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Work Status Changes More Common Among Women Receiving Chemotherapy For Breast Cancer, Study Says
Women with breast cancer who receive chemotherapy appear more likely than those treated with radiation therapy to experience a major change in work status, according to a study published in the journal Cancer, Reuters reports. For the study, Dana-Farber Cancer Institute researcher Michael Hassett and colleagues used a large health insurance claims database to identify 3,233 women who were first diagnosed with breast cancer between 1998 and 2002. All of the women were younger than age 64, insured, and working full time or part time as of diagnosis. About 54% of the women received chemotherapy, and 58% received radiation therapy.Hassett said that most of the women did "not experience a significant change in their employment after cancer diagnosis and treatment." However, of the 6.6% who experienced such a change, those who received chemotherapy had a 1.8-fold greater risk of leaving work, retiring or going on long-term disability leave in the subsequent year. Sixty-seven percent of women who experienced a change went from full-time employment to early retirement, while the rest went from full-time employment to long-term disability or retirement, or their status was unknown. Although the study looked at many factors, only chemotherapy and older age were associated with an increased likelihood of a change in employment. Hassett said that most of the participants in the study worked for large employers that offered health insurance. He added that further research is needed to evaluate the effect of cancer diagnosis and treatment on work status for women who are self-employed or work for smaller companies (Hendry, Reuters, 6/30).
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Legislation To Overhaul U.S. Foreign Aid Introduced
Senator John Kerry (D-Mass.), chairman of the Senate Foreign Relations Committee, and ranking member, Senator Richard Lugar (R-Ind.), on Tuesday "introduced a bill to overhaul the U.S. system for providing global development aid," the Boston Globe reports (Smith, 7/29). The legislation was also introduced by Senators Robert Menendez (D-NJ) and Bob Corker (R-Tenn.), according to a release from Menendez"s office (7/28).
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MedPAC Questions Spending But Comes Up Short On Solutions
The Medicare Payment Advisory Commission - an independent group that makes recommendations to Congress on Medicare issues - said in its annual June report that the "government must give doctors and health-care facilities incentives to rein in costs in providing care for the elderly and disabled," the Wall Street Journal reports. The panel, known as MedPAC, raised specific questions about high priced imaging services that encourage doctors to over use them, the possibility of penalizing physicians who provide poor care at high cost with lower payments, and whether to cut payments to private plans that provide Medicare coverage (Zhang, 6/16).
Nutrition

Moderately Reduced Carbohydrate Diet Keeps People Feeling Full Longer

A modest reduction in the amount of carbohydrates eaten, without calorie restriction and weight loss, appears to increase a sense of fullness, which may help people eat less, a preliminary study found. The results were presented at The Endocrine Society"s 91st Annual Meeting in Washington, D.C. "There has been great public interest in low-carbohydrate diets for weight loss, but they are difficult to maintain, in part because of the drastic reduction in carbohydrates," said coauthor Barbara Gower, PhD, a professor in the Department of Nutrition Sciences, University of Alabama at Birmingham. In this study funded by the National Institutes of Health, Gower and her co-workers investigated whether a modest reduction in dietary carbohydrates, or "carbs," would improve feelings of fullness better than a carbohydrate level comparable to that of the typical U.S. diet. In a standard American diet, according to Gower, 55 percent of daily calories consumed come from carbohydrates: sugars, starches and fiber. The control diet used in their study contained 55 percent of daily calories from carbohydrates, in contrast to their "moderate-carb diet" which was 43 percent of calories from carbohydrates. The moderate-carb diet had more fat than their control diet - 39 percent versus 27 percent of calories - so that protein intake could be the same percentage. The researchers matched the protein intake of both diets studied (18 percent of calories) because protein may influence both satiety ("fullness") and insulin secretion. The authors assigned the moderate-carb diet to 16 adults and the standard diet to 14 adults for a month. Subjects received enough calories to maintain their weight at what it was before the study. During the study they were weighed each weekday, and if a participant gained or lost weight, the amount of food was modified individually so weight could stay the same. After the subjects adjusted to their diet for 4 weeks, they ate a test meal, a breakfast that was specific to their diet. When carbs are eaten and digested, they change into sugar. Before and after the meal, the researchers measured the subjects" levels of insulin and circulating glucose (nonfasting blood sugar) and asked them to rate their hunger or fullness. They evaluated insulin response to a meal and blood sugar levels, because lower insulin and stable blood sugar levels may contribute to increased feelings of fullness, Gower explained. Their research showed that, even in the absence of weight loss, a modest reduction in dietary carbohydrates was sufficient to lower insulin and stabilize blood sugar after a meal. Ratings of fullness were higher in the group on the moderate-carb diet before eating breakfast and stayed higher for a longer time after the meal, compared with those eating the standard diet. "Over the long run a sustained modest reduction in carbohydrate intake may help to reduce energy consumption and facilitate weight loss," Gower said. Paula Chandler-Laney, PhD, of the University of Alabama at Birmingham presented the study results. Aaron Lohr The Endocrine Society


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