A mother’s war on germs at fast-food playlands

'There are very high (pathogen) counts, and that means these places are not cleaned properly or not cleaned at all,' scientist says

One of those who kicked off her shoes and slithered her way through the multihued plastic tubes of a fast-food restaurant playground here one recent morning was not enjoying herself in the least. In fact, she had a frown on her face.

“It’s bad,” Erin M. Carr-Jordan said, swab in hand, as she collected samples from a surface that she would later deliver to a lab for microbial testing. Nearby, a restaurant worker diligently sanitized tabletops and banisters outside the play area, but he did not appear to use his rag and spray bottle inside the children’s maze.

Dr. Carr-Jordan, a child development professor and a mother of four from Chandler, Ariz., has visited dozens of restaurant playgrounds in 11 states in recent months to test them for cleanliness. What the inspections and lab analyses have revealed is the widespread presence of an array of pathogens, from coliform bacteria to staphylococcus, at levels that experts said indicated that restaurants might not be disinfecting their playlands as diligently as they should.

Those same experts pointed out that germs are everywhere and that they are not always dangerous. They add that hand washing is an important safeguard.

“I’m not shocked or blown out of the water, because this is my business,” said Philip M. Tierno Jr., director of clinical microbiology and immunology at NYU Langone Medical Center in New York, who surveyed some of Dr. Carr-Jordan’s results. At the same time, Dr. Tierno said, “There are very high counts, and that means these places are not cleaned properly or not cleaned at all.”

'Gross and sticky'
Dr. Carr-Jordan’s campaign, which has attracted the attention of the fast-food industry, began in April when she stopped at a McDonald’s near her Phoenix-area home because one of her sons needed to go to the bathroom. On the way out, her children asked if they could play in the children’s park, which McDonald’s calls a PlayPlace. She assented and accompanied her children inside.

What she saw was alarming.

“My kids were going, ‘Yuck!’ ” she recalled of the scene, which she videotaped with her cellphone and posted on YouTube. “It was gross and sticky. There were curse words and gang graffiti. The windows were black. There was matted hair and an abandoned Band-Aid.”

Despite complaints to the manager and several follow-up visits, the play area was not cleaned, she said. So Dr. Carr-Jordan, who has a Ph.D. in developmental psychology but is no expert in microbiology, had samples tested. When the results were analyzed by Legend Technical Services Inc., an environmental testing company, they indicated the presence of potentially harmful bacteria, and she began inspecting and testing the playgrounds at other fast-food restaurants in her neighborhood. Lab results — she has since switched to another commercial lab — showed that most were far from clean, she said.

Intent on showing that the problem was not an isolated matter, she has been mixing family vacations with her play area inspections. From New York to California, she has squeezed herself into the playgrounds at Burger King, Chuck E. Cheese’s, Peter Piper Pizza and numerous other restaurants.

Playtime, a Colorado company that supplies play equipment to McDonald’s and other restaurants, recommends on its Web site that restaurant operators regularly clean and inspect their equipment to keep a check on “smudges, ink, goo.” The restaurants say they have policies in place that require the regular cleaning of their play areas. Danya Proud, a McDonald’s spokeswoman, said the company had stringent sanitizing procedures but had nonetheless assigned a team to review those procedures in light of Dr. Carr-Jordan’s complaints.

“We’re human, and we make mistakes,” Ms. Proud said, indicating that McDonald’s considers cleanliness a priority.

Still, Dr. Carr-Jordan said that of the nearly 50 play areas she had tested, only one had come back essentially free of pathogens, and that was at a Chick-fil-A restaurant not far from her home. That is now the only restaurant play area she permits her children to visit.

To draw attention to the issue and push for legislation mandating stricter standards for play areas, Dr. Carr-Jordan, who teaches at Arizona State University and several other institutions, has formed a nonprofit group called Kids Play Safe. Her calls to health officials, from local health departments to the Centers for Disease Control and Prevention, have failed to prompt any crackdown, she said.

