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Supplements containing soy isoflavones may do little to preserve women’s bone mass after menopause.

In a study of more than 200 women ages 46 to 65, researchers found that the soy supplement did not appear to ward off bone-density loss over 3 years. In general, women on the supplement showed the same degree of bone loss as those given a placebo — though there was some evidence that a higher dose helped protect bone density in the hip.

The findings, reported in the American Journal of Clinical Nutrition, add to a conflicting body of research on soy and postmenopausal bone health.

Some studies have suggested that soy-based foods, isolated soy protein or isoflavone-containing supplements may be beneficial, while others have found no advantage.

Isoflavones are natural chemicals found in soybeans and certain other plant foods that are structurally similar to estrogen, and may have certain estrogen-like effects in the human body. Since declining estrogen levels after menopause spur bone-density loss, isoflavone supplements could theoretically protect women’s bone mass.

The current findings, however, do not support that theory.

“I would not be able to recommend that women should take soy isoflavone tablets — extracted from soy protein — since these have not been demonstrated convincingly to be effective for prevention of bone loss,” lead researcher Dr. D. Lee Alekel, a professor of nutrition at Iowa State University in Ames, told Reuters Health in an email.

Still, she said, women should still try to eat a variety of soy-based foods — such as tofu, tempeh and soy-derived versions of cheese and yogurt — since these are “nutritionally sound” choices.

For their study, Alekel and her colleagues randomly assigned 255 postmenopausal women to one of three groups: one that took 80 milligrams (mg) of a soy isoflavone supplement each day; one that took a 120-mg dose; and one given inactive placebo pills.

All of the women also took calcium and vitamin D supplements.

Over three years, women in the isoflavone and placebo groups showed similar average declines in whole-body bone mass, as well as bone density in the spine and hip area.

Women in the higher-dose isoflavone group did, however, show less bone loss in the femoral neck — an area at the top of the thigh bone, where it meets the pelvis. But, the researchers write, because the effect was “very modest,” and limited to the femoral neck, “we cannot conclude that soy isoflavones hold potential promise in the prevention of postmenopausal osteoporosis.”

The idea that soy or soy isoflavones may protect bone mass comes, in part, from studies showing lower rates of hip fracture among women in Southeast Asia, where the traditional diet is rich in soy.

Those types of studies do not prove cause-and-effect, however. Because the current study looked only at soy isoflavone supplements, Alekel said it cannot speak to the potential effects of soy foods on women’s bone health.

You know that it’s important to eat a healthy, balanced diet with all the nutrients that your body needs. A poor diet lacking in essential vitamins and minerals can lead to serious health problems.

Here are warning signs of serious malnutrition that warrant a visit with your doctor and prompt treatment:
Losing consciousness or fainting.
Lack of menstrual periods in pre-menopausal women.
Stunted growth in children.
Sudden loss of hair.

Inappropriate clothing can limit or prevent young children’s outdoor physical activity, a U.S. study has found.

Researchers looked at 53 child-care providers from 34 child-care centers in Cincinnati to determine why children’s physical activity levels may vary across centers. They were surprised to find that clothing could be a major barrier to outdoor activity.

Clothing that limited or prevented outdoor activity included: inadequate weather protection, such as a lack of coats and gloves in the winter; unsuitable footwear, such as flip flops; and “nice” or expensive outfits that had to be treated with care.

Having a few children with inappropriate clothing could prevent an entire day-care class from going outside to play, the researchers said.

Children’s clothing choices were a significant source of conflict between parents and child-care providers, the study authors noted. Reasons why parents may dress children inappropriately include: forgetfulness, a hectic morning routine, limited income to buy clothes, a child’s preference for a favorite piece of clothing, and parents failing to understand the importance of outdoor play.

Low-level laser therapy appears to ease a common form of neck pain, a review of studies finds.

“It is effective against non-specific pain arising from the muscles and the joints, where there is not a clear cause, such as a herniated disc,” said Jan M. Bjordal, a professor of physiotherapy at Bergen University College in Norway and a member of an international team reporting the review in the Nov. 13 online issue of The Lancet.

The group, led by Dr. Roberta Chow of the Brain and Mind Research Institute at the University of Sydney in Australia, surveyed data from 16 controlled trials with a total of 820 people treated for neck pain, using a 100-point scale to determine the difference between results of different treatments.

There were two trials for acute neck pain. Those who received low-level laser therapy, in which a beam of focused radiation in the infrared to visual light portion of the spectrum is aimed at the painful area of the neck, were 70 percent more likely to report reduced pain than those given placebo treatment with a beam of ordinary light, the report said.

Five trials with people suffering chronic, persistent neck pain found that those who got laser treatment were four times more likely to have reduced pain compared with placebo. In 11 trials of chronic pain, 20-point reductions were reported by people given laser therapy.

Seven of those trials provided follow-up data for as long as 22 weeks. Pain relief persisted, with few or no side effects reported.

“The results of low-level laser therapy in this review compare favorably with other widely used therapies, and especially with pharmacological interventions, for which evidence is sparse and side effects are common,” the journal report said.

