Health Research Report
154th Issue Date 03 May 2013
Compiled By Ralph Turchiano
www.facebook.com/engineeringevil
In this issue:
- Painkillers taken before marathons linked to potentially serious side effects
- Grape intake may protect against metabolic syndrome-related organ damage
- 40 percent of parents give young kids cough/cold medicine that they shouldn’t
- Vitamin E identified as potential weapon against obesity
- Quit smoking? Vitamin E may give extra boost to heart health
- Study shows drinking one 12oz sugar-sweetened soft drink a day can increase the risk of type 2 diabetes by 22 percent
- Dietary medium chain triglycerides prevent nonalcoholic fatty liver disease
- Salk findings suggest vitamin D therapy could be a powerful weapon in the fight against liver fibrosis
- Mild iodine deficiency in womb associated with lower scores on children’s literacy tests
- Over-diagnosis and over-treatment of depression is common in the US
- Abstract 137 – Diet, ‘anti-aging’ supplements may help reverse blood vessel abnormality
- Study uncovers mechanism for how grapes reduce heart failure associated with hypertension
- Gray hair and vitiligo reversed at the root
Painkillers taken before marathons linked to potentially serious side effects
Risk increases with dose; unrecognised problem, doctors warn
Many competitors try to prevent pain interfering with their performance by taking painkillers that are readily available in pharmacies and supermarkets, say the authors.
And in a bid to find out what impact these common drugs might have, the authors quizzed participants in the 2010 Bonn Marathon/Half-Marathon about their use of medication and any symptoms they had during and/or after the race.
In all, just under 4000 (56%) of all 7048 competitors returned their online questionnaires. Most (87%) had run marathons before.
Of those who took painkillers before the race, 1 in 5 said they also used painkillers during training to curb or ward off pain; 1 in 10 said they had pain symptoms before the start of the race. This compares with 1% of those who didn’t touch painkillers.
Over half the drugs taken (54%) were bought over the counter without a prescription, and included diclofenac, asprin, and ibuprofen.
The numbers of those forced to withdraw during the race because of pain and other health symptoms differed little between those who took painkillers and those who didn’t.
But withdrawal from competition because of gastrointestinal problems was significantly more common among those taking painkillers, and while withdrawal as a result of muscle cramps was rare, it was significantly more common in those who had taken these drugs.
Runners who popped painkillers were five times as likely to experience symptoms as those who didn’t take these drugs; the overall difference in risk was 13%.
Symptoms included stomach cramps, cardiovascular problems, gastrointestinal bleeds, blood in the urine and joint and muscle pain.
The rate of symptoms rose in parallel with increasing dose. One in 10 of those taking diclofenac took over 100 mg; 43% of those who took ibuprofen, the second most popular choice, took doses of 800 mg or more—twice the recommended dose.
Virtually none of the respondents said they were aware of any risks associated with taking painkillers for endurance sports.
Nine runners who took painkillers said they had ended up in hospital: three for temporary kidney failure after taking ibuprofen; four for bleeding ulcers (aspirin), and two after a heart attack (aspirin), one of whom had taken 500 mg for mild foot pain.
None of the runners who competed without having topped up on painkillers was admitted to hospital.
Painkillers block enzymes called cyclooxygenases, which regulate the production of prostaglandins. But the authors suggest that prostaglandins also protect tissues when the body is under extreme stress, such as during endurance sports.
“Taken together, our data indicate that the widespread use of cyclooxygenase inhibitors in connection with endurance sports is potentially damaging. Further investigations are warranted to examine whether the use of analgesics before and during sports activities should be avoided altogether,” they conclude.
Grape intake may protect against metabolic syndrome-related organ damage
Study shows grapes reduced inflammation and fat storage, improved antioxidant defense
ANN ARBOR, MI
Consuming grapes may help protect against organ damage associated with the progression of metabolic syndrome, according to research presented Monday at the Experimental Biology conference in Boston. Natural components found in grapes, known as polyphenols, are thought to be responsible for these beneficial effects.
The study, led by investigator E. Mitchell Seymour, Ph.D., of the University of Michigan Health System, studied the effects of a high fat, American-style diet both with added grapes and without grapes (the control diet) on the heart, liver, kidneys, and fat tissue in obesity-prone rats. The grapes – a blend of red, green and black varieties – were provided as a freeze-dried grape powder and integrated into the animals’ diets for 90 days.
Specifically, the results showed that three months of a grape-enriched diet significantly reduced inflammatory markers throughout the body, but most significantly in the liver and in abdominal fat tissue. Consuming grapes also reduced liver, kidney and abdominal fat weight, compared with those consuming the control diet. Additionally, grape intake increased markers of antioxidant defense, particularly in the liver and kidneys.
