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Few Treatments for
Chronic Fatigue Disorder

E-Newsletter No. 17

Behavioral therapy may provide some benefit for patients with chronic fatigue syndrome, but overall there are few effective treatments for the mysterious disorder, according to a new survey. The syndrome affects as many as 800,000 Americans, primarily women, Latinos and African Americans.

Many physicians still adhere to the once common belief that it is a psychological problem rather than a physical one, but the consensus now is that it is a physiological problem with definite physical causes-even though it is not yet known what those causes may be.

Dr. Penny Whiting of the University of York in England and her colleagues surveyed 44 studies on CFS treatment dating from 1986 to the present. They reported in Wednesday’s Journal of the American Medical Association that cognitive behavioral therapy---counseling in coping strategies such as stress management---and a program of increasing exercise showed the most promising results.

The treatments produced only modest improvements, however. Drugs were even less effective, they concluded.

Elderly Are Dying of Disease, Not "Old Age"

The elderly rarely die of "old age," according to a new study. Instead, they die of specific diseases, just like their younger counterparts.

Researchers at Auckland University School of Medicine in New Zealand studied forensic autopsy reports on 319 people who were older than 90 when they died. Only 5% of the deaths were "written off" as being due to old age, the team reported in American Journal of Forensic Medicine and Pathology.

About 85% of the deaths were due to natural causes: heart diseases, pneumonia, complications from bone fractures, and stroke, primarily. Nearly all the unnatural deaths were due to accidents---usually falls---but there were also three suicides and one homicide.

"There is a common conception that the very old die of old age," the researchers wrote. But, they concluded, "the elderly die of disease, not old age."

Diet-Exercise Combo Is "Best of Both Worlds"

Low-fat diets that are high in carbohydrates lower levels of harmful cholesterol, but they can raise levels of other blood fats linked to heart disease. A new study, however, suggests that accompanying the diet with moderate exercise can block some of the potentially harmful effects of the diet.

Low-fat, high-carbohydrate diets reduce the risk of heart disease by lowering levels of LDL cholesterol, the so-called bad cholesterol. But they also raise the level of triglycerides, which are thought to increase the risk of heart disease, and lower levels of HDL cholesterol, the so-called good cholesterol.

Dr. Adrian E. Hardman and her colleagues at Loughborough University in Leicestershire, England, however, reported in the October issue of Arteriosclerosis Thrombosis and Vascular Biology that daily moderate exercise---brisk walking for an hour each---negated the adverse effects of the diet on triglycerides. It did not, however, reverse the decrease in good cholesterol.

Nonetheless, Hardman concluded, this diet-and-exercise combo "may be the best of both worlds for coronary heart disease risk".

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