In Victorian times, dreams were believed to represent repressed sexual desires or random brain activity. Now scientists believe they reflect an attempt by the unconscious mind to process and store emotion-laced events from the day.

“We take our problems to sleep and work through them during the night,” Rosalind Cartwright, a neuroscience professor at Rush University Medical Center told the Wall Street Journal.

According to Cartwright, during dreams the mind juxtaposes unprocessed emotions encountered during waking hours with older, related memories. “That’s why dreams look so peculiar. You have old memories and new memories Scotch-plaided into each other,” she added. “They are emotional connections rather than logical ones.”

If this theory is true, it may be possible for people to direct their own dreams. For example, people who experience recurring nightmares might learn to substitute happier endings or eliminate them altogether.

A small group of people who practice “lucid dreaming” believe this is indeed possible. According to these people, recurring nightmares are caused when people wake up from the frightening experiences, thereby interrupting the normal process of emotional reconciliation that takes place during dreaming. Without the reconciliation, the dream is left to repeat itself.

“Your brain seems to think that it’s helping you to prepare, but you don’t allow yourself to finish it so it becomes a broken record,” Shelby Freedman Harris, a Behavioral Sleep Medicine expert at Montefiore Medical Center explained to the Journal.

Harris runs a program that tries to help folks either rewrite or delete the script of recurring dreams using a technique known as Image Rehearsal Therapy. In implementing the technique, dreamers recreate the nightmare with better endings or more palatable story-lines (substituting dolphins for sharks, for example), and rehearse the new script several times per day. 

While far from 100% effective, many of Harris’ patients are able to dream the revised script, while others stop having the nightmare completely.

Traditional wisdom holds that children who are picky eaters will outgrow the behavior, so no intervention is required. That holds true for the vast majority of people, but recently scientists have called attention to a small group of adults who are remarkably picky eaters.

One woman featured in a Wall Street Journal article on the subject for example, has lived on the following diet for more than 20 years: French fries, pasta with butter or marinara sauce, vegetarian pizza, cooked broccoli, corn on the cob and cakes and cookies without nuts.

“When I was younger it was cute,” the woman told the Journal. “Now it’s embarrassing.”

Adult picky eaters don’t fit existing definitions for eating disorders, since their behavior is not driven by the need to achieve a certain body weight. In fact, they aren’t necessarily skinny or obsessed with their appearance, at all.

Yet their odd food preferences can interfere with their social and professional relationships, which suggests a true behavioral disorder. For example, some adult picky eaters lie about their diets and avoid parties or business lunches in order to keep their secret. Others refuse to eat with their families. Many feel ashamed or inconvenienced about their dietary preferences.

In an attempt to understand adult picky eating, scientists at Duke University have launched a national public registry that allows people to report on their unusual dietary habits (www.eatingdisorders.mc.duke.edu). Counseling is also available, though no therapeutic strategy has been shown to be effective so far.

Meanwhile, a group of experts that has been tasked to author the Eating Disorders section of the 2013 version of the Diagnostic and Statistical Manual of Mental Disorders may recognize for the first time a condition called “selective eating” that could apply to both adults and children.

Could coffee stave off more than just fatigue? A new study suggests that might be the case. Heavy coffee drinkers, it turns out, have a lower incidence of head and neck cancers, according to the study, which was published in Cancer Epidemiology, Biomarkers & Prevention.

To reach these conclusions, Mia Hashibi and colleagues pooled results from 9 previous studies which looked at coffee and tea drinking, as well as rates of head and neck cancers. In those studies, the behaviors of cancer patients were compared with either the general population or to patients that were hospitalized for reasons other than cancer.

The scientists found that people who drank coffee had a 12% lower risk of developing head and neck cancers than those who didn’t, after controlling for several factors including cigarette smoking. In addition, the scientists found an inverse correlation between the amount of coffee consumed and the risk of cancer: for people who drank at least 4 cups per day, the risk was cut by more than one third.

