, how long I should wait before I dressed, if I could use it on my arms or torso." A towel did get stained but the stain washed out.
Marcelle Tinted Self-Tanning Gel-Cream
 
Cost: $12.95
Size: 100 mL
Drying Time: 5 minutes
Moisturizer: No
Scent: Yes. The bottle says "perfume free" but Deb smelled "molasses with a chemical smell like the paint in my new kitchen but with a vaguely sweet undertone."
Deb used the product almost daily but her legs didn't get very dark. The gel spread easily and she was careful not to spread it too thick on her knees and ankles but noticed "the more I used it, the more speckly my legs looked." Also, she says she walks into things a lot – "I always have bruises on my shins" – and the bruises turned a darker colour than the rest of her leg.
She didn't notice any staining on her clothing but always waited at least five minutes before getting dressed. The tanner is not a moisturizer, and Deb noticed that her skin had a "papery" texture. She used a moisturizer after application.
Deb wonders about the safety of using self-tanners, with all the chemicals listed. Instead of competing with a beach tan in the summer, she'll aspire "to an 18th-century standard of beauty."
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A Guide to Diabetes

What is diabetes?
Diabetes is a disease in which blood glucose is above normal levels. Our bodies convert food into glucose, the main source of fuel for our bodies. The pancreas makes a hormone called insulin, which helps glucose get into the cells of our bodies.
With diabetes, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. This causes sugar to build up in the blood, overflow into the urine and pass out of the body.
As a result, blood sugar levels can drop too low, leading to a coma, or sustained elevated blood sugars can lead to damage of major organs such as the kidney and heart. The disease also puts people at risk for blindness and lower-extremity amputations due to wounds that do not heal properly.
DID YOU KNOW?
Rising numbers: More than 2 million Canadians have diabetes, with that number expected to rise to 3 million by 2010. The World Health Organization estimated in 2000 that more than 177 million people worldwide have diabetes. By 2025, it will top 300 million.
Complications: About 80 per cent of people with diabetes will die as a result of heart disease or stroke.
Premature deaths: Diabetes is a factor in the deaths of about 41,500 Canadians each year. Canadian adults with diabetes are twice as likely to die prematurely than those without diabetes.
Shortened life: Life expectancy for type 1 diabetics may be shortened by as much as 15 years.
Medical costs: A person with diabetes incurs medical costs that are two to three times higher than those without diabetes. A diabetic can face direct costs for medication and supplies ranging from $1,000 to $15,000 a year.
Health-care system: Based on a U.S. study, diabetes and its complications cost the Canadian health-care system an estimated $13.2 billion every year. By 2010, it's estimated these costs will rise to $15.6 billion a year and, by 2020, $19.2 billion a year.
Cutting risks: In a large study, people at risk of type 2 diabetes cut that risk 58 per cent by exercising moderately for 30 minutes a day and by losing 5 to 7 per cent of their body weight. In those over 60, the risk was cut by almost 71 per cent. Other studies have shown similar results.
Type 1
Definition: Previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, type 1 is an autoimmune disease in which the body makes little or no insulin.
Risk factors: Type 1 develops most often in children and young adults before age 30, although it can appear at any age. There is no known cause and, thus, no way to prevent it. It is not caused by consuming too much sugar.
Symptoms: Usually develop over a short period, although cell destruction can begin years earlier. Symptoms include increased thirst and urination, constant hunger, unexplained weight loss, blurred vision, extreme fatigue, tingling or numbness in hands or feet, very dry skin, sores that are slow to heal and more infections than usual. Those affected do not necessarily show symptoms. Risk factors are less well defined for type 1 than for type 2, but autoimmune, genetic and environmental factors are involved.
Treatments: A person who has type 1 diabetes must take insulin daily to live. Lifestyle changes such as healthy eating and increased physical activity are basic therapies. Blood glucose levels must be closely monitored through frequent blood glucose testing.
Complications: Early heart disease, amputation, stroke, kidney failure, nerve damage, blindness.
Type 2
Definition: Previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, type 2 is the most commonly diagnosed type of diabetes. With type 2 diabetes, the body can't use the insulin it makes.
