Govt proposes clearer labeling of meat additives (AP)

WASHINGTON � The Agriculture Department wants consumers to know when there's less chicken in their chicken.

A proposed rule aimed at food companies would require that poultry and other raw meats be labeled appropriately when they're plumped up by added solutions such as chicken broth, teriyaki sauce, salt or water. The practice of adding those ingredients is common, but many consumers don't know about it.

According to USDA, about one-third of poultry, 10 percent of beef and 90 percent of pork may have added ingredients � about 40 percent of all raw, whole cuts of meat. The rule does not apply to ground beef, which may have other added substances.

"Consumers should be able to make an informed choice in the store, which is why we need to provide clear, informative labels that will help consumers make the best decisions about feeding their families," said Elisabeth Hagen, head of food safety at the department. "It has become evident that some raw meat and poultry labels, even those that follow our current guidelines, may not be clear."

Labels now say that the meat contains added solutions or is "enhanced," but they may not be visible to consumers or understandable. If the rules are finalized, the label would now have to be part of the product title. An example of the new labels would be "chicken breast � 40% added solution of water and teriyaki sauce," according to USDA.

Richard Lobb of the National Chicken Council says the poultry industry is split on the issue, as some companies add ingredients to their poultry and some don't. He said the level of added ingredients in poultry is generally 15 to 18 percent of the piece of meat.

Red meat processors immediately objected to the rule. The American Meat Institute called it "wasteful" and "unnecessary" and said it would cause prices to go up for consumers.

Consumer groups have been pressuring the department to crack down on the practice for several years, saying the added ingredients are unhealthy.

"Who wants to pay $4.99 a pound for the added water and salt?" said Michael Jacobson, executive director of the advocacy group Center for Science in the Public Interest. "Besides cheating customers financially, `enhancing' meat and poultry delivers a stealth hit of sodium."

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Alzheimer's debate: Test if you can't treat it? (AP)

PARIS � Picture yourself in Barbara Lesher's shoes: 54 years old and fearing you are developing Alzheimer's disease.

"I don't remember if I had a bath," said Lesher, who lives north of Harrisburg, Pa. "It took me two hours to follow a recipe. I drove to my childhood homestead the other week instead of my own home. It's really scary."

Doctors are arguing about whether to test patients for signs of the incurable disease and tell them the results.

The debate raged this past week at the Alzheimer's Association International Conference in France, where research on new methods � easier brain scans, an eye test, a blood test � made it clear there soon may be more such tools available.

Here's why it's an issue: Many people have brain plaques, suggesting they might be developing Alzheimer's even if they don't have any symptoms. This plaque can be seen decades beforehand and does not ensure someone will get the disease. Many also won't live long enough to develop symptoms.

For those who do have Alzheimer's, there are no good treatments. Current drugs ease symptoms � they work for half who try them and for less than a year on average. Most experts think treatment starts too late, but there's no evidence that starting sooner or learning you have brain plaque will help. Experts are divided.

"We have to look for patients or signatures of the disease at earlier stages," urged Dr. Harald Hampel of the University of Frankfurt, Germany.

But Dr. Kenneth Rockwood of Dalhousie University in Halifax, Nova Scotia, Canada, says there is no data "to show that knowing makes any difference in outcomes. Until we do, this is going to be a tough sell."

More than 35 million people worldwide have Alzheimer's, the most common form of dementia. In the U.S., more than 5 million do � 13 percent of those 65 and over, and 43 percent of those 85 and up, a rapidly growing group.

Still, half of people who meet medical criteria for dementia have not been diagnosed with it, the Alzheimer's Association estimates. And many who are told they have Alzheimer's or are assumed to have it really don't.

Even when researchers use the best cognitive tests to enroll people in clinical trials, about 10 percent ultimately are discovered not to have the disease, said William Thies, the Alzheimer's Association's scientific director.

"The Alzheimer's drugs don't work in these folks, so there's no reason to expose them to those risks," said Thies, long an advocate of early diagnosis.

Misdiagnosis is a lost opportunity to help. A new medication or combination of medications may suddenly make someone appear demented. Brain fog can occur after surgery and abate over time. Sleep problems are common in older people and can cause profound confusion that can be misinterpreted as dementia, according to research presented at the conference by Dr. Kristine Yaffe of the University of California, San Francisco.

