Study: Dads less likely to die of heart problems (AP)

Fatherhood may be a kick in the old testosterone, but it may also help keep a man alive. New research suggests that dads are a little less likely to die of heart-related problems than childless men are.

The study � by the AARP, the government and several universities � is the largest ever on male fertility and mortality, involving nearly 138,000 men. Although a study like this can't prove that fatherhood and mortality are related, there are plenty of reasons to think they might be, several heart disease experts said.

Marriage, having lots of friends and even having a dog can lower the chance of heart problems and cardiac-related deaths, previous research suggests. Similarly, kids might help take care of you or give you a reason to take better care of yourself.

Also, it takes reasonably good genes to father a child. An inability to do so might mean a genetic weakness that can spell heart trouble down the road.

"There is emerging evidence that male infertility is a window into a man's later health," said Dr. Michael Eisenberg, a Stanford University urologist and fertility specialist who led the study. "Maybe it's telling us that something else is involved in their inability to have kids."

The study was published online Monday by the journal Human Reproduction.

Last week, a study by other researchers of 600 men in the Philippines found that testosterone, the main male hormone, drops after a man becomes a dad. Men who started out with higher levels of it were more likely to become fathers, suggesting that low levels might reflect an underlying health issue that prevents reproduction, Eisenberg said.

In general, higher levels of testosterone are better, but too much or too little can cause HDL, or "good cholesterol," to fall � a key heart disease risk factor, said Dr. Robert Eckel, past president of the American Heart Association and professor of medicine at the University of Colorado, Denver.

"This is a hot topic," Eckel said. "I like this study because I have five children," he joked, but he said many factors such as job stress affect heart risks and the decision to have children.

Researchers admit they couldn't measure factors like stress, but they said they did their best to account for the ones they could. They started with more than 500,000 AARP members age 50 and over who filled out periodic surveys starting in the 1990s for a long-running research project sponsored by the National Cancer Institute.

For this study, researchers excluded men who had never been married so they could focus on those most likely to have the intent and opportunity to father a child. Men with cancer or heart disease also were excluded to compare just men who were healthy when the study began.

Of the remaining 137,903 men, 92 percent were fathers and half had three or more children. After an average of 10 years of follow-up, about 10 percent had died. Researchers calculated death rates according to the number of children, and adjusted for differences in smoking, weight, age, household income and other factors.

They saw no difference in death rates between childless men and fathers. However, dads were 17 percent less likely to have died of cardiovascular causes than childless men were.

Now for all the caveats.

Researchers don't know how many men were childless by choice and not because of a fertility problem.

They don't know what fertility problems the men's partners may have had that could have left them childless.

They didn't have cholesterol or blood pressure information on the men � key heart risk factors.

Less than 5 percent of participants were blacks or other minorities, so the results may not apply to them.

All those questions aside, however, some prominent heart experts were reassured by the study's large size and the steps researchers took to adjust for heart disease risk factors.

"I think there's something there," and social science supports the idea that children can lower heart risks, said Dr. Eric Topol, a cardiologist and genetics expert at Scripps Health in La Jolla, Calif. "Whether it's with a pet, a spouse or social interaction ... all those things are associated with better outcomes."

Dr. Daniel Rader, director of preventive cardiology at the University of Pennsylvania, said: "It's biologically plausible that there's a connection," but the reduced risk attributed to having children "is pretty modest."

Men often ask him what they can do to keep from dying of a heart attack, he said.

"I'm not really prepared to, on the basis of this, tell them to start having a few kids," Rader said.

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Online:

Medical journal: http://humrep.oxfordjournals.org/content/early/recent

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Decade after anthrax attacks, worry over stockpile (AP)

WASHINGTON � Anthrax vaccine � check. Antibiotics � check. A botulism treatment � check. Smallpox vaccine � check.

Ten years after the anthrax attacks brought home the reality of bioterrorism, the nation has a stockpile of some basic tools to fight back against a few of the threats that worry defense experts the most.

These defenses are not just gathering dust awaiting the next attack. In August, a Minneapolis hospital dipped into the stockpile to treat a critically ill patient � a tourist who, somewhere on his Midwest vacation, had the extraordinary bad luck to breathe anthrax spores that naturally linger in the dirt in parts of the country. The man, who survived, received a kind of medication not available in October 2001 when anthrax spores sent through the mail killed five people and sickened 17.

But there's wide concern that the nation's arsenal hasn't grown fast enough. A decade later, there are no treatments for a number of bugs on the worry list, and little to offer for other threats like a radiation emergency. Even a long-promised next-generation anthrax vaccine, that would be easier to produce, hasn't arrived yet. Nor is there information on how to treat children.

"Where are the countermeasures?" advisers to the Department of Health and Human Services asked in a critical report last year.