Risk factors: Associated with those age 40 or older, obesity, family history of diabetes, high blood pressure, abnormal cholesterol levels, schizophrenia, polycystic ovary syndrome, acanthosis nigricans (darkened patches of skin), previous history of gestational diabetes, history of giving birth to a baby more than 9 pounds, physical inactivity and ethnicity (Aboriginal, Hispanic, Asian, South Asian, or African descent); type 2 is increasingly being diagnosed in children and adolescents.
Symptoms: Develop more slowly and may include fatigue or nausea, frequent urination, unusual thirst, weight loss, blurred vision, frequent infections and slow healing of wounds or sores; or there can be no symptoms.
Treatments: Healthy eating, physical activity and blood glucose testing are basic therapies. Many require oral medication, insulin or both to control blood glucose levels.
Complications: High blood glucose levels over a long period can cause blindness, heart disease, kidney problems, amputations, nerve damage and erectile dysfunction.
Gestational
Definition: Glucose intolerance, but with first onset during pregnancy.
Risk factors: It only affects women during pregnancy and usually disappears after pregnancy. Risk factors include a history of gestational diabetes, age over 35, obesity, a history of polycystic ovary syndrome, hirsutism (excessive hair growth in women), acanthosis nigricans and being a member of a population considered to be at high risk for diabetes.
Symptoms: The Canadian Diabetes Association's 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada recommend that all women be screened between 24 and 28 weeks gestation using a glucose tolerance test. For those with multiple risk factors, this testing should be done during the first trimester, then again during the second and third trimesters, even if the first test is negative.
Treatments: Similar to managing type 2 diabetes, nutritional therapy is recommended to achieve euglycemia or blood-glucose balance. It's important to ensure appropriate weight gain, but not weight loss, and adequate nutritional intake for mother and baby. If reductions in blood glucose do not reach the recommended levels within two weeks after eating and exercise adjustments, then certain types of insulin can be safely used in pregnancy.
Because women with a history of gestational diabetes risk developing type 2 diabetes later in life, a follow-up blood glucose test is recommended within six months of childbirth. In addition, it is recommended that women breastfeed to reduce the risk for subsequent diabetes in the baby. Women should be screened regularly for type 2 diabetes.
Complications: Babies born to mothers with gestational diabetes may be macrosomic (severely obese). This poses a risk of trauma to mother and child during childbirth.
Macrosomic babies have a higher risk of severe breathing problems and hypoglycemia (severely low blood glucose levels) after birth. They are also at higher risk for potential long-term obesity and glucose intolerance. Generally, glucose levels in women who have had GDM return to normal.
However, these women do face an increased risk of developing type 2 diabetes later in life.

LIVING WITH DIABETES
(CLICK HERE)
------------------------------------------------------------------------------Sources: Canadian Diabetes Association, Centers for Disease Control, National Diabetes Information Clearinghouse / Compiled by Marian Traynor and Peggy Mackenzie, Toronto Star Library.
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Study finds antidepressants no better than sugar pills
Feb 27, 2008 Toronto Star
Study: Four of the most commonly prescribed antidepressants, including Prozac, work no better than placebo sugar pills to help mild to moderate depression, says a study published in PloS (Public Library of Science) Medicine. Irving Kirsch of the department of psychology at Hull University in England and colleagues in the U.S. and Canada compared trial results for patients taking a sugar pill with those given the antidepressants fluoxetine (Prozac), paroxetine (Seroxat), venlafaxine (Effexor) and nefazodone (Serzone). They found that patients felt better but those on placebos improved as much as those on the drugs. The only exception: the most severely depressed did better on the drugs.
Method: Using freedom of information rules, researchers obtained a full set of trial data from the U.S. Food and Drug Administration, including results the drug companies had chosen not to publish.
Background: Prozac has been used by 40 million patients since 1988.
Claim: "There seems little reason to prescribe antidepressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide a benefit," Kirsch says. Alternatives include talk therapy.