A C.D.C. spokeswoman, Bernadette Burden, said the federal agency would get involved only if called in by state officials concerned about a major disease breakout. In Maricopa County, which includes Phoenix, the Environmental Services Department considers play areas nonfood areas, and thus less of a priority during inspections than other parts of restaurants, said Johnny Diloné, a spokesman.

So Dr. Carr-Jordan, fast-food vigilante, continues to climb into tubes, wriggle through tunnels and slide down slides. After emerging from one play area she inspected in Arizona last week, she shook her head. “No one would want their child playing in there,” she said, “and that one wasn’t the worst.”

Recent studies show that old-school relationship edicts just don't cut it nowadays

We live in a world of constant upgrades, but for some reason, many couples are still following the 1.0 version of love advice. Time to click refresh. "Playing by specific rules can make you less likely to pay attention to your own inner voice and experiences," says Bethany Marshall, Ph.D., author of "Deal Breakers: When to Work on a Relationship and When to Walk Away. Start with these modern guidelines."

RULED OUT:  Shacking up is bad for a relationship.

The old why-buy-the-cow adage can officially be put out to pasture. According to the most recent findings from the National Center for Health Statistics, a cohabiting couple has the same chances at a happy marriage as a pair who don't share an address before tying the knot. "Couples just need to be honest about why they're deciding to move in together," says Bill Cloke, Ph.D., author of Happy Together: Creating a Lifetime of Connection, Commitment, and Intimacy. "Is it a test run to see if the relationship is a good fit, with the option to bail if it isn't? That's a failing proposition from the get-go."

Nor should you and your guy shack up to save money or because a roommate has moved out. The grown-up way to play house: Make an emotional commitment first. Discuss your future together to make sure this move is a stepping-stone and not some sort of temporary or circumstantial solution, says Cloke.

RULED OUT:  A no-strings shag can never turn into something meaningful.

Mr. Tonight could very well become Mr. Right: A recent study from the University of Iowa suggests that casual sex sometimes evolves into a committed relationship.

a significant percentage of current relationships began with nonromantic sex," says study author Anthony Paik, Ph.D., an assistant professor of sociology. The reason? Casual sex has lost its taboo. "People now view hooking up as a predictable, normal part of life and don't let it contaminate or poison the beginning of a relationship," explains Marshall.

How do you boost the odds that your fling will turn into something more serious? Reset the pace. Despite how intimate your first date was, resist the temptation to see him every day and sleep over every time you hang out. "It takes time for a relationship to become real, and if you see him constantly and keep it all about sex, you will create only a false sense of closeness," says Marshall. Learning how to be together as a couple--both inside the bedroom and out--is one of the most important building blocks of a healthy union.
RULED OUT:   Sex needs to be spontaneous to be hot.

"Spontaneous sex is a myth," says Laurie Mintz, Ph.D., author of A Tired Woman's Guide to Passionate Sex: Reclaim Your Desire and Reignite Your Relationship. Most of the steamiest sheet twisting you've done over the course of your relationship was planned, anticipated, and orchestrated. Did you and your guy flirt your way through a romantic meal? Did you put on your sexiest lingerie one morning in anticipation of what might happen that night? Guess what? You scheduled that sex.

And planning becomes even more essential the deeper you get into a relationship.

"When couples no longer have the orchestrated passion of dates, it becomes critically important to stop waiting for sex to just catch you unaware," says Mintz. "You have to start consciously carving out time for it." The good news is that penciled-in passion has the potential to be even steamier than a spontaneous romp: The anticipation and preparation for it can actually function as all-day foreplay, building tension that heightens the encounter when you and your guy finally rendezvous.

RULED OUT: Never go to bed angry.

It's a widely held belief that if you don't troubleshoot a tiff immediately, the unresolved conflict will fester overnight.

The truth is, most couples don't see eye to eye when they're angry, so the chances of successfully resolving a dispute when you still have smoke coming out of your ears is slim. The answer: Sleep on it, but commit to work it out in the light of day. "When you hold on to anger for a reasonable amount of time before expressing it, you have time to process your feelings and gain mastery over them," says Marshall.