Metabolic syndrome is a cluster of conditions that occur together – increased blood pressure, a high blood sugar level, excess body fat around the waist or low HDL (the good cholesterol) and increased blood triglycerides – significantly increasing the risk for heart disease, stroke and Type 2 diabetes. Intake of fruits and vegetables is thought to reduce these risks, and grapes have shown benefits in multiple studies. Metabolic syndrome is a major public health concern, and is on the rise in the U.S.
“Our study suggests that a grape-enriched diet may play a critical role in protecting against metabolic syndrome and the toll it takes on the body and its organs,” said Seymour. “Both inflammation and oxidative stress play a role in cardiovascular disease progression and organ dysfunction in Type 2 diabetes. Grape intake impacted both of these components in several tissues which is a very promising finding.”
This work extends and reinforces the findings of Seymour’s previously published research which demonstrated that a grape-enriched diet reduced risk factors for heart disease and diabetes in obesity-prone rats.
Experimental Biology is a multidisciplinary, scientific meeting focused on research and life sciences, covering general fields of study such as anatomy, biochemistry, nutrition, pathology and pharmacology. The meeting is comprised of nearly 14,000 scientists and exhibitors.
40 percent of parents give young kids cough/cold medicine that they shouldn’t
Many parents disregard label warnings, give children under age 4 common medicines, according to new U-M National Poll on Children’s Health
ANN ARBOR, Mich. – Children can get five to 10 colds each year, so it’s not surprising that adults often turn to over-the-counter cough and cold medicines to relieve their little ones’ symptoms. But a new University of Michigan poll shows that many are giving young kids medicines that they should not use.
More than 40 percent of parents reported giving their children under age 4 cough medicine or multi-symptom cough and cold medicine, according to the latest University of Michigan C.S. Mott Children’s Hospital National Poll on Children’s Health. Twenty-five percent gave those children decongestants.
In 2008, the federal Food and Drug Administration issued an advisory that these over-the-counter medicines not be used in infants and children under age 2. They have not been proven effective for young children and may cause serious side effects, says Matthew M. Davis, M.D., M.A.P.P., director of the C.S. Mott Children’s Hospital National Poll on Children’s Health.
In response to the FDA, manufacturers of over-the-counter cough and cold products changed their labels back in 2008, to state that the medicines should not be used for children under 4 years old.
“These products don’t reduce the time the infection will lasts and misuse could lead to serious harm,” says Davis. “What can be confusing, however, is that often these products are labeled prominently as ‘children’s’ medications. The details are often on the back of the box, in small print. That’s where parents and caregivers can find instructions that they should not be used in children under 4 years old,” Davis says
The side effects from use of cough and cold medicines in young children may include allergic reactions, increased or uneven heart rate, drowsiness or sleeplessness, slow and shallow breathing, confusion or hallucinations, convulsions, nausea and constipation.
The poll found that use of the cough and cold medicines in children age four and under did not differ by parent gender, race/ethnicity or by household income.
“Products like these may work for adults, and parents think it could help their children as well. But what’s good for adults is not always good for children,” says Davis.
Davis says parents need to be vigilant about reading the directions and should always call their pediatrician or health care provider about questions regarding over-the-counter medications.
“Because young children often suffer from cold-like symptoms, more research is needed to test the safety and efficacy of these cough and cold medicines in our littlest patients,” Davis says.
Vitamin E identified as potential weapon against obesity
BOSTON — A potential new way to fight obesity-related illness has been uncovered, thanks to serendipitous research led by investigators at the Case Western Reserve University School of Medicine.
The collaborators, from Case Western Reserve University, the Cleveland Clinic Foundation and Cornell University, discovered the essential nutrient vitamin E can alleviate symptoms of liver disease brought on by obesity. “The implications of our findings could have a direct impact on the lives of the approximately 63 million Americans who are at potential risk for developing obesity-related liver disease in their lifetimes,” says Danny Manor, an associate professor at the Case Western Reserve University School of Medicine.
On Wednesday, April 24, Manor and colleague Varsha Thakur will present the group’s findings at the annual meeting of the American Society for Biochemistry and Molecular Biology, held in conjunction with the Experimental Biology 2013 meeting in Boston.
As is often the case in science, Manor’s research team at Case Western stumbled upon the findings entirely by accident. While studying the effect of vitamin E deficiency on the central nervous system, “we used liver tissue to practice our surgical techniques,” recalled Manor, an associate professor of nutrition and pharmacology. To the team’s surprise, they realized that the mice were in fact in the advanced stages of nonalcoholic steatohepatitis. Known as NASH for short, it’s a common complication of obesity characterized by fat accumulation, oxidative stress and inflammation in the liver. It is the most severe form of nonalcoholic fatty liver disease and is a major cause of tissue scarring known as cirrhosis that leads to liver failure and may progress to liver cancer.
