ASHLEY MALTZ, MD
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The jury's still out on cell phone use and risk of cancer

5/31/2011

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Here's the latest from Medscape (a very trusted medical resource for patients and practitioners alike):
"May 31, 2011 — The World Health Organization (WHO) announced today that radiation from cell phones can possibly cause cancer. According to the WHO's International Agency for Research on Cancer (IARC), radiofrequency electromagnetic fields have been classified as possibly carcinogenic to humans (group 2B) on the basis of an increased risk for glioma that some studies have associated with the use of wireless phones.

This announcement was based on an extensive review of studies on cell phone safety by a working group of 31 scientists from 14 countries, who have been meeting regularly to evaluate the potential carcinogenic hazards from exposure to radiofrequency electromagnetic fields. They reviewed exposure data, studies of cancer in humans and experimental animal models, and other relevant data.

More specifically, the IARC Monograph Working Group discussed and evaluated literature that included several exposure categories involving radiofrequency electromagnetic fields:
  • Occupational exposures to radar and to microwaves;
  • Environmental exposures associated with transmission of signals for radio, television, and wireless telecommunication; and
  • Personal exposures associated with the use of wireless telephones.
"Given the potential consequences for public health of this classification and findings," said IARC Director Christopher Wild, PhD, in a news release, "it is important that additional research be conducted into the long-term, heavy use of mobile phones. Pending the availability of such information, it is important to take pragmatic measures to reduce exposure such as hands-free devices or texting."

Inconsistent Data and Opinions

Cellular telephones have become an integral part of everyday life, and the number of users is estimated at 5 billion globally. However, as 
previously reported by Medscape Medical News, there has been growing concern over possible health risks associated with the use of cell phones. In particular, some data have suggested that their use, especially over the long term, represent a "significant" risk for brain tumors.

But study results have been inconsistent, although some European countries have taken precautionary measures aimed specifically at children.

Some of the strongest evidence supporting a link between brain tumors and cell phone use comes from a series of Swedish studies, led by Lennart Hardell, MD, PhD, from the Department of Oncology, Orebro Medical Center. These studies showed that risk increased with the number of cumulative hours of use, higher radiated power, and length of cell phone use. They also reported that younger users had a higher risk. (
Int J Oncol. 2006;28:509-518;Int Arch Occup Environ Health. 2006;79:630-639; Arch Environ Health. 2004;59:132-137; Pathophysiology.2009;16:113-122).

The issue of cell phone safety was to have been settled once and for all by the huge 13-nation industry-funded Interphone study. But to date, the industry-funded Interphone studies 
found no increased risk for brain tumors from cell phone use, with only 4 exceptions. The findings contradicted the Swedish studies, which were independent of industry funding.

Consistent with the literature, there is no consensus among physicians and scientists about the severity of risk, or if one even exists. One issue in attempting to evaluate the potential connection between brain tumors and cell phone use is the relatively short period of time that these devices have been heavily used in a large population and the long latency period for many tumors.

The National Cancer Institute, for example, has stated that although a 
consistent link has not been establishedbetween cell phone use and cancer, "scientists feel that additional research is needed before firm conclusions can be drawn." In a similar fashion, the American Cancer Society points out that even though the weight of the evidence has shown no association between cell phone use and brain cancer, information on the potential health effects of very long-term use, or use in children, is simply not available.

Evidence Strong Enough

The WHO established the International Electromagnetic Fields (EMF) Project in 1996, in response to public and governmental concern, with the goal of evaluating the possibility of adverse health effects from electromagnetic fields. In a 
press release issued last year, the WHO stated that it would conduct a formal health risk assessment of radiofrequency fields exposure by 2012, but in the interim, the IARC would review the carcinogenic potential of mobile phones this year.

Jonathan Samet, MD, chairman of the working group, notes that "the evidence, while still accumulating, is strong enough to support a conclusion and the 2B classification.

"The conclusion means that there could be some risk, and therefore we need to keep a close watch for a link between cell phones and cancer risk," he said in a news release.

A full report summarizing the main conclusions and evaluations of the IARC Working Group is slated to be published online soon in 
The Lancet Oncology and in print in its July 1 issue."

Note that the large 13-country study that published that they found no changes in cancer risk (except on 4 occasions) with cell phone use was INDUSTRY-SPONSORED! Complete bias!

Overall - be wary: use headsets (not Bluetooth), try to minimize use of cell phones and other wireless phones (includes at home) and turn your signal OFF before handing your phone over to your baby or young child! 

Maybe the ol' land line ain't so bad after all...?


Best,
Dr. M
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Sunscreens alone cannot prevent skin cancer!

5/25/2011

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Looking for ways to keep you and your family safe from the sun's harmful rays this summer? Then read on! (Parts in red are lesser known and really important!)