Caveat: Patients are strongly advised not to stop taking medication without consulting their doctor. "This analysis has only examined a small subset of the total data available while regulatory bodies around the world have conducted extensive reviews and evaluations of all the data available," says GlaxoSmithKline, which makes Seroxat. Eli Lilly, maker of Prozac, also defended research showing the antidepressant is effective.
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GLOBAL EPIDEMIC
TheStar.com | Health | TB’s deadly comeback

Toronto, with its growing immigrant population, will likely see an increase of deadly, contagious tuberculosis, experts say. The current system simply couldn't handle an outbreak, but the province has yet to make the changes required to protect citizens
Feb 24, 2008 04:30 AM
Megan Ogilvie
Health Reporter
At first, Lynda thought it was a cough like any other: a dry hack that rattled her chest from time to time. Nothing to be bothered about.
But soon the tickle was accompanied by a high fever, unrelenting fatigue and a deep, aching pain in her right lung.
Worried, the 41-year-old mother went to see her family doctor in Newmarket. She told him about the persistent cough, that she had inexplicably lost 20 pounds in the spring, and how she felt dark shadows of depression slowly creeping over her.
He advised her to work fewer hours and stop smoking, and he sent her home with stronger asthma medication. But months passed, and Lynda, who continued to see her doctor, kept getting weaker and weaker, until one day she was unable to climb a flight of stairs.
"That was a scary feeling because I knew something was not right," recalls Lynda. "In my head I heard a voice. It said, I think I'm dying."
She was.
Hordes of tuberculosis bacteria were living in her lungs, thriving and multiplying, steadily destroying the delicate tissues.
But since many Canadians consider tuberculosis a thing of the past, Lynda's family doctor misdiagnosed the deadly disease for months. Since she got her diagnosis two years ago, she has told few people, for fear of being ostracized – which is why she asked the Star not to use her last name.
Experts say few family doctors know the singular signs of tuberculosis any more. And few patients nowadays consider that they might be suffering from a disease that once killed thousands of Canadians every year, and then seemed to vanish.
Yet tuberculosis hasn't disappeared from our neighbourhoods. In Toronto, more than any other city in Canada, there is still an undercurrent of disease. About one-quarter of the country's TB cases are here – there are currently about 1,600 active cases in Canada and 400 in Toronto – and experts expect the incidence to rise as immigration swells from countries where TB is epidemic.
Despite those concerns, Ontario is the only TB-afflicted province without a centralized system of tuberculosis clinics. Right now, many Ontario TB patients are seen by doctors who have little experience with the disease, rather than specialists.
That means patients are being diagnosed too late and given less-than-aggressive treatment – and so are more likely to develop resistance to the antibiotics, to have permanent lung damage, to relapse later on in life, and even to die. They are also more likely to pass on the disease to the people around them.
Experts also say the current system is only just keeping up with demand and would be woefully inadequate if a TB outbreak hit the city.
"Many developing countries are doing a better job of managing TB than we do," says Dr. Michael Gardam, chief of infection control at the University Health Network and head of the tuberculosis clinic at Toronto Western Hospital.
Tuberculosis is a highly infectious disease that is passed from person to person when an infected person coughs or sneezes and spreads bacteria into the air. More than one-third of the world's population is infected with the TB bacillus – of them, about 10 per cent will go on to develop full-blown TB, which then becomes infectious (according to Dr. Kamran Kahn, a tuberculosis expert at St. Michael's Hospital, close to a million Canadians have latent tuberculosis). Close to 2 million people will die from it this year.
In recent years, some strains have become resistant to our best antibiotic treatments, making what is often a curable disease much more difficult – and sometimes impossible – to treat. The World Health Organization says extremely drug-resistant tuberculosis, or XDR-TB, is one of its top concerns and calls it a grave public health threat.
The threat of drug resistance first emerged in Tugela Ferry, a rural town in KwaZulu-Natal province in South Africa, when an outbreak of XDR-TB killed 52 of 53 infected patients. XDR-TB has been reported in 41 countries, including Canada.
Concern about drug-resistant tuberculosis proliferating in North America came into focus last May and June when infected Atlanta lawyer Andrew Speaker ignored public health warnings and endangered fellow passengers when he took commercial flights to his wedding in Greece and then returned to North America via Montreal.
