Health Technology Research Synopsis
119th Issue Date 30DEC2011
Compiled By Ralph Turchiano
Editors Top Five:
1. Fish oil may hold key to leukemia cure
2. Scientists identify an innate function of vitamin E
3. Could cod liver oil help combat tuberculosis?
4. Diet patterns may keep brain from shrinking
5. JAMA commentary contends vitamin therapy can still reduce stroke
In this issue:
1. Potential concern about drugs in clinical trial
2. Eating less keeps the brain young
3. High bodily levels of nickel and selenium may lower pancreatic cancer risk
4. Wayne State study finds soybean compounds enhances effects of cancer radiotherapy
5. Frankincense production ‘doomed’ warn ecologists
6. Could cod liver oil help combat tuberculosis?
7. Scientists identify an innate function of vitamin E
8. Breastfeeding promotes healthy growth
9. Some ‘low-gluten’ beer contains high levels of gluten
10. Do our medicines boost pathogens?
11. Myths and Truths of Obesity and Pregnancy
12. Disease-causing strains of Fusarium prevalent in plumbing drains
13. Virgin Olive Oil & Fish Fatty Acids Help Prevent Acute Pancreatitis
14. JAMA commentary contends vitamin therapy can still reduce stroke
15. Fish oil may hold key to leukemia cure
16. Unhealthy eating: a new form of occupational hazard?
17. ELDERLY CAN BE AS FAST AS YOUNG IN SOME BRAIN TASKS, STUDY SHOWS
18. Diet patterns may keep brain from shrinking
19. Monsanto GMO Seeds Use to Further Expand Within US
Potential concern about drugs in clinical trial
Drugs that enhance levels of small molecules derived naturally in the body from a major component of animal fats (small molecules known as epoxyeicosatrienoic acids [EETs]) are currently in clinical trials for the treatment of high blood pressure and diabetes. A team of researchers — led by Dipak Panigrahy and Mark Kieran, at the Dana-Farber Cancer Institute, Boston; Sui Huang, at the Institute for Systems Biology, Seattle; and Darryl Zeldin, at the National Institute of Environmental Health Science, Research Triangle Park — has now generated data in mice that raise concern about the use of these drugs in humans.
The key observation of the team was that EETs promote primary tumor growth and spread to distant sites (metastasis) in a variety of mouse models of cancer. As noted by the authors and, in an accompanying commentary, Raymond DuBois and Dingzhi Wang, at The University of Texas MD Anderson Cancer Center, Houston, the data generated suggest not only that raising levels of EETs in humans could have severe adverse effects but also that EET antagonists could provide a new approach to preventing and treating metastasis
Eating less keeps the brain young
Italian scientists discovered a molecule for ‘brain longevity’ turned on by diet
Overeating may cause brain aging while eating less turns on a molecule that helps the brain stay young.
A team of Italian researchers at the Catholic University of Sacred Heart in Rome have discovered that this molecule, called CREB1, is triggered by “caloric restriction” (low caloric diet) in the brain of mice. They found that CREB1 activates many genes linked to longevity and to the proper functioning of the brain.
This work was led by Giovambattista Pani, researcher at the Institute of General Pathology, Faculty of Medicine at the Catholic University of Sacred Heart in Rome, directed by Professor Achille Cittadini, in collaboration with Professor Claudio Grassi of the Institute of Human Physiology. The research appears this week in the Proceedings of the National Academy of Sciences USA (PNAS).
“Our hope is to find a way to activate CREB1, for example through new drugs, so to keep the brain young without the need of a strict diet,” Dr Pani said.
Caloric restriction means the animals can only eat up to 70 percent of the food they consume normally, and is a known experimental way to extend life, as seen in many experimental models. Typically, caloric-restricted mice do not become obese and don’t develop diabetes; moreover they show greater cognitive performance and memory, are less aggressive. Furthermore they do not develop, if not much later, Alzheimer’s disease and with less severe symptoms than in overfed animals.
Many studies suggest that obesity is bad for our brain, slows it down, causes early brain aging, making it susceptible to diseases typical of older people as the Alzheimer’s and Parkinson’s. In contrast, caloric restriction keeps the brain young. Nevertheless, the precise molecular mechanism behind the positive effects of an hypocaloric diet on the brain remained unknown till now.
