Health Technology Research Synopsis 110th Issue Date 14AUG2011 Compiled By Ralph Turchiano http://www.vit.bz
Editors Top Five:
1. Academics ‘guest authoring’ ghostwritten medical journal articles should be charged with fraud 2. Newer antidepressants not necessarily safest for older people
3. Authorship rules for medical journals flouted by pharma industry
4. Baker’s yeast protects against fatal infections
5. Curry spice could offer treatment hope for tendinitis In this Issue:
1. Study finds exposure to magnetic fields in pregnancy increases asthma risk
2. Some exercise is better than none; more is better to reduce heart disease risk
3. Smoking’s up-side: Nicotine protects the brain from Parkinson’s disease
4. Academics ‘guest authoring’ ghostwritten medical journal articles should be charged with fraud
5. Why diets don’t work? Starved brain cells eat themselves
6. Brain chemical may explain why heavy smokers feel sad after quitting
7. Cooked green vegetables, dried fruit, legumes, and brown rice associated with fewer colon polyps
8. Newer antidepressants not necessarily safest for older people
9. Can Eggs Be a Healthy Breakfast Choice?
10. What’s in a kids meal? Not happy news
11. Drinking just 1 measure of spirits increases the risk of acute pancreatitis
12. Prescriptions for Antidepressants Increasing among Individuals with no Psychiatric Diagnosis
13. Authorship rules for medical journals flouted by pharma industry
14. Baker’s yeast protects against fatal infections
15. Curry spice could offer treatment hope for tendinitis
16. Resistance training can help smokers kick the habit, according to Miriam Hospital study
17. Can blaming others make people sick?
18. Psychiatrists failing to adequately monitor patients for metabolic side-effects of prescribed drugs
19. No proof fibrate drugs reduce heart risk in diabetes patients on statins
20. Poultry farms that go organic have significantly fewer antibiotic-resistant bacteria
21. Red meat linked to increased risk of type 2 diabetes
22. Paper money worldwide contains bisphenol A
23. High levels of potentially toxic flame retardants in California pregnant women
24. Antioxidant spices reduce negative effects of high-fat meal
25. New American Chemical Society podcast: Banana peels purify contaminated water
26. Scared of the wrong things: Lack of major enzyme causes poor threat-assessment in mice
27. Get Off the Couch, Please!
28. Blood Tests for Active TB Not Accurate or Cost-Effective
29. Low vitamin D linked to earlier first menstruation, a risk factor for health problems throughout life
30. Contrary to earlier findings, excess body fat in elderly decreases life expectancy
Public release date: 1-Aug-2011
Study finds exposure to magnetic fields in pregnancy increases asthma risk
OAKLAND, Calif., August 1, 2011 – Women with high exposure to magnetic fields during pregnancy may have a higher risk of asthma in their children, according to a Kaiser Permanente study appearing online in the Archives of Pediatrics & Adolescent Medicine.
In this prospective study, researchers compared the daily magnetic field exposure of 801 pregnant women in Kaiser Permanente Northern California and used electronic medical records to follow their children for 13 years to see which children developed asthma. The study found that women with high MF exposure in pregnancy had a more than threefold risk of asthma in their offspring compared with mothers whose exposure level was low.
This is the first study to demonstrate a link between maternal magnetic field exposure in pregnancy and the risk of asthma in offspring. Previous research has found that MF – generated typically by power lines and appliances such as microwave ovens, hair dryers and vacuum cleaners — could lead to miscarriage, poor semen quality, immune disorders, and certain type of cancers. Recently, the International Agency for Research on Cancer, a WHO agency, classified radio frequency EMF as a possible carcinogen.
“While the replication of the finding is needed, the message here is exposure to electromagnetic fields is not good, and we need to pay attention to its adverse effect on health,” said study lead author De-Kun Li, MD, PhD, a reproductive and perinatal epidemiologist at the Kaiser Permanente Division of Research in Oakland, Calif. Dr. Li published the original study in 2002 that found high MF exposure can lead to miscarriage.
The prevalence of asthma has been steadily rising since the 1980s, making it the most common chronic condition among children. Thirteen percent of children under 18 have asthma, which is caused by malfunction of the respiratory organs and the immune system.
“EMF exposure is ubiquitous. Because of the widespread exposure, any adverse health effect of EMF could impact many people and cause a serious public health problem”, said Dr. Li.
Studying the EMF health effect has been difficult because everyone is exposed to EMF at some level, so there is no truly “unexposed control group” for easy comparison, researchers said. Health researchers must rely on comparing those with high EMF exposure levels to those with low EMF exposure levels to detect potential adverse EMF effects, Li said.
Women in this study wore a small meter during their pregnancy that measured their daily exposure to low
frequency MFs from electricity-related sources such as microwave ovens, hair dryers, vacuum cleaners, fans, coffee grinders and fluorescent light bulbs, power lines, and transformer stations. This study did not measure high frequency (radio frequency) MFs from wireless networks, wireless towers and wireless devices such as cell phones and smart meters. The researchers adjusted for study participants who lived near freeways but it did not change the results of the EMF-asthma association.
“In this study, we observed a dose-response relationship between mother’s MF level in pregnancy and the asthma risk in her offspring. In other words, a higher maternal MF exposure during pregnancy led to a higher asthma risk in offspring,” Dr. Li said.
In this new study, the researchers also found that two known risk factors for asthma, maternal history of asthma and being the first-born child, exacerbated the MF effect on the asthma risk. “This finding further supports the MF-asthma association,” says Dr. Li.
“The best way to reduce your magnetic field exposure is distance. Magnetic field strength drops dramatically with increasing distance from the source,” said Li. “So pregnant women should try to limit their exposure to known MF sources and keep distance from them when they are in use.”
Public release date: 1-Aug-2011
Some exercise is better than none; more is better to reduce heart disease risk
Even small amounts of physical activity will help reduce heart disease risk, and the benefit increases as the amount of activity increases, according to a quantitative review reported in Circulation, journal of the American Heart Association.
People who engaged in 150 minutes of moderate-intensity leisure activity had a 14 percent lower risk of coronary heart disease (CHD) compared to those who reported no exercise or physical activity. At higher levels of activity, the relative risk of CHD was progressively lower. Researchers found that even people who got below the United States guidelines for physical activity, which recommends 2 hours and 30 minutes of moderate exercise per week, had a lower risk of CHD than those who had no activity.
“The overall findings of the study corroborate federal guidelines – even a little bit of exercise is good, but more is better – 150 minutes of exercise per week is beneficial, 300 minutes per week will give even more benefits,” said Jacob Sattelmair, ScD, of the Department of Epidemiology at the Harvard School of Public Health.
Sattelmair said this work differs from previous reviews of studies examining physical activity and heart disease risk because it included quantitative assessments of the amount of physical activity a person may need to reduce their risk as well as the magnitude of benefit. In a meta-analysis, researchers examined more than 3,000 studies of physical activity and heart disease, and included 33 of them in their analysis. Among those, nine measured leisure activity quantitatively.
“Early studies broke people into groups such as active and sedentary. More recent studies have begun to assess the actual amount of physical activity people are getting and how that relates to their risk of heart disease.”
The study also notes a significant interaction by gender, as these results were stronger in women than in men.
Public release date: 1-Aug-2011
Smoking’s up-side: Nicotine protects the brain from Parkinson’s disease
New research in the FASEB Journal suggests that nicotine protects dopamine neurons in the brain, by activating the alpha-7 nicotinic receptor
Bethesda, MD—If you’ve ever wondered if smoking offered society any benefit, a new research report published in The FASEB Journal (https://www.fasebj.org) offers a surprising answer. Nicotine protects us from Parkinson’s disease, and the discovery of how nicotine does this may lead to entirely new types of treatments for the disease.
“This study raises the hope for a possible neuroprotective treatment of patients at an early step of the disease or even before at a stage where the disease has not been diagnosed according to motor criteria,” said Patrick P. Michel, co-author of the study from the Institut du Cerveau et de la Moelle Épinière, Hôpital de la Salpêtrière, in Paris, France.
To make this discovery, scientists used mice genetically engineered without a specific nicotine receptor (the alpha-7 subtype) and mice with a functional receptor. Using tissue from mouse embryos, researchers prepared brain cultures using conditions that favor the slowly progressing loss of dopamine neurons, a hallmark of the disease. The scientists found that nicotine had the potential to rescue dopamine neurons in cultures from normal mice, but not in cultures from mice without the nicotine receptor. These findings suggest that it may be feasible to develop novel therapies for Parkinson’s disease that target nicotine receptors, particularly the alpha-7 nicotine receptor.
“If you’re a smoker, don’t get too excited,” said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. “Even if smoking protects you from Parkinson’s, you might not live long enough to develop the disease because smoking greatly increases the risk for deadly cancers and cardiovascular diseases. But now, we should be able find non-toxic ways to hit the same target.”
Public release date: 2-Aug-2011
Academics ‘guest authoring’ ghostwritten medical journal articles should be charged with fraud
Ghostwriting and guest authoring in industry-controlled research raise ‘serious ethical and legal concerns, bearing on integrity of medical research and scientific evidence used in legal disputes,’ say UofToronto law professors
(Toronto, ON) Two University of Toronto Faculty of Law professors argue that academics who ‘lend’ their names, and receive substantial credit, as guest authors of medical and scientific articles ghostwritten by industry writers, should be charged with professional and academic misconduct and fraud, even if they contain factually correct information.
In an article published today in PLoS Medicine, Professors Simon Stern and Trudo Lemmens argue “Guest authorship is a disturbing violation of academic integrity standards, which form the basis of scientific reliability.” In addition, “The false respectability afforded to claims of safety and effectiveness through the use of academic investigators risks undermining the integrity of biomedical research and patient care.”
In “Legal Remedies for Medical Ghostwriting: Imposing Fraud Liability on Guest Authors of Ghostwritten Articles,” Stern and Lemmens argue that since medical journals, academic institutions, and
professional disciplinary bodies have not succeeded in enforcing effective sanctions, a more successful deterrence would be through the imposition of legal liability on the guest authors, “and may give rise to claims that could be pursued in a class action based on the Racketeer Influenced and Corrupt Organizations Act (RICO).”