An essential antioxidant, vitamin E had been shown by recent studies to alleviate some symptoms of NASH in human patients, suggesting that there is a link between adequate vitamin E levels and liver disease. To test this hypothesis, the team studied a mouse that was engineered to lack a protein that regulates the levels of vitamin E in the body. As expected, they observed increased oxidative stress, fat deposition and other signs of liver injury in the mice. Importantly, points out Manor, “supplementation with vitamin E averted the majority of NASH-related symptoms in these animals, confirming the relationship between vitamin E deficiency and liver disease.”
The precise effects of vitamin E on health have previously been difficult to ascertain, though its antioxidative properties were suggested to offer some protection from a variety of well-known maladies, including heart disease, cancer and neurological diseases such as Alzheimer’s and Lou Gehrig’s disease (amyotrophic lateral sclerosis, or ALS).
“These findings may have a significant impact on public health,” says Manor, “as the vast majority of adults in the United States do not consume the amount of vitamin E recommended by the National Institute of Medicine.”
For adults, the recommended dietary allowance of vitamin E is 15 milligrams a day. Vegetable oils, nuts and seeds, leafy greens and fortified cereals commonly contain vitamin E.
“Simple and affordable dietary intervention may benefit people at risk for this debilitating disease,” Manor says.
There is currently no treatment for NASH, making it one of the most common reasons for liver transplantation. Manor also points out that “NASH piggybacks on the two great epidemics of our time: obesity and Type 2 diabetes.”
According to the Centers for Disease Control and Prevention, obesity affects more than one-third of adults and one-sixth of children in the U.S., while nearly one in 10 Americans today suffers from diabetes, rates that have been climbing over the past two decades. Thus, for Manor, the significance of his group’s findings is not only the possibility that they will aid those who are currently sick but that they may also “affect many people who are presently healthy, but are at risk for becoming obese or diabetic in the future.”
Moreover, Manor believes that his group’s discovery will be key to determining the molecular details of NASH itself. “Right now, we really don’t understand how NASH progresses from mild liver damage to severe liver failure,” he said. “Our results will enable us to dissect the different steps in this progression, as well as study how oxidative stress affects liver function more generally, giving possible insights into other related disorders.”
Quit smoking? Vitamin E may give extra boost to heart health
Study suggests specific form of vitamin improves function of blood vessels
COLUMBUS, Ohio – Taking a specific form of a vitamin E supplement can accelerate the health benefits that occur when people quit smoking, new research suggests.
In the small study, improvement in blood vessel function associated with the added vitamin E potentially translates into an estimated 19 percent greater drop in future risk for cardiovascular disease.
Smokers were recruited to participate in a study to quit smoking for seven days, with blood markers of inflammation and blood vessel function measured before and after the trial. After seven days of not smoking, participants saw an increase in their vascular function by an average of 2.8 percent. Those who quit smoking and also took the gamma-tocopherol form of vitamin E showed a 1.5 percent additional improvement in vascular function.
While these changes in vascular function may appear to be small, previous large-scale studies suggest that every 1 percent increase in vascular function – or improvement in the blood vessel’s ability to dilate – translates into a 13 percent drop in risk of developing heart disease later in life.
“This is a very short-term study that shows very promising effects,” said Richard Bruno, associate professor of human nutrition at The Ohio State University and senior author of the study.
“The underlying rationale is that we know it takes many years before the risk for cardiovascular disease of a former smoker matches that of a nonsmoker. We hope to develop a therapy to combine with smoking cessation that could accelerate the restoration of vascular function and reduce cardiovascular risk.”
The research was presented Tuesday (4/23) at the annual Experimental Biology meeting in Boston.
The supplement in the study is not the same as the average vitamin E available on most store shelves. Vitamin E occurs in eight forms based on their chemical structure, and the most well-known form belongs to a variety called tocopherols. In this study, researchers tested the effects of the gamma-tocopherol form. The most common form of vitamin E, and the one for which humans have a dietary requirement, is alpha-tocopherol.
Though taking gamma-tocopherol is safe, Bruno noted that longer-term studies with more participants would be required to nail down specific dietary recommendations related to smoking cessation.
A total of 30 smokers in their 20s who had smoked at least half a pack per day for a year participated in the study. All participants stopped smoking, and 16 received 500 milligrams daily of gamma-tocopherol while 14 received a placebo.