Meanwhile, it's the rampage of tuberculosis outside our borders that has Toronto TB experts so worried. The WHO warns, "TB anywhere is TB everywhere." And especially with the surge in global travel and the role of the GTA as a hub for new immigrants, this city may be particularly vulnerable.
"Toronto reflects the world, and the world is having an epidemic of TB," says Gardam. "If the world has a problem, then we have a problem."
Up until the early 1980s, Ontario did have a centralized system of tuberculosis clinics managed by each region's public health unit and run by the province. But as infection rates fell, officials assumed the disease would eventually be eliminated, and the system was dismantled.
"It seemed like infectious diseases would disappear from the planet," says Dr. Elizabeth Rea, an associate medical officer of health for Toronto Public Health's TB prevention and control program. "They haven't. Particularly for Toronto. Our rates are driven by what is happening outside the city ... TB is not going to disappear from Toronto as long as we are an immigration centre. We need to plan for cases to continue to arrive here and to be able to deal with them at the highest level of care."
Toronto's TB rate has slowly been slowly going down for the past 10 years but, cautions Rea, "Every single jurisdiction that has cut back on TB control has had a resurgence."
New York City offers the most striking object lesson. In the early 1990s, after the city had repeatedly cut spending on TB control, an outbreak swept through the most vulnerable communities – the homeless, working poor crammed into tight living quarters, people with immune systems beaten back by HIV. By 1992, there were 3,811 new cases of TB, up from 1,307 cases in 1978, the first year the city kept statistics.
"It was a massive, heartbreaking outbreak," says Rea. "It took years and millions and millions of dollars to get it under control."
According to The New York Times, the city spent $40 million on tuberculosis control in 1993, in the midst of the epidemic, compared to $4 million in 1988.
Toronto has seen it's own mini-outbreaks of TB in the shelter system. In 2001, Joseph Teigesser died of tuberculosis while living in a city shelter during a 17-month-long outbreak that also infected 15 other homeless people.
A 2004 inquest into Teigesser's death made 13 recommendations, primarily to the provincial government, for reducing TB transmission among the homeless. One of them was for the Ministry of Health to establish a centralized clinic system for TB management, funded 100-per-cent by Queen's Park.
Since 2000, at least seven reports, including one by the Ontario Medical Association, have recommended a centralized model of TB care. In 2005, the ministry convened a task force of tuberculosis experts to outline how such a system could be implemented. Eighteen months ago the task force submitted its 25-page report – endorsed by the Lung Association, the Homeless and Underhoused Community Advisory Panel and the Tuberculosis Prevention and Control Program of the Public Health Agency of Canada – but still hasn't received a response from the province.
According to ministry spokesperson Andrew Morrison, the ministry supports the proposed model for developing a centralized clinic system in Toronto and is currently reviewing the task force's proposal.
According to the provincial task force, the current fragmented system means TB patients are not being managed properly as set out by Canadian Tuberculosis Standards, a book on prevention and treatment published by the Public Health Agency of Canada and the Lung Association. The task force also says they are at higher risk of dying or developing drug resistance and are staying sick longer, which increases their likelihood of spreading the disease.
Right now, there are four tuberculosis clinics in Toronto – at Toronto Western, St. Michael's and Sick Kids hospitals and at West Park Healthcare Centre, the only hospital in the province to offer long-term in-patient care for TB patients. All these facilities get funding from their respective hospital foundations. There are no such clinics in 905 areas.
Kamran Kahn of St. Michael's Hospital says it's becoming more and more challenging for the four clinics to keep up with demand, because patients are arriving with complex health and social issues. And he points out that three of the clinics are downtown and hardly accessible to the many immigrant patients who live east, west and north of the city.
The 2006 task force, which Kahn was a part of, highlighted the immediate need for two additional TB clinics, one in Etobicoke and one in Scarborough, a neighbourhood that sees, on average, one-third of the city's active patients.
What all of this means, says Kahn, is that family physicians in the GTA have to pick up the slack. In 2002, he points out, there were 178 physicians managing TB cases in southern Ontario, and few doing it well since almost two-thirds had managed less than one TB case per year.