There are some: There's enough smallpox vaccine for everyone, plus some of a specially formulated version safe for cancer patients and others with weak immune systems. There's an improved version of the decades-old anthrax vaccine used in 2001. There are a few treatments for the toxins produced by anthrax and botulism, and a smallpox treatment is due soon.

But federal health officials are working to jumpstart production of more countermeasures and they say that more than 80 candidates are in advanced development. Over the past year, the goal has evolved into a push for more multiuse therapies, products that work not just for biodefense but for everyday health problems, too.

That's a major shift that should entice more big drug companies to the field, says Dr. Robin Robinson, who heads the federal Biomedical Advanced Research and Development Authority, or BARDA. It funds late-stage research of promising countermeasures.

Consider: BARDA just agreed to help pay for drug giant GlaxoSmithKline's testing of a novel antibiotic that might fight bioterrorism germs like plague � as well as certain hospital-spread bacteria that cause such problems as pneumonia in the already seriously ill.

So-called broad-spectrum antibiotics that can kill more than one kind of bacteria aren't unusual � this one just targets some hard-to-treat types in a new way.

The next step: Scientists are beginning to create the first broad-spectrum antivirals, medicines that would treat more than one kind of virus. Rather than having an anti-flu drug and a separate anti-AIDS drug, the goal is to have a single injection that could treat those viruses plus the gruesome Ebola virus and a few more for good measure.

It's early work, still years away, cautions Dr. Michael Kurilla, biodefense research chief at the National Institute of Allergy and Infectious Diseases. But one of the antivirals is a direct result of biodefense research to understand how viruses infect � specifically, the Nipah virus that was the model for the even-scarier fictional bug in the new movie "Contagion."

And these multipurpose antivirals are a huge goal because if they pan out, the next time a brand-new virus emerges � like the respiratory SARS bug in 2003 � treatments might not have to be started from scratch.

"We feel very excited and confident that what we're working on ... can change the whole paradigm of how we approach infectious diseases," Kurilla says.

The U.S. has invested $67 billion in biosecurity since 2001, according to research by the Center for Biosecurity at the University of Pittsburgh Medical Center.

Most of that wasn't solely for biodefense but went to broader health programs that are as crucial for dealing with natural crises � like the 2009 swine flu global epidemic � as for dealing with manmade ones, says center director Dr. Thomas Inglesby. These include scientific research, beefing up struggling public health departments to better detect and treat emerging outbreaks, and training hospitals in disaster preparedness.

Inglesby worries that the economic crisis imperils those gains � public health funding already has been cut � and will further slow the countermeasure hunt. A program named BioShield that buys countermeasures for the stockpile expires in 2013 unless Congress reauthorizes it. It's time, he says, for the government to spell out its countermeasure priorities and how to reach them.

Meanwhile, what if another anthrax attack happened? No more scrambling to buy antibiotics: 60 million 60-day treatment courses are stockpiled, Robinson says, and the plan is for the post office to get the first doses to people's homes.

Sometimes antibiotics aren't enough. In a severe infection, the germs can produce dangerous toxins that spread in the bloodstream. So also in the stockpile are two experimental toxin-clearing treatments, to be used if the immune system alone can't battle the toxin.

In August, Minnesota's sick tourist became the 19th person in the world ever treated with one of them � immune globulin culled from the blood of anthrax-vaccinated soldiers, says Dr. Mark Sprenkle of Hennepin County Medical Center. It's hard to know how much the drug contributed to the man's recovery, Sprenkle says, but his patient's toxin levels did drop more quickly after he began using it.

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EDITOR'S NOTE � Lauran Neergaard covers health and medical issues for The Associated Press.

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Do hospitals' freebies undermine breast-feeding? (AP)

CHICAGO � Jessica Ewald brought more than a new baby boy home when she gave birth earlier this year. Like many new moms, she got a hospital goody bag, with supplies including free infant formula and formula coupons.

"We gave it away the moment we came home because I said I'm not having that in our house," Ewald said.

Ewald, 32, of Oakbrook Terrace, Ill., is the daughter of a breast-feeding activist who fought to get those goody bags out of hospitals. Ewald was taught early on that "breast is best," and even though as a teen she rolled her eyes when her mom asked pregnant women about nursing, Ewald knew she'd choose breast over bottle when her own time came.

Borrowing a line from a blogger, Ewald says hospitals sending newborns home with formula "is like giving somebody divorce papers at their wedding." It can really undermine a woman's determination to breast-feed, she said.

The head of the federal Centers for Disease Control and Prevention shares her concern.

"Hospitals need to greatly improve practices to support mothers who want to breast-feed," Dr. Thomas Frieden said last month in releasing a CDC report card on breast-feeding. It showed that less than 5 percent of U.S. infants are born in "baby-friendly" hospitals that fully support breast-feeding, and that 1 in 4 infants receive formula within hours of birth.