Plus, your brain actually needs Z's to prep you to patch things up: Lack of sleep impairs judgment, decreases concentration and problem-solving ability, and changes the balance of neurotransmitters in the brain that are in charge of regulating mood, which is why sleep-deprived people have a shorter fuse, says Mintz. Just make sure, however, that you're biding your anger in order to process it and not to wall yourself off from the problem or your relationship.

RULED OUT:   Don't talk about money matters unless you're married.

It's no surprise that people try to avoid conversations about cash — experts say money is one of the top three hot-button issues for couples. But it's important to find out if you're on the same page financially before you get hitched. "If you are a committed couple and you don't talk (or fight, albeit respectfully) about money issues while you're dating, there will be a 'flight' at some point — a potential splitting-up over these issues," says Cloke.

There's no need to bring up your 401(k) on the first date, but you should definitely disclose whatever financial baggage you're bringing into the relationship before things get serious. Whether you're saddled with serious student loans or you regularly change your phone number to avoid the good folks at MasterCard, come clean--and encourage your guy to do the same. "Bring up money issues from the perspective of 'no secrets' and 'we are in this together,' so there won't be any surprises down the road," says Cloke.

And it's important to figure out if you and your partner have the same money style.

"Ask yourselves whether you share similar values, goals, and interests about how you spend, save, and invest money," says Cloke. Even if you're not drawing cash from the same bank account, you and your guy should try to sync up your spending habits and make a budget you can stick to. (It's also important to be honest with each other when you don't.) How you spend and save as a couple will affect not only your daily lifestyle but also the plans you're able to make for the future.

Porn star's false-positive HIV test raises questions

Adult film shoots came to a stop — until it turned out the test was wrong

The porn film star who tested HIV-positive last week and shut down Los Angeles’ billion-dollar industry, does not have the virus, an advocacy group for the adult entertainment industry announced.

Diane Duke, a spokesperson for the Free Speech Coalition in Los Angeles, told the Associated Press the group is investigating how the porn star falsely tested positive for the virus, and said the industry would resume film production.

While the issue raised questions in the adult film industry, which requires its members to take HIV tests every 30 days, Ged Kenslea, communication director for the AIDS Healthcare Foundation, says the chance of a false positive is rare.

“The public at large doesn’t need to start getting two HIV tests,” he says. “We conduct 40,000 tests each year in California, Florida and Washington, D.C., and of those 40,000 tests we have probably 30 false positives.”

False positives can occasionally occur if the counselor contaminates a sample in some way, something is wrong with the actual test or the person has another virus that throws the test, Kenslea adds.

Dr. Bernard Branson, medical epidemiologist with the Centers for Disease Control and Prevention, says based on 5 million blood donors, the chance of a false positive is about 1 in 250,000. If someone tests positive, the person should be automatically retested, he says.

“While more people are being tested for HIV than ever before — half of Americans adults still have not been tested,” he says. “HIV testing saves lives.”

The Centers for Disease Control and Prevention estimates about 50,000 new HIV infections each year. In 2009, the latest year for which data is available, about 48,000 new HIV cases were reported. CDC recommends that adolescents and adults be tested for HIV as a routine part of healthcare and that people at high risk be tested more often than others.

Plant-rich diets tied to lower breast cancer risk

Women with diets rich in vegetables, fruit and legumes may have a somewhat decreased risk of developing one type of breast cancer, a new study suggests.

The findings, from a large, long-running study of U.S. nurses, showed that women with diets high in plant foods -- but low in red meat, sodium and processed carbohydrates -- tended to have a lower risk of developing certain breast tumors.

Specifically, they were less likely than other women to develop breast tumors that lack receptors for the hormone estrogen. Those estrogen receptor-negative tumors account for about one-quarter of breast cancers.

Of more than 86,000 women the study followed for 26 years, slightly less than one percent developed ER-negative breast cancer.

The risk, researchers found, was lower among women whose diets most closely resembled the Dietary Approaches to Stop Hypertension (DASH) diet -- an eating plan experts recommended for lowering blood pressure. It emphasizes vegetables, fruit, fiber-rich grains, legumes and nuts, and low-fat dairy.