The Italian team discovered that CREB1 is the molecule activated by caloric restriction and that it mediates the beneficial effects of the diet on the brain by turning on another group of molecules linked to longevity, the “sirtuins”. This finding is consistent with the fact that CREB1 is known to regulate important brain functions as memory, learning and anxiety control, and its activity is reduced or physiologically compromised by aging.
Moreover, Italian researchers have discovered that the action of CREB1 can be dramatically increased by simply reducing caloric intake, and have shown that CREB is absolutely essential to make caloric restriction work on the brain. In fact, if mice lack CREB1 the benefits of caloric restriction on the brain (improving memory, etc.) disappeear. So the animals without CREB1 show the same brain disabilities typical of overfed and/or old animals.
“Thus, our findings identify for the first time an important mediator of the effects of diet on the brain,” Dr. Pani said. “This discovery has important implications to develop future therapies to keep our brain young and prevent brain degeneration and the aging process. In addition, our study shed light on the correlation among metabolic diseases as diabetes and obesity and the decline in cognitive activities.”
High bodily levels of nickel and selenium may lower pancreatic cancer risk
High bodily levels of the trace elements nickel and selenium may lower the risk of developing the most common type of pancreatic cancer, finds research published online in Gut.
Similarly, high levels of lead, arsenic, and cadmium could boost the likelihood of developing the disease, the study shows.
The researchers assessed 12 trace element levels in the toenails of 118 patients with exocrine pancreatic cancer—the most common form of the disease—and just under 400 hospital patients without cancer.
Nails, and particularly toenails, are considered reliable indicators of trace element levels, rather than dietary assessment, because they capture intake/exposure from other sources over the long term.
Analysis of the nail content showed that levels of certain trace elements were significantly higher or lower among the cancer patients than among patients in the comparison group. The higher or lower the level, the greater or lesser was the risk of having the disease.
Patients with the highest levels of arsenic and cadmium in their nails were between two and 3.5 times more likely to have pancreatic cancer than those with the lowest levels.
And those with the highest levels of lead were more than 6 times as likely to have the disease.
On the other hand, those with the highest levels of nickel and selenium were between 33% and 95% less likely to have the disease compared with those with the lowest levels.
These findings held true even after taking account of other known risk factors, such as diabetes, overweight, and smoking.
Smoking is thought to account for around a third of all cases of pancreatic cancer. Tobacco contains trace metals, including cadmium, which is a known cancer causing agent, and has been associated with an increased risk of lung, kidney, and prostate cancers.
High levels of selenium, on the other hand, have been associated with conferring protection against certain cancers, and previous research indicates that selenium may counter the harmful effects of cadmium, arsenic, and lead.
The authors point out that despite decades of research, the causes of pancreatic cancer remain largely unknown: “Our results support an increased risk of pancreatic cancer associated with higher levels of cadmium, arsenic, and lead, as well as an inverse association with higher levels of selenium and nickel,” they conclude.
“These novel findings, if replicated in independent studies, would point to an important role of trace elements in pancreatic carcinogenesis.”
Wayne State study finds soybean compounds enhances effects of cancer radiotherapy
Detroit – A Wayne State University researcher has shown that compounds found in soybeans can make radiation treatment of lung cancer tumors more effective while helping to preserve normal tissue.
A team led by Gilda Hillman, Ph.D., professor of radiation oncology at Wayne State University’s School of Medicine and the Barbara Ann Karmanos Cancer Institute, had shown previously that soy isoflavones, a natural, nontoxic component of soybeans, increase the ability of radiation to kill cancer cells in prostate tumors by blocking DNA repair mechanisms and molecular survival pathways, which are turned on by the cancer cells to survive the damage radiation causes.
At the same time, isoflavones act to reduce damage caused by radiation to surrounding cells of normal, noncancerous tissue. This was shown in a clinical trial conducted at WSU and Karmanos for prostate cancer patients treated with radiotherapy and soy tablets.
In results published in the journal Nutrition and Cancer in 2010, those patients experienced reduced radiation toxicity to surrounding organs; fewer problems with incontinence and diarrhea; and better sexual organ function. Hillman’s preclinical studies in the prostate tumor model led to the design of that clinical trial.