These front-line health-care workers, used to diagnosing diabetes, heart disease and the other chronic diseases confronting modern-day North America, can miss the cluster of symptoms that spell tuberculosis – a constant cough, unexplained weight loss, night sweats, a general feeling of malaise. Especially when the patients do not come from prisons, homeless shelters and the other overcrowded settings where TB usually emerges.
In a 2006 study published in the Canadian Medical Association Journal, Kahn and Gardam found patients who were treated by TB-experienced physicians were less likely to die than those treated by inexperienced physicians.
Just as cancer patients are referred to cancer clinics, experts say tuberculosis patients need to be managed by specialists. Kahn says this is particularly true for complicated TB cases, including patients who are new to the country and who may not speak English and those who have other health problems, such as HIV or mental illness. More than 90 per cent of TB patients in Toronto are foreign-born.
Most days, Lynda can hardly believe she has tuberculosis. It's been two years since she was diagnosed with the disease, and she's not sure if she'll ever get her old life back.
At 43, the vivacious mother in York Region wants to be out playing with her two young daughters, not confined to a couch because her lungs have been ravaged by TB. Even now, a cough could turn into a phlegm-filled fight for breath.
"It's changed my life so much," she says. "I'll have a couple of good days, then some bad days. Every morning I cough, every morning I gag, every morning I retch. It hurts to laugh. I can't run. I was always a hard-working person, I can try to go-go-go, but ... "
Lynda is waiting to hear whether her right lung, which has been almost completely destroyed by the disease, will have to be removed.
"I guess if it was caught sooner, maybe it wouldn't have been so bad," she says.
Gardam, who now treats Lynda at his clinic at Toronto Western, confirms that she would be well now if she had got proper care from the start. Not only was Lynda misdiagnosed by her family doctor, but when she finally got a proper diagnosis six months later, the community hospital gave her the wrong regime of antibiotics.
"There is no doubt, the earlier you catch it, the better you do," he says. "In general, (Lynda's) case is a very common story for us."
Lynda never wanted to be an example of what is wrong with Ontario's current tuberculosis care system. But that is exactly what she has come to be. She still doesn't know where she got infected, though there's some evidence she got it at the factory where she worked for three years.
Lynda pauses to cough, making a gurgling sound, and then goes on.
"It's not just a Third World problem, I don't think," she says. "It's coming back here ... People need to be educated about tuberculosis ... It's not a dead disease."
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The truth about MSG

MSG, or monosodium glutamate, is the heavyweight champion of flavour enhancers the world over.
It was discovered in seaweed. A century later, monosodium glutamate
MSG –is the heavyweight champion of food additives. It's also a villain.
What else do you sprinkle on steak that's the subject of conspiracy theories?
Jan 20, 2008 04:30 AM
Murray Whyte
Staff Reporter
An innocent question, asked recently at a very popular, very established Chinatown eatery that shall remain nameless: "Do you use MSG?"
The answer? "We always put a little bit," the cheery waiter replies. "If you want more, we can put more."
Say what? To some ears, the helpful-seeming offer would sound much like choosing to endure a more severe beating if the first wasn't painful enough. Indeed, to say that MSG, or monosodium glutamate, far and away the heavyweight champion of flavour "enhancers" the world over, has a checkered history is something of an understatement.
This year, it enjoys the dubious distinction of its centenary as an officialized food additive. Since its intitial isolation in 1908 by a Japanese chemist, Kikunae Ikeda, it's become a food industry staple, and along the way, hailed as both a revolutionary innovation and a despised symbol of callous quasi-food profiteering.
Either way, it's been a prevalent ingredient in the North American diet for 60 years (the brand of MSG called Accent was introduced here in 1947), embraced in the post-war "better living through chemistry" era as a cheap, easy way to boost flavour in any number of packaged or canned foods.
And for almost as long, it's been maligned, fairly or unfairly, as a chemicalized toxin blamed, according to Health Canada, for migraines, hypertension, nausea and chest pain. More extreme – and often unproven – accusations have linked MSG to obesity, diabetes and liver inflammation. The Times of India – and, curiously, nowhere else – reported just this month that the Netaji Subhas Chandra Bose Cancer Research Institute, an institution without a website, apparently, had concluded in a report that MSG causes cancer.
