Taken separately, the studies on the drug, Eli Lilly & Company’s solanezumab, missed their main goals of significantly slowing the mind-robbing disease or improving activities of daily living. But pooled results found 34 percent less mental decline in mild Alzheimer’s patients compared to those on a placebo treatment for 18 months.

Doctors called the results encouraging, although probably not good enough to win Food and Drug Administration approval of the drug without another study to confirm there is a benefit. Investors were more optimistic, driving Lilly’s stock up $2.55, or 5.3 percent, to $50.78 on Monday and more than 19 percent since August, when the company described the results in general terms.

Detailed results of the combined studies were disclosed on Monday at an American Neurological Association conference in Boston.

“It’s certainly not the home run we all wanted, but we’re very encouraged by these results,” said Maria C. Carrillo, senior director of medical and scientific relations for the Alzheimer’s Association, which had no role in the research.

Solanezumab aims to bind to and help clear the sticky deposits that clog patients’ brains. The two studies each had about 1,000 patients, about two-thirds with mild disease and one-third with moderately severe Alzheimer’s, in 16 countries. Their average age was 75.

The main measures were two tests — one reflecting language, memory and thinking and the other, ability to perform daily activities like eating and grooming. The combined results on the patients with mild disease showed a nearly two-point difference in the roughly 90-point score on thinking abilities. Previous studies suggest that a change of three to four on the score is needed to show a clinical benefit, like an improvement in how well patients can take care of themselves.

“It’s a small difference,” Dr. Rachelle S. Doody of Baylor College of Medicine said of the drug’s effect. Still, “you slow the decline” with the drug, she said.

It became apparent Thursday that hundreds, and perhaps thousands, of people who got the shots between July and September could be at risk after officials revealed that a tainted steroid suspected to have caused a meningitis outbreak in the South had made its way to 75 clinics in 23 states.

The Food and Drug Administration urged physicians not to use any products at all from the Massachusetts pharmacy that supplied the preservative-free methylprednisolone acetate.

So far, 35 people in six states — Tennessee, Virginia, Maryland, Florida, North Carolina and Indiana — have contracted fungal meningitis, and five of them have died, according to the Centers for Disease Control and Prevention. All had received steroid shots for back pain, a highly common treatment.

It is not clear how many patients received tainted injections, or even whether everyone who got one will get sick. The time from infection to onset of symptoms is anywhere from a few days to a month, so the number of people stricken could rise.

The pharmacy involved, the New England Compounding Center of Framingham, Mass., has recalled three lots consisting of a total of 17,676 single-dose vials of the steroid, preservative-free methylprednisolone acetate, Massachusetts health officials said.

Investigators this week found contamination in a sealed vial of the steroid at the company, FDA officials said. Tests are under way to determine if it is the same fungus blamed in the outbreak.

Several hundred of the vials, maybe more, have been returned unused, but many others were used. At one clinic in Evansville, Ind., more than 500 patients received shots from the suspect lots, officials said. At two clinics in Tennessee, more than 900 patients — perhaps many more — did.

The company has shut down operations and said it is working with regulators to identify the source of the infection.

“Out of an abundance of caution, we advise all health care practitioners not to use any product” from the company, said Ilisa Bernstein, director of compliance for the FDA’s Center for Drug Evaluation and Research.

Massachusetts health officials said NECC has a pending complaint against it from this year, related to the potency of a medication used in eye surgery. It appears unrelated to the current outbreak, said Dr. Madeleine Biondolillo, director of the state’s Bureau of Healthcare Safety.

Biondolillo said two prior complaints, including one for sterile compounding procedures, were both resolved in 2006. The pharmacy was inspected and cleared by the state Department of Public Health last year after relocating its operations on the same site, she said.

The first known case in the meningitis outbreak was diagnosed about two weeks ago in Tennessee, which still has by far the most cases with 25, including three deaths. Deaths have also been reported in Virginia and Maryland.

Meningitis is an inflammation of the lining of the brain and spinal cord. Symptoms include severe headache, nausea, dizziness and fever.

The type of fungal meningitis involved is not contagious like the more common forms. It is caused by a fungus often found in leaf mold and is treated with high-dose antifungal medications, usually given intravenously in a hospital.

Robert Cherry, 71, a patient who received a steroid shot at a clinic in Berlin, Md., about a month ago, went back Thursday morning after hearing it had received some of the tainted medicine.

“So far, I haven’t had any symptoms … but I just wanted to double check with them,” Cherry said. “They told me to check my temperature and if I have any symptoms, I should report straight to the emergency room, and that’s what I’ll do.”