"Some of these are treatable" by avoiding naps during the day or treating sleep apnea, in which brief interruptions of breathing cause people to wake during the night, Yaffe said. Snoring is a big sign. Older people with sleep problems are more likely to be put in nursing homes, she said.

Dr. R. Scott Turner, director of the memory disorders program at Georgetown University Medical Center, has seen that all too often.

"I'm certainly in the camp that screening should be done," he said. Many patients are simply declared to have dementia without testing to see if they have another condition.

"Sometimes it's thyroid disease, or depression, or vitamin B-12 deficiency � something that's very treatable," he said.

Testing someone with symptoms is far less controversial than testing people with no symptoms but a lot of fear. Doctors worry that these newer methods, such as an easier type of brain scan that's expected to be available within months, will be directly marketed to the public, prompting expensive and excessive testing based on fear.

"The phrase you often hear is that the 'Big A' (Alzheimer's) has replaced the 'Big C' (cancer)" as a major source of fear, said Dr. Jason Karlawish, a University of Pennsylvania ethicist specializing in dementia issues.

Recent guidelines by the U.S. National Institute on Aging and the Alzheimer's Association say these tests should be used only in research until they have been standardized and validated as useful and accurate tools.

A researcher using one of these tests, such as a spinal fluid check for a substance that may predict Alzheimer's risk, has no obligation to disclose the results to a patient until there is a meaningful treatment for the disease, Karlawish argued at the conference.

The more symptoms a patient has, the more justified it is to help understand what is known about possible reasons, he said.

Lynda Hogg of Edinburgh, Scotland, is very glad her doctors diagnosed her Alzheimer's in 2006. She is doing exceptionally well on one of the existing drugs and is in a clinical trial for an experimental one she hopes will help her and help advance knowledge in the field.

At a discussion connected with the conference, she said the early diagnosis helped her get financial and legal matters in order and serve on the Scottish Dementia Working Group and the board of Alzheimer's Disease International.

"I am certain involvement keeps me focused and involved in society," she said.

The Alzheimer's Association says early diagnosis and evaluation can bring the following benefits:

� Treatment of reversible causes of impairment.

� Access to drugs that help treat symptoms.

� Inclusion in clinical trials that give expert care.

� Avoiding drugs that can worsen cognition.

� Letting others know of a need for help managing medicines and daily life.

� Easing anxiety about the cause of symptoms.

� Access to education, training and support services.

� The ability to plan for the future.

Lesher, the woman from Pennsylvania, wishes she had a clearer picture of what lies ahead for her.

"Not being able to get diagnosed is the must frustrating thing in the world," she said.

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Online:

National Institute on Aging: http://www.nia.nih.gov/Alzheimers

Alzheimer's Association: http://www.alz.org

National Alzheimer's Plan: http://bit.ly/fFWWCT

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

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Lack of sperm coating plays role in infertility (AP)

WASHINGTON � Scientists have found a new contributor to male infertility, a protein that's supposed to coat sperm to help them swim to an egg, unless that coating goes missing.

About 20 percent of men may harbor gene mutations that leave their sperm coat-free and thus lower their fertility, an international research team reported Wednesday.

Today's reproductive tests can't spot the problem, said study co-author Dr. Theodore Tollner of the University of California, Davis.

"You would have no reason to think many of these men with the genetic mutation would have reduced sperm function," he said.

Anywhere from 10 percent to 15 percent of couples experience infertility, and doctors can't always find the cause. A lack of sperm or problems with their shape or ability to move explains only a fraction of infertility.

The California-led team found a new reason, a protein that's part of a family of germ-killing molecules found on the surfaces of a variety of tissues. It's secreted as sperm journey into the female reproductive tract, helping the sperm to penetrate the mucus in a woman's cervix and to avoid being tagged as an invader by her immune system.

Having two copies of a particular gene mutation means sperm cannot produce that coating. Lab tests show those sperm have a hard time making it through the mucus.

But how much does that affect fertility?

The researchers tracked 500 newly married Chinese couples attempting to conceive. The birth rate was 30 percent lower among couples with a husband who harbored that double mutation, scientists reported in the journal Science Translational Medicine.

Having just one copy of the mutated gene doesn't seem to hinder conception.

The coatless sperm don't always fail, so it's not clear just how much this issue contributes to male infertility overall.