The authors continue: “The same fraud could support claims of ‘fraud on the court’ against a pharmaceutical company that has used ghostwritten articles in litigation.” Such a claim could prevent the pharmaceutical sponsor of the articles from presenting them as evidence in court, and could also lead to sanctions against the lawyers who sought to treat the articles as legally valid evidence.
Concerns about ghostwriting have troubled the medical profession and editors of medical journals for years. Industry-sponsored articles, with only minor contributions from academic “guest authors,” have been published in leading medical journals, including articles on Hormone Replacement Therapies, Vioxx, Neurontin, Fen-Phen, and various anti-depressants. These articles are often cited by the pharmaceutical sponsors to promote off-label use of their products.
Lemmens, who is also cross-appointed to the Faculty of Medicine, has tough words for academics who participate in this guest authorship-ghostwriting dance. “It’s a prostitution of their academic standing. And it undermines the integrity of the entire academic publication system.”
Ralph’s Note- After all the people that have died from fabricated science. Fraud should be the very least that happens to them.. A vast majority of People have no clue, how little some medical professionals care about the unnecessary torturous pain they inflict on them or their children for a few extra bucks…
Public release date: 2-Aug-2011
Why diets don’t work? Starved brain cells eat themselves
A report in the August issue of the Cell Press journal Cell Metabolism might help to explain why it’s so frustratingly difficult to stick to a diet. When we don’t eat, hunger-inducing neurons in the brain start eating bits of themselves. That act of self-cannibalism turns up a hunger signal to prompt eating.
“A pathway that is really important for every cell to turn over components in a kind of housekeeping process is also required to regulate appetite,” said Rajat Singh of Albert Einstein College of Medicine.
The cellular process uncovered in neurons of the brain’s hypothalamus is known as autophagy (literally self-eating.) Singh says the new findings in mice suggest that treatments aimed at blocking autophagy may prove useful as hunger-fighting weapons in the war against obesity.
The new evidence shows that lipids within the so-called agouti-related peptide (AgRP) neurons are mobilized following autophagy, generating free fatty acids. Those fatty acids in turn boost levels of AgRP, itself a hunger signal.
When autophagy is blocked in AgRP neurons, AgRP levels fail to rise in response to starvation, the researchers show. Meanwhile, levels of another hormone, called I-melanocyte stimulating hormone, remain elevated. That change in body chemistry led mice to become lighter and leaner as they ate less after fasting, and burned more energy.
Autophagy is known to have an important role in other parts of the body as a way of providing energy in times of starvation. However, unlike other organs, earlier studies had shown the brain to be relatively
resistant to starvation-induced autophagy.
“The present study demonstrates the unique nature of hypothalamic neurons in their ability to upregulate autophagy in response to starvation that is consistent with the roles of these neurons in feeding and energy homeostasis,” the researchers wrote.
Singh said he suspects that fatty acids released into the circulation and taken up by the hypothalamus as fat stores break down between meals may induce autophagy in those AgRP neurons. Singh’s research earlier showed a similar response in the liver.
On the other hand, he says, chronically high levels of fatty acids in the bloodstream, as happens in those on a high-fat diet, might alter hypothalamic lipid metabolism, “setting up a vicious cycle of overfeeding and altered energy balance.” Treatments aimed at the pathway might “make you less hungry and burn more fat,” a good way to maintain energy balance in a world where calories are cheap and plentiful.
The findings might also yield new insight into metabolic changes that come with age given that autophagy declines as we get older. “We already have some preliminary evidence there might be changes with age,” Singh said. “We are excited about that.”
Public release date: 2-Aug-2011
Brain chemical may explain why heavy smokers feel sad after quitting
August 2 (Toronto) – Heavy smokers may experience sadness after quitting because early withdrawal leads to an increase in the mood-related brain protein monoamine oxidase A (MAO-A), a new study by the Centre for Addiction and Mental Health (CAMH) has shown. This finding, which was published in the Archives of General Psychiatry, may also explain why heavy smokers are at high risk for clinical depression.
Using an advanced brain imaging method, a team led by Senior Scientist Dr. Jeffrey Meyer discovered that MAO-A levels in the brain regions that control mood rose by 25 per cent eight hours after withdrawal from heavy cigarette smoking. These levels were much higher than in a comparison group of non-smoking study participants. All 48 participants filled out questionnaires, and smokers with high brain MAO-A levels during withdrawal also reported greater feelings of sadness.
“Understanding sadness during cigarette withdrawal is important because this sad mood makes it hard for people to quit, especially in the first few days. Also, heavy cigarette smoking is strongly associated with clinical depression,” said Dr. Meyer, who holds a Canada Research Chair in the Neurochemistry of Major Depression. “This is the first time MAO-A, a brain protein known to be elevated in clinical depression has been studied during cigarette withdrawal.”
MAO-A “eats up” chemicals in the brain, such as serotonin, that help maintain a normal mood. When MAO-A levels are higher as in early cigarette withdrawal, it means that this removal process is overly active, making people feel sad. For this study, MAO-A was detected using a brain imaging technique called positron emission tomography (PET). CAMH has the only PET scanner in the world dedicated solely to mental health and addiction research.
A specific substance in cigarette smoke, called harman, may be responsible for these changes, the researchers note. During active smoking, harman attaches to MAO-A. During early withdrawal in heavy smokers who had 25 or more cigarettes a day, MAO-A levels rose rapidly to a level beyond that seen in the healthy comparison group.
“This study opens new ways to prevent sad mood during cigarette withdrawal to make it easier to quit smoking. For example, it may be possible to improve the existing cigarette filters that partially screen out harman, or regulate the amount of tryptophan contained in cigarettes, since tryptophan becomes harman when it burns,” said Dr. Meyer, who is also head of the Neurochemical Imaging Program in Mood Disorders at CAMH’s Research Imaging Centre, and professor of psychiatry at the University of Toronto. “We also identified MAO-A as a target to shut down during the early critical stage of withdrawal with a short course of medication, but this requires further study.”
“This finding may explain why heavy smokers are at high risk for clinical depression,” says Dr. Anthony Phillips, Scientific Director of the Canadian Institutes of Health Research’s (CIHR’s) Institute of Neurosciences, Mental Health and Addiction, which funded this study.
Public release date: 2-Aug-2011
Cooked green vegetables, dried fruit, legumes, and brown rice associated with fewer colon polyps
High consumption of these foods may decrease risk for colorectal cancer, says Loma Linda University
LOMA LINDA, Calif. — Eating legumes at least three times a week and brown rice at least once a week was linked to a reduced risk of colon polyps by 33 percent and 40 percent respectively, according to Loma Linda University research recently published in Nutrition and Cancer. High consumption of cooked green vegetables and dried fruit was also associated with greater protection, the study shows.
“Eating these foods is likely to decrease your risk for colon polyps, which would in turn decrease your risk for colorectal cancer,” says lead author Yessenia Tantamango, MD, a post-doctoral research fellow with Adventist Health Study-2 at Loma Linda University. “While a majority of past research has focused on broad food groups, such as fruits and vegetables, in relation to colon cancer, our study focused on specific foods, as well as more narrowed food groups, in relation to colon polyps, a precursor to colon cancer. Our study confirms the results of past studies that have been done in different populations analyzing risks for colon cancer.”
Colon cancer is the second leading cause of cancer death in the United States and the third most common cancer in both men and women, according to the American Cancer Society.
Results also show that consuming cooked green vegetables once a day or more, as compared to less than five times a week, was associated with a 24 percent reduction in the risk of rectal/colon polyps. Consuming dried fruit three times a week or more, versus less than once a week, was associated with a 26 percent reduced risk.
The protective effects of these foods could be due in part to their cancer-fighting agents, the study reported.
“Legumes, dried fruits, and brown rice all have a high content of fiber, known to dilute potential carcinogens,” Dr. Tantamango says. “Additionally, cruciferous vegetables, such as broccoli, contain detoxifying compounds, which would improve their protective function.”
Past studies examining the effect of meat intake and legumes on colon cancer have shown that people eating meat, associated with an increased risk of colon cancer, may receive some protection when they also consume legumes. Dr. Tantamango says this suggests that besides fiber content, there may be
something else present in legumes that provides a protective effect.
Researchers analyzed data from 2,818 subjects who participated in Adventist Health Study-1 (administered from 1976-77) and who answered a follow-up survey 26 years later from Adventist Health Study-2. The first survey asked respondents to indicate how often, on average, they consumed specific foods. The follow-up survey asked respondents who had undergone colonoscopies to indicate physician- diagnosed colorectal polyps. During the 26-year follow-up, 441 cases of rectal/colon polyps were identified.
The study assessed several possible confounding factors, including a family history of colorectal cancer, education, physical activity level, alcohol intake, smoking, constipation, intake of sweets, pain medication, and multivitamins, as well as different food variables. The study then adjusted for those factors that were shown to distort the effect of the foods and food groups under study. About 25 foods and food groups in total were examined.
Dr. Tantamango says there is a need for future studies to examine foods shown to reduce the risk of colon polyps, since it is possible that interactions between various nutrients with anti-cancerous properties will be better able to explain these findings.
Public release date: 2-Aug-2011
Newer antidepressants not necessarily safest for older people
Research: Antidepressant use and the risk of adverse outcomes in older people: population-based cohort study
New generation antidepressants, known as selective serotonin reuptake inhibitors (SSRIs) are associated with an increased risk of several severe adverse outcomes in older people compared with older tricyclic antidepressants (TCAs), finds a study published on bmj.com today.
The authors say the risks and benefits of different antidepressants should be carefully evaluated when prescribing these drugs to older people.
Depression is a common condition in older people, and antidepressants – particularly SSRIs – are widely used. Yet very little is known about the safety of these drugs in older people.