“The effects turned out to be fairly good,” Bjordal said. “We think it is a combination of mechanisms, and we can’t say which is more important. We think that an anti-inflammatory effect is one of the mechanisms that are involved.”

Neck pain is predicted to be a medical problem of increasing importance in the United States and other countries because of a growing population of older people, so a treatment that does not require drugs and has no apparent side effects is attractive.

But it’s necessary to be cautious about the reported results, said Dr. Andrew Sherman, head of medical rehabilitation at the Spine Institute at the University of Miami Miller School of Medicine.

“It is true that neck pain is an increasingly difficult problem in our society,” Sherman said. “Such a problem is best treated with a large-population, double-blind placebo-controlled study.”

The U.S. Food and Drug Administration has approved a laser device for treating neck pain. But that approval differs from approval of a medication, which requires poof that the drug is safe and effective. Device approval indicates only that the technology is safe.

Medical insurance coverage of laser therapy for pain differs from country to country, Bjordal said. “In some countries, it gets reimbursed if done by physical therapists,” he said. In others, it is not covered. In the United States, Medicare does not cover the laser therapy.

It is often assumed that the schoolyard is where bullies go to make other kids miserable, but a new study suggests that classrooms are another popular site.

The study, presented recently at the American Public Health Association’s annual meeting in Philadelphia, is based on survey results from more than 10,000 middle-school students who anonymously answered questions online.

Of those surveyed, 43 percent said they’d been physically bullied within the last month. A bit more than half said they’d been teased in an unfriendly way, and half reported being called hurtful names.

About one-third said groups had excluded them to hurt their feelings. Twenty-eight percent said their belongings had been taken or broken; 21 percent said someone threatened to hurt them. According to the results, two-thirds of the students said they’d been bullied in more than one way over the previous month.

The study authors noted that 8 percent of respondents said they’d skipped school at least once during the school year because of fear of being bullied. Twenty-five percent said they’d taken other actions, such as skipping recess, not going to the bathroom or lunch, skipping classes, or avoiding some area of the school to avoid encountering a bully.

Bullies did much of their intimidating in the classroom, lunchroom and school hallways, the researchers found. Those who were bullied in the classroom felt more threatened and unsafe on campus than other students.

“These findings show that it is erroneous to think of the classroom as a safe haven from bullying and to think that more remote or less-monitored areas of school are necessarily the greatest risk for students,” H. Wesley Perkins, lead researcher on the study, said in a news release.

More than 65 percent of U.S. mothers with depression don’t receive adequate treatment, a new study has found.

Black, Hispanic and other minority mothers are least likely to receive adequate treatment. Mothers with health insurance are three times more likely to receive adequate treatment than those without insurance, wrote the researchers at the University of Wisconsin-Madison School of Medicine and Public Health.

“Health insurance facilitates access to adequate treatment for maternal depression. Expanding health insurance coverage to mothers with depression is a critical step in helping them get the care that they need,” study author Dr. Whitney P. Witt, an assistant professor of population health sciences, said in a news release from the university.

The analysis of national data on 2,130 mothers with depression also found that working mothers were less likely to receive adequate treatment, possibly because long work hours make it difficult for them to find time to seek treatment. This means that workplaces could prove a useful location for depression intervention.

“Services like employee-assistance programs can help these mothers get screened and treated, even if they are unable to visit a provider or a mental health professional in the health-care setting,” co-author Kristin Litzelman, a population health sciences doctoral student, said in the release. “Since healthy employees are productive employees, it’s often a win-win for employers to offer benefits that support employee mental health.”

Depression in mothers can have a major impact on the entire family, especially on the health and well-being of their children, the researchers noted. Treating depression in mothers can improve the long-term health of their families.

Health-care providers need to understand the racial, ethnic and educational disparities that affect treatment of mothers with depression in order to intervene and help these patients get the care they need, the study authors noted.

New research suggests that deep brain stimulation, already a common treatment for some neurological conditions, may be an effective way to treat Tourette syndrome.

“Our findings hold promise for helping people with severe Tourette syndrome, who are in need of new treatment options to improve their quality of life,” study author Dr. Andrea Cavanna, of the University of Birmingham in England, said in a news release from the American Academy of Neurology.

An estimated 2 million Americans suffer from Tourette syndrome, which is best known for making people uncontrollably shout words out loud. Other symptoms include spastic movements, facial tics, shoulder shrugging and jerking of the head or shoulders.

In the new study, 15 patients with severe Tourette syndrome plus obsessive compulsive disorder received deep brain stimulation — electrical impulses — through a surgically implanted brain pacemaker.

The subjects had about half as many tics on average after the treatment, and their symptoms of obsessive compulsive disorder, depression and anxiety fell by 26 percent to 33 percent, the researchers reported in the Oct. 27 issue of the journal Neurology.

“Despite having only 15 patients in this study, it is the largest to date on the effectiveness of deep brain stimulation as a treatment for Tourette syndrome,” Cavanna said. “The results showed that all 15 people who were assessed after two years’ treatment experienced improvements in disabling tics and neurological problems, which is encouraging,” Cavanna added.