         Per the AMA (American Medical Association) Morning Rounds, "The CNN (5/24, Caruso) "The Chart" blog reported that, according to the Environmental Working Group (EWG), "sunscreens alone cannot prevent cancer," a message the group drives home in its latest sunscreen report, encouraging people to stay in the shade, don clothing protective of the sun, avoid being out in the sun from 10 am to 4 pm, in addition to the use of sunscreens. This coming Friday, May 27, has been designated by the National Council on Skin Cancer as "Don't Fry Friday." The council recommends that people who want to prevent sun-related skin damage wear a wide-brimmed hat and sunglasses designed for UVA and UVA protection, and choose sunscreen "products with UVA filters like avobenzone and octocrylene, as well as protection against UVB rays."

        
WebMD (5/23, Doheny) focused on the EWG's "annual guide to sunscreen products," noting that "just one in five of more than 600 beach and sport sunscreens made the cut," while 11 products were consigned to the Hall of Shame. The EWG advised consumers to avoid using sunscreen sprays because they might be accidentally inhaled. Report co-author Sonya Lunder, MPH, of EWG, explained that "sunscreens with a form of vitamin A known as retinyl palminate -- in about 30% of sunscreens -- should also be avoided because of concerns about it producing skin lesions." In addition, "oxybenzone, which EWG calls a 'hormone disrupter,' is another ingredient to be avoided, she says."

Click here for EWG's best-rated sunscreens - http://breakingnews.ewg.org/2011sunscreen/best-sunscreens/best-beach sport sunscreens/inlist=Y&utm_source=2011sunscreenfull&utm_medium=email&utm_content=second-link&utm_campaign=toxics
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Jessica Alba stands up for safer chemicals and products!

5/24/2011

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Great job by Jessica Alba, who after researching about chemicals in baby products has decided to take a stand and fight for regulations to get them removed from everyday household products and cosmetics. (BTW, many of these regulations already exist in Europe!) Those of us fighting for this type of regulation are so proud to have her as a spokeswoman! 

For more information, go to www.healthychild.org and www.saferchemicals.org. Go Jessica!

Here's the YouTube video: http://www.youtube.com/watch?v=cTgzSrKWsiA&feature=youtu.be
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Having trouble getting your 150 minutes per week of exercise in? Here's a unique solution!

5/9/2011

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Try Activity Burst Everywhere (ABE For Fitness)! Developed by my current mentor, Dr. David Katz, a world-renowned expert of nutrition and physical activity and director of the Yale-Griffin PRevention Research Center where I am currently working, this website brings small bursts of powerful exercise to your office, home or hotel room...and it's FREE! The workouts can be done in business attire and are perfect for those of us who can't get to the gym or park to work out (first of all, you are not to blame given our increasingly "obesegenic" environment and secondly, you are definitely not alone!). Scientifically, small bursts of activity are just as effective as longer moderately-intense workouts! (Haskell WL, Lee I, Pate RR, et al. Physical activity and public health: updates recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007; 39 (8): 1423-34)

Dr. Katz's research on nutrition and activity bursts is internationally-acclaimed and evidence-based. It's making waves in schools (Activity Bursts in the Classroom - ABCs For Fitness) and now at home and work! You can peruse his website at www.davidkatzmd.com for tons of information on nutrition (including numerous books that he and his PhD wife, Catherine, have written over the years and info on the NuVal nutrition scoring system being used in various supermarkets throughout the northeast (and being piloted in Texas!)). He's also the President of the Turn the Tide Foundation, a non-profit dedicated to fixing the obesity epidemic. All in all, he's a Prevenitve Medicine superstar and has been featured on numerous talk shows (including Oprah and Dr. Oz!!!!!!!!!!!!) and was even nominated for the position of Surgeon General. I couldn't imagine working for anyone more exciting than Dr. Katz right now!

So, check it all out and get MOVING!

Best,
Dr. M
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Glute-"in" or Glute-"out": New research on gluten sensitivities

5/6/2011

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There's no doubt that the popularity of gluten-free diets is growing exponentially. It's almost impossible to walk through a grocery store and not see products labeled as "gluten-free" in the health food section. But does this mean we should all switch to a gluten-free diet? My argument is no, we shouldn't. But, then what is all the fuss about??

To start, there seems to be a lot of confusion over what defines an allergy and what defines a sensitivity. The research presented in this article, taken from the University of Maryland School of Medicine website, aims to help clarify that gluten "insensitivity" is actually a spectrum of disease, ranging from very tolerant (not sensitive) to celiac disease (an absolute inability to digest gluten that leads to severe medical problems, including weight and other stigmata of malnutrition).
 
It is my presumption (and that of many health practitioners) that most people tolerate gluten well. I also believe that many of us lie somewhere in the middle of the above extremes, however, the research on these sensitivities is still in the early phases. Ideally, the medical community would create a diagnostic test (other than that for celiac disease) that better quantifies the range and degree of gluten sensitivities. 

Another way to discover your sensititivy is to attempt an elimination diet. This diet involves eliminating all possible offending foods for at least 2-3 weeks, taking careful notice of how you body reacts and feels to the changes.  Then, the offending foods are slowly (one-by-one) added back to the diet to see if any changes occur. This is an easy, relatively quick way to discover your level of sensitivity. But it does take a bit of homework (which I'm happy to help out with).  