So a team of researchers at the Universities of Nottingham and East Anglia set out to investigate the association between antidepressant treatment and the risk of a number of potentially life threatening outcomes in older people.
They identified 60,746 UK patients aged 65 and over with a newly diagnosed episode of depression between 1996 and 2007. Many patients had other conditions, such as heart disease and diabetes, and were taking several medications.
Patients were tracked until the end of 2008. During this time, 54,038 (89%) received at least one prescription for an antidepressant: 55% of prescriptions were for SSRIs, 32% for TCAs, 0.2% for monoamine oxidase inhibitors (MAOIs), and 13.5% for other antidepressants.
Antidepressant use was then analysed against several adverse outcomes including all-cause mortality, attempted suicide or self harm, heart attack, stroke, falls, fractures, epilepsy or seizures, and hyponatraemia (high salt levels in the blood).
After adjusting for factors which could affect the results, including age, sex, severity of depression, other illnesses and use of other medications, the team found that SSRIs and drugs in the group of other antidepressants were associated with an increased risk of several adverse outcomes compared with TCAs.
SSRIs were associated with an increased risk of all-cause mortality, stroke, falls, fracture, epilepsy or seizures, and hyponatraemia compared with TCAs. The group of other antidepressants were associated with an increased risk of all-cause mortality, attempted suicide or self harm, stroke, fracture, and epilepsy or seizures.
Depressed patients who were not taking antidepressants at all had a 7% risk of dying (absolute risk of all- cause mortality) some time in the next year, while the comparable risks were 8.1% for those taking TCAs, 10.6% for SSRIs, and 11.4 % for the group of other antidepressants. For stroke, one-year risks were 2.3%, 2.6% and 3.0% (compared to 2.2% for those not on antidepressants) and for fracture they were 2.2%, 2.7% and 2.8% compared to 1.8%.
Among individual drugs, trazodone, mirtazapine and venlafaxine were associated with the highest risks for several outcomes.
Rates of most outcomes were highest in the first 28 days after starting an antidepressant, and also in the first 28 days after stopping.
The authors point out that TCAs were prescribed at lower doses than SSRIs and other antidepressant drugs, which they say “could in part explain our findings.” They also warn that differences between patients prescribed different antidepressant drugs may account for some of the associations seen in the study and suggest that further research is needed to confirm these findings.
However, they conclude that the risks and benefits of different antidepressants should be carefully evaluated when prescribing these drugs to older people.
In an accompanying editorial, Professor Ian Hickie from the University of Sydney says that, despite some limitations, “the study has clear implications for more informed prescribing and enhanced clinical monitoring.”
He adds: “Given the potential harms, the decision to prescribe for an older person with depression should not be taken lightly.”
Public release date: 2-Aug-2011
Can Eggs Be a Healthy Breakfast Choice?
TAU researcher says the answer is on a hen’s plate
Eggs, one of the most commonly consumed breakfast foods in the United States, have long been a subject of controversy. Are they healthy or are they a high-cholesterol trap? The answer depends on what the hen eats, says a Tel Aviv University researcher.
Dr. Niva Shapira of Tel Aviv University’s School of Health Professions says that all eggs are not created equal. Her research indicates that when hens are fed with a diet low in omega-6 fatty acids from a young age — feed high in wheat, barley, and milo and lower in soy, maize and sunflower, safflower, and maize oils — they produce eggs that may cause less oxidative damage to human health. That’s a major part of what determines the physiological impact of the end product on your table.
Her findings were published in the Journal of Agricultural and Food Chemistry.
Cholesterol oxidation: an industry standard?
Eggs high in omega-6 fatty acids heighten cholesterol’s tendency to oxidize, which forms dangerous plaque in our arteries. Dr. Shapira’s research shows that eggs laid by hens with healthier feed can lessen oxidation of LDL (low density lipoprotein), the body’s “bad cholesterol.”
But healthier eggs are likely to cost more, Dr. Shapira says. The price of chicken feed varies from region to region, and in many areas, feed containing products high in omega-6 fatty acids, such as maize, soy, and their oils, are much cheaper for egg producers to purchase.
To test the effect of a healthier feed on the eventual composition of the egg, Dr. Shapira and her fellow researchers designed feeds that were high in anti-oxidants and lower in omega-6 fatty acids, based on wheat, barley, and milo. The specialized feed was given to young hens who had not yet accumulated n-6 fatty acids in their tissues, and the composition of their eggs was then tested. When researchers achieved the desired composition of low omega-6 and high anti-oxidants, the eggs were given to test participants, who were instructed to eat two of these special eggs daily. Their results were measured against daily intake of two standard grocery store eggs, and a weekly intake of only two to four standard eggs.
There were vast differences in outcome among the treatments. Daily consumption of two industry- standard eggs, high in omega-6, caused a 40 percent increase in LDL oxidizability in participants. After eating two per day of the specially-composed eggs, with both high anti-oxidant and low omega-6 levels, however, LDL oxidation levels were similar to the control group eating only two to four eggs a week.
Surprisingly, with the “healthier” eggs, we might be able to eat more than twice today’s generally recommended egg intake and still maintain a healthy level of LDL oxidation, Dr. Shapira concludes.
Demanding a better product
The drawback is that these eggs aren’t being widely produced. For now, consumers can only buy what the grocery store stocks.
Dr. Shapira recommends that consumers demand “health-oriented agriculture.” “In addition to factoring in the cost of the chicken feed, farmers need to think about the health of the consumer,” she says. To produce healthy foods, they need support from local authorities and increased consumer awareness. That would help to expand access to better foods.
As her study demonstrates, consumers should beware of egg studies that draw a single conclusion about the health value of all eggs, Dr. Shapira cautions, because the outcome could have a lot to do with how the egg was produced. In Europe, corn and soy are less commonly used in chicken feed, whereas in North America, these two ingredients often make up the bulk of the hen’s diet.
Public release date: 2-Aug-2011
What’s in a kids meal? Not happy news
UC San Diego researchers tally the nutritional value of what kids actually eat at a fast food restaurant
High-calorie, high-sodium choices were on the menu when parents purchased lunch for their children at a San Diego fast-food restaurant. Why? Because both children and adults liked the food and the convenience.
However, the study of data compiled by researchers in the Department of Pediatrics at the University of California, San Diego, appearing this week in the new journal, Childhood Obesity, showed that convenience resulted in lunchtime meals that accounted for between 36 and 51 percent of a child’s daily caloric needs. In addition, 35 to 39 percent of calories came from fat and the meals provided more than 50 percent of the recommended total daily sodium intake for most children– and as high as 100 percent of sodium levels recommended for pre-schoolers.
“We found that families perceived fast-food restaurants as easy and cheap, and many were using fast food as a reward for their children,” said Kerri N. Boutelle, PhD, Behavioral Director of the Weight and Wellness Clinic at the University of California, San Diego and Rady Children’s Hospital-San Diego, who has studied childhood obesity, its causes and treatment for over 15 years. “Considering the high prevalence of fast-food consumptions by adults as well as kids, it’s important to recognize the impact of fast food and its impact on the current obesity epidemic in the U.S.”
The UC San Diego researchers surveyed 544 families with children entering a fast-food chain restaurant located inside Rady Children’s Hospital in San Diego, California at lunch time over a six-week period. Families were asked to retain and present their receipts from food purchases and complete a brief survey. Families were provided a $2 incentive to participate.
Families were asked to clarify their purchases: for whom each item was purchased, if items were shared, sizes of individual items (small, medium, large), whether soft drinks were regular or diet, what items were included in any combination meals purchased, and if there were any modifications to their order. For every purchased item, the surveyors asked for age and gender of the person eating it.
“The number of meals and snacks eaten away from home is believed to contribute to excess calories consumed by children, and this number has increased dramatically in the past 30 years,” said Boutelle. “On a typical day, a remarkable 30 percent of youth report consuming fast food.”
The purpose of the study was to evaluate the nutritional content and quality of food, as well as the reasons reported for dining at a fast-food restaurant. Perhaps unsurprisingly, the top reasons for going to this restaurant were “the children like the food” and it was “convenient.” Just over half the families reported the choice as “a reward for visiting the hospital” (about the same number as replied “hungry with no other options”).
But adults also overwhelmingly reported that they liked the food. The toys included with the children’s meals did not appear to be a top reason (49 percent said it didn’t enter into their decision “at all”).
The nutritional content of the food choices supported other published data on fast-food and dietary intake on children. The highest percentage of daily caloric needs represented by these meals (51 percent) was in the age 2 to 5 years. Menu items most frequently purchased for preschoolers were French fries, soda, chicken nuggets, cheeseburgers and hamburgers. Meals for older children years were similar, with the addition of hot apple pies (ages 6 to 11) and chocolate chip cookies (ages 12 to 18).
Of note, soda was purchased much more often than milk or juice when a drink was purchased. The researchers also observed that while healthier options such as apple dippers or fruit parfaits were available, families did not seem to choose them over more typical fast foods.
Strengths of this study were that purchase receipts were an objective measure of meal choices, and a large number of families – both economically and ethnically diverse – was polled. However, limitations included the lack of data on what was actually consumed, and that the study may have been influenced by the restaurant’s location inside a children’s hospital, limiting the choice of restaurants if not the food choices themselves.
“Bottom line, we need to educate families on making health decisions when in a fast-food restaurant,” said Boutelle, acknowledging that any intervention to decrease fast-food consumption will need to take into account that people of all ages simply like fast food.
Public release date: 4-Aug-2011
Drinking just 1 measure of spirits increases the risk of acute pancreatitis
Wine and beer do not appear to have the same effect
Drinking just one 4cl measure of spirits can increase the risk of an acute attack of pancreatitis, but wine or beer does not appear to have the same effect, according to a study published online by BJS, the British Journal of Surgery.
Researchers from the Karolinska Institutet in Sweden followed 84,601 people from 46 to 84 years of age from the general population in Vastmanland and Uppsala for a median of ten years. During that time 513 developed acute pancreatitis.