The company that supplied the steroid in question is what is known as a compounding pharmacy. These pharmacies custom-mix solutions, creams and other medications in doses or in forms that generally aren’t commercially available.

Other compounding pharmacies have been blamed in recent years for serious and sometimes deadly outbreaks caused by contaminated medicines.

Two people were blinded in Washington, D.C., in 2005. Three died in Virginia in 2006 and three more in Oregon the following year. Twenty-one polo horses died in Florida in 2009. Earlier this year, 33 people in seven states developed fungal eye infections.

Compounding pharmacies are not regulated as closely as drug manufacturers, and their products are not subject to FDA approval.

A national shortage of many drugs has forced doctors to seek custom-made alternatives from compounding pharmacies.

The New England Compounding Center makes dozens of other medical products, state officials said. But neither the company nor health officials would identify them.

The company said in a statement Thursday that despite the FDA warning, “there is no indication of any potential issues with other products.” It called the deaths and illnesses tragic and added: “The thoughts and prayers of everyone employed by NECC are with those who have been affected.”

A 2011 state inspection of the Framingham facility gave the business a clean bill of health.

Associated Press writers Travis Loller in Nashville, Jay Lindsay in Boston, Randall Chase in Wilmington, Del., and AP chief medical writer Marilynn Marchione in Milwaukee contributed to this story.

Learn the signs and symptoms of depression

Depression signs and symptoms vary from person to person. They can include:

• Feeling sad, down or “empty”
• Losing interest in activities that were once a source of pleasure
• Feeling hopeless, worthless or helpless
• Feeling irritable or restless
• Changes in appetite, and losing or gaining weight unintentionally
• Sleeping poorly or oversleeping
• Feeling tired or having less energy
• Having persistent feelings of guilt
• Having trouble thinking, concentrating or making decisions
• Decreased capability and performance
• Having thoughts of suicide
• Abusing alcohol or drugs

Encourage treatment

People with depression may not recognize or acknowledge that they’re depressed. They may not be aware of signs and symptoms of depression, so they may think their feelings are normal.

All too often, people feel ashamed about their depression and mistakenly believe they should be able to overcome it with willpower alone. But depression seldom gets better without treatment and may get worse. With the right treatment approach, the person you care about can get better. In addition, here’s what you can do to help.

• Talk to the person about what you’ve noticed and why you’re concerned.
• Explain that depression is a medical condition, not a personal flaw or weakness — and that it usually gets better with treatment.
• Suggest that the person see a professional — a medical doctor or a mental health provider, such as a licensed counselor or psychologist.
• Offer to help prepare a list of questions for the person to discuss in an initial appointment with a doctor or mental health provider.
• Express your willingness to help by setting up appointments, going with the person to appointments and attending family therapy sessions.

If your loved one’s illness is severe or potentially life-threatening, contact a doctor, a hospital or emergency medical services.

Identify warning signs of worsening depression

Everyone experiences depression differently. Learn how depression affects your family member or friend — and learn what to do when it gets worse. Observe your loved one. Consider these issues:

• What are the typical signs and symptoms of depression in your family member or friend?
• What behaviors or language do you observe when depression is worse?
• What behaviors or language do you observe when he or she is doing well?
• What circumstances trigger episodes of more severe depression?
• What activities are most helpful when depression worsens?

Worsening depression needs to be treated as soon as possible. Your loved one should work with his or her doctor or mental health professional to come up with a plan for what to do when signs and symptoms reach a certain point. As part of this plan, your loved one may need to:

• Contact his or her doctor to see about adjusting or changing medications
• See a psychotherapist, such as a licensed counselor or psychologist
• Take self-care steps, such as being sure to eat healthy meals, get enough sleep and be physically active

Understand suicide risk

People with depression are at an increased risk of suicide. If your loved one is severely depressed, prepare yourself for the possibility that at some point he or she may feel suicidal. Take all signs of suicidal behavior seriously, and act immediately.

Take action if necessary:

• Talk to the person about your concern. Ask if he or she has been thinking about committing suicide or has a plan for how to commit suicide. Having an actual plan indicates a higher likelihood of attempting suicide.
• Seek help. Contact the person’s doctor, mental health provider or other health care professional. Let other family members or close friends know what’s going on.
• Call a suicide hotline number. In the United States, you can reach the toll-free, 24-hour hot line of the National Suicide Prevention Lifeline at 800-273-8255 to talk to a trained counselor. Use that same number and press 1 to reach the Veterans Crisis Line.
• Make sure the person is in a safe environment. Eliminate things that could be used to commit suicide. For example, remove or lock up firearms, other weapons and medications.
• Call 911 or your local emergency number immediately if the person may be in danger of self-harm or suicide. Make sure someone stays with that person at all times.

