Date: 12/30/2008
By KEVIN FREKING
Associated Press Writer
WASHINGTON (AP) — Note to President-elect Barack Obama: Health reform doesn’t have to be all about expanding health insurance. It can be about the little things too, such as shorter waits in the doctor’s office and putting in place incentives such as free checkups that catch little problems before they became big ones.
That was the message Tuesday from two-dozen seniors who gave their views about what ails America’s health care system to former Senate Majority Leader Tom Daschle, Obama’s choice for secretary of health and human services. They listed a broad range of concerns, from four-hour waits to see a doctor, to the high cost of prescription drugs, to lack of Medicare coverage for certain treatments and medical devices.
Daschle said conversations like Tuesday’s will put the new administration “on the right track” for overhauling the nation’s health care system next year.
Alethea Campbell said she wanted more emphasis on medical research, particularly for Alzheimer’s Disease. “My family is loaded with Alzheimer’s. I feel like I’m going to be a victim of it,” she said. “What is going to happen to me four or five years down the road. Who is going to take care of me?”
Eugene Kinlow wants greater emphasis on helping people live more healthy lifestyles. “A major part of the cost problem is us. We keep driving up the cost of health care, all of us, in our daily behavior and habits,” he said.
And Frederick Gore wants medical providers to be less concerned about how they’re going to be paid when a patient walks into their room with urgent medical conditions. “The other patients could see there was something wrong with me,” he said. “I’m sitting there and can barely breathe and he’s looking at how he’s going to get paid.”
Some 8,500 meetings similar to the one at the Congress Heights Senior Wellness Center have been held around the country since Dec. 15. Daschle attended his second such meeting Tuesday, along with his mother, Betty. Obama’s transition team will gather the information from those meetings and post the material on its Web site, http://change.gov. Daschle said the information would be used to help craft a health proposal.
Daschle said lawmakers will be more likely to take up health reform if there is enough pressure from voters. In a book published earlier this year, he urged the next president to quickly capitalize on the good will that comes with a new administration. He said the meetings will add to the sense of urgency.
“It will lead to members of Congress taking note. It will lead to governors taking note,” Daschle said in an interview. “It’s going to lead to a greater degree of commitment on the part of elected people.”
About 25 people talked to Daschle about the problems they’ve confronted with the health care system. Most participate in Medicare, the government’s health insurance program for the elderly and disabled.
Although they had coverage for most treatments, they were not short of suggestions for improving the health care system. Some described waiting three or four hours before they could be seen by a doctor. Others talked of how they helped pay health care costs for uninsured children and grandchildren. And some longed for a return of the days when teenagers volunteered to work at the local hospital or at local senior centers.
“It’s conversations like this that put us on the right track,” Daschle told the audience. “It’s discussions like this that give us a better understanding of how it should be done.”
The public meetings orchestrated by Obama’s transition team resemble an effort that took place in 2005 and 2006. Congress created its Citizens Health Care Working Group that heard from 6,650 people at 84 meetings around the country and more than 14,000 in an Internet survey.
The group’s recommendations were not acted on. The recommendations included guaranteeing health coverage for specific checkups and treatments and protecting consumers from high medical expenses.
Daschle said the health care system’s problems have only grown since then, which could ensure action in Congress.
“We wouldn’t have had 8,500 of these discussions in a two-week period over the Christmas holidays a few years ago. This is an indication of the degree of severity and concern that people have all over the country,” Daschle said.
Copyright 2008 The Associated Press.
Brain’s reaction to yummy food may predict weight
Date: 10/16/2008 2:04 PM
By LAURAN NEERGAARD
AP Medical Writer
WASHINGTON (AP) _ Drink a milkshake and the pleasure center in your brain gets a hit of happy — unless you’re overweight.
It sounds counterintuitive. But scientists who watched young women savor milkshakes inside a brain scanner concluded that when the brain doesn’t sense enough gratification from food, people may overeat to compensate.
The small but first-of-a-kind study even could predict who would pile on pounds during the next year: Those who harbored a gene that made their brain’s yum factor even more sluggish.
“The more blunted your response to the milkshake taste, the more likely you are to gain weight,” said Dr. Eric Stice, a senior scientist at the Oregon Research Institute who led the work, published in Friday’s edition of the journal Science.
A healthy diet and plenty of exercise are the main factors in whether someone is overweight. But scientists have long known that genetics also play a major role in obesity — and one big culprit is thought to be dopamine, the brain chemical that’s key to sensing pleasure.
Eating can temporarily boost dopamine levels. Previous brain scans have suggested that the obese have fewer dopamine receptors in their brains than lean people. And a particular gene version, called Taq1A1, is linked to fewer dopamine receptors.
“This paper takes it one step farther,” said Dr. Nora Volkow of the National Institutes of Health, a dopamine specialist who has long studied the obesity link. “It takes the gene associated with greater vulnerability for obesity and asks the question why. What is it doing to the way the brain is functioning that would make a person more vulnerable to compulsively eat food and become obese?”
It’s “very elegant work,” she added.