“Our study revealed a steady increase between each measure of spirits a person drank on one occasion and the risk of having an acute attack of pancreatitis, starting at just under ten per cent for one 4cl drink” says lead author Dr Omid Sadr-Azodi.
“For example, drinking 20cl of spirits – five standard Swedish measures – on a single occasion increased the risk of an acute episode by 52 per cent and the risk then continued to increase at that rate for every five additional units consumed. But drinking more than five 15cl glasses of wine or five 33cl beers on one occasion did not increase the risk.
“We also discovered that the average monthly consumption of alcohol did not increase the risk. However, it is important to point out that most of the people included in our study drank alcohol within acceptable ranges, consuming one to two glasses a day.”
The authors were keen to investigate the affect that different types of alcohol had on acute pancreatitis after noticing that incidence rates declined in Sweden when spirits sales declined, despite increased sales of wine and beer. A similar pattern was observed in Finland.
Key findings of the study included:
•In 56 per cent of cases the cause of the acute pancreatitis was alcohol-related or of uncertain or unknown origin (66 per cent were men) and in 44 per cent of cases it was gallstone related (48 per cent were men). The average age of the patients with pancreatitis was 64 years.
•Single occasion alcohol consumption, including wine, beer and spirits, was highest in males and younger patients.
•High single occasion spirits consumption was associated with higher levels of diabetes (nine per cent) than low alcohol consumption (six per cent)
•People who had never smoked, were more highly educated and regularly ate fruit and vegetables were less likely to drink large quantities of beer and spirits.
•Eliminating patients with gallstone-related disease did not affect the overall results and only reduced the overall risk of an acute attack after consuming five measures of spirits from 52 per cent to 39 per cent.
“When alcohol metabolises it induces oxidative stress and this in turn can lead to damaged pancreatic tissue” says Dr Sadr-Azodi.
“However research has shown that alcohol on its own is not sufficient to cause acute pancreatitis. Our study suggests that there are constituents in spirits that are not present in wine and beer and that they can cause acute pancreatitis, either on their own or in combination with alcohol.”
The authors are calling for more research into the association between increased spirit consumption and acute pancreatitis, with a greater focus on constituents other than the alcohol.
Public release date: 4-Aug-2011
Prescriptions for Antidepressants Increasing among Individuals with no Psychiatric Diagnosis
Americans are no strangers to antidepressants. During the last 20 years the use of antidepressants has grown significantly making them one of the most costly and the third most commonly prescribed class of medications in the U. S. According to the Centers for Disease Control and Prevention, from 2005-2008 nearly 8.9 percent of the U.S. population had at least one prescription in this drug class during any given month. A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health examines national trends in antidepressant prescribing and finds much of this growth was driven by a substantial increase in antidepressant prescriptions by non-psychiatrist providers without any accompanying psychiatric diagnosis. The results are featured in the August 2011 issue of Health Affairs.
“We’ve seen a marked increase in antidepressant use among individuals with no psychiatric diagnosis. Nearly four out of every five antidepressant prescriptions are written by non-psychiatrist providers,” said Ramin Mojtabai, MD, PhD, MPH, lead author of the study and an associate professor with the Bloomberg School’s Department of Mental Health. “Between 1996 and 2007, the number of visits where individuals were prescribed antidepressants with no psychiatric diagnoses increased from 59.5 percent to 72.7 percent and the share of providers who prescribed antidepressants without a concurrent psychiatric diagnosis increased from 30 percent of all non-psychiatrist physicians in 1996 to 55.4 percent in 2007.”
Using data from the 1996-2007 National Ambulatory Medical Care Surveys, researchers reviewed a national sample of office-based physician visits by patients ages 18 years and older during a one-week period. They conducted two sets of logistic regression analyses, comparing antidepressant visits lacking psychiatric diagnoses with antidepressant visits including psychiatric diagnoses and visits lacking both prescriptions for antidepressants and psychiatric diagnoses. In addition, Mojtabai and colleagues assessed physician practice-level trends in antidepressant visits without psychiatric diagnosis and found that in the general medicine practice, antidepressant use was concentrated among people with less severe and poorly defined mental health conditions.
An earlier study led by Mojtabai and published in the Journal of Affective Disorders examined the impact of expansion of antidepressant use on the prevalence and characteristics of depression and suicidal ideations. That study found that antidepressant use significantly reduced the prevalence of more severe
depression and suicidal ideations among individuals with sever depressive episodes. The findings lead researchers to recommend that antidepressants be prescribed primarily to individuals with severe depression or a confirmed psychiatric diagnosis.
“With non-specialists playing a growing role in the pharmacological treatment of common mental disorders, practice patterns of these providers are becoming increasingly relevant for mental health policy,” adds Mojtabai. “To the extent that antidepressants are being prescribed for uses not supported by clinical evidence, there may be a need to improve providers’ prescribing practices, revamp drug formularies or undertake broad reforms of the health care system that will increase communication between primary care providers and mental health specialists.”
“The Proportion of Antidepressants Prescribed Without a Psychiatric Diagnosis is Growing” was written by Ramin Mojtabai and Mark Olfson and was supported in part by the Agency for Healthcare Research and Quality.
“The public health impact of antidepressants: An instrumental variable analysis” was written by Ramin Mojtabai.
Public release date: 9-Aug-2011
Authorship rules for medical journals flouted by pharma industry
Press release from PLoS Medicine
Rather than ensure the proper attribution of authorship, rules set up by leading medical journals to define and credit authorship of published articles are exploited by the pharmaceutical industry in its attempt to conceal and misrepresent industry contributions to the literature. This is a perspective contained in an article by Alastair Matheson, an academic and commercial consultant with extensive industry experience, based in the UK and Canada, who argues in this week’s PLoS Medicine that the current International Committee of Medical Journal Editors (ICMJE) authorship guidelines allow for industry to exaggerate the contribution of named academic authors and downplay that of commercial writers who are excluded from authorship but listed as contributors in the small print.
Matheson contends that the ICMJE guidelines should be fundamentally revised and the concept of origination given comparable importance to authorship and contributorship. Pharmaceutical companies and writers who work on industry publications should be listed as byline authors, he says.
In another perspective article, Linda Logdberg of Fernbank Science Center, USA, who worked in the medical communication industry for 11 years, offers her personal view of her work and why she did it, writing that “ethical concerns about medical ghostwriting have been directed primarily at ”guest” authors and the pharmaceutical companies that pay them. One voice that is largely missing is that of the ghostwriters themselves who, after all, create the documents that are in the ethical and legal crosshairs. Without them, one could argue, there can be no fraud, because it is they who create the fraudulent product.”
Ralph’s Note – Corruption among the Pharmaceutical industry is out of control. There are very few people that seem to be able to work our way out of this wholesale slaughter of people. Through the gradual poisoning of very poorly researched toxin/medicines. There is a reason these companies lie.
Public release date: 9-Aug-2011
Baker’s yeast protects against fatal infections
Injecting mice with simple baker’s yeast protects against the fatal fungal infection, aspergillosis, according to research published in the Journal of Medical Microbiology. The work could lead to the development of a human vaccine that protects immunocompromised people against a range of life- threatening fungal infections, for which current therapy often fails.
Researchers from the California Institute for Medical Research, Santa Clara Valley Medical Center and Stanford University gave mice three injections of killed Saccharomyces (baker’s yeast), one week apart. Vaccinated mice were able to survive high doses of Aspergillus – the fungus that causes aspergillosis. Mice that survived also showed a reduced infection load in their organs.
Aspergillosis is the leading fungal killer among immunocompromised individuals. It is an invasive infection that attacks the lungs, can disseminate to other organs, such as the brain, and can lead to kidney and liver failure. The disease currently has very high mortality as the current available therapy has a high failure rate.
The research team used a simple yeast preparation as a vaccine against Aspergillus in mice. They found that unmodified yeast gave just as much protection against the development of aspergillosis as yeasts that had been engineered to display Aspergillus surface proteins. Dr. David A. Stevens, from Santa Clara Valley Medical Center, in whose laboratory the studies were performed, said, “Our results suggest that the protective component of the yeast is in the cell wall. What’s more, the simple preparation we used has been shown by us to also protect against infection due to three other fungi that cause human disease – Candida, Cryptococcus and Coccidioides.”
Baker’s yeast is being studied by other groups in human clinical trials for other purposes and appears to be safe. “Research to date, including our study, supports the development of a yeast vaccine against all pathogenic fungi that infect humans. Such a ‘panfungal’ vaccine would further reduce mortality in immunocompromised individuals,” explained Dr. Stevens. “While vaccinating all individuals with impaired immune systems would be a formidable challenge, there are certain patient groups that might be the initial target of a vaccine effort. These include transplant candidates, leukemics following induction therapy and also patients diagnosed with solid tumours.”
Ralph’s note – Really would not call this a vaccine.
Public release date: 9-Aug-2011
Curry spice could offer treatment hope for tendinitis
A derivative of a common culinary spice found in Indian curries could offer a new treatment hope for sufferers of the painful condition tendinitis, an international team of researchers has shown.
In a paper due to be published in the Journal of Biological Chemistry, the researchers at The University of Nottingham and Ludwig Maximilians University in Munich have shown that curcumin, which also gives the spice turmeric its trademark bright yellow colouring, can be used to suppress biological mechanisms that spark inflammation in tendon diseases.
Dr Ali Mobasheri of the University’s School of Veterinary Medicine and Science, who co-led the research, said: “Our research is not suggesting that curry, turmeric or curcumin are cures for inflammatory conditions such as tendinitis and arthritis. “However, we believe that it could offer scientists
an important new lead in the treatment of these painful conditions through nutrition. Further research into curcumin, and chemically-modified versions of it, should be the subject of future investigations and complementary therapies aimed at reducing the use of non-steroidal anti-inflammatory drugs, the only drugs currently available for the treatment of tendinitis and various forms of arthritis.”