In addition to taking blood samples, researchers measured vascular function by obtaining ultrasound images of an artery in the upper arm as the vessel responded to a surge of blood flow after circulation in the arm was stopped for five minutes.
The quality of vascular function is defined by the artery’s ability to dilate in response to the surge of blood – more dilation suggests the vessel has appropriate responses to changes in blood flow.
“Greater dilatory response is an indicator of vascular health. People with a long history of smoking tend to have low vasodilatory responses,” Bruno said.
Participants who took the supplements showed greater improvements in vascular function and also had lower levels of two inflammation-related proteins in their blood than did participants who received a placebo.
Bruno said the lower levels of those two proteins in the supplemented participants’ blood suggest that the gamma-tocopherol form of vitamin E restores vascular function at least in part by lowering inflammation.
Gamma-tocopherol is abundant in the American diet, but is difficult to obtain from low-calorie sources. Food sources include soybean, canola and some other vegetable oils, and certain nuts such as pistachios, pecans, cashews and peanuts. Supplements that are rich in gamma-tocopherol can be found in specialty stores.
Study shows drinking one 12oz sugar-sweetened soft drink a day can increase the risk of type 2 diabetes by 22 percent
Drinking one (or one extra)* 12oz serving size of sugar-sweetened soft drink a day can be enough to increase the risk of developing type 2 diabetes by 22%, a new study suggests. The research is published in Diabetologia (the journal of the European Association for the Study of Diabetes) and comes from data in the InterAct consortium**. The research is by Dr Dora Romaguera, Dr Petra Wark and Dr Teresa Norat, Imperial College London, UK, and colleagues.
Since most research in this area has been conducted in North American populations, the authors wanted to establish if a link between sweet beverage consumption and type 2 diabetes existed in Europe. They used data on consumption of juices and nectars, sugar-sweetened soft drinks and artificially sweetened soft drinks collected across eight European cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC study; UK, Germany, Denmark, Italy, Spain, Sweden, France, Italy, Netherlands)***, covering some 350,000 participants.
As part of the InterAct project, the researchers did a study which included 12,403 type 2 diabetes cases and a random sub-cohort of 16,154 identified within EPIC. The researchers found that, after adjusting for confounding factors, consumption of one 12oz (336ml) serving size of sugar-sweetened soft drink per day increased the risk of type 2 diabetes by 22%. This increased risk fell slightly to 18% when total energy intake and body-mass index (BMI) were accounted for**** (both factors that are thought to mediate the association between sugar-sweetened soft drink consumption and diabetes incidence). This could indicate that the effect of sugar-sweetened soft drink on diabetes goes beyond its effect on body weight.
The authors also observed a statistically significant increase in type 2 diabetes incidence related to artificially sweetened soft drink consumption, however this significant association disappeared after taking into account the BMI of participants; this probably indicates that the association was not causal but driven by the weight of participants (i.e. participants with a higher body weight tend to report higher consumption of artificially sweetened drinks, and are also more likely to develop diabetes). Pure fruit juice and nectar***** consumption was not significantly associated with diabetes incidence, however it was not possible using the data available to study separately the effect of 100% pure juices from those with added sugars.
The authors say the increased risk of diabetes among sugar-sweetened soft drink consumers in Europe is similar to that found in a meta-analysis of previous studies conducted mostly in North America (that found a 25% increased risk of type 2 diabetes associated with one 12 oz daily increment of sugar-sweetened beverage consumption).
Dr Romaguera concludes: “Given the increase in sweet beverage consumption in Europe, clear messages on the unhealthy effect of these drinks should be given to the population.”
Dietary medium chain triglycerides prevent nonalcoholic fatty liver disease
Scientists at the Arkansas Children’s Nutrition Center, a U.S. Department of Agriculture Agricultural Research Service Human Nutrition Research Center at the University of Arkansas for Medical Sciences, led by Dr. Martin Ronis have determined that dietary substitution of saturated fats enriched in medium chain triglycerides (MCT) for polyunsaturated fat prevents the development of nonalcoholic fatty liver disease (NAFLD). NAFLD occurs in patients with obesity and type II diabetes and is being seen at younger ages in association with the obesity epidemic. NAFLD is characterized by excessive accumulation of fat in the liver. In a proportion of NAFLD cases, liver pathology progresses to hepatitis, fibrosis and liver cancer. The findings which appear in the February 2013 issue of Experimental Biology and Medicine used a laboratory animal model of NAFLD to demonstrate that isocaloric substitution of a mixture of MCT rich saturated fats for of dietary polyunsaturated fats prevented liver fat accumulation. In addition progression of injury was blocked as a result of reduced susceptibility of lipids to radical attack and increased basal metabolic rate produced by activation of PPAR signaling.