First, Stice’s team had to figure out how to study the brain’s immediate reactions to food. Moving inside an MRI machine skews its measurements, which ruled out letting the women slurp up the milkshakes. Yale University neuroscientist Dana Small solved that problem, with a special syringe that would squirt a small amount of milkshake or, for comparison, a tasteless solution into the mouth without study participants moving. They were told when to swallow, so researchers could coordinate the scans with that small motion.
Then they recruited volunteers, 43 female college students ages 18 to 22 and 33 teenagers, ages 14 to 18. Body mass index calculations showed the young women spanned the range from very skinny to obese.
Brain scanning showed that a key region called the dorsal striatum — a dopamine-rich pleasure center — became active when they tasted the milkshake, but not when they tasted the comparison liquid that just mimicked saliva.
Yet that brain region was far less active in overweight people than in lean people, and in those who carry that A1 gene variant, the researchers reported. Moreover, women with that gene version were more likely to gain weight over the coming year.
It’s a small study with few gene carriers, and thus must be verified, Volkow stressed.
Still, it could have important implications. Volkow, who heads NIH’s National Institute of Drug Abuse, notes that “dopamine is not just about pleasure.” It also plays a role in conditioning — dopamine levels affect drug addiction — and the ability to control impulses.
She wonders if instead of overeating to compensate for the lack of pleasure — Stice’s conclusion — the study really might show that these people with malfunctioning dopamine in fact eat because they’re impulsive.
Regardless, most people’s tongues find a milkshake quite tasty; the brain reaction is subconscious.
But if doctors could determine who carries the at-risk gene, children especially could be steered toward “recreational sports or other things that give them satisfaction and pleasure and dopamine that aren’t food … and not get their brains used to having crappy food,” said Stice, a clinical psychologist who has long studied obesity.
“Don’t get your brain used to it,” he said of non-nutritious food. “I would not buy Ho Hos for lunch every day because the more you eat, the more you crave.”
Copyright 2008 The Associated Press.
By LAURAN NEERGAARD
AP Medical Writer
WASHINGTON (AP) _ Drink a milkshake and the pleasure center in your brain gets a hit of happy — unless you’re overweight.
It sounds counterintuitive. But scientists who watched young women savor milkshakes inside a brain scanner concluded that when the brain doesn’t sense enough gratification from food, people may overeat to compensate.
The small but first-of-a-kind study even could predict who would pile on pounds during the next year: Those who harbored a gene that made their brain’s yum factor even more sluggish.
“The more blunted your response to the milkshake taste, the more likely you are to gain weight,” said Dr. Eric Stice, a senior scientist at the Oregon Research Institute who led the work, published in Friday’s edition of the journal Science.
A healthy diet and plenty of exercise are the main factors in whether someone is overweight. But scientists have long known that genetics also play a major role in obesity — and one big culprit is thought to be dopamine, the brain chemical that’s key to sensing pleasure.
Eating can temporarily boost dopamine levels. Previous brain scans have suggested that the obese have fewer dopamine receptors in their brains than lean people. And a particular gene version, called Taq1A1, is linked to fewer dopamine receptors.
“This paper takes it one step farther,” said Dr. Nora Volkow of the National Institutes of Health, a dopamine specialist who has long studied the obesity link. “It takes the gene associated with greater vulnerability for obesity and asks the question why. What is it doing to the way the brain is functioning that would make a person more vulnerable to compulsively eat food and become obese?”
It’s “very elegant work,” she added.
First, Stice’s team had to figure out how to study the brain’s immediate reactions to food. Moving inside an MRI machine skews its measurements, which ruled out letting the women slurp up the milkshakes. Yale University neuroscientist Dana Small solved that problem, with a special syringe that would squirt a small amount of milkshake or, for comparison, a tasteless solution into the mouth without study participants moving. They were told when to swallow, so researchers could coordinate the scans with that small motion.
Then they recruited volunteers, 43 female college students ages 18 to 22 and 33 teenagers, ages 14 to 18. Body mass index calculations showed the young women spanned the range from very skinny to obese.
Brain scanning showed that a key region called the dorsal striatum — a dopamine-rich pleasure center — became active when they tasted the milkshake, but not when they tasted the comparison liquid that just mimicked saliva.
Yet that brain region was far less active in overweight people than in lean people, and in those who carry that A1 gene variant, the researchers reported. Moreover, women with that gene version were more likely to gain weight over the coming year.
It’s a small study with few gene carriers, and thus must be verified, Volkow stressed.
Still, it could have important implications. Volkow, who heads NIH’s National Institute of Drug Abuse, notes that “dopamine is not just about pleasure.” It also plays a role in conditioning — dopamine levels affect drug addiction — and the ability to control impulses.
She wonders if instead of overeating to compensate for the lack of pleasure — Stice’s conclusion — the study really might show that these people with malfunctioning dopamine in fact eat because they’re impulsive.
Regardless, most people’s tongues find a milkshake quite tasty; the brain reaction is subconscious.
But if doctors could determine who carries the at-risk gene, children especially could be steered toward “recreational sports or other things that give them satisfaction and pleasure and dopamine that aren’t food … and not get their brains used to having crappy food,” said Stice, a clinical psychologist who has long studied obesity.
“Don’t get your brain used to it,” he said of non-nutritious food. “I would not buy Ho Hos for lunch every day because the more you eat, the more you crave.”
Copyright 2008 The Associated Press.