Tendons, the tough cords of fibrous connective tissue that join muscles to bones, are essential for movement because they transfer the force of muscle contraction to bones. However, they are prone to injury, particularly in athletes who may overstretch themselves and overuse their joints. Tendinitis (or tendonitis) is a form of tendon inflammation, which causes pain and tenderness near to joints and is particularly common in shoulders, elbows, knees, hips, heels or wrists. Other examples of common tendon disease include tennis and golfer’s elbow and Achilles tendinitis.
The global incidence of tendinitis is on the increase in line with the rise in ageing and inflammatory diseases. It is also linked to other arthritic and rheumatic diseases such as rheumatoid arthritis or metabolic diseases such as diabetes.
The only treatment is to relieve pain and reduce inflammation and the only medicines which are effective in treating tendinitis are non-steroidal anti-inflammatory drugs (NSAIDS), such as aspirin or ibuprofen. In more serious cases of tendon injury, steroid injections can be given directly into the tendon sheath to control pain and enable physical therapy to start.
However, NSAIDS and steroids are associated with undesired side effects including stomach ulcers, nausea, vomiting, heartburn, headache, diarrhoea, constipation, drowsiness and fatigue.
Consequently, there is an acute need for new treatments with fewer debilitating side effects.
This latest research centres on curcumin, a key ingredient of the spice turmeric, which has been used for centuries in traditional Indian or ‘Ayurvedic’ medicine as an anti-inflammatory agent and remedy for symptoms related to irritable bowel syndrome and other disorders.
More recently, studies have linked curcumin to potential uses in treating arthritis and a range of rheumatic diseases and, potentially, even as an agent to kill cancer cells directly or make them more sensitive to killing by chemotherapy and radiotherapy.
The Nottingham-Munich study used a culture model of human tendon inflammation to study the anti- inflammatory effects of curcumin on tendon cells. The main objective of the study was to observe the effects that curcumin had on the inflammatory and degenerative properties induced by signalling molecules called interleukins. Interleukins are a type of small cell-signalling protein molecules called cytokines that can activate a whole series of inflammatory genes by triggering a dangerous ‘switch’ called NF-κB.
The results showed that introducing curcumin in the culture system inhibits NF-κB and prevents it from switching on and promoting further inflammation.
The results follow on from another study by the Nottingham-Munich collaboration, published in the Journal of Biological Chemistry earlier this year, demonstrating that a compound found in red wine could have therapeutic potential for osteoporosis related bone loss in elderly patients, post-menopausal women and patients with rheumatoid arthritis.
The research found that resveratrol, a naturally occurring phytoestrogen found in the skin of red grapes, vines and various other fruits and nuts, inhibits inflammation in bone cells. Its effects extended to inhibiting the formation of osteoclasts, giant congregations of blood-derived cells responsible for bone degeneration, especially in osteoporosis in later life. Resveratrol prevented NF-
κB from switching on to trigger inflammation.
The results suggest that resveratrol plays a pivotal role in regulating the balance between the formation of new bone and bone loss, which can lead to weak or brittle bones.
The findings are an important step in the search for new drugs to treat conditions such as osteoporosis, which are currently treated using medications including calcium and vitamin D supplements and a class of drugs known as bisphosphonates. Post-menopausal women can also benefit from hormone replacement therapy (HRT), however, it is associated with a large number of side-effects ranging from headaches to behavioural changes and acne and long-term use can increase the risk of developing uterine cancer.
Public release date: 9-Aug-2011
Resistance training can help smokers kick the habit, according to Miriam Hospital study
•Smokers who regularly lifted weights more likely to quit smoking, sustain efforts
•Pilot study is the first to examine role of resistance training in smoking cessation
PROVIDENCE, R.I. – Resistance training, or weight lifting, can do more than just build muscle: it may also help smokers kick the habit, say researchers from The Miriam Hospital’s Centers for Behavioral and Preventive Medicine.
Although exercise has been shown to reduce many of the negative experiences that accompany quitting, such as cigarette cravings, withdrawal symptoms and weight gain, the majority of these studies have focused only on women and only on aerobic exercise. The Miriam study, published online by the journal Nicotine & Tobacco Research, is the first to examine resistance training as an aid for smoking cessation.
According to the findings, male and female smokers who completed a 12-week resistance training regimen as part of a standard smoking cessation treatment program were twice as likely to successfully quit compared to those who did not regularly lift weights.
“Cigarette smoking kills more than a thousand Americans every day, and while the large majority of smokers want to quit, less than five percent are able to do it without help,” said lead author Joseph Ciccolo, Ph.D., an exercise psychologist, researcher and physiologist with The Miriam Hospital’s Centers for Behavioral and Preventive Medicine. “We need any new tools that can help smokers successfully quit and it appears resistance training could potentially be an effective strategy.”
In their pilot study, Ciccolo and colleagues enrolled 25 male and female smokers between the ages of 18 and 65 who reported smoking at least five cigarettes a day for the past year or more. All participants received a 15-20 minute smoking cessation counseling session as well as an 8-week supply of the nicotine patch before being randomized into two groups.
The resistance training group engaged in two, 60-minute training sessions per week for 12 weeks. The full-body routine involved 10 exercises, with researchers gradually increasing weight and intensity every three weeks. Participants in the control group watched a brief health and wellness video twice a week.
At the end of the 12 weeks, 16 percent of smokers in the resistance training group had not only quit smoking, but they also decreased their body weight and body fat. In comparison, 8 percent of individuals in the control group had quit smoking, yet they increased their body weight and fat.
And the effects appear to be long-lasting: three months after the study was completed, 15 percent of those in the resistance training group had successfully maintained their quit attempt compared to 8 percent of the control group.
Although Ciccolo says the study’s results are “promising,” he cautions that further research is needed before resistance training can be used as a clinical treatment for smoking cessation.
According to the Centers for Disease Control and Prevention (CDC), more than 46 million American adults were current smokers in 2009 – or about one out of five people. Smoking costs the United States approximately $193 billion each year in health care expenditures and lost productivity.
Public release date: 9-Aug-2011
Can blaming others make people sick?
Concordia researchers probe link between bitterness and disease
Montreal, August 9, 2011 — Constant bitterness can make a person ill, according to Concordia University researchers who have examined the relationship between failure, bitterness and quality of life.
“Persistent bitterness may result in global feelings of anger and hostility that, when strong enough, could affect a person’s physical health,” says Carsten Wrosch, a professor in the Concordia University Department of Psychology and a member of the Centre for Research in Human Development.
Wrosch is particularly interested in why some people avoid bitterness at different stages of life and why others don’t. He’s incorporated his theoretical considerations regarding bitterness in “Self-Regulation of Bitterness Across the Lifespan,” a chapter from the recently published book, Embitterment: Societal, psychological, and clinical perspectives (Springer 2011).
Over the last 15 years, Wrosch has investigated how negative emotions, such as regret or sadness, affect people. Most recently, he has focused his attention on the impact of bitterness. With his co-author, Concordia alumna Jesse Renaud, they single out failure as one of the most frequent causes of bitterness. Anger and recrimination are its typical attendants.
Unlike regret, which is about self-blame and a case of “woulda, coulda, shoulda,” acrimony points the finger elsewhere — laying the blame for failure on external causes. “When harboured for a long time,” says Wrosch, “bitterness may forecast patterns of biological dysregulation (a physiological impairment that can affect metabolism, immune response or organ function) and physical disease.”
Bitterness as a medical disorder?
It is one thing to suggest that bitterness may cause sickness, quite another to propose that it be recognized as a mental illness. Such is the proposal that was first made by Michael Linden, head of the psychiatric clinic at Free University of Berlin in 2003.
Linden argues that bitterness is actually a medical disorder and should be categorized as post-traumatic embitterment disorder (PTED). He estimates that between one and two per cent of the population is embittered and by giving the condition a proper name, people with PTED will receive the therapeutic attention they deserve.
The jury is still out on this proposal. Wrosch and Renaud say bitterness can be avoided, if people who experience failure can find other ways to fulfil their goals. If they can’t, the researchers stress, it’s essential to disengage from the fruitless effort (e.g., to get promoted, to save a marriage) and reengage in something
that’s equally meaningful (e.g., a new job or passion).
Called self-regulation processes, disengaging and reengaging can be necessary for a person to avoid bitter emotions. “Any effective therapeutic intervention,” says Renaud, “hinges on the affected individual finding ways to self-regulate.”
In some cases, overcoming bitterness demands more than self-regulation. When bitterness arises from blaming other people, then recovery may involve others. “In order to deal with bitter emotions there may need to be something else required to enable a person to overcome the negative emotion — that something is forgiveness,” says Wrosch.
Public release date: 9-Aug-2011
Psychiatrists failing to adequately monitor patients for metabolic side- effects of prescribed drugs
People treated in psychiatric settings are receiving inadequate medical monitoring following high risk antipsychotic medication
New research from the University of Leicester demonstrates that psychiatrists are not offering adequate checks for metabolic complications that are common in patients with mental ill health – especially those prescribed antipsychotic medication.
Patients treated with antipsychotic medication, especially those with schizophrenia, have a high rate of metabolic problems, for example up to 60% have lipid abnormalities, 40% have high blood pressure, and 30% suffer from the metabolic syndrome. Some estimate that 90% of patients treated with antipsychotic medication have at least one metabolic risk factor.
Given this, there are strong reasons why patients under psychiatric care should be offered regular monitoring.
Researchers from the University of Leicester in the UK, Kortenberg, Belgium and Albert Einstein College of Medicine, Bronx, New York reviewed 48 studies (involving almost 300,000 individuals) conducted between 2000-2011 in five countries. The work is published online today (Wednesday August 10) in Psychological Medicine. The full paper can be viewed online at http://journals.cambridge.org/psm/Mitchell
The research found that only blood pressure and triglycerides were measured in more than half of patients who were under psychiatric care. Cholesterol, glucose and weight checks were offered to less than half.
Monitoring was similar in US and UK studies and for both inpatients and outpatients.