“There is a real shortage of potential therapies for NAFLD short of weight loss and increased exercise” states Dr. Ronis. “In this study, we show that even if total dietary fat content remains high and excess calories continue to be consumed, the metabolic effects of MCT to change liver lipid profiles and increase respiration can prevent the development of liver pathology”. Although complete substitution of MCT oil for vegetable oils in cooking is not feasible as a result of its low smoking point, the studies demonstrated that the protective effects of MCT were dose-dependent.
Dr. Ronis states that “Future studies will be designed to determine if MCT rich diets can reverse NAFLD and nonalcoholic steatohepatitis in disease models, and if successful, clinical trials may be initiated in patients with metabolic syndrome.” Dr. Ronis states that “the technology to produce synthetic cooking oils incorporating MCT is already with us. The Japanese are currently testing an oil containing monounsaturated 18:1 fatty acids and MCT for beneficial health effects. There is no reason why similar synthetic products incorporating saturated fatty acids such as 16:0 or 18:0 and MCT cannot be developed for the US market”.
Dr. Steven R. Goodman, Editor-in-Chief of Experimental Biology and Medicine, said “with obesity and type II diabetes on the rise development of nonalcoholic fatty liver disease (NAFLD) that can lead to hepatitis, fibrosis and liver cancer is an increasing problem. Dr. Martin Ronis and colleagues using an animal model of NAFLD have shown that substitution of saturated fat in the form of medium chain triglycerides (MCT) for polyunsaturated fats can prevent the progression of NAFLD-associated liver injury. As pointed out by Ronis and colleagues this provides a potential future therapy for NAFLD where we simply alter our cooking oils to contain therapeutic levels of MCTs.”
Salk findings suggest vitamin D therapy could be a powerful weapon in the fight against liver fibrosis
LA JOLLA, CA—-Liver fibrosis results from an excessive accumulation of tough, fibrous scar tissue and occurs in most types of chronic liver diseases. In industrialized countries, the main causes of liver injury leading to fibrosis include chronic hepatitis virus infection, excess alcohol consumption and, increasingly, nonalcoholic steatohepatitis (NASH).
Now, in a new study published in the journal Cell, scientists at the Salk Institute for Biological Studies have discovered that a synthetic form of vitamin D, calcipotriol (a drug already approved by the FDA for the treatment of psoriasis), deactivates the switch governing the fibrotic response in mouse liver cells, suggesting a potential new therapy for fibrotic diseases in humans.
“Because there are currently no effective drugs for liver fibrosis, we believe our findings would open a new door for treatment,” says senior author Ronald M. Evans, a professor in Salk’s Gene Expression Laboratory and lead researcher in the Institute’s new Helmsley Center for Genomic Medicine.
The Salk study focused on a star-shaped “stellate” cell in the liver that serves as a beacon for damage. When called into action, stellate cells produce fibrotic proteins in an attempt to heal an injury. Under chronic stress, however, localized fibrosis expands, eventually leading to cirrhosis, increased risk of liver cancer, and the need for a liver transplant in advanced cases.
The Evans lab discovered a genetic switch through which vitamin D-related ligands such as calcitriol, a hormonally active form of the vitamin, can put the brakes on fibrosis. “Preclinical results suggest the ‘vitamin D brake’ is highly efficacious and led us to believe that the time is right to consider a trial in the context of chronic liver disease,” says Evans, a Howard Hughes Medical Institute Investigator and holder of the March of Dimes Chair in Molecular and Developmental Biology.
Previous studies have shown a physiologic role for vitamin D in liver function, but “it was our discovery of high levels of vitamin D receptor (VDR) in the stellate cell that led us to consider it as a possible off switch for liver fibrosis,” says lead author Ning Ding, a research associate in the Gene Expression Laboratory.
“Current therapeutic approaches, which treat the symptoms of liver disease, don’t stop liver fibrosis from progressing,” says Michael Downes, a senior staff scientist in the Gene Expression Laboratory and co-corresponding author on the paper. “In liver diseases where the underlying cause cannot be cured, progression to cirrhosis is currently inevitable in some people. What we have discovered is that by acting on the genome, VDR can simultaneously defend against multiple fibrotic activators. This is important because many different pro-fibrotic signaling pathways converge on the genome to affect their fibrotic response.”
The Salk discovery that calcipotriol counters the fibrotic response in stellate cells illuminates a potentially safer, more effective strategy capable of neutralizing multiple convergent fibrotic triggers.