Soy isoflavones can make cancer cells more vulnerable to ionizing radiation by inhibiting survival pathways that are activated by radiation in cancer cells but not in normal cells. In normal tissues, soy isoflavones also can act as antioxidants, protecting those tissues from radiation-induced toxicity.
During the past year, Hillman’s team achieved similar results in non-small cell lung cancer cells in vitro. She recently received a two-year, $347,000 grant from the National Cancer Institute, part of the National Institutes of Health, to investigate whether those results also proved true for non-small cell lung tumors in mice, and has found that they do. Her findings, which she called “substantial” and “very promising,” appear in the November 2011 edition of the journal Radiotherapy and Oncology.
Hillman emphasized that soy supplements alone are not a substitute for conventional cancer treatment, and that doses of soy isoflavones must be medically administered in combination with conventional cancer treatments to have the desired effects.
“Preliminary studies indicate that soy could cause radioprotection,” she said. “It is important to show what is happening in the lung tissue.”
The next step, she said, is to evaluate the effects of soy isoflavones in mouse lung tumor models to determine the conditions that will maximize the tumor-killing and normal tissue-protecting effects during radiation therapy.
“If we succeed in addressing preclinical issues in the mouse lung cancer model showing the benefits of this combined treatment, we could design clinical protocols for non-small cell lung cancer to improve the radiotherapy of lung cancer,” Hillman said. “We also could improve the secondary effects of radiation, for example, improving the level of breathing in the lungs.”
Once protocols are developed, she said, clinicians can begin using soy isoflavones combined with radiation therapy in humans, a process they believe will yield both therapeutic and economic benefits.
“In contrast to drugs, soy is very, very safe,” Hillman said. “It’s also readily available, and it’s cheap.
“The excitement here is that if we can protect the normal tissue from radiation effects and improve the quality of life for patients who receive radiation therapy, we will have achieved an important goal.”
Frankincense production ‘doomed’ warn ecologists
Trees that produce frankincense – used in incense and perfumes across the world and a key part of the Christmas story – are declining so dramatically that production of the fragrant resin could be halved over the next 15 years, according to a new study published in the British Ecological Society’s Journal of Applied Ecology.
Ecologists from the Netherlands and Ethiopia say tree numbers could decline by 90% in the next 50 years. If fire, grazing and insect attack – the most likely causes of the decline – remain unchecked frankincense production could be doomed, they warn. Their predications are based on large-scale field studies – the first to monitor the fate of the frankincense-producing tree.
Frankincense is obtained by tapping various species of Boswellia, a tree that grows in the Horn of Africa and the Arabian peninsula. Yet despite its economic importance – incense has been traded internationally for thousands of years – little is known about how tapping affects Boswellia populations.
Working in an isolated part of north-west Ethiopia near the source of the Blue Nile the team, led by Dr Frans Bongers of Wageningen University, studied 13 two-hectare plots, some where trees were tapped for frankincense and some where they were untapped. Over two years, they monitored survival, growth and seed production of more than 6,000 Boswellia trees, collecting over 20,000 individual measurements.
They then used this data to construct demographic models capable of predicting the fate of Boswellia populations in coming years. Alarmingly, the model shows Boswellia populations are declining so dramatically that frankincense production could be halved in the next 15 years.
According to Dr Bongers: “Current management of Boswellia populations is clearly unsustainable. Our models show that within 50 years populations of Boswellia will be decimated, and the declining populations mean frankincense production is doomed. This is a rather alarming message for the incense industry and conservation organisations.”
Crucially, the researchers found all populations they studied are declining, not only those from tapped stands of trees, suggesting that factors other than tapping are at the root of the problem.
“Frankincense extraction is unlikely to be the main cause of population decline, which is likely to be caused by burning, grazing and attack by the long-horn beetle, which lays its eggs under the bark of the tree,” says Dr Bongers.
In the areas they studied, the team found that as well as high levels of mortality among adult trees, the older trees in the population were not being replaced because few Boswellia seedlings survived to become saplings.
“The number of fires and intensity of grazing in our study area has increased over recent decades as a result of a large increase in the number of cattle, and this could be why seedlings fail to grow into saplings. At the same time, a large proportion of trees we studied died after being attacked by the long-horn beetle,” Dr Bongers explains.
