GOOD HEALTH

HEART: Nine factors that could save your life

NO matter where you live, how old you are or what you look like, health researchers have recently discovered that 90 % of first heart attacks (myocardial infarction) suffered by people can be attributed to nine risk factors.

The risk factors include: cigarette smoking, an abnormal ratio of blood lipids, high blood pressure, diabetes, abdominal obesity, stress, a lack of daily consumption of fruits and vegetables, as well as a lack of daily exercise.

Modest alcohol consumption (three-to-four drinks weekly) has been determined to be a preventative measure.

A study conducted by Dr. Salim Yusuf conducted The study involved 15,000 patients with a first acute myocardial infarction (AMI) and 15,000 asymptomatic control subjects (age and sex matched) drawn from 262 centers in 52 countries throughout Asia, Europe, the Middle East, Africa, Australia, and North and South America.

INTERHEART is a global study led by McMaster University's Dr. Salim Yusuf that focuses on cardiovascular disease (CVD) and was co-funded by the Canadian Institutes of Health Research (CIHR), the Heart and Stroke Foundation of Ontario and 37 other funding sources. Structured questionnaires were administered and physical examinations were conducted on patients. Information was gathered relating to demographic factors, socioeconomic status, lifestyle, personal and family history of CVD, and psychosocial factors. Non-fasting blood samples were taken from every individual and frozen immediately after processing for later analysis. Waist measurements and hip circumferences were recorded.

Current smokers were defined as individuals who smoked any tobacco in the previous 12 months and included those who had quit within the past year. Former smokers were defined as those who had quit more than a year earlier. All of this information was collected and sent to the Population Health Research Institute, McMaster University and Hamilton Health Sciences for quality control and statistical checks.

The effect of these nine risk factors is consistent in men and women, across different geographic regions, and by ethnic group, making the study applicable worldwide.

(From Healthcare Quarterly, Vol. 8, no. 1, 2005 -  http://www.longwoods.com/hq/HQ81-2005/HQ81index.html

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Umbilical Cord

A few more minutes of maternal attachment may give newborns months of significant health benefits, according to a new McMaster University study that urges doctors not to cut umbilical cords immediately after birth.

In their efforts to "tidy things up" as quickly as possible, many doctors and midwives clamp and cut off umbilical cords as soon as babies have been delivered. According to McMaster university researcher Eileen Hutton in the Journal of the American Medical Association, “waiting at least two minutes would allow precious red and white blood cells to be transferred to the infant from the placenta before it is expelled from the womb.  "We really haven't given a lot of consideration in the past to the fact that there may be some value to the placenta remaining attached," said Hutton, an epidemiologist and assistant dean of the Hamilton school's midwifery programme.

“...The baby's born and the next thing you do is to clamp the cord, and people haven't really thought about whether this is a good thing or not a good thing. But delaying the cut could protect against anemia and irregular breathing for weeks and months after delivery,” she said. "If you increase the overall volume of blood in the infant, you're increasing the iron stores and the number of red blood cells. And the white blood cells, which contribute to immunities." According to Dr. Donald Davis, president of the Society of Obstetricians and Gynecologists of Canada, this study could change the way babies are delivered in this country.

Umbilical cords are typically cut within 30 to 60 seconds after normal deliveries, but leaving them intact for a few minutes might benefit babies, especially those whose mothers did not eat nutritious food while pregnant. Dr Davis maintained "I don't think there would be a problem waiting two minutes and certainly there are benefits," he said. "If these babies have a little bit better iron stores, a little bit higher hemoglobin, then they're going to fare better ... their blood is going to be able to carry more oxygen to vital and growing tissues like the heart and the brain."

The society is interested in Hutton's research and, if it recommends the study's findings, delayed cord cutting could become standard procedure in Canada.  The placenta, which grows attached to the wall of the uterus, is a temporary organ that allows the transfer of nutrients from mother to fetus via the umbilical cord and becomes part of the baby's circulatory system. It typically remains within the womb for several minutes after birth until continued uterine contractions expel it.

According to the study, between 25 and 60 per cent of a newborn's blood supply stays in the placenta and cord after birth. But the womb can act like a pump, moving more blood from the placenta to the infant.” Depending on when you do the clamping, the baby will have more or less of what is, in fact, its own blood," Hutton said.

According to Joseph Hall of the Toronto Star who reported the study, “There was not enough information in the study to determine whether babies born through caesarean section would benefit equally from prolonged placental attachment.” This required further probing experts felt.

The delay would have no negative health impacts on the mother during a normal, full-term birth. The umbilical cord is long enough in most cases that the mother can hold her infant on her stomach until it is cut.  Normal postnatal care of the newborn can be administered while the infant is still attached. It’s an intervention that has the potential to have a (positive) impact on a large number of babies and at a very low cost. This benefits the baby without any real down sides for mom.

The study, co-authored by University of British Columbia researchers, looked at 15 earlier papers involving almost 2,000 newborns in 11 countries. Now parents have to decide in advance about it with the help of doctors.

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