The women who, at the outset, had the highest DASH "score" were 20 percent less likely to develop ER-negative breast cancer than those with the lowest DASH scores.

When the researchers took a closer look, it seemed to be high vegetable and fruit intake that mainly accounted for the link.

The results,do not prove that a plant-rich diet, itself, cuts breast cancer risk.

And in general, studies have come to mixed conclusions on whether diet habits are connected to breast cancer.

But recent research has been suggesting that the risk of ER-negative breast tumors, in particular, may be related to diet, explained Teresa T. Fung, an associate professor of nutrition at Simmons College in Boston and the lead researcher on the new study.

Why that might be is unclear. But in an interview, Fung speculated that with ER-positive breast tumors -- whose growth is fueled by estrogen -- the hormone's influence may be so important that it "overwhelms" potential dietary benefits.

But for now, that's a theory.

The bottom line for women, Fung said, is that the type of eating habits that are generally healthy anyway may also be associated with a lower risk of certain breast cancers. And vegetables may be especially key, the current findings hint.

Along with the DASH findings, the study also showed that women with diets high in vegetable protein -- from foods like beans, soy and nuts -- but low in refined carbs (like white bread and other starchy foods) had a 19 percent lower risk of ER-negative cancer, versus women with the opposite diet pattern.

Of course, Fung pointed out, "healthy behaviors don't occur in isolation."

But when the researchers accounted for factors like weight, exercise habits and smoking, the link between plant-rich diets and lower breast cancer risk still held.

Again, that doesn't prove cause and effect, Fung acknowledged. And the researchers could only look at the risk across large groups of women.

Exactly how much any one woman might benefit from eating more vegetables -- at least as far as breast cancer risk -- is unclear, according to Fung. In general, the average U.S. woman has about a 12 percent chance of developing breast cancer in her lifetime, with ER-positive tumors being most common.

Fung suggested that women who have less-than-ideal diets gradually introduce healthier fare to make the change seem less daunting. "Find one item you can work on," Fung said. "Maybe start by adding beans to your diet."

"Any improvement," she noted, "is better than no improvement."

The DASH diet recommends that the average woman should get four to five servings of vegetables and the same amount of fruit each day. It also recommends four to five servings of legumes, nuts and seeds per week.

Nutrient powder may fight anemia in kids

Kids given extra iron, zinc and vitamin A were one third less likely to be anemic, study finds

Sprinkling a vitamin- and mineral-packed powder onto young kids' food may help prevent anemia in countries where many people don't get enough iron, according to a new report.

Kids with the extra nutrients, including iron, zinc and vitamin A, were about 30 percent less likely to be anemic and 50 percent less likely to be iron deficient, researchers found.

Their work sums up data from past studies of anemia and iron deficiency in babies and toddlers who received the vitamin boost compared with those who didn't.

For other aspects of nutrition or kids' development, there's still not enough data to say if the supplements have an impact, according to the researchers

"Anemia and iron deficiency probably are the most widespread nutritional deficiencies in the world," said study author Luz Maria de Regil, from the World Health Organization in Geneva.

Half of all young kids are affected by an iron, zinc or vitamin A deficiency

most of them in poor countries. The studies that she and her colleagues reviewed all took place in Asia, Africa, and the Caribbean.

By the time babies are six months old, they are starting to run low on the iron reserves they were born with, researchers say.

The WHO recommends exclusive breastfeeding up to six months and continued breastfeeding until kids are at least two years old. During that in-between period, parents typically start to incorporate semi-solid food into babies' diets -- possibly offering an opportunity for the addition of extra sources of vitamins and minerals.

Health programs have relied on iron drops or syrups to prevent anemia in young kids, de Regil said. However, she added, "supplements can be perceived by the mom...as something like a drug. Micronutrient powders are sprinkled into the food so that they don't change the flavor -- (parents) think that they are improving the diet without giving a medication."