He says strong and far-reaching management incentives need to be introduced if Boswellia populations – and future frankincense production – are to be preserved.
In the short term this involves preventing fires and beetle attack, although the latter is difficult because scientists know little about its lifecycle. In the long-term, Dr Bongers says areas should be set aside and protected from fire and grazing for 5-10 years to allow Boswellia saplings to become established.
Could cod liver oil help combat tuberculosis?
Cod liver oil and tuberculosis
A review of a historical study from 1848 reveals that cod liver oil was an effective treatment for tuberculosis, says Professor Sir Malcolm Green in the Christmas issue published on bmj.com today.
In the study, carried out by physicians at the Hospital for Consumption, Chelsea (now the Royal Brompton Hospital), 542 patients with consumption (tuberculosis) received standard treatment with cod liver oil. These patients were compared with 535 ‘control’ patients who received standard treatment alone (without cod liver oil).
While improvement rates were similar in the two groups, the disease was stabilised in 18% of the patients given cod liver oil, compared with only 6% of those in the control group. Deterioration or death occurred in 33% of patients given standard treatment alone, but in only 19% of those given cod liver oil, a reduction of 14%.
Professor Green says that some children are still given cod liver oil today and perhaps this relates back to the late 19th and early 20th centuries when cod liver oil was widely used to treat and prevent tuberculosis.
He adds that the steady fall in tuberculosis deaths in the late 19th and early 20th centuries is often attributed to better living conditions. While a reduction in overcrowded living might have reduced transmission, Green believes improved nutrition was probably as important. “It could well be that the widespread use of cod liver oil encouraged by doctors played a significant part,” he writes.
Cod liver oil is a rich source of Vitamin D, which we now know is important in fighting infections, as well as preventing conditions such as rickets, says the author.
He says: “A role for vitamin D in combating tuberculosis gives a rational basis for sunshine therapy, which was widely practised for patients in sanatoriums before chemotherapy became available, as vitamin D is synthesised in the skin when exposed to the sun. Patients were put out on their beds to lie in the sun in summer and winter, and many were sent to Switzerland and other sunny countries for treatment.” He adds that today many patients who develop TB in the UK are found to be Vitamin D deficient.
Green concludes that since tuberculosis is still a common infection, accounting for millions of deaths annually across the world, there may yet be a role for vitamin D supplements in combating this terrible killer.
Scientists identify an innate function of vitamin E
|IMAGE:Dr. Paul McNeil, cell biologist at Georgia Health Sciences University, has discovered one of the innate functions of vitamin E.|
AUGUSTA, Ga. – It’s rubbed on the skin to reduce signs of aging and consumed by athletes to improve endurance but scientists now have the first evidence of one of vitamin E’s normal body functions.
The powerful antioxidant found in most foods helps repair tears in the plasma membranes that protect cells from outside forces and screen what enters and exits, Georgia Health Sciences University researchers report in the journal Nature Communications.
Everyday activities such as eating and exercise can tear the plasma membrane and the new research shows that vitamin E is essential to repair. Without repair of muscle cells, for example, muscles eventually waste away and die in a process similar to what occurs in muscular dystrophy. Muscle weakness also is a common complaint in diabetes, another condition associated with inadequate plasma membrane repair.
“Without any special effort we consume vitamin E every day and we don’t even know what it does in our bodies,” said Dr. Paul McNeil, GHSU cell biologist and the study’s corresponding author. He now feels confident about at least one of its jobs.
Century-old animal studies linked vitamin E deficiency to muscle problems but how that happens remained a mystery until now, McNeil said. His understanding that a lack of membrane repair caused muscle wasting and death prompted McNeil to look at vitamin E.
Vitamin E appears to aid repair in several ways. As an antioxidant, it helps eliminate destructive byproducts from the body’s use of oxygen that impede repair. Because it’s lipid-soluble, vitamin E can actually insert itself into the membrane to prevent free radicals from attacking. It also can help keep phospholipids, a major membrane component, compliant so they can better repair after a tear.
For example, exercise causes the cell powerhouse, the mitochondria, to burn a lot more oxygen than normal. “As an unavoidable consequence you produce reactive oxygen species,” McNeil said. The physical force of exercise tears the membrane. Vitamin E enables adequate plasma membrane repair despite the oxidant challenge and keeps the situation in check.