Routinely offering new moms free formula is among practices the CDC would like to end. In some cases, hospitals agree to give out those freebies in exchange for getting free supplies for special-needs infants, Frieden said.

Exactly how many U.S. hospitals hand out formula is unclear. The American Hospital Association and the International Formula Council, a trade group for formula makers, do not keep statistics and formula companies contacted for this story declined to comment.

A nationwide study of more than 3,000 U.S. hospitals and maternity centers published last year in the Journal of Human Lactation found that 91 percent sent new moms home with free formula in 2006-07. A smaller 2010 study of 1,239 hospitals suggests that the practice has decreased, although most � 72 percent � still offered formula. That study is being released Monday in October's Pediatrics.

"I don't think hospitals are the right place to market anything and I don't think hospitals should be marketing a product that is nutritionally inferior to breast milk," said study author Anne Merewood, an associate pediatrics professor at Boston University medical school and editor of the Journal of Human Lactation.

"People do think if a doctor gives something it must be good for you," Merewood said.

Some women and activists, though, say the move to end formula freebies is part of a breast-feeding movement that has gone too far, overstating the benefits and guilt-tripping new moms who have difficulty nursing or just choose not to. And even some breast-feeding moms don't have a problem with the free formula.

"I think it's fine to offer freebies to any mom, especially those who are undecided or have already made up their mind not to breast-feed. We are always free to refuse," said the Rev. Camille Lebron Powell, an associate Presbyterian pastor in Little Rock, Ark.

Breast milk contains antibodies that strengthen babies' immune systems and help them fight infections. Research has shown that breast-fed babies have reduced chances of becoming obese or developing diabetes in childhood, and sudden infant death syndrome is less common in breast-fed infants.

The American Academy of Pediatrics and other medical groups recommend that infants receive only breast milk for their first six months. The new CDC report shows that only 15 percent of new mothers achieve that goal, and only 44 percent of new moms breast-feed at all for six months.

Lebron Powell doesn't dispute the benefits and chose to breast-feed her children, aged 9 months and 4 years old. But she says those who choose to use formula shouldn't be demonized.

"Breast-feeding is free. It's good for the baby and it's good for the mom. But it's hard and if you work and the employer doesn't support your pumping needs, you are in trouble," she said.

Hospitals have been offering formula freebies for decades, but they have a new incentive to abandon the practice.

The Joint Commission hospital accrediting group last year added "exclusive breast milk feeding" during newborns' hospital stays as a measure that hospitals can be evaluated on. While formula giveaways won't be evaluated, the commission mentions monitoring that practice when it educates hospitals on how to improve their performance, said Celeste Milton, an associate project director at the commission.

The goal is to discourage hospitals from giving infants formula when it's not medically necessary, said commission spokeswoman Elizabeth Zhani.

Central DuPage Hospital in Winfield, Ill., the suburban Chicago hospital where Ewald had her baby last March, boasts that 93 percent of its new mothers are breast-feeding when they're sent home. It also supplies lactation consultants to new moms � a service Ewald said she appreciated. But Ewald said she got a mixed message about breast-feeding, because nurses there wanted to give her baby formula to help him gain weight, and because of those free samples in her goody bag.

Hospital spokeswoman Amy Jo Steinbruecker said the gift bags contain "literature and samples of common items newborns may need, including a small sample of formula," and are meant to support healthy parenting and baby care.

But she said the hospital is examining the formula freebies as it seeks to be designated "baby-friendly."

The World Health Organization and the United Nations Children's Fund established that designation to encourage breast-feeding, with 10 criteria hospitals must meet. These include allowing new moms and infants to remain together throughout the hospital stay and not giving newborns any pacifiers or formula.

Jennifer Smoter, a spokeswoman for Abbott Nutrition, makers of Similac formula, declined to disclose how many hospitals Abbott provides with formula samples and would not comment on the practice. Representatives of Mead Johnson, makers of Enfamil formula, did not respond to several email and telephone requests for comment.

Haley Stevens, a scientific affairs specialist for the International Formula Council trade group, said not offering new moms formula samples "is really irresponsible."

New moms should have formula available, along with information on how to use it so they don't water it down or make other mistakes that could endanger their babies' health, Stevens said.

"We agree breast-feeding is the best, when you can do it," she said. "There's no question. But if one size doesn't fit all, it's good to have a backup."

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Online:

CDC breast-feeding report: http://www.cdc.gov/breastfeeding/data/reportcard.htm

American Academy of Pediatrics: http://www.aap.org

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AP Medical Writer Lindsey Tanner can be reached at www.twitter.com/LindseyTanner

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