The Salk scientists say that clinical trials of the vitamin D analog for the treatment of liver fibrosis are being planned. The synthetic vitamin D analog is better than natural vitamin D, they say, for a couple of reasons. First, natural vitamin D, which is found in small amounts in a few foods and produced in the body by exposure to sunlight, degrades quickly, while synthetic versions of vitamin D are less susceptible to breakdown. Second, too much natural vitamin D can cause hypercalcemia, or elevated calcium in the blood, which can lead to nausea and vomiting, frequent urination, muscle weakness and joint aches and pain. The synthetic vitamin D analog, on the other hand, produces a strong response without adding calcium to the blood.
In addition, the researchers say this new model for treating liver fibrosis may also be helpful in treating other diseases with a fibrotic component, including those of the lung, kidney and pancreas.
Mild iodine deficiency in womb associated with lower scores on children’s literacy tests
Changes in mother’s diet, supplements may prevent long-term neurological impairment
Chevy Chase, MD––Children who did not receive enough iodine in the womb performed worse on literacy tests as 9-year-olds than their peers, according to a recent study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).
Iodine is absorbed from food and plays a key role in brain development. Even mild deficiency during pregnancy can harm the baby’s neurological development.
“Our research found children may continue to experience the effects of insufficient iodine for years after birth,” said the study’s lead author, Kristen L. Hynes, PhD, of the Menzies Research Institute at the University of Tasmania in Australia. “Although the participants’ diet was fortified with iodine during childhood, later supplementation was not enough to reverse the impact of the deficiency during the mother’s pregnancy.”
The longitudinal study examined standardized test scores of 228 children whose mothers attended The Royal Hobart Hospital’s antenatal clinics in Tasmania between 1999 and 2001. The children were born during a period of mild iodine deficiency in the population. Conditions were reversed when bread manufacturers began using iodized salt in October 2001 as part of a voluntary iodine fortification program.
The study found inadequate iodine exposure during pregnancy was associated with lasting effects. As 9-year-olds, the children who received insufficient iodine in the womb had lower scores on standardized literacy tests, particularly in spelling. However, inadequate iodine exposure was not associated with lower scores on math tests. Researchers theorize iodine deficiency may take more of a toll on the development of auditory pathways and, consequently, auditory working memory and so had more of an impact on students’ spelling ability than their mathematical reasoning ability.
“Fortunately, iodine deficiency during pregnancy and the resulting neurological impact is preventable,” Hynes said. “Pregnant women should follow public health guidelines and take daily dietary supplements containing iodine. Public health supplementation programs also can play a key role in monitoring how much iodine the population is receiving and acting to ensure at-risk groups receive enough iodine in the diet.”
Over-diagnosis and over-treatment of depression is common in the US
Americans are over-diagnosed and over-treated for depression, according to a new study conducted at the Johns Hopkins Bloomberg School of Public Health. The study examines adults with clinician-identified depression and individuals who experienced major depressive episodes within a 12-month period. It found that when assessed for major depressive episodes using a structured interview, only 38.4 percent of adults with clinician-identified depression met the 12-month criteria for depression, despite the majority of participants being prescribed and using psychiatric medications. The results are featured in the April 2013 issue of Psychotherapy and Psychosomatics.
“Depression over-diagnosis and over-treatment is common in the U.S. and frankly the numbers are staggering,” said Ramin J. Mojtabai, PhD, author of the study and an associate professor with the Bloomberg School’s Department of Mental Health. “Among study participants who were 65 years old or older with clinician-identified depression, 6 out of every 7 did not meet the 12-month major-depressive-episodes criteria. While participants who did not meet the criteria used significantly fewer services and treatment contacts, the majority of both groups used prescription psychiatric medication.”
Using a sample of 5,639 participants from the 2009-2010 United States National Survey of Drug Use and Health, Mojtabai assessed clinician-identified depression based on questions about conditions that the participants were told they had by a doctor or other medical professional in the past 12 months. The study indicates that even among participants without a lifetime history of major or minor depression, a majority reported having taken prescription psychiatric medications.
“A number of factors likely contribute to the high false-positive rate of depression diagnosis in community settings, including the relatively low prevalence of depression in these settings, clinicians’ uncertainty about the diagnostic criteria and the ambiguity regarding sub-threshold syndromes,” said Mojtabai. “Previous evidence has highlighted the under-diagnosis and under-treatment of major depression in community settings. The new data suggest that the under-diagnosis and under-treatment of many who are in need of treatment occurs in conjunction with the over-diagnosis and over-treatment of others who do not need such treatment. There is a need for improved targeting of diagnosis and treatment of depression and other mental disorders in these settings.”