When he mimicked what happens with exercise by using hydrogen peroxide to produce free radicals, he found that tears in skeletal muscle cells would not heal unless pretreated with vitamin E.
Next steps, which will be aided by two recent National Institutes of Health grants, include examining membrane repair in vitamin E-deficient animals.
McNeil also wants to further examine membrane repair failure in diabetes. Former GHSU graduate student Dr. Amber C. Howard showed in a recent paper in the journal Diabetes that cells taken from animal models of types 1 and 2 diabetes have faulty repair mechanisms. Howard found high glucose was a culprit by soaking cells in a high-glucose solution for eight to 12 weeks, during which time they developed a repair defect. It’s also well documented that reactive oxygen species levels are elevated in diabetes.
The Nature Communications paper showed that vitamin E treatment in an animal model of diabetes restored some membrane repair ability. Also, an analogue of the most biologically active form of vitamin E significantly reversed membrane repair deficits caused by high glucose and increased cell survival after tearing cells in culture.
Now McNeil wants to know if he can prevent the development of advanced glycation end products – a sugar that high glucose adds to proteins that his lab has shown can also impede membrane repair – in the animal models of diabetes. The researchers have a drug that at least in cultured animal cells, prevents repair defects from advanced glycation end products.
Breastfeeding promotes healthy growth
A PhD project from LIFE – the Faculty of Life Sciences at the University of Copenhagen has shown that breastfed children follow a different growth pattern than non-breastfed children. Breastfeeding lowers the levels of the growth hormones IGF-I and insulin in the blood, which means that growth is slightly slower. This is believed to reduce the risk of overweight and diabetes later in life.
The PhD project is part of SKOT, a large-scale Danish study of small children, diet and wellbeing, which has followed and examined 330 healthy children at 9, 18 and 36 months. The SKOT project is to increase our knowledge of what Danish children eat in the critical phase when they move from breastmilk or formula to solids. The transition is critical because the food intake during this period has a significant bearing on the child’s growth and risk of developing lifestyle diseases later in life.
PhD Anja Lykke Madsen has gathered the first results of the SKOT study in her PhD project:
“We can see that breastfeeding has a significant, measurable effect on the important growth regulators in the blood, IGF-I and insulin. The more times the child was breastfed, the lower the hormone levels. This suggests that the child has a slightly lower risk of becoming overweight later in childhood. At the same time, there was a correlation between how long the children were breastfed and their weight at 18 months,” says LIFE PhD Anja Lykke Madsen.
Mother’s milk for healthy growth
According to Professor Kim Fleischer Michaelsen from LIFE, head of the SKOT project, the study provides valuable knowledge about the factors affecting the early onset of obesity.
“It is well-known that children who are breastfed grow slightly more slowly than children who are given formula, and it looks as if this growth pattern is optimal because it reduces the risk of developing lifestyle diseases later in life. However, the new results from SKOT show that breastfeeding also affects levels of IGF-I and insulin at 9 months, i.e. at a time when the children are well into eating solids,” says Professor Kim Fleischer Michaelsen from LIFE. He continues:
“Looking at the children’s growth up to 18 months identified a number of interesting correlations which may improve our understanding of the mechanisms behind early-onset obesity. The longer the children were breastfed, the lower their weight at 18 months. It’s as simple as that.”
The study also showed that the longer the children slept, the smaller their waist circumference. Moreover, the children of mothers who gained lot of weight during pregnancy had a slightly thicker layer of subcutaneous fat than the children of mothers who put on less weight.
Need to study long-term effects
Kim Fleischer Michaelsen stresses the need to follow up and to continue to examine the children to establish the long-term effects, while also looking at correlations in other studies.
Anja Lykke Madsen defended her PhD thesis on 9 December 2011 at LIFE – the Faculty of Life Sciences at the University of Copenhagen.
Some ‘low-gluten’ beer contains high levels of gluten
Beer tested in a new study, including some brands labeled “low-gluten,” contains levels of hordein, the form of gluten present in barley, that could cause symptoms in patients with celiac disease (CD), the autoimmune condition treated with a life-long gluten-free diet, scientists are reporting. The study, which weighs in on a controversy over the gluten content of beer, appears in ACS’ Journal of Proteome Research.