In addition, iron drops "really do taste awful," said Purnima Menon, from the International Food Policy Research Institute, based in New Delhi. "A really substantial advantage of this is you can feed it really easily."

De Regil and her colleagues found six studies that compared the nutrient powders to nothing extra or a nutrient-free placebo powder in kids between 2 and 23 months old. Of more than 3,000 youngsters, those who got the extra vitamins and minerals for a few months at a time, usually daily, were less likely to be anemic or iron deficient at the end of the fortification period.

In two studies that compared the nutrient powders with iron drops or syrups, the researchers found no difference in anemia rates, but cautioned against drawing too much from the less-robust findings.

And there wasn't enough data for them to say whether the extra nutrients, including iron and zinc, made any difference in kids' general health and well-being -- but previous studies have suggested the minerals are important for growth and brain development.

The researchers also couldn't definitively address the worry that giving kids in high-malaria areas extra iron may increase their risk of infection (the parasite needs iron to grow).

"There is a huge controversy," de Regil told

"A possible side effect of iron supplements given very frequently is to increase the risk of malaria in some places."

In 2008, malaria caused close to one million deaths, mostly in African kids, according to the WHO.

Regarding the nutrient powder, de Regil said that "it's still a concern, but we didn't find evidence that in (high-malaria) settings it doesn't work or it is harmful."

Based on the current findings, the WHO has updated its guidelines on nutrient supplementation in young children, which now state, "Home fortification of foods with multiple micronutrient powders is recommended to improve iron status and reduce anemia among infants and children 6 - 23 months of age."

The authors note that the nutrient powder packets are convenient and could also be used in schools or refugee camps, for example. They are currently looking at their effect in older, school-age kids.

Menon told Reuters Health that the nutrient powders typically run about $2 for a 2-month supply, and that more research is needed to figure out the best way to provide them to parents in low-income countries, including whether powder packets should be given out for free by the government.

For now, the new review suggests that the powder "is a promising innovation to address childhood anemia," said Menon, who did not participate in the study. "Any innovations that take us closer to solving the problem are more than welcome."

Need help with nasal allergies? Try a little CO2

Study: A shot of carbon dioxide to nose may relieve allergies related to dust, mold and pet dander

A shot of carbon dioxide to the nose may bring some quick, though short-lived, relief to people with nasal allergies, a preliminary study suggests. So-called intranasal carbon dioxide (CO2) is not yet an approved treatment for nasal allergies. The new study is one of a number of clinical trials being funded by Capnia, Inc., a Palo Alto, California-based company that is developing a hand-held device that -- if approved -- would allow people to administer the CO2 therapy to themselves.

In the new study, researchers recruited 348 adults with year-round nasal allergies -- to irritants like dust, mold or pet dander.

They randomly assigned participants to have either one dose of CO2, delivered via a nosepiece attached to a CO2 cylinder, or a placebo "treatment" where nothing was delivered through the nosepiece.

Those receiving the real treatment were further divided into four groups, receiving either a lower or higher CO2 dose for either 10 seconds or 30 seconds.

About 30 minutes later, one of the CO2 groups -- the one getting the higher dose for 10 seconds -- reported bigger improvements in nasal congestion, itching, sneezing and watery eyes than those getting the placebo.

The advantage lasted about four hours

Asthma & Immunology.

The degree of symptom improvement was similar to what's typically seen with standard treatments like antihistamine nasal sprays, according to lead researcher Dr. Thomas B. Casale, a professor of medicine at Creighton University in Omaha, Nebraska.

If approved, intranasal CO2 could offer an alternative to people with seasonal or year-round nasal allergies, Casale told Reuters Health.

Prescription nasal sprays with anti-inflammatory corticosteroids, taken regularly, are the most effective treatment out there, Casale said. But some people -- including parents of young children with nasal allergies -- are reluctant to use steroids, even though the low doses in allergy nasal sprays are generally considered safe.

"There are still a lot of people who don't like to take medication," Casale said, "and might view this as a 'natural' treatment."

Because the treatment is still experimental, it is not clear how much it would cost if it makes it to the market.

An allergy expert not involved in the study was unimpressed with the results.