Careful, though. In the haze of MSG hysteria, dark conspiracies and gruesome consequences are the norm (in the same report, the newspaper claimed that MSG had been declared unsafe by the World Health Organization in 2004, but the report could not be located; meanwhile, a 2005 WHO report says MSG has "no adverse effects.")
Such is the potent mythos of the great villain of all food additives. One thing that's indisputable: MSG's continued – and in some cases, growing – presence in all our diets. Despite the organic food craze blossoming in some circles, MSG is doing quite nicely, thank you. According to the Food Ingredient News, a specialized (to say the least) trade publication, MSG consumption globally was increasing by 2.5 per cent per year.
Granted, more than 80 per cent of the consumption is in Asia, and growth, specifically in China. There, MSG, in its raw form, a powdered, white crystalline substance, is left on restaurant tables like salt or pepper for customers to administer to their liking. And it's more pervasive in the North American diet than ever before. MSG may be additive-non-grata here, but keep your eyes peeled: Hydrolyzed protein, autolyzed yeast extract and dozens of others – all contain MSG.
It was in 1968 when the New Hampshire Journal of Medicine coined the somewhat politically incorrect term "Chinese Restaurant Syndrome" for the apparent prevalence of MSG in Asian foods and the apparent symptoms its consumption could cause. You would have expected MSG to wither away. The furor prompted Chinese restaurants all over North America to display an exculpatory sign in their window: "NO MSG." The other day in Chinatown was a different story entirely. "Everyone uses some MSG," the waiter explains, just as cheery. "Every restaurant. Chinese, everyone else. If they say they're not," he pauses, "it's bull---t."
So, is the apparent and ongoing alarm well-founded? With the swirl of contending thought, it's difficult to tell. One thing's certain: MSG, the sodium salt of the protein glutamate, is, naturally, high in sodium. Not as high as salt (as the MSG side of the tracks points out). But it takes no conspiracist to tell you that a high-sodium diet increases the risks of all sorts of heart problems and hyper-tension, however it's consumed. People on a low sodium diet should "Read food labels. Buy products low in sodium, MSG . . ." urges, for instance, McKinley Health Centre at the University of Illinois.
For Keith Mitchell at Calico Foods, the sodium content in MSG and its ilk looked like an opportunity. "It's had a lot of bad press over the years, and people don't want it on their labels," he says.
That's why the company he works for is selling a low-sodium, amino acid-based flavour enhancer as an alternative. The problem: Sticker shock. "When you go to lower sodium, the flavour perception drops dramatically," he says. "It's one of the hardest things to replace – especially when it's practically free."
Indeed, salt – "one of the cheapest things going," Mitchell says – is a tough competitor to fight with pricey, innovative, low-sodium alternatives. "The business is not by any stretch of the imagination where I'd like to see it," he says. "For a company to reformulate everything and take salt out of its products takes time, and money. The industry is well aware of the issue. The question is, is the public willing to pay for it?"
Especially when, for all the consumer can see, MSG is perfectly safe. Nearly every regulatory agency, including the FDA in the U.S., has few issues with MSG. In 2005, the World Health Organization acknowledged that "neurotoxic effects have been seen in animal studies, but only at very high doses," often administered by injection; it concluded that "there is a substantial body of work investigating MSG at lower doses with no indication of any adverse effects."
Health Canada allows that "some individuals who consume MSG may exhibit an allergic-type reaction or hypersensitivity," but "(t)he safety of MSG has been studied worldwide.
"The Joint Food and Agriculture Organization of the United Nations / World Health Organization expert Committee on Food Additives (1987) and Federation of American Societies for Experimental Biology (1995) conducted thorough evaluations and concluded that use of MSG does not constitute a health hazard to consumers. Health Canada scientists concur with these views. In addition," it goes on, "contrary to some allegations found on certain websites, there is no scientific evidence linking obesity in humans with the consumption of foods containing this flavour enhancer."