Stay alert for warning signs of suicide

Learn and stay alert for common warning signs of suicide or suicidal thoughts:

• Talking about suicide — for example, making statements such as “I’m going to kill myself,” “I wish I were dead” or “I wish I hadn’t been born”
• Getting the means to commit suicide, such as buying a gun or stockpiling pills
• Withdrawing from social contact and wanting to be left alone
• Having mood swings, such as being emotionally high one day and deeply discouraged the next
• Being preoccupied with death, dying or violence
• Feeling trapped or hopeless about a situation
• Increasing use of alcohol or drugs
• Changing normal routine, including eating or sleeping patterns
• Doing risky or self-destructive things, such as using drugs or driving recklessly
• Giving away belongings or getting affairs in order when there is no other logical explanation for why this is being done
• Saying goodbye to people as if they won’t be seen again
• Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above

Provide support

Remember that your loved one’s depression isn’t anyone’s fault. You can’t fix the person’s depression — but your support and understanding can help.

What you can do for your loved one:

• Encourage sticking with treatment. If your friend or family member is in treatment for depression, help him or her remember to take prescribed medications and to attend scheduled appointments.
• Be willing to listen. Let your loved one know that you want to understand how he or she feels. When the person wants to talk, listen carefully, but avoid giving advice or opinions or making judgments. Just listening and being understanding can be a powerful healing tool.
• Give positive reinforcement. People with depression may judge themselves harshly and find fault with everything they do. Remind your loved one about his or her positive qualities and how much the person means to you and others.
• Offer assistance. Your friend or family member may not be able to take care of certain tasks very well. Give suggestions about specific tasks you’d be willing to do, or ask if there is a particular task that you could take on.
• Help create a low-stress environment. Creating a regular routine may help a person with depression feel more in control. Offer to make a schedule for meals, medication, exercise and sleep, and help organize household chores.
• Locate helpful organizations. A number of organizations offer support groups, counseling and other resources for depression. For example, the National Alliance on Mental Illness, employee assistance programs and many religious organizations offer help for mental health concerns.
• Encourage participation in spiritual practice. For many people, faith is an important element in recovery from depression — whether it’s involvement in an organized religious community or personal spiritual beliefs and practices.
• Make plans together. Ask your loved one to join you on a walk, see a movie with you, or work with you on a hobby or other activity he or she previously enjoyed. But don’t try to force the person into doing something.

What you can do for yourself:

• Learn about depression. The better you understand what causes depression, how it affects people and how it can be treated, the better you’ll be able to talk to and help the person you care about.
• Take care of yourself. Supporting someone with depression isn’t easy. Ask other family members or friends to help, and take steps to prevent becoming frustrated or burned out. Find your own time for hobbies, physical activity, friends and spiritual renewal.
• Depression symptoms do improve with treatment, but it can take time. Finding the best treatment may require trying more than one type of medication or treatment approach. For some people, symptoms quickly improve after starting treatment. For others, it will take longer.

Sound familiar? You’re not alone. Thanks in part to technology and its constant pinging and chiming, roughly 41 million people in the United States — nearly a third of all working adults — get six hours or fewer of sleep a night, according to a recent report from the Centers for Disease Control and Prevention. And sleep deprivation is an affliction that crosses economic lines. About 42 percent of workers in the mining industry are sleep-deprived, while about 27 percent of financial or insurance industry workers share the same complaint.

Typically, mention of our ever increasing sleeplessness is followed by calls for earlier bedtimes and a longer night’s sleep. But this directive may be part of the problem. Rather than helping us to get more rest, the tyranny of the eight-hour block reinforces a narrow conception of sleep and how we should approach it. Some of the time we spend tossing and turning may even result from misconceptions about sleep and our bodily needs: in fact neither our bodies nor our brains are built for the roughly one-third of our lives that we spend in bed.

The idea that we should sleep in eight-hour chunks is relatively recent. The world’s population sleeps in various and surprising ways. Millions of Chinese workers continue to put their heads on their desks for a nap of an hour or so after lunch, for example, and daytime napping is common from India to Spain.