But creating a test to diagnose these men would be easy, the researchers said. Such a test potentially would lessen the time that a couple having problems conceiving spends in limbo before trying treatments such as having sperm placed directly into the woman's uterus.

One day, a vaginal gel might even let sperm pick up the protein coating as it travels into the cervix. The California researchers say they're already trying that with animals.

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CDC: Frogs tied to salmonella being sold again (AP)

ATLANTA � A California company has resumed selling a kind of pet frog that caused salmonella illnesses in more than 240 people, most of them children. And federal health officials are not happy.

Centers for Disease Control and Prevention officials on Wednesday warned consumers that Blue Lobster Farms in June had resumed shipping African dwarf frogs from its Madera County, California, breeding facility. They say the frogs may still pose a serious health risk.

The company voluntarily stopped shipping the frogs in April, after an investigation fingered them as the source of a salmonella outbreak that sickened people nationwide over two years. No one died, but many illnesses were in children under 5 years old � some hospitalized.

Company officials could not be reached for comment.

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http://www.cdc.gov/salmonella/water-frogs-0411/

http://www.cdc.gov/media/matte/2011/05_waterfrogs.pdf

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Progress is seen on a blood test for Alzheimer's (AP)

PARIS � Scientists are closing in on a long-sought goal: A blood test to screen people for Alzheimer's disease.

An experimental test did a good job of indicating how much of the telltale Alzheimer's plaque lurks in people's brains, Australian researchers reported Wednesday. If the test proves accurate in larger studies, it could offer a way to check people having memory problems to see who needs more definitive testing for the disease.

Many blood tests are being developed and a few are used in research settings now, but only the Australian one has been validated against brain scans and other accepted diagnostic tests with good accuracy in large groups of people, said Maria Carrillo, senior director of medical and scientific relations for the Alzheimer's Association.

The results, reported Wednesday at the Alzheimer's Association International Conference in France, "give us hope that we may be able to use a blood test in the near future," although that doesn't mean next year, she said.

More than 5.4 million Americans and 35 million people worldwide have Alzheimer's, the most common form of dementia. It has no cure and drugs only temporarily ease symptoms. Finding it early allows patients and their families to prepare, and ruling it out could lead to diagnosing a more treatable cause of symptoms, such as sleep problems.

Brain scans can show signs of Alzheimer's � sticky clumps of a protein called beta amyloid � a decade or more before it causes memory and thinking problems, but scans are too expensive and impractical for routine use. Doctors and patients need simple ways to screen people for the disease.

Samantha Burnham and others at Australia's national science agency, CSIRO, working with several universities, used a long-running study of more than 1,100 people � some healthy, some impaired � to develop the blood test.

They started with blood samples from 273 study participants and identified nine hormones and proteins that seemed most predictive of amyloid levels in the brain. A cutoff level was set for what was considered high.

"The belief is that people above that point will go on to get Alzheimer's disease, and the lag is about 8 to 10 years," Burnham explained.

When researchers used the nine-marker blood test on these same participants, they found that it separated healthy people from those with mild cognitive impairment or Alzheimer's as verified by their brain scans. The test correctly identified 83 percent of people with high amyloid levels and correctly ruled out 85 percent of people without this condition.

"That's pretty high," the Alzheimer's Association's Carrillo said of the test's accuracy.

More importantly, she said, the Australian researchers validated the test's accuracy in two additional groups: the other 817 folks in the Australian study and 74 people in a big U.S.-led study aimed at finding novel Alzheimer's disease biomarkers.

The test performed well in those situations, too, Burnham said.

CSIRO has patented the test and is talking with major companies about making it commercially available.

"It sounds like the Australians do have good clinical data" and that the markers they are testing for track with cases of the disease, said Creighton Phelps, a neuroscientist with the U.S. National Institute on Aging.

The next step is wider validation work and ensuring it can be standardized to give reliable results regardless of what lab or doctor would use it, he said.

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Online:

National Institute on Aging: http://www.nia.nih.gov/Alzheimers

Alzheimer's Association: http://www.alz.org

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

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Over 65 and not worried about heat? You should be (AP)

CHICAGO � This week's heat wave may be uncomfortable, but you're healthy, active and feel just fine. So what if you're over 65? Think again. Feeling good doesn't mean you're safe.

There are changes in an older person that raise the risk for heat stroke and other problems. An older body contains far less water than a younger one. Older brains can't sense temperature changes as well, and they don't recognize thirst as easily.