Dr Alex Mitchell, a consultant psychiatrist with the Leicestershire Partnership NHS Trust and a researcher at the University of Leicester, said: “This study highlights that psychiatrists are not always considering the metabolic complications of prescribed medication. Several guidelines highlight the need for regular medical checks (see Br J Psychiatry. 2011 Aug;199:99-105) but even after the release of guidelines, monitoring rates have remained low especially for those checks that need a blood test. Even in the most recent studies about a quarter of patients don’t receive weight or blood pressure checks. One explanation is that responsibility is often lost between psychiatry and general practice. We recommend that mental health providers schedule physical health checks as a mandatory part of routine care.”
Public release date: 10-Aug-2011
No proof fibrate drugs reduce heart risk in diabetes patients on statins
New England Journal of Medicine commentary
LOS ANGELES (Strictly Embargoed until Aug. 10, 2011 at 5:00 P.M. ET) — Type 2 diabetes patients, who face higher risk of cardiovascular disease, often take a combination of medications designed to lower their LDL or “bad” cholesterol and triglyceride levels while raising their HDL or “good” cholesterol because doctors long have thought that taken together, the drugs offer protection from heart attacks and improve survival.
But in a commentary in the current New England Journal of Medicine, a trio of doctors who served on a recent Food and Drug Administration panel that evaluated the drugs’ effectiveness says the commonly prescribed medications have not been proven successful at preventing heart attacks in Type 2 diabetes patients with elevated cholesterol.
The drugs, called fibrates, seek to lower blood triglyceride levels and raise the amount of HDL cholesterol. They often are prescribed to diabetes patients as an add-on to statins, drugs that lower LDL cholesterol.
Annual sales in the U.S. for the three fibrates now approved by the FDA — gemfibrozil (Lopid), fenofibrate (Tricor) and fenofibric acid (Trilipix) — amount to billions of dollars.
“There have been few studies regarding the clinical outcome efficacy of fibrates,” said Sanjay Kaul, MD, a commentary author and director of the Cardiology Fellowship Training Program at the Cedars- Sinai Heart Institute. “Thousands and thousands of Americans take fibrates every day but so far, there are no long-term studies showing that fibrates lower cardiovascular risk or improve survival among diabetes patients who are also on statins.”
The commentary calls for more studies. Meantime, the authors suggest that doctors prescribe the statin- fibrate combination only to diabetic patients at high risk for a heart attack and only after optimal control of LDL cholesterol has been achieved with statin treatment.
Public release date: 10-Aug-2011
Poultry farms that go organic have significantly fewer antibiotic- resistant bacteria
UMD School of Public Health Study suggests that removing antibiotic use from large-scale U.S. poultry farms can result in immediate and significant reductions in antibiotic resistance for some bacteria
Antibiotic use in conventional animal food production in the United States has created public health concern because it has been shown to contribute to the development of antibiotic-resistant bacteria that can potentially spread to humans. A new study, led by Dr. Amy R. Sapkota of the University of Marylan School of Public Health, provides data demonstrating that poultry farms that have transitioned from conventional to organic practices and ceased using antibiotics have significantly lower levels of drug- resistant enterococci bacteria. The study, published in Environmental Health Perspectives (online August 10, 2011), is the first to demonstrate lower levels of drug-resistant bacteria on newly organic farms in the United States and suggests that removing antibiotic use from large-scale U.S. poultry farms can result in immediate and significant reductions in antibiotic resistance for some bacteria.
“We initially hypothesized that we would see some differences in on-farm levels of antibiotic-resistant enterococci when poultry farms transitioned to organic practices. But we were surprised to see that the differences were so significant across several different classes of antibiotics even in the very first flock that was produced after the transition to organic standards,” explains Sapkota, an Assistant Professor with the
Maryland Institute for Applied Environmental Health. “It is very encouraging.”
Sapkota and her team, which included R. Michael Hulet (Pennsylvania State University), Guangyu Zhang, Sam Joseph and Erinna Kinney (University of Maryland), and Kellogg J. Schwab (Johns Hopkins Bloomberg School of Public Health), investigated the impact of removing antibiotics from U.S. poultry farms by studying ten conventional and ten newly organic large-scale poultry houses in the mid-Atlantic region. They tested for the presence of enterococci bacteria in poultry litter, feed, and water, and tested its resistance to 17 common antimicrobials.
“We chose to study enterococci because these microorganisms are found in all poultry, including poultry on both organic and conventional farms. The enterococci are also notable opportunistic pathogens in human patients staying in hospitals. In addition, many of the antibiotics given in feed to farm animals are active against Gram-positive bacteria such as the enterococci. These features, along with their reputation of easily exchanging resistance genes with other bacteria, make enterococci a good model for studying the impact of changes in antibiotic use on farms,” Sapkota explains.
While all farms tested positive for the presence of enterococci in poultry litter, feed, and water as expected, the newly organic farms were characterized by a significantly lower prevalence of antibiotic- resistant enterococci. For example, 67% of Enterococcus faecalis recovered from conventional poultry farms were resistant to erythromycin, while 18% of Enterococcus faecalis from newly organic poultry farms were resistant to this antibiotic. Dramatic changes also were observed in the levels of multi-drug resistant bacteria (organisms resistant to three or more antimicrobial classes) on the newly organic farms. Forty-two percent of Enterococcus faecalis from conventional farms were multi-drug resistant, compared to only 10% from newly organic farms, and 84% of Enterococcus faecium from conventional farms were multi-drug resistant compared to 17% of those from newly organic farms [see figure]. Multi-drug resistant bacteria are of particular public health concern because they can be resistant to all available antibiotics, and are therefore very difficult to treat if contracted by an animal or human.
“While we know that the dynamics of antibiotic resistance differ by bacterium and antibiotic, these findings show that, at least in the case of enterococci, we begin to reverse resistance on farms even among the first group of animals that are grown without antibiotics. Now we need to look forward and see what happens over 5 years, 10 years in time,” says Sapkota.
She expects that reductions in drug-resistant bacteria on US farms that “go organic” are likely to be more dramatic over time as reservoirs of resistant bacteria in the farm environment diminish.
Public release date: 10-Aug-2011
Red meat linked to increased risk of type 2 diabetes
Processed red meats especially boost risk
Boston, MA – A new study by Harvard School of Public Health (HSPH) researchers finds a strong association between the consumption of red meat—particularly when the meat is processed—and an increased risk of type 2 diabetes. The study also shows that replacing red meat with healthier proteins, such as low-fat dairy, nuts, or whole grains, can significantly lower the risk.
The study, led by An Pan, research fellow in the HSPH Department of Nutrition, will be published online in the American Journal of Clinical Nutrition on August 10, 2011 and will appear in the October print edition.
Pan, senior author Frank Hu, professor of nutrition and epidemiology at HSPH, and colleagues analyzed
questionnaire responses from 37,083 men followed for 20 years in the Health Professionals Follow-Up Study; 79,570 women followed for 28 years in the Nurses’ Health Study I; and 87,504 women followed for 14 years in the Nurses’ Health Study II. They also conducted an updated meta-analysis, combining data from their new study with data from existing studies that included a total of 442,101 participants, 28,228 of whom developed type 2 diabetes during the study. After adjusting for age, body mass index (BMI), and other lifestyle and dietary risk factors, the researchers found that a daily 100-gram serving of unprocessed red meat (about the size of a deck of cards) was associated with a 19% increased risk of type 2 diabetes. They also found that one daily serving of half that quantity of processed meat—50 grams (for example, one hot dog or sausage or two slices of bacon)—was associated with a 51% increased risk.
“Clearly, the results from this study have huge public health implications given the rising type 2 diabetes epidemic and increasing consumption of red meats worldwide,” said Hu. “The good news is that such troubling risk factors can be offset by swapping red meat for a healthier protein.”
The researchers found that, for an individual who eats one daily serving of red meat, substituting one serving of nuts per day was associated with a 21% lower risk of type 2 diabetes; substituting low-fat dairy, a 17% lower risk; and substituting whole grains, a 23% lower risk.
Based on these results, the researchers advise that consumption of processed red meat—like hot dogs, bacon, sausage, and deli meats, which generally have high levels of sodium and nitrites—should be minimized and unprocessed red meat should be reduced. If possible, they add, red meat should be replaced with healthier choices, such as nuts, whole grains, low-fat dairy products, fish, or beans.
Worldwide, diabetes has reached epidemic levels, affecting nearly 350 million adults. In the U.S. alone, more than 11% of adults over age 20—25.6 million people—have the disease, according to the Centers for Disease Control and Prevention. Most have type 2 diabetes, which is primarily linked to obesity, physical inactivity, and an unhealthy diet.
Previous studies have indicated that eating processed red meats increases the risk of developing type 2 diabetes. Risks from unprocessed meats have been less clear. For instance, in 2010, HSPH researchers found no clear evidence of an association between eating unprocessed meats and increased risk for either coronary heart disease or type 2 diabetes, but that study was based on smaller samples than the current study, and the researchers recommended further study of unprocessed meats. Another HSPH study in 2010 linked eating red meat with an increased risk of heart disease—which is strongly linked to diabetes—but did not distinguish between processed and unprocessed red meats.
This new study—the largest of its kind in terms of sample size and follow-up years—finds that both unprocessed and processed meats pose a type 2 diabetes risk, thus helping to clarify the issue. In addition, this study is among the first to estimate the risk reduction associated with substituting healthier protein choices for red meat.
“Our study clearly shows that eating both unprocessed and processed red meat—particularly processed—is associated with an increased risk of type 2 diabetes,” said Pan. He noted that the 2010 U.S. dietary guidelines continue to lump red meat together with fish, poultry, eggs, nuts, seeds, beans, and soy products in the “protein foods” group. But since red meat appears to have significant negative health effects—increased risk of diabetes, cardiovascular disease, and even total mortality, as suggested by several recent studies—Pan suggested the guidelines should distinguish red meat from healthier protein sources and promote the latter instead.
