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Am Fam Physician. 2003;68(3):413

Inherited mutations in the melanocortin 4 receptor (MC4R) gene result in a distinct obesity syndrome, according to a study published in the New England Journal of Medicine. MC4R gene mutations were found in 29 (5.8 percent) of 500 adults with severe early-onset obesity; 23 of the adults were heterozygous, and six were homozygous for the mutations. Adults with the MC4R mutations had hyperphagia, severe obesity, increased lean mass, and severe hyperinsulinemia. A less severe phenotype was found in those who had mutations with residual signaling capacity.

Antimicrobial clothes? Just wait, they may be on the way. According to New Scientist, researchers have developed tiny molecular “daggers” that may be used to make microbe-killing clothes. The daggers, which are attached to fabric fibers in a solution, cut the fatty membranes of bacteria and fungal spores; the charged ends of the daggers then disrupt delicate bonds within the pathogens. In early tests, culinary yeast and Candida have been destroyed. Eventually, the technology could be tailored to create antifungal socks, and even military uniforms that destroy anthrax.

A diet rich in calcium may prevent obesity. As reported in Time, a study found that girls who had more calcium in their diets weighed less and had less abdominal fat than other girls. Researchers studied the diets of 321 girls (ages: nine to 14 years) Dairy foods or a combination of calcium-rich foods and supplements had similar effects. Consumption of one serving of dairy products a day, such as one cup of milk or one small piece of cheese, was associated with 2 lb less weight. The findings of the study were presented at a meeting of the American Society for Nutritional Sciences.

Should pregnant women cut back on coffee? According to a prospective follow-up study published in BMJ, drinking large quantities of coffee during pregnancy increases the risk of stillbirth. A review of 18,478 deliveries found that women who drank four to seven cups of coffee a day had an 80 percent increased risk of stillbirth compared with women who drank no coffee. The risk of stillbirth was increased to 300 percent in women who drank eight or more cups of coffee a day. Caffeine, which increases the release of catecholamines from the renal medulla, may lead to vasoconstriction in the uteroplacental circulation and fetal hypoxia. It also may affect the fetal cardiovascular system. No significant association was found between coffee consumption and infant death in the first year of life.

Sleep problems may make it more difficult for older persons to cope with chronic medical conditions, according to a telephone survey conducted for the National Sleep Foundation (NSF). The survey of 1,506 adults (55 to 84 years of age) found that the majority of persons with chronic medical conditions also had sleep problems. Of those persons surveyed who had four or more medical conditions, 80 percent said they had trouble sleeping compared with 53 percent of those reporting no medical problems. The NSF notes that sleep problems currently are diagnosed and treated in only a small fraction of older adults.

A healthy employee would be a happy one. A study commissioned by the American Association of Occupational Health Nurses Inc. found that more than one half of 500 employees would stay in their current job if their employer provided a health and wellness program. Work stress was the top health concern cited by the survey respondents.

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