Michelle Colgrave and colleagues explain that celiac disease (CD) affects more than 2 million people worldwide. Gluten, a protein found in foods and beverages made from barley, wheat and rye triggers a reaction in CD patients that affects the small intestine, blocking the absorption of essential nutrients from food. Symptoms vary, but often include diarrhea or constipation, fatigue and abdominal pain. The cause is unknown, and there is no cure. The only treatment is to stay on a life-long gluten-free diet. Barley is used to make beer, but whether the finished product contains gluten is controversial, with some beer companies contending that the brewing process gets rid of gluten or reduces it to very low levels. Existing tests for detecting gluten in malted products are not very accurate. So the scientists developed a highly accurate new test for hordein, the gluten component in barley-based beers.
As expected, their analysis of 60 commercial beers found that eight labeled “gluten-free” did not contain gluten. But many regular, commercial beers had significant levels of gluten. Most surprising, two beers labeled as “low-gluten” had about as much gluten as regular beer.
Do our medicines boost pathogens?
Scientists of the Institute of Tropical Medicine (ITG) discovered a parasite that not only had developed resistance against a common medicine, but at the same time had become better in withstanding the human immune system. With some exaggeration: medical practice helped in developing a superbug. For it appears the battle against the drug also armed the bug better against its host. “To our knowledge it is the first time such a doubly armed organism appears in nature”, says researcher Manu Vanaerschot, who obtained a PhD for his detective work at ITG and Antwerp University. “It certainly makes you think.”
Vanaerschot studies the Leishmania parasite, a unicellular organism that has amazed scientists before. Leishmania is an expert in adaptation to different environments, and the only known organism in nature disregarding a basic rule of biology: that chromosomes ought to come in pairs. (The latter was also discovered by ITG-scientists recently.)
The parasite causes Leishmaniasis, one of the most important parasitic diseases after malaria. It hits some two million people, in 88 countries – including European ones – and yearly kills fifty thousand of them. The parasite is transmitted by the bite of a sand fly. The combined resistance against a medicine and the human immune system emerged in Leishmania donovani, the species causing the deadly form of the disease.
On the Indian subcontinent, where most cases occur, the disease was treated for decades with antimony compounds. As was to be expected, the parasite adapted to the constant drug pressure, and evolved into a form resisting the antimonials. In 2006 the treatment was switched to another medicine, because two patients out of three did not respond to the treatment. The antimonials closely work together with the human immune system to kill the parasite. This probably has given Leishmania donovani the opportunity to arm itself against both. It not only became resistant against the drug, but also resists better to the macrophages of its host. Macrophages are important cells of our immune system.
There is no absolute proof yet (among other things, because one obviously cannot experiment on humans) but everything suggests that resistant Leishmania not only survive better in humans – have a higher “fitness” – but also are better at making people ill – have a higher “virulence” – than their non-resistant counterparts.
It is the first time that science finds an organism that always benefits from its resistance. Normally resistance is only useful when a pathogen is bombarded by drugs; the rest of the time it is detrimental to the organism.
Resistant organisms are a real problem to medicine. More and more pathogens become resistant to our drugs and antibiotics – to a large extend because you and I use them too lavishly and improperly. For several microbes, the arsenal of available drugs and antibiotics has so diminished that people may die again from pneumonia, or even from ulcerating wounds.
Luckily for us, resistance helps pathogens only in a drug-filled environment. In the open field their resistance is a disadvantage to them, because they have to invest energy and resources into a property with no use there. Just like a suit of armour is quite useful on the battle field, but a real nuisance the rest of the time.
So the propagation of resistant organisms is substantially slowed down because they are at a disadvantage outside of sick rooms. But this rule, too, is violated by Leishmania: even in absence of the drug, the resistant parasite survives better, instead of worse, and it is more virulent than a non-resistant parasite.