Public release date: 10-Aug-2011
Paper money worldwide contains bisphenol A
The cash register receipts that people place near paper money in billfolds, purses, and pockets has led to a worldwide contamination of paper money with bisphenol A (BPA) — a potentially toxic substance found in some plastics, thermal paper and other products. The amounts of BPA on dollars, Euros, rubles, yuans, and other currencies, are higher than in house dust, but human intake from currency is at least 10 times less than those from house dust. That’s the conclusion of a new study in the ACS’ journal Environmental Science & Technology.
Kurunthachalam Kannan and Chunyang Liao point out that manufacturers use BPA to make polycarbonate plastics used in some consumer products, including water bottles, sports equipment, and household electronics. Studies indicate that BPA acts as an endocrine disruptor — meaning it mimics the action of the sex hormone estrogen. Exposure to BPA has been linked to a variety of health problems.
Although a recent study found traces of BPA in U.S. currency, nobody knew until now about BPA in paper money worldwide.
The scientists’ analysis of 156 pieces of paper money from 21 countries found that all contained traces of BPA. The report notes, however, that “estimated daily intake from paper currencies were 10- fold lower than those reported from exposures due to [indoor] dust ingestion in the United States.” The highest BPA levels were in paper money from Brazil, the Czech Republic and Australia, while the lowest occurred in paper money from the Philippines, Thailand, and Vietnam. Levels in U.S. notes were about average.
Kannan and Liao also found that the most likely source of the BPA in the currency is the thermal paper used in cash register receipts. They showed that receipts can transfer BPA onto cash when placed next to it or when a receipt is touched before handling currency. “Although high levels of BPA were measured in paper currencies, human exposure through dermal [skin] absorption appears to be minor,” the article notes.
Public release date: 10-Aug-2011
High levels of potentially toxic flame retardants in California pregnant women
A new study finds that pregnant women in Northern California have the highest PBDE flame retardant exposures reported to date among pregnant women worldwide. It also describes some of the first evidence from humans that certain flame retardants may interfere with thyroid hormone signaling during pregnancy, which is critical to fetal brain development. The study, described as one of the most extensive to date on flame retardant exposures in pregnant women, appears in the ACS journal Environmental Science & Technology.
Ami Zota and colleagues note that the flame retardant chemicals, known as polybrominated diphenyl ethers (PBDEs), have been widely used in furniture foam, plastics, carpets, consumer electronics, wire insulation, and other products since the 1970s. Although California banned manufacture and import of certain PBDEs in 2004, human exposure continues from old products, house dust, food, and other sources. Studies suggest that PBDE exposure during pregnancy may disrupt thyroid function, with adverse effects on normal development of the fetus’s brain that persist throughout life, and also have adverse effects on the mother.
In their study of 25 second-trimester pregnant women in California, the researchers found the highest-ever levels of certain PBDEs among pregnant women worldwide. The high exposure most likely was the unintended consequence of California’s furniture flammability standards, which
manufacturers have met since 1975 by adding PBDE’s to foam in upholstered furniture, Zota and colleagues said. While preliminary, the study also found a link between PBDE levels and levels of thyroid-stimulating hormone, a substance produced in the brain, that helps regulate activity of the thyroid gland.
Public release date: 10-Aug-2011
Antioxidant spices reduce negative effects of high-fat meal
Eating a diet rich in spices, like turmeric and cinnamon, reduces the body’s negative responses to eating high-fat meals, according to Penn State researchers.
“Normally, when you eat a high-fat meal, you end up with high levels of triglycerides, a type of fat, in your blood,” said Sheila West, associate professor of biobehavioral health, Penn State, who led the study. “If this happens too frequently, or if triglyceride levels are raised too much, your risk of heart disease is increased. We found that adding spices to a high-fat meal reduced triglyceride response by about 30 percent, compared to a similar meal with no spices added.”
West and her colleagues prepared meals on two separate days for six men between the ages of 30 and 65 who were overweight, but otherwise healthy. The researchers added two tablespoons of culinary spices to each serving of the test meal, which consisted of chicken curry, Italian herb bread, and a cinnamon biscuit. The control meal was identical, except that spices were not included. The team drew blood from the participants every 30 minutes for three hours. They reported their findings in the current issue of the Journal of Nutrition.
“In the spiced meal, we used rosemary, oregano, cinnamon, turmeric, black pepper, cloves, garlic powder and paprika,” said Ann Skulas-Ray, postdoctoral fellow. “We selected these spices because they had potent antioxidant activity previously under controlled conditions in the lab.”
When the meal contained a blend of antioxidant spices, antioxidant activity in the blood was increased by 13 percent and insulin response decreased by about 20 percent.
According to West, many scientists think that oxidative stress contributes to heart disease, arthritis and diabetes. “Antioxidants, like spices, may be important in reducing oxidative stress and thus reducing the risk of chronic disease,” she said, adding that the spice dose they used provided the equivalent amount of antioxidants contained in 5 ounces of red wine or 1.4 ounces of dark chocolate.
Skulas-Ray noted that adding two tablespoons of spices to meals did not cause stomach upset in the participants. “They enjoyed the food and had no gastrointestinal problems,” she said. But, she added, “The participants were notified ahead of time that they would be eating highly spiced foods and they were willing to do so.”
In the future, West plans to investigate whether she can get the same results by adding smaller doses of spices to meals.
Public release date: 10-Aug-2011
New American Chemical Society podcast: Banana peels purify contaminated water
WASHINGTON, Aug. 10, 2011 — To the surprisingly inventive uses for banana peels which include polishing silverware, leather shoes, and the leaves of house plants, scientists have added purification of drinking water contaminated with potentially toxic metals. That’s the topic of the latest episode in the American Chemical Society’s (ACS) award-winning “Global Challenges/Chemistry Solutions” podcast series.
It actually points out that minced banana peel performs better than an array of other traditional purification materials.
Gustavo Castro and colleagues note in the podcast that mining processes, runoff from farms, and industrial wastes can all put heavy metals, such as lead and copper, into waterways. Heavy metals can have adverse health and environmental effects. Current methods of removing heavy metals from water are expensive, and some substances used in the process are toxic themselves. Previous work has shown that some plant wastes, such as coconut fibers and peanut shells, can remove these potential toxins from water. The researchers wanted to find out whether minced banana peels could also act as water purifiers.
They discovered that minced banana peel could quickly remove lead and copper from river water as well as, or better than, many other materials. A purification apparatus made of banana peels can be used up to 11 times without losing its metal-binding properties, they note. The team adds that banana peels are very attractive as water purifiers because of their low cost and because they don’t have to be chemically modified.
Public release date: 10-Aug-2011
Scared of the wrong things: Lack of major enzyme causes poor threat- assessment in mice
Mice without enzyme were also less inquisitive
LOS ANGELES — August 10, 2011 — Do you run when you should stay? Are you afraid of all the wrong things? An enzyme deficiency might be to blame, reveals new research in mice by scientists at the University of Southern California.
In a paper appearing in the October 2011 issue of the International Journal of Neuropharmacology, USC researchers show that mice lacking a certain enzyme due to genetic mutation are unable to properly assess threat. The mice exhibited defensive behaviors (such as biting or tail rattling) in the presence of neutral stimuli, such as plastic bottles.
Conversely, in the presence of true danger cues such as predator urine or an anesthetized rat, the mice with the enzyme mutation were less cautious and defensive than their littermates, even climbing on the unconscious rat.
Mice without the enzyme also took longer to leave an open chamber, indicating reduction in exploratory and escape tendencies.
“Taken together, our findings suggest that monoamine oxidase A deficiency leads to a general inability to appropriately assess contextual risk, as indicated by the inappropriateness of their defensive behaviors,” said senior author Jean C. Shih, University Professor and Boyd and Elsie Welin Professor of pharmacology and pharmaceutical sciences in the USC School of Pharmacy.
Monoamine oxidase A is the main enzyme in the brain that breaks down serotonin, norepinephrine and dopamine, which have been shown to contribute to the “fight or flight” impulse by raising heart rates and increasing blood and oxygen flow. Previous research in Shih’s lab and elsewhere has shown that deficiency in monoamine oxidase A causes aggression in mice and humans, but this study is among the first to clarify that what was perceived as aggressiveness may more accurately be described as an inability to properly adapt and respond to environmental cues.
“Mice without monoamine oxidase A exhibited a distinct inability to attune their response to the situation,” said Sean Godar, a post-doctoral research associate at the USC School of Pharmacy and co-lead author of the study. “The paradoxical responses to neutral and fear-inducing stimuli are markedly reminiscent of deficits in facial affect processing in schizophrenia and autism.”
The researchers found no significant differences in sensory ability between the mice with a monoamine oxidase A deficiency and their littermates — both groups found buried mini-chocolate cereal chips at about the same rate, on average, and were similarly able to traverse a ledge and recognize objects.
“When compared to the broader, multi-faceted behavioral repertoire of other mice, the behavior observed in mice without monoamine oxidase A may reflect a limited range of emotional responses and flexibility,” said Marco Bortolato, co-lead author of the study and research assistant professor of pharmacology and pharmaceutical sciences at the USC School of Pharmacy.
The researchers suggest that the strange defensive behavior exhibited by the enzyme-deficient mice may actually reflect a limited range of adaptive responses and lack of emotional flexibility — the mice may only have one gear for fear.
Public release date: 10-Aug-2011
Get Off the Couch, Please!
Arthritis sufferers are not engaging in physical activity critical to their health
By Erin White
CHICAGO — Being physically active is one of best ways people with arthritis can improve their health, but a new study from Northwestern University Feinberg School of Medicine shows that more than half of women and 40 percent of men with arthritis are virtually couch potatoes.
This is the first study to use a device to objectively measure the physical activity of people with arthritis and determine if they meet federal guidelines. Past research relied on self-reported accounts of exercise and activity.
The study was published in Arthritis & Rheumatism, August 2011.
Researchers asked more than 1000 people with radiographic knee osteoarthritis to wear an accelerometer-
–a small, sophisticated device that looks like a pedometer—to measure their physical activity for one week during waking hours. The participants are part of a larger national study called the Osteoarthritis Initiative and are 49 to 84 years old.