That's what they want you to think, says Jack Samuels. Depending on whom you believe, Samuels and his wife, Adrienne, are either tireless champions of food safety, or obsessive conspiracy theorists with too much time on their hands (their self-directed anti-MSG lobby, "Truth in Labeling," has been described as both across the painfully vast swath of MSG opinion found in cyberspace).
Since 1971, when, Samuels says, he starting collapsing in certain restaurants after a meal – he concluded he was hypersensitive to MSG – the pair have campaigned endlessly against the additive. Samuels allows that he's a "very, very rare" type, to have these kinds of extreme reactions. "Most people would go through life and not have any kind of problem at all," he says. But, he says, speaking as someone "who can die" from eating MSG, he's pretty devoted to the cause.
Whether you choose to believe Truth in Labeling campaign information or not, Samuels makes a salient point. MSG is, at its base, a naturally occurring substance in all sorts of foods – tomatoes, Parmesan cheese, mushrooms, and, way back in 1908, kombu.
That was the seaweed Ikeda correctly suspected to be the source of a mysterious "fifth taste" in his soup, complementary but different from the basics – hot, sour, salty, sweet.
Distilling it to its base elements, he called the results umami – or "deliciousness" in Japanese. More than 35 years of research have told the Samuels that naturally occurring MSG – that is, the stuff Ikeda found – produces no reaction even in MSG-sensitive people.
When it's processed, as it most typically is, using fermentation or other chemical reactions, it frees the glutamatic acid from its protein compound, provoking some of the reactions its detractors claim.
For Frederick Oh, director of the Richmond Hill Culinary Arts Centre, therein lies the problem. "Over the years, the demand exceeded the supply and they started to make it chemically," he says. "That's where the problems started."
Whether they're as dire as the worst detractors suggest is nearly impossible to divine. Free glutamic acid – processed and unlinked from its base protein – is, like any chemically-created compound, hard for the body to absorb.
But for Oh, MSG's constant presence is more a symptom of a convenience-driven society that has neither the time nor the inclination to create authentic flavour.
"Making real stock – boiling down bones, doing it the right way – takes time, and it takes labour. Why bother if you can buy an enhancer for 10 bucks and you're done?" he says.
Oh says the issue is more than one of convenience. "We've developed a taste for it," he says. "Fat, salt, sugar – these are all the things we like to eat. MSG mimics those flavours. Nobody wants to eat plain-Jane food. If you open a restaurant advertising blandness, how long do you think you'll last?"
Ever-mindful of the MSG stigma the glutamate industry – a powerful lobby worth billions – has found a way to repackage itself, drawn from Ikeda's original soup test of a century ago.
Umami, they call it – a flavour increasingly finding its way into culinary lexicons and onto the pages of such magazines and newspapers as Gourmet and The Wall Street Journal, which said in an article in December that "(umami) was changing the way everyone from top chefs to Frito-Lay executives thinks about food."
So everything old is new again. "Give it a sexy name, re-package it and re-market it and you're on your way," Oh says. He sees us caught in a familiar catch-22.
"Everyone talks about the environment, but look at all the SUVs that are being produced," he says. "The whole world is in a predicament right now. We've become accustomed to living a certain way, at a certain cost. Will anyone have the guts to put on the brakes?"
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Where cancer-causing
agents lurk

What do cosmetics have in common with cellphones? They both worry a leading cancer scientist about their potential as health risks
Jan 15, 2008 04:30 AM
Nancy J. White
Living Reporter
The Star
First off, Devra Davis won't do the interview on her cellphone.
Call me back on the land line, she instructs. It's not the money she's concerned about. It's the microwaves.
She's also concerned about drinking diet pop, wearing a lot of cosmetics and eating non-organic red meat.
But make no mistake: she's not some trendy health-scare type. She's a blue-chip cancer epidemiologist, director of the Center for Environmental Oncology at the University of Pittsburgh Cancer Institute with a Grade A scientific pedigree: a PhD from the University of Chicago, a decade at the National Academy of Sciences, an author of more than 170 published articles.
And she's worried about her environmental exposure to cancer.