Head and neck cancer is relatively rare, affecting only about 1 in 10,000 people per year. It is known to be associated with alcohol intake and cigarette smoking.

Hashibi’s group noted that the association doesn’t prove that coffee protects against cancer of the head and neck. Other factors associated with coffee drinking could be driving the association. Alternatively, people with the disease might have reduced their coffee consumption for some reason.

There are several mechanisms by which coffee might be protective, although they are all speculative at this point.

“Coffee contains more than a thousand chemicals,” wrote the authors, including compounds like cafestol and kahweol which are thought to protect DNA from the damaging effects of certain carcinogens.

America’s epidemic of overweight and obesity sets back private employers by nearly $45 billion per year in health care costs and diminished productivity. In response, nearly one-third of US companies either offer, or are considering financial incentives that motivate employees to lose weight or otherwise become healthier.

The incentives are quite diverse. Some companies simply reward employees for getting a check-up evaluation or pay the costs of diet classes. Others pay employees that achieve certain exercise targets. Still others cut health-insurance premiums.

IBM has long been considered a leader in such programs. Nearly half of its workforce earns upwards of $150 per year for participating. In one scheme, IBM pays employees for completing 3-month, Web-based health programs.

As another example, OhioHealth, a hospital chain, began paying employees for walking. The provider uses pedometers and pays up to $500 depending on the distance travelled. “We thought that would be a big enough number to help people think twice,” Lisa Meddock, OhioHealth’s benefits manager told the Wall Street Journal.

Nearly half of OhioHealth’s 9,000 employees participated, and the provider has paid out over $377,000 so far.

The literature contains few studies designed to assess the impact of employer-based health incentive programs like this. In one of the largest studies, Cornell University scientists examined 7 such programs and found that the average participant lost just over 1 pound.

The Cornell team did find, however that programs designed to put employees at risk for losing their own money were more effective than those designed to win money. In one such study featuring so-called “refundable bonds,” participants agreed to shed X pounds by Y date or forfeit the money they deposited. In this program, employees lost an average of 4 pounds.

Has salt finally reached its moment of truth as a staple of Western diets? US government experts estimate we consume at least twice as much as the recommended daily allowance, and that across-the-board reductions in salt consumption could save 150,000 lives per year.

Numerous health officials, Michelle Obama and New York’s Mayor Michael Bloomberg have all recently urged food makers to cut out some salt in their food. The prestigious Institute of Medicine actually wants the feds to force food makers to do so.

But this isn’t going to be easy, and it may not be possible. Salt is a cheap way to create tastes and textures that consumers demand in their food, so doing without salt can lead to reduced profit and therefore, unhappy investors.

Take Kellogg’s Cheez-Its, for example. A cup of the iconic snack contains one third of the daily recommended amount of salt. Part of the salt load is sprinkled atop the orange squares to titillate the tongue at the moment of contact, that’s obvious.

But did you know Kellogg adds salt to the cheese itself in order to give Cheez-Its their memorable crunch? Or that the food maker adds salt to the dough to block a tangy taste that develops during fermentation?

In fact, in a recent demonstration for reporters, Kellogg created a batch of Cheez-Its leaving out most of the salt. The snack’s pleasing orange color faded to brown. They were sticky after being chewed, with the gruel caking onto teeth. And the taste became downright medicinal.

Similarly produced Corn Flakes tasted like brass, and the buttery flavor of Keebler Light Buttery Crackers (which in fact contain no butter), simply vanished.

“Salt changes the way that your tongue will taste the product,” Kellogg vice president and food scientist, John Kepplinger explained. “You make one little change and something that was a complementary flavor now starts to stand out and become objectionable.”

Responding to complaints by high school and college students that free condoms being distributed by Washington DC health officials are of poor quality and too small, the city now intends to offer Trojan condoms, including extra-large versions, in addition to the less expensive Durex condoms it had  distributed exclusively until now. 