One of the first signs that the emphasis on a straight eight-hour sleep had outlived its usefulness arose in the early 1990s, thanks to a history professor at Virginia Tech named A. Roger Ekirch, who spent hours investigating the history of the night and began to notice strange references to sleep. A character in the “Canterbury Tales,” for instance, decides to go back to bed after her “firste sleep.” A doctor in England wrote that the time between the “first sleep” and the “second sleep” was the best time for study and reflection. And one 16th-century French physician concluded that laborers were able to conceive more children because they waited until after their “first sleep” to make love. Professor Ekirch soon learned that he wasn’t the only one who was on to the historical existence of alternate sleep cycles. In a fluke of history, Thomas A. Wehr, a psychiatrist then working at the National Institute of Mental Health in Bethesda, Md., was conducting an experiment in which subjects were deprived of artificial light. Without the illumination and distraction from light bulbs, televisions or computers, the subjects slept through the night, at least at first. But, after a while, Dr. Wehr noticed that subjects began to wake up a little after midnight, lie awake for a couple of hours, and then drift back to sleep again, in the same pattern of segmented sleep that Professor Ekirch saw referenced in historical records and early works of literature.

It seemed that, given a chance to be free of modern life, the body would naturally settle into a split sleep schedule. Subjects grew to like experiencing nighttime in a new way. Once they broke their conception of what form sleep should come in, they looked forward to the time in the middle of the night as a chance for deep thinking of all kinds, whether in the form of self-reflection, getting a jump on the next day or amorous activity. Most of us, however, do not treat middle-of-the-night awakenings as a sign of a normal, functioning brain.

Doctors who peddle sleep aid products and call for more sleep may unintentionally reinforce the idea that there is something wrong or off-kilter about interrupted sleep cycles. Sleep anxiety is a common result: we know we should be getting a good night’s rest but imagine we are doing something wrong if we awaken in the middle of the night. Related worries turn many of us into insomniacs and incite many to reach for sleeping pills or sleep aids, which reinforces a cycle that the Harvard psychologist Daniel M. Wegner has called “the ironic processes of mental control.”

As we lie in our beds thinking about the sleep we’re not getting, we diminish the chances of enjoying a peaceful night’s rest.

This, despite the fact that a number of recent studies suggest that any deep sleep — whether in an eight-hour block or a 30-minute nap — primes our brains to function at a higher level, letting us come up with better ideas, find solutions to puzzles more quickly, identify patterns faster and recall information more accurately. In a NASA-financed study, for example, a team of researchers led by David F. Dinges, a professor at the University of Pennsylvania, found that letting subjects nap for as little as 24 minutes improved their cognitive performance.

In another study conducted by Simon Durrant, a professor at the University of Lincoln, in England, the amount of time a subject spent in deep sleep during a nap predicted his or her later performance at recalling a short burst of melodic tones. And researchers at the City University of New York found that short naps helped subjects identify more literal and figurative connections between objects than those who simply stayed awake.

Robert Stickgold, a professor of psychiatry at Harvard Medical School, proposes that sleep — including short naps that include deep sleep — offers our brains the chance to decide what new information to keep and what to toss. That could be one reason our dreams are laden with strange plots and characters, a result of the brain’s trying to find connections between what it’s recently learned and what is stored in our long-term memory. Rapid eye movement sleep — so named because researchers who discovered this sleep stage were astonished to see the fluttering eyelids of sleeping subjects — is the only phase of sleep during which the brain is as active as it is when we are fully conscious, and seems to offer our brains the best chance to come up with new ideas and hone recently acquired skills. When we awaken, our minds are often better able to make connections that were hidden in the jumble of information.

Gradual acceptance of the notion that sequential sleep hours are not essential for high-level job performance has led to increased workplace tolerance for napping and other alternate daily schedules.

Employees at Google, for instance, are offered the chance to nap at work because the company believes it may increase productivity. Thomas Balkin, the head of the department of behavioral biology at the Walter Reed Army Institute of Research, imagines a near future in which military commanders can know how much total sleep an individual soldier has had over a 24-hour time frame thanks to wristwatch-size sleep monitors. After consulting computer models that predict how decision-making abilities decline with fatigue, a soldier could then be ordered to take a nap to prepare for an approaching mission. The cognitive benefit of a nap could last anywhere from one to three hours, depending on what stage of sleep a person reaches before awakening.

Most of us are not fortunate enough to work in office environments that permit, much less smile upon, on-the-job napping. But there are increasing suggestions that greater tolerance for altered sleep schedules might be in our collective interest. Researchers have observed, for example, that long-haul pilots who sleep during flights perform better when maneuvering aircraft through the critical stages of descent and landing.