“Unfortunately, three patients from the original group of 18 were no longer part of the study at follow-up and this limits the ability to generalize our findings. More research needs to be done to confirm that deep brain stimulation is a safe and effective treatment for Tourette syndrome,” Cavanna said.

Traditional Pap tests and the newer liquid-based cytology are equally reliable in screening for cervical cancer, a new study has found.

In the United States, liquid-based cytology testing has all but replaced the traditional Pap test, but in Europe the debate continues over which method is best, according to Dr. Mark Schiffman, a senior investigator at the U.S. National Cancer Institute, co-author of an editorial accompanying the study’s publication in the Oct. 28 issue of the Journal of the American Medical Association.

The study’s lead researcher, Albertus G. Siebers, from Radboud University Nijmegen Medical Centre in the Netherlands, reflects that debate. “Liquid-based cytology is neither more sensitive nor more specific in detecting cancer,” he said. “However, the decision to convert to liquid-based cytology cannot be based on the performance of the method alone, as other arguments also play an important role.”

The difference between the two tests is not in the way samples are collected but in how they are treated in the laboratory. In a traditional Pap test, cells are collected and smeared on a slide for evaluation. In liquid-based cytology, the cells are rinsed in a vial of preservation solution.

The advantage of liquid-based cytology is that it also screens for human papillomavirus (HPV), which causes most cervical cancers.

To find out which test was best, the researchers randomly assigned 89,784 women who participated in the Dutch cervical screening program to have either a traditional Pap tests or a liquid-based cytology test.

“The main finding of the study is that we provided strong evidence that a relatively new screening method is not necessarily better than the old way of screening with conventional PAP smears,” Siebers said.

The Dutch screening program did not allow use of liquid-based cytology testing until recently, he said, because officials did not have sufficient data comparing it with the conventional method.

“The decision to convert to a new method is a very complex one,” Siebers said. “The performance of the method is, of course, imperative, but it is not the only factor. Other things must be considered, [including] screening time, the handling of the specimen, the reduced number of inadequates, the possibility of using residue for further diagnostic procedures such as HPV testing [and] the much more standardized way of handling the material that enables computer-assisted screening.”

All these factors should be considered to objectively estimate cost-effectiveness and decide whether a change in screening method should be made, Siebers said.

The study’s findings led to Dutch officials deciding to allow use of liquid-based cytology testing, he said.

Schiffman noted that liquid-based cytology is more expensive than the traditional Pap smear, but it is preferred by U.S. laboratories because specimens are easier to handle, and more analyses can be done in a day. In addition, the specimen can be used for HPV testing, which is common in the United States.

But any Pap testing could be on the way out, he said, because the ability to prevent and screen for cervical cancer is changing. “We now have vaccines that are going to keep getting better, and we have HPV testing, which is even more sensitive than Pap smears,” Schiffman said. “And new techniques will come along.”

He predicted major changes in cervical cancer screening in the next few years, “with the powerful sensitivity of doing HPV testing plus a Pap smear that is optimally done no more than every three years starting at age 30.”

But he said it remains to be seen whether women will accept screening every three years after having been accustomed to annual testing. “That’s a major change coming,” Schiffman said.

Female veterans of the Iraq and Afghanistan wars are less likely to complain of painful physical conditions than their male counterparts are.

The findings, from a study of more than 91,000 U.S. veterans, run counter to what is seen in the general population — where women typically show higher rates of chronic pain conditions, including migraines, fibromyalgia and persistent abdominal pain.

Among veterans in the study, 43 percent reported some type of physical pain over one year. And of those who had their pain evaluated at least three times, 20 percent had symptoms lasting at least several months.

Men, it turned out, were more likely to report either problem: 44 percent said they had pain at some point over the year, compared with 38 percent of women. Of those assessed for persistent pain, 21 percent of men had lingering symptoms, versus 18 percent of women.

When women did have pain, however, they were somewhat more likely than men to describe it as moderate to severe. Among veterans with any pain, 68 percent of females had moderate or severe pain, compared with 63 percent of men.

Researchers led by Dr. Sally G. Haskell, of the VA Connecticut Healthcare System in West Haven, report the findings in the journal Pain Medicine.

Exactly why these findings in veterans differ from what’s been found among civilians is unclear, according to Haskell’s team.

The researchers speculate that combat exposure could be a factor. If men are more likely to be seriously injured or suffer from post-traumatic stress disorder after serving in a war zone that could explain their higher rate of pain complaints.

In addition, the researchers write, it’s possible that the “persistent level of threat” faced by soldiers in Iraq and Afghanistan essentially equalizes men’s and women’s risk of stress-related pain.

Understanding sex differences in veterans’ risks of various health problems will be increasingly important as more and more women enter the military, according to the researchers.

“As the VA plans care for the increasing numbers of female personnel,” Haskell said in a written statement, “a better understanding of the prevalence of pain, as well as sex-specific variations in the experience and treatment of pain, is important for policy makers and providers who seek to improve identification and management of diverse pain disorders.”