"Everyone has to start where they're comfortable, taking control of their own homes," says Davis, who will be the keynote speaker at Women's College Hospital's health forum Friday. "Then they have to make sure they vote for politicians who understand the importance of this issue."
This issue is how we've let modern life, from the air we breathe to the products we use, poison our bodies.
"We've made remarkable progress in treating some forms of cancer," says Davis, 61. "But if we only improve our ability to find and treat the disease, without dealing with the underlying causes, we will not have made enough progress."
In her newest book, The Secret History of the War on Cancer, Davis argues that the long march against cancer has been misled too often by corporate interests and sidetracked by missed opportunities.
In 1936, more than 200 of the world's top cancer scientists convened in Brussels, a gathering of the best minds to create a new way forward in understanding and fighting the disease. When Davis unearthed the transcripts of those meetings, she was stunned to read how much those scientists knew about cancer's social and environmental causes.
Many widely used agents of the time, including ionizing and solar radiation, arsenic, benzene, asbestos, synthetic dyes and hormones, were recognized as cancerous in humans, she writes.
This knowledge came from researchers combining autopsies with medical, personal and workplace histories of cancer victims and conducting animal lab studies.
However, she says, these findings didn't seep into the mainstream medical practice of the day, due, in part, to the scant media coverage given scientific meetings back then. But mainly it was the timing, the brink of World War II. "The world had very different priorities," says Davis.
"Cancer is the ultimate long-term disease. To be concerned about cancer implies a certain optimism in the future."
In 1971, U.S. President Richard Nixon declared war on cancer, reflecting the idea that the type of ingenuity that built the A-bomb and put a man on the moon could wipe out cancer within the decade.
Rocket engineers from NASA held meetings with medical researchers, setting up charts with overlapping diagrams and lots of arrows, mapping out how the war on cancer should be conducted, writes Davis. Most serious researchers viewed the idea of a single cure as preposterous, a political fuss, she says.
The war did not take aim at any of the known or suspected carcinogens. Not even tobacco smoking, which the U.S. surgeon general had declared a cause of cancer in 1964.
"There were very close ties between the tobacco industry and, later the chemical industry, and the development of the war on cancer," she says.
Today, the emphasis is not so much on declaring war against cancer as it is dealing with a chronic condition, says Davis. "We need to make changes in the infrastructures of our lives that will help reduce the risks."
She's most worried about air pollution, such as emissions from coal-fired plants and growing vehicle traffic, that's distributed across the population. "It's important for people to understand that the burning of fossil fuels that's warming the Earth is the same process increasing our health risks, including cancer in the long term."
There are several other issues that concern her, particularly because health officials aren't paying much attention to them:
Cellphones – New data from Sweden, she says, show that people using cellphones for 10 years or more have double the risk of brain cancer. She's worried about kids under 16 glued to their cellphones. "Would you let your child play Russian roulette?" she asks.
Aspartame – The artificial sweetener's negative effects in animal studies occurred in the last third of the creatures' lives, which corresponds to human beings in their 60s to 80s. Again, she is especially concerned about children consuming the product over many decades.
The doses that induced cancer in animals, she says, were not especially high: about two cans of diet pop, two yogurts and a couple of sticks of gum a day.
Diagnostic radiation – The medical community is becoming increasingly concerned about unnecessary Computed Tomography scans of children, she writes. A CT scan of a child's stomach can be equivalent to 600 chest X-rays and one of an infant's head may equal a few thousand.
While a CT scan may well be warranted in a medical emergency, she says, repeated follow-up scans may not be a wise idea.
Ritalin – Several papers have indicated that Ritalin, valuable for treating Attention Deficit Disorder, might pose a risk to the user's genetic makeup, says Davis. In one study, researchers tested the blood of a dozen children before and after they were put on the drug, she writes, and found chromosome damage after three months' use.
Davis cautions that the numbers tested were small, no direct link to Ritalin was found and genetic damage and repair happens all the time. But given the widespread use of the drug in children, she says, governments and the private sector need to further investigate.
Overall, Davis believes the growing awareness of global climate change is sparking more concern about environmental health.
"The connection is obvious," she says.
"We only have one planet."
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