But I digress. Read on for a synopsis of what these researchers have accomplished...Gary, this one's for you! : )

Source: University of Maryland School of Medicine website -http://somvweb.som.umaryland.edu/absolutenm/templates/?a=1474&z=5

"Scientists at the University of Maryland School of Medicine’s Center for Celiac Research have proven that gluten sensitivity is different from celiac disease at the molecular level and in the response it elicits from the immune system. The research, published online in BMC Medicine, provides the first scientific evidence of a different mechanism leading to gluten sensitivity. It also demonstrates that gluten sensitivity and celiac disease are part of a spectrum of gluten-related disorders.

“We found differences in levels of intestinal permeability and expression of genes regulating the immune response in the gut mucosa,” says lead investigator
Alessio Fasano, M.D., professor of pediatrics, medicine and physiology at the University of Maryland School of Medicine and director of the Center for Celiac Research. The research documents the genes and the pathways — a sequence of reactions in the small intestine — possibly associated with gluten sensitivity. “Identifying and isolating specific ‘biomarkers’ in the immune response of people with gluten sensitivity could lead to diagnostic tools for the condition,” says Dr. Fasano, who also directs the University of Maryland School of Medicine Mucosal Biology Research Center.

In people with celiac disease, gluten sets off an autoimmune reaction in the small intestine. The complex proteins found in wheat, rye and barley trigger the immune system of a person with celiac disease to attack the person’s small intestine. Left undiagnosed and untreated, celiac disease can lead to the development of other autoimmune disorders, as well as osteoporosis, infertility, neurological conditions and, in rare cases, cancer.

Unlike celiac disease, gluten sensitivity is not associated with these serious conditions. Common symptoms of gluten sensitivity include abdominal pain similar to irritable bowel syndrome, fatigue, headaches, “foggy mind” or tingling of the extremities. There is also evidence that a subgroup of schizophrenic patients and autistic children might be affected by gluten sensitivity. 

The Center for Celiac Research estimates that approximately six percent of the U.S. population, or 18 million people, suffers from gluten sensitivity. This group reacts with some of the same symptoms as people with celiac disease, but gluten-sensitive individuals typically test negative for celiac disease in diagnostic blood tests and show no signs of the damage to the small intestine that defines celiac disease.

“Imagine gluten ingestion on a spectrum, says Dr. Fasano. “At one end, you have people with celiac disease, who cannot tolerate one crumb of gluten in their diet. At the other end, you have the lucky people who can eat pizza, beer, pasta and cookies — and have no ill effects whatsoever. In the middle, there is this murky area of gluten reactions, including gluten sensitivity. This is where we are looking for answers about how to best diagnose and treat this recently identified group of gluten-sensitive individuals,” says Dr. Fasano.

“The Center for Celiac Research is leading the way in the effort to better understand the spectrum of gluten disorders,” says
E. Albert Reece, M.D., Ph.D., M.B.A, vice president for medical affairs, University of Maryland, and John Z. and Akiko K. Bowers Distinguished Professor and dean, University of Maryland School of Medicine. “I have no doubt that further research will lead to new diagnostic tools and treatments for those who suffer from gluten sensitivity.”

The latest research was conducted in collaboration with the Johns Hopkins School of Medicine, the Department of Experimental Medicine of the University of Naples in Italy, and the Institute of Food Sciences in Avellino, Italy. The BMC Medicine article is titled “Divergence of Gut Permeability and Mucosal Immune Gene Expression in Two Gluten-Associated Conditions: Celiac Disease and Gluten Sensitivity.”

The University of Maryland School of Medicine’s Center for Celiac Research has been at the forefront of education, research, diagnosis and treatment for more than a decade. A groundbreaking 2003 study conducted by the Center for Celiac Research estimated that 1 in 133 people in the United States suffers from the disease. In 2000 the Center for Celiac Research developed a diagnostic blood test that is used to identify the disease. Founded in 1995, the Center for Celiac Research is an international leader in promoting the awareness of celiac disease to provide better care, better quality of life, and more adequate support for the celiac disease community worldwide."



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    Dr. Maltz earned a Medical Degree and Master in Public Health from the University of Texas Medical Branch (UTMB) in Galveston, TX. She completed a combined Internal and Preventive Medicine Residency at UTMB in June, 2011. She then completed a 2-year Integrative Medicine Fellowship at Stamford Hospital in Stamford, CT, during which she simultaneously underwent an intensive 1000-hour curriculum created by The University of Arizona Integrative Medicine Program founded by Dr. Andrew Weil.  

    Dr. Maltz's specific interests include helping her patients and populations improve their health through lifestyle interventions including, but not limited to, natural pain relief, nutrition, mind-body techniques and decreasing environmental exposures. She spent the last year of her four-year medical residency participating in health policy, cancer prevention and environmental health rotations and enjoys guiding people through the overwhelming amount of health information available on the web.

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