City officials decided it was worth the extra few thousand dollars per year to encourage sexually active teens to practice safe sex.

“We want to support the regularization of condom use citywide,” Shannon Hader, director of the city’s HIV/AIDS administration told the Washington Post. “We are promoting this idea that using condoms is healthy . . . to destigmatize condom use,  for kids (and) grown-ups.”

The District’s health department distributed 3.2 million condoms last year, including about 15,000 in schools, to its 600,000 residents. The program costs the city $165,000 per year. The city pays 5.7 cents per Durex condom, and will pay from 6 to 9 cents for the Trojans, depending on size.

Interested parties can get the condoms online or at more than 100 locations, including liquor stores, barbershops and youth centers. 

In a survey of high school students in the District last spring, most participants “felt Trojan brand condoms were of better quality and protection.” They regarded the extra large “Magnum” condom marketed by Trojan as the best because it was “thicker.”

Durexes were perceived by the students to most likely to “pop or break.”

Despite these perceptions, health officials agree that the condoms are equally effective in terms of preventing pregnancy and sexually transmitted diseases.

Simply hearing mom’s voice on the telephone triggers a marked calming effect in girls. The response is triggered by the release of a stress-reducing hormone, say scientists at the University of Wisconsin-Madison. 
 
To reach these conclusions, Leslie Seltzer created a stressful situation by asking a cohort 7- to 12-year-old girls to deliver an extemporaneous speech and solve difficult math problems in front of an audience of strangers.

The stressed-out pre-teens were then randomized into 3 groups. Girls in the first group received hugs and related in-person comforting from their mothers. The second group received phone-based support from their mothers. The third group was hung out to dry watching an emotionally neutral video.
 
Seltzer’s group found that girls in the first two groups experienced a marked rise in oxytocin levels, whether their contact with mom was in person or via the telephone. They also found that the calming effects of the interaction, and the associated bump in oxytocin and reduction in cortisol, lasted for hours after the comfort session with mom.
 
Oxytocin is known to be associated with emotional bonding, but increased levels of the female hormone had previously been thought to require physical contact between mother and daughter.

“It’s clear that a mother’s voice can have the same effect as a hug, even if they’re not standing there,” Seltzer told BurrillReport.
 
“For years I’ve seen students leaving exams and the first thing they do is pull out their cell phone and make a call,” Seth Pollak, a psychology professor at UW-Madison told Burrill. “I used to think, ‘How could those over-attentive, helicopter parents encourage that?’ But now? Maybe it’s a quick and dirty way to feel better. It’s not pop psychology or psychobabble.”
 
The write-up appears in Proceedings of the Royal Society B.

Spouses who care for a husband or wife that has dementia are 6 times more likely to develop the condition themselves, according to study by scientists at Utah State, Johns Hopkins and Duke.

To reach this conclusion, the scientists looked at 1,221 married couples who were at least 65 years old. The subjects had been enrolled in the Cache County (Utah) Memory Study, which has followed more than 900 people with dementia since the study began in 1995.

The six-fold increase in dementia rivals that associated with a well-known gene variant, APOE ε4, according to the scientists. The risk was found to be present even after the scientists accounted for socioeconomic status and other factors that are known to increase the risk of dementia. 

Researchers have studied this general topic for years, although most of the earlier studies focused on emotional distress experienced by caretakers rather than any impact on the cognitive abilities of spouses who cared for persons with dementia. 

The scientists suspect that stress associated with caregiving is driving their findings.  

“Caregiving has positive aspects, as well as negative ones,” Peter Rabin, a professor of psychiatry at Johns Hopkins University told BurrillReport. “If we can boost the positive aspects and reduce the negative ones, we may be able to reduce a caregiver’s risk of developing dementia.”