Did our medicines create a superbug? A legitimate question, and the phenomenon has to be investigated, but this sole case doesn’t imply we better stop developing new medicines (as a matter of fact, the antimony-resistant Leishmania are still susceptible to a more recent drug, miltefosine). On the contrary, we should develop more new drugs, to give new answers to the adaptive strategies of pathogens, and we should protect those drugs, for instance by using them in combination therapies. In this never-ending arms race we should use our drugs wisely, to minimise the chances for pathogens to develop resistance
Myths and Truths of Obesity and Pregnancy
Vitamins, Weight Gain, Preterm Birth and More
December 21, 2011
Ironically, despite excessive caloric intake, many obese women are deficient in vitamins vital to a healthy pregnancy. This and other startling statistics abound when obesity and pregnancy collide. Together, they present a unique set of challenges that women and their doctors must tackle in order to achieve the best possible outcome for mom and baby.
In the December issue of the journal Seminars in Perinatology, maternal fetal medicine expert Loralei L. Thornburg, M.D., reviews many of the pregnancy-related changes and obstacles obese women may face before giving birth. The following myths and truths highlight some expected and some surprising issues to take into account before, during and after pregnancy.
“I treat obese patients all the time, and while everything may not go exactly as they’d planned, they can have healthy pregnancies,” said Thornburg, who specializes in the care of high-risk pregnancies and conducts research on obesity and pregnancy. “While you can have a successful pregnancy at any size, women need to understand the challenges that their weight will create and be a partner in their own care; they need to talk with their doctors about the best way to optimize their health and the health of their baby.”
Myth or Truth?
Many obese women are vitamin deficient.
Forty percent are deficient in iron, 24 percent in folic acid and 4 percent in B12. This is a concern because certain vitamins, like folic acid, are very important before conception, lowering the risk of cardiac problems and spinal defects in newborns. Other vitamins, such as calcium and iron, are needed throughout pregnancy to help babies grow.
Thornburg says vitamin deficiency has to do with the quality of the diet, not the quantity. Obese women tend to stray away from fortified cereals, fruits and vegetables, and eat more processed foods that are high in calories but low in nutritional value.
“Just like everybody else, women considering pregnancy or currently pregnant should get a healthy mix of fruits and vegetables, lean proteins and good quality carbohydrates. Unfortunately, these are not the foods people lean towards when they overeat,” noted Thornburg. “Women also need to be sure they are taking vitamins containing folic acid before and during pregnancy.”
Obese patients need to gain at least 15 pounds during pregnancy.
In 2009, the Institute of Medicine revised its recommendations for gestational weight gain for obese women from “at least 15 pounds” to “11-20 pounds.” According to past research, obese women with excessive weight gain during pregnancy have a very high risk of complications, including indicated preterm birth, cesarean delivery, failed labor induction, large-for-gestational-age infants and infants with low blood sugar.
If a woman starts her pregnancy overweight or obese, not gaining a lot of weight can actually improve the likelihood of a healthy pregnancy, Thornburg points out. Talking with your doctor about appropriate weight gain for your pregnancy is key, she says.
The risk of spontaneous preterm birth is higher in obese than non-obese women.
Obese women have a greater likelihood of indicated preterm birth – early delivery for a medical reason, such as maternal diabetes or high blood pressure. But, paradoxically, the risk of spontaneous preterm birth – when a woman goes into labor for an unknown reason – is actually 20 percent lower in obese than non-obese women. There is no established explanation for why this is the case, but Thornburg says current thinking suggests that this is probably related to hormone changes in obese women that may decrease the risk of spontaneous preterm birth.
Respiratory disease in obesity – including asthma and obstructive sleep apnea – increases the risk for non-pulmonary pregnancy complications, such as cesarean delivery and preeclampsia (high blood pressure).
Obese women have increased rates of respiratory complications, and up to 30 percent experience an exacerbation of their asthma during pregnancy, a risk almost one-and-a-half times more than non-obese women. According to Thornburg, respiratory complications represent just one piece of the puzzle that adds to poor health in obesity, which increases the likelihood of problems in pregnancy. She stresses the importance of getting asthma and any other respiratory conditions under control before getting pregnant.
Breastfeeding rates are high among obese women.
Breastfeeding rates are poor among obese women, with only 80 percent initiating and less than 50 percent continuing beyond six months, even though it is associated with less postpartum weight retention and should be encouraged as it benefits the health of mom and baby.