Several Major League Baseball teams have adapted to the demands of a long season by changing their sleep patterns. Fernando Montes, the former strength and conditioning coach for the Texas Rangers, counseled his players to fall asleep with the curtains in their hotel rooms open so that they would naturally wake up at sunrise no matter what time zone they were in — even if it meant cutting into an eight-hour sleeping block. Once they arrived at the ballpark, Montes would set up a quiet area where they could sleep before the game. Players said that, thanks to this schedule, they felt great both physically and mentally over the long haul.

Strategic napping in the Rangers style could benefit us all. No one argues that sleep is not essential. But freeing ourselves from needlessly rigid and quite possibly outdated ideas about what constitutes a good night’s sleep might help put many of us to rest, in a healthy and productive, if not eight-hour long, block.

by David Randall
The New York Times

Medication is a proven way to treat — and prevent — migraines. But medication is only part of the story. It’s also important to take good care of yourself. The same lifestyle choices that promote good health can reduce the frequency and severity of your migraines. In fact, combining lifestyle measures with medication is often the most effective way to handle migraines.

Seek a calm environment

At the first sign of a migraine, retreat from your usual activities if possible.

• Turn off the lights. Migraines often increase sensitivity to light and sound. Relax in a dark, quiet room. Sleep if you can.
• Try temperature therapy. Apply hot or cold compresses to your head or neck. Ice packs have a numbing effect, which may dull the sensation of pain. Hot packs and heating pads can relax tense muscles; warm showers or baths may have a similar effect.
• Massage painful areas. Apply gentle pressure to your scalp or temples. Alleviate muscle tension with a shoulder or neck massage.
• Drink a caffeinated beverage. In small amounts, caffeine alone can relieve migraine pain in the early stages or enhance the pain-reducing effects of acetaminophen (Tylenol, others) and aspirin. Be careful, however. Drinking too much caffeine too often can lead to withdrawal headaches later on.

Sleep well

Migraines may keep you from falling asleep or wake you up at night. Likewise, migraines are often triggered by a poor night’s sleep. Here’s help encouraging sound sleep.

• Establish regular sleep hours. Wake up and go to bed at the same time every day — even on weekends. If you nap during the day, keep it short. Naps longer than 20 to 30 minutes may interfere with nighttime sleep.
• Unwind at the end of the day. Anything that helps you relax can promote better sleep: Listen to soothing music, soak in a warm bath or read a favorite book. But watch what you eat and drink before bedtime. Intense exercise, heavy meals, caffeine, nicotine and alcohol can interfere with sleep.
• Minimize distractions. Save your bedroom for sleep and intimacy. Don’t watch television or take work materials to bed. Close your bedroom door. Use a fan to muffle distracting noises.
• Don’t try to sleep. The harder you try to sleep, the more awake you’ll feel. If you can’t fall asleep, read or do another quiet activity until you become drowsy.
• Check your medications. Medications that contain caffeine or other stimulants — including some medications to treat migraines — may interfere with sleep.

Eat wisely

Your eating habits can influence your migraines. Consider the basics:

• Be consistent. Eat at about the same time every day.
• Don’t skip meals. Eating breakfast is especially important.
• Avoid foods that trigger migraines. If you suspect that a certain food — such as aged cheese, chocolate, caffeine or alcohol — is triggering your migraines, eliminate it from your diet to see what happens.

Exercise regularly

During physical activity, your body releases certain chemicals that block pain signals to your brain. These chemicals also help alleviate anxiety and depression, which can make migraines worse. If your doctor agrees, choose any exercise you enjoy. Walking, swimming and cycling are often good choices. But it’s important to start slowly. Exercising too vigorously can trigger migraines.

Manage stress

Stress and migraines often go hand in hand. You can’t avoid daily stress, but you can keep it under control — which can help you prevent migraines.

• Simplify your life. Rather than looking for ways to squeeze more activities or chores into the day, find a way to leave some things out.
• Manage your time wisely. Update your to-do list every day — both at work and at home. Delegate what you can, and divide large projects into manageable chunks.
• Take a break. If you feel overwhelmed, a few slow stretches or a quick walk may renew your energy for the task at hand.
• Adjust your attitude. Stay positive. If you find yourself thinking, “This can’t be done,” switch gears. Think instead, “This will be tough. But I can make it work.”
• Let go. Don’t worry about things you can’t control.
• Relax. Deep breathing from your diaphragm can help you relax. Focus on inhaling and exhaling slowly and deeply for at least 10 minutes every day. It may also help to consciously relax your muscles, one group at a time. When you’re done, sit quietly for a minute or two.