Even if the symptom reduction is around what's seen with antihistamine nasal sprays, the latter have longer-lasting effects, according to Dr. Harold Nelson

One dose is good for 24 hours, Nelson said in an interview with Reuters Health, whereas the benefits of intranasal CO2 wore off after 4 to 6 hours in this study.

On top of that, he added, intranasal CO2 "seems uncomfortable."

Of all CO2 patients in the study, upwards of 80 percent said they had nasal discomfort during the treatment -- versus just about eight percent in the placebo group. Around one-quarter became teary-eyed, and 14 percent to 20 percent developed headaches.

"I must say, it's not a very attractive treatment," Nelson said.

He also pointed to what he saw as a weakness in the study: the placebo. Instead of comparing CO2 against some other gas, the researchers only gave placebo patients a nosepiece to insert.

That makes it unclear, Nelson said, if CO2 has some distinct effect, or if it was simply the intranasal pressure that somehow brought some people relief.

But Casale said that in an earlier study -- this one of people with seasonal allergies -- the researchers did use air in the placebo group, and the CO2-treated patients had greater symptom improvement.

Casale also pointed out that an advantage CO2 may have over antihistamines (both nasal spray and pill) and corticosteroids is that it works quickly. So the therapy might best fit into the nasal-allergy armament as an occasional, "as-needed" fix.

But that's still under study, Casale said. It also remains unclear why intranasal CO2 would be helpful against allergy symptoms, if that turns out to be the case.

Global health experts: Healthier living could cut millions of cancer cases

Cancer deaths could be prevented by curbing alcohol, improving diets, and promoting physical activity

Healthier lifestyles and better diets could prevent up to 2.8 million cases of cancer each year, the World Cancer Research Fund (WCRF) said on Wednesday, calling on governments to "avoid a public health disaster."

The number of global cancers has increased by a fifth in less than a decade to around 12 million new cases a year, and along with other chronic diseases like heart and lung disease and diabetes are the world's biggest health challenges, the Fund said.

In a report released two weeks before a United Nations summit on non-communicable diseases (NCDs), the charity said political leaders had a "once in a generation" opportunity to tackle a wave of cancer and other lifestyle diseases.

Global health experts say many deaths from NCDs, including around a third of all common cancers, could be prevented by curbing excessive alcohol intake, improving diets, discouraging smoking and promoting more physical activity.

But these measures often need government action such as taxation, regulation and advertising curbs, bringing politicians into conflict with tobacco, food and alcohol industries.

"With millions of lives at risk around the world, the stakes are incredibly high," said Martin Wiseman, WCRF's medical and scientific adviser.

"People are still unaware that risk factors such as alcohol and obesity affect cancer risk, while at the same time, from television advertising to the pricing of food, our society works in a way that discourages people from adopting healthy habits."

Non-communicable diseases such as cancer, heart disease, diabetes and respiratory diseases kill 36 million people a year, according to the U.N.'s Geneva-based health agency, the World Health Organization. Over the next 20 years, this epidemic is projected to accelerate and that by 2030, the number of deaths from NCDs could reach 52 million a year.

While they are often thought of as diseases of the rich world, NCDs actually disproportionately affect people in poorer nations. More than 80 percent of NCD deaths are among people living in low and middle income countries.

The WCRF said around seven million of the 12 million cancer cases diagnosed each year are in developing countries and that figure is also predicted to rise dramatically.

"Unless we act now..the charity appeals of the future will not be just for disasters and famines, but to pay for cancer care," Kate Allen, the fund's director of science and communications, told reporters at the briefing.

The U.N. meeting, slated for September 19 and 20 in New York, is only the second ever such high-level meeting to be convened on a threat to global health -- the first, a decade ago, was dedicated to fighting HIV and AIDS.

But there are already fears the summit could be ineffective, with major rich-world players such as the United States, Europe and Japan reluctant to commit to taxes, regulations and targets for reducing the burden of these diseases.

"The real problem is not coming up with new solutions, the real problem is having the will to implement what we already know," said Wiseman.