Obesity is a serious threat to health, but recent research suggests that being 10-15 pounds overweight doesn’t increase health risks and may help in certain circumstances. Here is a summary of these findings:

Mildly overweight people do not have an increased risk of death from cancer or cardiovascular disease-In a study published in JAMA, Katherine Flegal and colleagues from the CDC looked at mortality rates reported in NHANES, an annual health survey. They found that mortality among those classified as overweight was lower than they had estimated. By contrast, those classified as underweight and obese had higher mortality rates than had been predicted.

Another study of 9,000 people conducted in Australia showed a reduced risk of death among septuagenarians who were overweight when compared to those of normal weight. The scientists concluded a little extra weight could protect folks against illness and injury as they age.

A little extra weight appears to protect against osteoporosis in women-Scientists who have reported this suggest that estrogen, produced by subcutaneous fat, helps increase bone mass. “Women should not worry if they are 10 to 15 pounds overweight, particularly if the fat is not concentrated in [the] belly,” Felicia Cosman, director of National Osteoporosis Foundation told the Wall Street Journal.

Slightly overweight women tend to look younger-According to a study in last year’s Archives of Dermatology, older women who were a bit overweight looked younger because the subcutaneous fat combats sagging and wrinkles.

The key is the location of the fat. Subcutaneous fat, common in the mildly overweight, tends to appear on the hips, thighs and butt. It is benign physiologically. Visceral fat attaches to internal organs and causes protruded bellies. It increases the risk of diabetes, cancer and cardiovascular disease.

The Food and Drug Administration wants to reduce salt consumption by Americans in an effort to cut morbidity and mortality from cardiovascular disease.

The unprecedented move would be implemented over a decade or more.

It would begin by quantifying salt content in processed foods and progress to the establishment of salt limits in various food categories. Subsequently, these would be ratcheted down over years so that consumers wouldn’t take notice.

At the moment, FDA classifies salt as “generally recognized as safe,” meaning that food producers can add as much as they want. All they have to do is report salt content on nutrition labels.

Americans’ salt consumption has risen steadily for 3 decades as they consume more processed foods and eat out more frequently. Most of us consume twice as much as the government’s daily recommended limit.

Scientists at Stanford and Columbia recently published a study showing that reducing salt intake by 3 grams per day could prevent tens of thousands of strokes and heart attacks per year.

The feds had heretofore tried to coax the food industry to voluntarily reduce salt and educate consumers about its risk. However, a recently released report by the Institute of Medicine has found these approaches have failed.

The FDA’s challenge is that, “historically, consumers have found low-sodium products haven’t been of the quality that’s expected,” according to Todd Abraham, an SVP of research and nutrition at Kraft Foods.

Meanwhile, Morton Satin, who directs technical and regulatory affairs for the Salt Institute, a trade group representing salt producers, believes regulation “would be a disaster for the public.” He added that the scientific evidence linking salt consumption to cardiovascular disease is mixed and that salt intake is not necessarily associated with health problems.

Chocolate is more than an indulgence! It lowers blood pressure and the consequent risk of heart disease–especially dark chocolate–say German scientists who published the heartening news in the European Heart Journal.

The scientists added that just a small square of chocolate per day is enough to reap the cardiovascular benefits…after that, it really is just an indulgence.
 
To reach these conclusions, Brian Buijsse and colleagues followed 19,357 people between the ages of 35 and 65, for at least 10 years. They found that people in the highest quartile for chocolate consumption  (averaging 7.5 grams of chocolate per day), had lower blood pressure, a 27% lower risk of heart attack, and a 48% lower risk of stroke than those in the lowest quartile for chocolate consumption (about 1.7 grams per day).

Buijsse’s team believes it’s the flavanols in cocoa that are responsible for these beneficial effects. There are more flavanols in dark chocolate than milk chocolate.
 
“Flavanols…are responsible for improving the bioavailability of nitric oxide from the cells that line the inner wall of blood vessels–vascular endothelial cells,” explained Buijsse. “Nitric oxide…causes smooth muscle cells of the blood vessels to relax and widen. This may contribute to lower blood pressure. Nitric oxide also improves platelet function and makes vascular endothelium less attractive for white blood cells to attach and stick around.”
 