Blistering summer heat is an underappreciated killer, claiming by some estimates as many as 1,000 U.S. lives each year � more than any other type of weather.

One federal study found 40 percent of heat-related deaths were in people 65 and older. Those numbers could be lower if more heeded heat warnings aimed at seniors. Yet research has shown many people over 65 don't think the warnings apply to them � because they don't think they're "old."

Don Worden is 79 and an avid tennis buff who prefers playing doubles on outdoor courts along Chicago's lakefront � even in oppressive 90-degree temperatures like those hitting the Midwest this week.

"I don't pay too much attention to those" warnings, Worden said. "I stay in pretty good shape, and I don't feel they apply to me."

Worden said he drinks a lot of water and would stop a match if he started feeling effects from the heat, "but that hasn't happened."

Scott Sheridan, who studies the effects of heat and climate on health at Kent State University, researched how people over 65 view heat warnings. In his 2006 study of more than 900 people, he found about 70 percent knew about advice to drink plenty of water on very hot days, avoid outdoor activities and stay inside with air conditioning. But only about half said they followed the advice.

"People well into their 70s would say old people should watch out but not them," he said. "People just didn't want to be thought of in that same category."

Dr. David Zich, an emergency medicine specialist at Northwestern Memorial Hospital, said he has colleagues in medicine that age who shun being thought of as "elderly." But those heat warnings apply to them, too.

As Dr. William Dale, geriatrics chief at the University of Chicago Medical Center explains it, "Any older adult has less reserve and is more likely to become dehydrated than others, just because their overall body water goes down with age no matter how healthy you are."

The amount of water in the body declines with aging, from about 80 percent in young adulthood to about 55 to 60 percent for people in their 80s, Dale said.

Temperature sensors in the brain become less sensitive as people age, so the body doesn't get the same signals to drink water in hot weather, and older people often don't feel thirsty even when they need to replenish, Dale said.

They also may not feel the typical symptoms of dehydration, such as headache or dizziness. Some complain of just feeling "bad" and think they're getting sick, he said.

Conditions were ripe for those types of complaints Tuesday as a dense dome of hot air remained parked over much of the nation's midsection, raising temperatures into the mid- to upper-90s from the Texas Gulf Coast to the Rockies and the northern Plains. Tropical-level humidity raised the heat index in many places to nearly 120 degrees.

In South Dakota, up to 1,500 head of cattle died across the state from the heat. And in eastern Iowa, the scorching sun caused a portion of Interstate 380 to buckle. The weather also sent dozens of people to hospitals, canceled outdoor sporting events and caused sporadic power outages.

In such conditions, dehydration can lead to heat exhaustion and potentially deadly heat stroke. During a heat wave, that can happen in a matter of hours in older people if they over-exert themselves, don't drink enough water or are frail and don't get out of uncooled homes, said Dr. Chris Carpenter, an emergency medicine physician at Washington University School of Medicine in St. Louis.

Heat exhaustion can cause muscle cramps, low blood pressure, rapid pulse and nausea. It can be treated at home, by drinking water, getting into an air-conditioned room or sitting in front of a fan and misting the body with cool water.

But affected people should be monitored for mental changes and to make sure their temperature does not rise above 102 because the condition can quickly lead to heat stroke. A medical emergency, heat stroke involves temperatures of 104 or higher and can cause seizures, loss of consciousness and death.

Medicines many older people take also may make them more vulnerable to the heat. These include diuretics for high blood pressure, which increase urination � and make it more important to drink plenty of water, Dale said.

Some types of drugs can interfere with sweating and raise body temperature, including some medicines for insomnia, nausea, prostate conditions, Parkinson's disease and even Benadryl. Many list "dry mouth" as a side effect � a tip-off to drink more water, Zich said.

There aren't specific guidelines on how much water older people should drink in a heat wave.

Dale said he generally tells his older patients to drink a quart of water throughout the day, and to drink even if they don't feel thirsty.

Doctors also advise older patients to avoid alcohol and coffee during extreme heat because they can cause the body to lose fluid and contribute to dehydration.

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Online:

Centers for Disease Control and Prevention: http://emergency.cdc.gov/disasters/extremeheat/elderlyheat.asp

American Geriatrics Society: http://www.healthinaging.org/public_education/hot_weather_tips.php

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

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