Keep a migraine diary

A diary may help you determine what triggers your migraines. Note when your migraines start, what you were doing at the time, how long they last and what, if anything, provides relief. Eventually you may be able to prevent migraines by changing patterns in your daily life.

Strive for balance

Living with migraines is a daily challenge. But making healthy lifestyle choices can help. Ask your friends and loved ones for support. If you’re feeling anxious or depressed, consider joining a support group or seeking counseling. Believe in your ability to take control of the pain.

To play it safe, avoid taking more than the recommended dietary allowance (RDA) of any micronutrient through supplements. (To check the RDA for any supplement, visit: ods.od.nih.gov/factsheets/list-all.)

It is especially important to avoid taking too much of the vitamins and minerals listed below:

Vitamin A. Most of us get plenty of vitamin A in foods — liver, milk, eggs, carrots, spinach and many other foods. Too much vitamin A in supplements can harm bones and can lead to birth defects. About 20 years ago there was some evidence that beta carotene supplements, which the body converts to vitamin A, might have health benefits. However, newer studies in the past two decades do not show clear benefits. Too much beta carotene can also give your skin and eyes a yellowish hue.

Vitamin E. Too much vitamin E can cause bleeding, headache, fatigue and blurred vision. Until about 10 years ago, I thought the weight of scientific evidence suggested that vitamin E supplements might have health benefits. But bigger and better studies in the past decade generally do not show benefits.

Calcium (for men). Recent studies have found that excess intake of calcium appears to increase the risk of prostate cancer. While not all scientists agree, I think that most men should avoid taking calcium supplements and should not consume too many dairy products. An exception is men who have osteoporosis, or thin bones, who may need a combination of calcium and vitamin D.

Iron. Large doses of iron supplements can trigger an iron overload. Some people inherit a genetic condition that causes them to absorb more iron from the gut than most people. This can damage body tissues and can raise the risk of heart disease, liver cancer, infections and arthritis. Your body can’t easily shed excess iron. Also, taking high doses of vitamin C allows your body to absorb more iron than it normally would. In my opinion, the only people who should take iron supplements are people who have a clear iron deficiency, as shown by blood tests.

Zinc. Getting enough but not too much zinc is a bit of a high-wire act. The RDA for zinc is 8 mg for women and 11 mg for men. Yet levels higher than 15 mg can trigger side effects, such as a depressed immune system, poor healing, hair loss and interference with taste and smell. It’s best to get zinc from food sources rather than supplements.

Dr. Anthony Komaroff
Harvard Medical School

A new study by Stanford researchers has added fuel to a debate about the differences between organic and conventionally grown foods. The Stanford report, an analysis of 237 studies of organic produce, meats and dairy foods, concluded that organic foods are no more nutritious than their conventional counterparts. Advocates of organic foods, meanwhile, say that the study takes a narrow view of organic food choices, and that most people choose organic because they want to avoid pesticides, hormones and other chemicals used in conventional farming.

Here are answers to some commonly asked questions about the Stanford study and organic foods.

And in some cases, researchers have measured significant differences. A 2010 study by Washington State University scientists found organic strawberries have more vitamin C and antioxidants than conventional strawberries. Organic tomatoes also have more of a type of antioxidant called polyphenols than commercially grown tomatoes, according to a study published in July by scientists at the University of Barcelona.

However, other variables, like ripeness, may influence nutritional content even more. A peach or berry that reaches peak ripeness with the use of pesticides could contain considerably more vitamins than a less-ripe organically grown fruit.

The Stanford study reviewed decades of research to determine whether choosing organic produce, meats and milk would lead to better nutrition generally. They concluded the answer was no. That is, just following “organic” for everything does not bring obvious, immediate health benefits.

But producers of organic milk are required to allow their cows to spend a certain amount of time grazing, and that does produce a noticeable effect on the fatty acids in the milk. Compared with conventional milk, organic milk has lower levels of omega-6 fatty acids, which are believed to be unhealthy for the heart in high concentrations, and higher levels of healthful omega-3 fatty acids. The Stanford researchers noted that organic milk does have modestly higher levels of omega-3 fatty acids, based on a few small studies included in the analysis.

Organic Valley, a cooperative of organic farmers, says its organic milk shows omega-3 levels that are 79 percent higher than those in conventional milk, as well as much lower levels of omega-6.

For farm workers, some pesticides appear to cause some cancers.
Over the past few decades the E.P.A. has banned many of the most toxic pesticides, so presumably the risk to workers is lower now than it was. Many people who buy organic foods say they do so because they are concerned about the health of farm workers.