Buijsse warned that people who chose to increase their chocolate intake should not increase their overall caloric intake or their consumption of healthy foods. “Small amounts of chocolate may help to prevent heart disease, but only if it replaces other energy-dense food, such as snacks, in order to keep body weight stable,” he told BurrillReport.

Aging motorcyclists are nearly twice as likely as their younger counterparts to die in a motorcycle accident, say researchers at the University of Rochester Medical Center.

To reach this conclusion, Mark Gestring, who directs the Center’s trauma program and his colleagues studied nearly 62,000 motorcycle crashes in the US between 1996 and 2005. The ages of involved riders ranged from 17-89 years old.

The scientists found that during that 10 year period, the mean age of bikers who were involved in crashes rose from 34 to 39, and the proportion of injured riders who were at least 40 years old increased from 28% to 50%.

Motorcyclists in the 50-59 year age range experienced the most rapid rise in injuries, while those in the 20-29 year-old age range had fewer accidents in 2005 than in 1996.

“We made the clinical observation that older patients — people in their 50s, 60s and even 70s — were being injured on motorcycles with increasing frequency,” Gestring told MSNBC. “We wanted to see if this observation was true on a national level and we found that it was.”

The scientists also noted that riders who were at least 40 years of age had more severe injuries and longer lengths of ICU stay than younger bikers. 

“Treating a 60-year-old who has been in a motorcycle accident is very different from treating a 21-year-old who has been in a similar accident — 60-year-olds bring a lot more medical baggage with them, and this can adversely impact outcomes following injury,” Gestring said.

The write-up appears in American Surgeon.

Twenty years ago the World Health Organization recommended that people should consume at least 5 portions of fruit and vegetables per day in order to prevent cancer and other chronic diseases. The advice has become gospel pretty much ever since.

Unfortunately, a recent study by Paolo Boffetta and colleagues at Mount Sinai School of Medicine does not substantiate the claim.

The scientists analyzed 500,000 subjects from 10 countries who were enrolled in the European Prospective Investigation into Cancer and Nutrition. They concluded that consuming an extra 2 portions of fruits and veggies per day could prevent at most 2.6% of cancers in men and 2.3% of cases in women, after accounting for lifestyle factors like smoking and exercise.

Even these modest gains could have been due to the fact that people who consumed more fruit and vegetables lived healthier lives in other respects, with the latter behaviors actually accounting for the gains.

The scientists found that vegetables, which tend to have more nutrients, were more beneficial than fruits, and that heavy drinkers and smokers appeared to gain the most from increased consumption of fruits and vegetables.

In an accompanying editorial, Harvard University nutrition expert Walter Willet said the study confirmed previous findings. “Any association of intake and fruits and vegetables with risk of cancer is weak at best,” he told the BBC.

Although the link between diet and cancer seems less certain, it is becoming increasingly clear that obesity is a major risk factor for cancer. Thus to the extent that fruits and vegetables are substituted in the diet for higher calorie foods, they could still drop cancer risk via this mechanism. 

The write-up appears in the Journal of the National Cancer Institute.

Many normal people abhor something about their physical appearance–a beauty mark, their nose, flabby thighs or whatever. In a few people however, the issue becomes an all-consuming, irrational obsession that prevents them from focusing on work or school or even leaving their homes. The obsession can lead to drug abuse or attempted suicide.

The latter instance, which is believed to affect tens of thousands of Americans, is known as body dysmorphic disorder (BDD), a syndrome that has been recognized for more than 100 years but that only recently made it into DSM-V, the diagnostic manual for psychiatrists.

Unlike eating disorders which disproportionately affect women, BDD is nearly as prevalent in men as in women. In one form of BDD affecting guys (muscular dysmorphic disorder), people who are totally jacked from compulsive weight training actually think they look puny and weak.