“We had assumed that people might be overstating physical activity in past self-reported data, but were surprised to find that the physical activity rates were much, much lower than what was
previously reported,” said Dorothy Dunlop, associate professor of medicine at Feinberg and lead author of the study.
Physical activity can help people with arthritis better control and lower pain and improve general function. Some studies indicate exercise may delay or even prevent disability in people with arthritis, Dunlop said.
The federal guidelines recommend that adults with arthritis participate in 150 minutes per week of moderate-intensity, low-impact activity. That amounts to an average of slightly more than 20 minutes per day. Previous studies estimated that a quarter of people with arthritis met those guidelines.
“This study found that fewer than one in seven men and one in 12 women met those guidelines when we had this objective measure, using the accelerometer,” said Dunlop a health services researcher who also is with the Institute for Healthcare Studies at Feinberg. “The more alarming finding is that so many people actually qualified as being inactive.”
Participants were deemed inactive if they failed to sustain a 10- minute period of moderate-to-vigorous activity over the entire week of wearing the accelerometer. A substantial 40.1 percent of men and 56.5 percent of women studied were found to be inactive.
While more than half of men engaged in significantly more moderate-to-vigorous activity than women, the majority of men who didn’t fall into this category were spending their time in no to very light activity.
“The fact that so many people with arthritis are inactive should be a wake-up call to physicians,” Dunlop said.
Brisk walks and water aerobics are two recommended activities for people with arthritis, but Dunlop said patients should talk with their physician about any concerns before starting an exercise program.
“Even though they have joint disease, patients need to be reminded that physical activity is actually good for them,“ Dunlop said. “People with arthritis should be as physically active as possible, even if they accomplish less than the recommended levels. When it comes to physical activity, there is good evidence that the benefits far outweigh the risks and being inactive is especially detrimental to health.”
This study was supported in part by National Institute for Arthritis and Musculoskeletal Diseases and the Falk Medical Research Trust.
Public release date: 10-Aug-2011
Blood Tests for Active TB Not Accurate or Cost-Effective
Based on Data, WHO Advises Against Use of Blood Antibody Test for Active TB
Commercial blood serum antibody tests—widely used in India and other developing countries to diagnose active tuberculosis—are not accurate or cost-effective, according to an analysis by researchers at the Johns Hopkins Bloomberg School of Public Health, the University of Washington School of Public Health and McGill University. Use of serological tests in India resulted in more DALYs (years of healthy life lost to premature death and illness), more secondary infections, and more false-positive diagnoses of TB, compared to the use of microscopic sputum smear analysis or culture. The findings, published in the
August 9, 2011 edition of PLoS Medicine, recently led the World Health Organization to recommend against the use of commercial serology tests in the diagnosis of active TB.
“Microscopic analysis of sputum for TB is cheap and widely available, but misses half of all TB cases,” said David Dowdy, MD PhD, lead author of the study and assistant professor in the Department of Epidemiology at the Bloomberg School of Public Health. “TB culture, the current gold standard, requires training and equipment not available in most resource-limited settings. Serological tests are simpler and faster than culture, and are also commercially available in India, so they are an attractive option in theory. However, we found that they are not accurate enough to be useful—after accounting for missed and false- positive TB diagnoses, serological tests cost more and delivered less than either microscopy or culture.
Quite simply, serological tests should not be used to diagnose active TB.”
For the study, Dowdy and his colleagues constructed a mathematical model to analyze 1.5 million patients with suspected active TB in India—about 15% of India’s annual TB burden. Their analysis concluded that use of serology would result in an estimated 14,000 more TB diagnoses than microscopy, but would also incorrectly diagnose 121,000 more patients without active TB (false-positives). Serology use would also generate 102,000 more DALYs and 32,000 more secondary TB cases compared to microscopy. The estimated total cost of serologic testing (including treatment of newly diagnosed cases) was approximately four times that of microscopy, at $47.5 million versus $11.9 million.
“Unfortunately, we still do not have an accurate point-of-care test for TB, as we have for infections like HIV or malaria. The WHO policy strongly encourages future research to develop novel or improved serological tests,” said the study’s senior author, Madhukar Pai, MD, PhD, associate professor at McGill University and the Respiratory, Epidemiology and Clinical Research Unit at the Montreal Chest Institute and the Research Institute of the McGill University Health Centre.
Funding for the research was provided by the Stop TB Partnership’s New Diagnostics Working Group, via the subgroup on Evidence Synthesis, and support from the Canadian Institutes of Health Research (CIHR).
Public release date: 10-Aug-2011
Low vitamin D linked to earlier first menstruation, a risk factor for health problems throughout life
ANN ARBOR, Mich.—A study links low vitamin D in young girls with early menstruation, which is a risk factor for a host of health problems for teen girls as well as women later in life.
Researchers from the University of Michigan School of Public Health measured the blood vitamin D levels in 242 girls ages 5-12 from Bogota, Colombia, and followed them for 30 months. Girls low on vitamin D were twice as likely to start menstruation during the study than those with sufficient vitamin D, said epidemiologist Eduardo Villamor, associate professor in the U-M SPH.
This is important for several reasons, Villamor said. Worldwide, there has been a slow decline in the age of the first menstruation, or menarche, for years, which Villamor says suggests an environmental cause, since the genetics that trigger puberty haven’t changed.
“We know relatively little about what triggers puberty from an environmental perspective,” Villamor said. “If we learn what is causing the decline in age of first menstruation, we may be able to develop interventions” to prevent premature menarche.
Early menstruation is a risk factor for behavioral and psychosocial problems in teens. Also, girls who have an earlier menarche appear to have increased risk of developing cardiometabolic diseases and cancer—
particularly breast cancer, as adults.
This study formally explored the link between vitamin D status of girls and the time of their first menstruation. Previous research has suggested that menarche happens later in girls living closer to the Equator than girls living in northern countries. Coincidentally, girls in northern countries may harbor high rates of vitamin D deficiencyduring winter months because of limited sun exposure.
In the research by Villamor and colleagues, 57 percent of the girls in the vitamin D-deficient group reached menarche during the study, compared to 23 percent in the vitamin D-sufficient group. In terms of age, girls who were low in vitamin D were about 11.8 years old when they started menstruating, compared to the other group at about age 12.6 years old. This 10-month difference is substantial, Villamor said, because even though 10 months may not seem like a long time, at that age a lot is happening rapidly to a young girl’s body.
Still, while the results suggest a link between vitamin D and menarche, they have not established a causal relationship. It’s necessary to do more studies to show if interventions that change girls’ vitamin D status result in a change in their age of menarche.
The University of Michigan School of Public Health has been promoting health and preventing disease since 1941, and is ranked among the top public health schools in the nation. Whether making new discoveries in the lab or researching and educating in the field, our faculty, students, and alumni are deployed around the globe to promote and protect our health http://www.sph.umich.edu/
Public release date: 11-Aug-2011
Contrary to earlier findings, excess body fat in elderly decreases life expectancy
Elderly individuals should maintain a normal weight, suggests Loma Linda University research LOMA LINDA, Calif. – While some past studies have shown that persons carrying a few extra
pounds in their 70s live longer than their thinner counterparts, a new study that measured subjects’
weight at multiple points over a longer period of time reveals the opposite.
Research from Adventist Health Studies recently published in the Journal of the American Geriatrics Society showed that men over 75 with a body mass index (BMI) greater than 22.3 had a 3.7-year shorter life expectancy, and women over 75 with a BMI greater than 27.4 had a 2.1-year shorter life expectancy. Generally, a BMI between 18.5 and 24.9 is considered normal weight, and a BMI of 25 to 29.9 is considered overweight. A BMI of 30 or more is considered obese.
Previous work in this area by others found a protective association for a high body weight among the elderly. Pramil N. Singh, DrPH, lead author of the paper and an associate professor in the School of Public Health at Loma Linda University, says the data from many past studies is problematic because only a single baseline measure of weight was taken, which does not account for weight changes or how weight changes affect life expectancy. Additionally, most past studies had mortality surveillance of fewer than 19 years, which analyses have shown to be an inadequate amount of time to study risks associated with weight.
“We had a unique opportunity to do 29 years of follow-up with a cohort that was also followed for mortality outcomes,” Dr. Singh said. “Across this long period of time, we had multiple measures of body weight, which provided a more accurate assessment.”
The study looked at 6,030 adults who never smoked and who were free of major chronic diseases at
enrollment. It then examined only those adults who maintained a stable weight. This was done in an effort to exclude individuals who, for example, were in the normal weight category because they experienced significant weight loss due to a disease. Therefore their death would not have been related to their normal weight, but rather to the disease that caused them to reach normal weight.
“When you control for confounding by disease-related weight loss, overweight and obesity remain a risk for persons over the age of 75,” Dr. Singh said. “This suggests that elderly individuals of normal weight should continue to maintain their weight.”
Researchers noted a difference between genders in that men had a higher sensitivity to body fat than women. Men started to experience a greater risk of mortality at a BMI of 22.3, while this risk did not appear for women until a BMI of 27.4. One possible reason for the difference between genders, Dr. Singh said, is that body fat is the primary source of estrogen in post-menopausal females, and a minimum level of estrogen in those years can be protective against heart disease and hip fractures.
“This is not to say that extra weight is good for women over 75,” Dr. Singh said, “but rather that the negative effects of extra weight in women over 75 appear at a higher weight than in males.”
The study population itself is unique in that all were Seventh-day Adventists, who, because of church recommendations, are lifelong non-smokers, consume little if any alcohol, are more physically active, and consume less meat than the general population. This means those who maintained a lower BMI did so intentionally with healthy lifestyle choices rather than as a result of smoking for weight control or as a result of poverty-related factors. Dr. Singh said further studies are needed to understand the positive and negative effects of lifestyle patterns that help individuals maintain low body weight over long periods of time.
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Just honorable people, doing honorable things.
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