In terms of the environmental effects of organic farming versus conventional farming, it depends on how you view it. One meta-analysis found that organic farming had fewer environmental impacts per acre. However, because of lower yields from organic crops, the environmental effect of organic produce was actually greater per product shipped.

In addition, there are growing concerns about the role of agricultural antibiotics leading to new antibiotic-resistant strains of bacteria.

Produce: The majority of my summer “cooking” includes smoothies and green juices, so fruits, veggies, and herbs make up the bulk of my cart.  I have a few basics but the rest changes based on what’s in season and what’s on sale (often they overlap). Organic is ideal, but I’m still a stingy 26-year-old.

In my cart: lettuce, kale, carrots, cucumbers, tomatoes, peaches, grapefruit, watermelon, avocado, cilantro

Seeds, nuts, nut milks: year-round essentials. Nuts and seeds have really healthy fats, including lots of vitamin E, great for your skin and hair. They’re great for on the go.

In my cart: pecans or pistachios, almond butter, almond milk, chia seeds, chickpeas or black beans.

Beans and grains: all are versatile in salads and for side dishes. Nothing like homemade hummus. And when there are so many options out there, regular old pasta just sounds boring.

In my cart: quinoa, amaranth, chickpeas or black beans, roasted red pepper hummus, popcorn

Meat, fish, and dairy: meat and dairy are one of the areas where if you can do organic, you should. Hormones and antibiotics are not something you knowingly want to get more of.  When it comes to fish, try to stay wild (fish can’t be organic).

In my cart: organic chicken (if I’m lazy, organic rotisserie chicken), fresh turkey breast, Greek yogurt, half and half (for coffee), pasture-raised eggs, string cheese, wild salmon.

The extras: I’m a freezer fanatic – I use it for extra veggies and always have 1-2 frozen meal options in there for “safety.” I’m a fan of Organic Bistro, Amy’s, and EVOL.  Then there’s the chocolate… but what used to be artificially flavored milk chocolate is now dark chocolate with almonds.

So, what’s in your grocery cart?

By Carolyn Brown, MS, RD

Prior studies have found that being overweight or obese increases the risk of getting a number of cancers, including breast cancer. And smaller studies have noted that obese breast cancer patients tended to fare worse than those who are normal weight.

The new study takes a fresh look at data collected on more than 7,000 breast cancer patients who were enrolled in three government-sponsored clinical trials.

The trials were originally designed to test the effectiveness of different combinations of chemotherapy drugs. All the women in the studies had operable cancers without spread to distant organs and received cutting-edge treatment for their cancers.

As Body Weight Climbs, So Does the Risk

Despite that, a woman’s weight was still linked to the likelihood that she might beat the disease.

Among women with hormone-sensitive tumors, those who were overweight or obese when they were diagnosed were about 30% more likely than those with normal body weights to see their breast cancers come back after surgery and chemotherapy. They were also about 50% more likely to die over the course of the studies.

The risk appeared to increase in a step-wise fashion — the higher a woman’s weight, the greater her odds of recurrence and early death.

The study doesn’t prove that too much body fat causes cancer directly. But as scientists learn more about fat, they think that’s a strong possibility.

Fat cells play a role in the production of hormones like estrogen and insulin that spur the growth of tumors. Fat also increases inflammation, another cancer driver, says researcher Joseph A. Sparano, MD, associate director of medical oncology at Montefiore Medical Center in New York City.

What it means, simply, is “the more you weigh, the worse the outcome,” says Stefan Gluck, MD, a professor of medicine and a breast oncologist at the University of Miami’s Sylvester Comprehensive Cancer Center. He was not involved in the research.

Advice to Patients

Beyond surgery and chemotherapy, “every patient asks, ‘What else can I do?’” Gluck says. “It’s always part of my counseling to explain that” too much body fat “leads to a more aggressive cancer behavior and you want to avoid it.”

But that’s not always easy to do. Many breast cancer drugs zap energy, making it harder to exercise.

Sparano says this study makes it important for patients and doctors to do what they can to try prevent those extra pounds.

“What we don’t know yet is whether weight loss in breast cancer patients will significantly reduce the risk of breast cancer recurrence or death,” he says.

Gluck says studies are under way to answer that question.

By Brenda Goodman, MA
WebMD Health News

A group of studies, all conducted independently, have reached a similar sobering conclusion: sleep problems—including several common sleep difficulties faced by millions of people on a regular basis—may, over time, lead to cognitive impairment and even dementia.