According to Katharine Phillips, a professor of psychiatry at Brown Medical School and a BDD expert, many individuals trace the problem to emotional trauma in childhood like being teased about their looks, parental neglect or abuse. Most people overcome this without developing BDD, especially if other factors in their lives lift self-esteem.

There may be a genetic component as well: about 20% of BDD patients have an affected parent, sibling or child.

Both cognitive behavioral therapy and serotonin-enhancing drugs (SSRIs) appear to be effective treatments for BDD. In the former, counselors help patients reorder their self-perceptions and expose their “defect” to others. SSRIs help 50-75% of affected individuals, although positive effects aren’t usually seen for months after drug therapy is initiated.

Cosmetic treatments do not work. They can modify one “defect,” but the affected individual often develops another.

Anger management programs are a popular antidote these days for immature celebrities, road ragers, obstreperous airline passengers, and foul-mouthed employees.

But the programs, which range from pricey private sessions with therapists to anonymous group sessions on a conference line, may or may not work. Few studies have been designed to find that out.

There are no licensing requirements for trainers and no regulatory oversight of the programs, and there have been notorious failures—those Columbine kids attended one before shooting up their school in 1999, for example. 

The problem is made worse by the fact that clinicians often can’t determine whether a pattern of angry outbursts signifies mental illness or a simple behavioral issue. This means that some people who need psychiatric help don’t get it. 

Psychiatrists typically recommend a psychiatric exam for people with repetitive outbursts, because anger often accompanies common psychiatric disorders.

The closest thing to a psychiatric diagnosis for isolated anger is Intermittent Explosive Disorder, which is defined as recurrent episodes of aggression against people or property that is out of proportion to any provocation. Scientists estimate that 5% of Americans (mostly men) fit these criteria.

“These people are hot heads, and the people around them are walking on egg shells. They don’t know when they are going to blow up next,” University of Chicago psychiatrist Emil Coccaro told the Wall Street Journal.

While some people with IED respond antidepressants, most psychologists believe that individual talk therapy is the way to go for treating the condition. 

For their part, anger-management trainers think psychiatrists over-diagnose the condition. 

“I don’t want everybody who calls up for anger management to be assumed to have a mental illness,” Ian Shaffer told the Journal. Shaffer is chief medical officer for MHN, which runs employee-assistance programs including anger management. MHN claims that ¾ of the employees whose jobs were on the line when they began the program were in good standing upon its completion.

Coffee drinkers are less likely to be hospitalized for heart rhythm disturbances, according to scientists who presented at an American Heart Association conference last month.

The findings might seem counterintuitive for people that experience palpitations after drinking coffee, especially if they believe palpitations are associated with heart rhythm disturbances (they are, but the association is weak, especially in young, healthy people).
 
Nevertheless Arthur Klatsky and colleagues from the Kaiser Permanente Division of Research reached this conclusion by following 130,054 people. Those who reported drinking four or more cups of Joe per day had an 18% reduction in the risk of hospitalization for arrhythmias. People who reported consuming one to three cups per day had a 7% lower risk.
 
Previous studies showing the opposite result—that caffeine can produce arrhythmias—were based on much higher levels of caffeine intake, Klatsky said. He also cited the findings of a Danish study showing that heavy and light coffee drinkers experienced the same risk of atrial fibrillation, a common major disturbance of cardiac rhythm.
 
 “Coffee drinking is related to lower risk of hospitalization for rhythm problems, but the association does not prove cause and effect,” Klasky told BurrillReport. It is possible, for example, that other characteristics of coffee drinkers, like their dietary habits or how much they exercise, could be driving the apparent association.

As a result, it’s certainly not possible to advise people to drink coffee in order to prevent heart rhythm disturbances. Still, Klatsky felt his findings might reassure people who drink moderate amounts of coffee: their habit isn’t going to trigger a major rhythm disturbance.