Abstract 137 – Diet, ‘anti-aging’ supplements may help reverse blood vessel abnormality
A diet low in grains, beans and certain vegetables — combined with “anti-aging” supplements — improved blood vessel function, in a study presented at the American Heart Association’s Arteriosclerosis, Thrombosis and Vascular Biology 2013 Scientific Sessions.
The blood vessel abnormality, or endothelial dysfunction, occurs when cells lining the interior wall of blood vessels malfunction. It’s a serious condition that’s often one of the first signs of heart disease.
Of the 200 51- to 86-year-old people in the study, 40 percent were women. All had risk factors for blood vessel disease and nearly three-quarters had endothelial dysfunction.
The diet restricted foods high in the sugar-binding protein lectin, generally regarded as a healthy nutrient. The restricted foods included grains, beans, fruit, poultry and plants belonging to the nightshade family, which includes tomatoes. At the same time, patients consumed plenty of leafy greens, shellfish and fish, olive oil and grass-fed animal protein, while taking supplements containing the antioxidant polyphenol from fish oil, grape seed extract and vitamins. Antioxidants are thought to slow cell aging.
“These findings represent a fundamental paradigm shift in how the diseases of the ‘Western Diet’ should be treated,” said Steven R. Gundry, M.D., lead author and medical director of the International Heart & Lung Institute at The Center for Restorative Medicine in Palm Springs, Calif. “Simple removal of ‘healthy’ lectin-containing foods, and taking a few inexpensive supplements, may restore endothelial function to normal, which in turn can reverse high blood pressure, diabetes and obesity.”
Despite the study’s findings, consumers shouldn’t eliminate tomatoes or other healthy foods from their diets, said the American Heart Association, which recommends consuming a diet with plenty of fruits, vegetables, whole grains and fish.
Study uncovers mechanism for how grapes reduce heart failure associated with hypertension
Grapes found to activate genes responsible for antioxidant defense in the heart
A study appearing in the Journal of Nutritional Biochemistry¹ demonstrates that grapes are able to reduce heart failure associated with chronic high blood pressure (hypertension) by increasing the activity of several genes responsible for antioxidant defense in the heart tissue. Grapes are a known natural source of antioxidants and other polyphenols, which researchers believe to be responsible for the beneficial effects observed with grape consumption. This study, funded by a grant from the National Institutes of Health (NIH), and conducted at the University of Michigan Health System, uncovered a novel way that grapes exert beneficial effects in the heart: influencing gene activities and metabolic pathways that improve the levels of glutathione, the most abundant cellular antioxidant in the heart.
An estimated 1 billion people worldwide have hypertension, which increases the risk of heart failure by 2 to 3-fold. Heart failure resulting from chronic hypertension can result in an enlarged heart muscle that becomes thick and rigid (fibrosis), and unable to fill with blood properly (diastolic dysfunction) or pump blood effectively. Oxidative stress is strongly correlated with heart failure, and deficiency of glutathione is regularly observed in both human and animal models of heart failure. Antioxidant-rich diets, containing lots of fruits and vegetables, consistently correlate with reduced hypertension.
In this study, conducted at the University of Michigan Health System, hypertensive, heart failure-prone rats were fed a grape-enriched diet for 18 weeks. The results reproduced earlier findings that grape consumption reduced the occurrence of heart muscle enlargement and fibrosis, and improved the diastolic function of the heart. Furthermore, the mechanism of action was uncovered: grape intake “turned on” antioxidant defense pathways, increasing the activity of related genes that boost production of glutathione.
“Our earlier studies showed that grapes could protect against the downward spiral of hypertensive heart failure, but just how that was accomplished – the mechanism – was not yet known,” said lead investigator E. Mitchell Seymour, Ph.D. “The insights gained from our NIH study, including the ability of grapes to influence several genetic pathways related to antioxidant defense, provide further evidence that grapes work on multiple levels to deliver their beneficial effects.”
Seymour noted that the next phase of the NIH study, which will continue into 2014, will allow his team to further define the mechanisms of grape action, and also look at the impact of whole grape intake compared to individual grape phytonutrients on hypertension-associated heart failure.
“Our hypothesis is that whole grapes will be superior to any individual grape component, in each of the areas being investigated,” said Dr. Seymour. “The whole fruit contains hundreds of individual components, which we suspect likely work together to provide a synergistic beneficial effect.”
The insights gained from this research will further the knowledge on grapes and heart health, but will also provide translational information on the value of dietary (whole foods) and dietary supplement approaches for prevention of heart disease stemming from chronic hypertension.