Four studies presented at the Alzheimer’s Association International Conference investigated the possible relationship between sleep disorders and cognitive function among older adults. Each study looked at the question from a different angle, and used different methods to obtain results. The collective result? Information that some of our most common sleep troubles—including sleep deprivation, oversleeping, daytime tiredness, and sleep-disordered breathing—may play a significant role in cognitive decline as we age.

Sleeping too little—or too much—linked to cognitive decline

Researchers at Brigham & Women’s Hospital, Boston used data from the Nurses’ Health Study to examine risk factors for cognitive problems in older adults. The Nurses’ Health Study is a landmark, long-running, and ongoing study of women’s health, using information collected from thousands of nurse-participants.

To investigate the relationship between sleep and cognitive decline, researchers examined data from 15,263 women, all of whom were 70 years or older at the time of the first cognitive assessment. The women received follow-up cognitive tests every other year for the following six years. Participants were also asked to report their daily sleep patterns and habits. Researchers found that sleeping too little and sleeping too much were both associated with cognitive decline over time:

• Women who slept five hours a day or less had lower average cognitive scores than women who slept seven hours per day
• Women who slept more than nine hours had lower average scores than women who slept seven hours per day
• Women whose sleep duration changed by more than two hours—up or down—had lower cognitive assessment scores than women whose daily sleep patterns did not change significantly
• In a small subgroup of women, researchers analyzed blood samples for changes in protein levels that are considered markers for changes to the brain that are associated with Alzheimer’s disease. Women who slept more or less than seven hours were more likely to show evidence of these Alzheimer-indicative changes to protein levels.

Sleep-disordered breathing may increase risk of dementia

A study led by scientists at University of California San Francisco also examined the relationship between cognitive function and sleep disorders among older women. In this study, researchers did not use self-reported information about sleep. Instead, they measured sleep quality and quantity among 1309 women ages 75 and older over a period of several days. Researchers used polysomnography and wrist sensors to collect detailed data about physical changes that occurred during sleep—including brain activity and breathing—as well as information about rest and activity levels. Five years later, the women were given tests to measure their cognitive functioning. The results of this study showed a connection between disrupted sleep—especially sleep-disordered breathing—and diminished cognitive function:

• Women with sleep-disordered breathing were more than two times as likely to show evidence of dementia than women without sleep-disordered breathing
• Women who showed signs of disrupted sleep cycles were also more likely to demonstrate cognitive problems and dementia.
• Total sleep time was not associated with cognitive decline among these women. However, women who experienced greater periods of nighttime wakefulness scored lower on their cognitive function tests.

A preliminary version of these results was published last year in the Journal of the American Medical Association.

Daytime sleepiness may be a risk for cognitive impairment

An international group of researchers, from INSERM and Stanford University, used data from the Three-City Study to examine the effect of sleep on cognitive function among men and women age 65 and older. The study used self-reported sleep information from 4,894 adults, including details on trouble falling asleep and staying asleep, poor sleep quality, waking early, and daytime sleepiness. Participants were given cognitive assessments every two years over a 10-year period.

In contrast with some of the other findings on sleep and cognition presented at AAIC, researchers in this study did not find that sleep duration or difficulty falling asleep and staying asleep were associated with cognitive decline. They did find, however, that excessive daytime sleepiness was associated with diminishing cognitive function among these older adults.

Do disruptions to circadian rhythms lead to dementia?

A fourth study examined a hypothesis related to Alzheimer’s disease: that abnormal levels of a particular protein known as amyloid-beta contributes to dementia. Changes in the body’s production and clearance of this protein are considered a bio-marker for Alzheimer’s disease. Levels of amyloid-beta protein naturally change in the body over time and also fluctuate within a 24-hour period, and we don’t currently know a lot about why or how these natural cycles work. This limited understanding makes accurately measuring and tracking abnormalities more difficult.

Scientists at St. Louis’ Washington University School of Medicine examined changes in amyloid-beta protein in relation to circadian rhythms, and found that the protein’s daily fluctuations conform to circadian patterns, suggesting that disruptions to circadian rhythms—which happen with age as well as with disordered sleep—may affect the production and regulation of this protein linked to dementia.

This is a lot to digest. In the case of each study, there is more work to be done to establish a causal link between disrupted sleep and cognitive decline. We’re still a long way from a real understanding about just how sleep affects cognitive function over the course of a lifetime, and how lack of sleep may contribute to the onset of dementia or other conditions involving cognitive impairment and decline. But such unanimity among the results of no fewer than four separate studies certainly feels like the sounding of an alarm.