“The NIH grant is allowing the team at the University of Michigan Medical System to expand its work in this important area and further highlight the multi-faceted role of grapes in supporting heart health,” said Kathleen Nave, president of the California Table Grape Commission. “This work will also provide key insights into the role of whole fruit versus individual components of a fruit, using grapes as the benchmark.”
Children with milk allergy may be ‘allergic to school’
Chalk dust can contain milk protein, triggering respiratory symptoms
ARLINGTON HEIGHTS, ILL. (May 2, 2013) – Many of today’s school teachers opt for dustless chalk to keep hands and classrooms clean. But according to a study published in the May issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI), this choice in chalk may cause allergy and asthma symptoms in students that have a milk allergy.
Casein, a milk protein, is often used in low-powder chalk. When milk allergic children inhale chalk particles containing casein, life-threatening asthma attacks and other respiratory issues can occur.
“Chalks that are labeled as being anti-dust or dustless still release small particles into the air,” said Carlos H. Larramendi, MD, lead study author. “Our research has found when the particles are inhaled by children with milk allergy, coughing, wheezing and shortness of breath can occur. Inhalation can also cause nasal congestion, sneezing and a runny nose.”
Milk allergy affects an estimated 300,000 children in the United States, according to the ACAAI. Although it has been believed the majority of children will outgrow milk allergy by age three, recent studies contradict this theory, showing school aged children are still affected. However, 80 percent of children with milk allergy will likely outgrow it by age 16.
“Chalk isn’t the only item in a school setting that can be troublesome to milk allergic students,” said James Sublett, MD, chair of the ACAAI Indoor Environment Committee. “Milk proteins can also be found in glue, paper, ink, and in other children’s lunches.”
Even in the wake of whiteboards, overhead projectors and tablets, chalk is a classroom staple that likely won’t become extinct anytime soon. Parents with milk allergic children should ask to have their child seated in the back of the classroom where they are less likely to inhale chalk dust, advises Sublett.
“Teachers should be informed about foods and other triggers that might cause health problems for children,” said Sublett. “A plan for dealing with allergy and asthma emergencies should also be shared with teachers, coaches and the school nurse. Children should also carry allergist prescribed epinephrine, inhalers or other life-saving medications.”
Gray hair and vitiligo reversed at the root
New research in The FASEB Journal suggests that loss of skin or hair color can be corrected by a new compound — a pseudocatalase — that reverses oxidative stress
Bethesda, MD—Hair dye manufacturers are on notice: The cure for gray hair is coming. That’s right, the need to cover up one of the classic signs of aging with chemical pigments will be a thing of the past thanks to a team of European researchers. In a new research report published online in The FASEB Journal (http://www.fasebj.org) people who are going gray develop massive oxidative stress via accumulation of hydrogen peroxide in the hair follicle, which causes our hair to bleach itself from the inside out, and most importantly, the report shows that this massive accumulation of hydrogen peroxide can be remedied with a proprietary treatment developed by the researchers described as a topical, UVB-activated compound called PC-KUS (a modified pseudocatalase). What’s more, the study also shows that the same treatment works for the skin condition, vitiligo.
“To date, it is beyond any doubt that the sudden loss of the inherited skin and localized hair color can affect those individuals in many fundamental ways,” said Karin U. Schallreuter, M.D., study author from the Institute for Pigmentary Disorders in association with E.M. Arndt University of Greifswald, Germany and the Centre for Skin Sciences, School of Life Sciences at the University of Bradford, United Kingdom. “The improvement of quality of life after total and even partial successful repigmentation has been documented.”
To achieve this breakthrough, Schallreuter and colleagues analyzed an international group of 2,411 patients with vitiligo. Of that group, 57 or 2.4 percent were diagnosed with strictly segmental vitiligo (SSV), and 76 or 3.2 percent were diagnosed with mixed vitiligo, which is SSV plus non-segmental vitiligo (NSV). They found that for the first time, patients who have SSV within a certain nerval distribution involving skin and eyelashes show the same oxidative stress as observed in the much more frequent general NSV, which is associated with decreased antioxidant capacities including catalase, thioredoxin reductase, and the repair mechanisms methionine sulfoxide reductases. These findings are based on basic science and clinical observations, which led to successful patient outcomes regarding repigmentation of skin and eyelashes.
“For generations, numerous remedies have been concocted to hide gray hair,” said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal, “but now, for the first time, an actual treatment that gets to the root of the problem has been developed. While this is exciting news, what’s even more exciting is that this also works for vitiligo. This condition, while technically cosmetic, can have serious socio-emotional effects of people. Developing an effective treatment for this condition has the potential to radically improve many people’s lives.”
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