Thornburg acknowledges that it can be challenging for obese women to breast feed. It often takes longer for their milk to come in and they can have lower production (breast size has nothing to do with the amount of milk produced). Indicated preterm birth can result in prolonged separations of mom and baby as infants are admitted to the neonatal intensive care unit or NICU. This, coupled with the higher rate of maternal complications and cesarean delivery – up to 50 percent in some studies – in obese women, can make it harder to successfully breast feed.
“Because of these challenges, mothers need to be educated, motivated and work with their doctors, nurses and lactation professionals to give breast feeding their best shot. Even if you can only do partial breastfeeding, that is still better than no breastfeeding at all,” said Thornburg.
Disease-causing strains of Fusarium prevalent in plumbing drains
|IMAGE:The Fusarium species cultured here are commonly found in sink drains. A new study found that about 70 percent of Fusarium samples taken from drains belong to one of the…|
A study examining the prevalence of the fungus Fusarium in bathroom sink drains suggests that plumbing systems may be a common source of human infections.
In the first extensive survey of its kind, researchers in Penn State’s College of Agricultural Sciences sampled nearly 500 sink drains from 131 buildings — businesses, homes, university dormitories and public facilities — in Pennsylvania, Maryland, Virginia, North Carolina, South Carolina, Georgia, Florida and California.
They analyzed fungal DNA to compare the spectrum of Fusarium species and sequence types found in drains with those recovered from human infections.
The study identified at least one Fusarium isolate in 66 percent of the drains and in 82 percent of the buildings. About 70 percent of those isolates came from the six sequence types of Fusarium most frequently associated with human infections.
“With about two-thirds of sinks found to harbor Fusarium, it’s clear that those buildings’ inhabitants are exposed to these fungi on a regular basis,” said lead investigator Dylan Short, who recently completed his doctorate in plant pathology. “This strongly supports the hypothesis that plumbing-surface biofilms serve as reservoirs for human pathogenic fusaria.”
The researcherrs published their results in the December issue of the Journal of Clinical Microbiology.
Fusarium may be best known for causing a variety of diseases in agricultural crops. In Pennsylvania, Fusarium diseases of grains and greenhouse crops are of particular concern. Fusarium species also produce mycotoxins in association with plants, causing a direct health threat to animals and humans that eat the plants.
Some species of Fusarium also cause opportunistic and sometimes fatal infections in humans, typically entering the body through wounds or trauma, via catheters and intravenous devices or by introduction of a biofilm to the eye. While relatively rare, Fusarium infections can be difficult to treat because of the organism’s resistance to many antifungal drugs. Those most at risk are individuals with weak or compromised immune systems.
In one high-profile case, Fusarium was found to have caused a widely publicized 2005-06 outbreak of fungal keratitis — infection of the cornea — among contact-lens wearers.
“In the recent outbreaks of fungal keratitis in Southeast Asia and North America connected to contact-lens use, plumbing systems were the main environmental sources of the most frequent Fusarium species and sequence types associated with eye infections,” Short said.
He explained that biofilms on plumbing surfaces are known to comprise a diverse spectrum of fungi and other microbes. “Based on its very high frequency, it is clear that Fusarium is a ubiquitous component of biofilm microbial communities in plumbing systems,” he said. “The adaptations that make Fusarium biofilm growth possible also may facilitate infection of humans.
“For example, in the 2005-06 mycotic keratitis outbreak, it was hypothesized that improper use of a contact lens solution led to reduced efficacy of its antimicrobial properties, which allowed fusaria to establish biofilms on contact lens surfaces and in lens cases,” he said.
“The biofilm also may play an important role in established infections in humans by protecting the fungus from drug treatments, since biofilm-phase fusaria tend to be more resistant to antifungal drugs than those growing in a fluid medium.”
Of the 59 sequence types identified from sinks in this study, 32 had not been found in previous multilocus sequence typing studies of Fusarium. These novel types included members of four apparently new Fusarium species.
David Geiser, professor of plant pathology and a member of the research team, pointed out that the serious infections caused by fusaria are relatively uncommon and that these fungi may even play positive roles in plumbing systems. But he said the study provides the strongest evidence to date supporting an epidemiological link between human fusarioses and plumbing systems.
“Our apparently constant physical proximity to these fungi belies their relative obscurity in terms of public awareness and understanding by the scientific community,” said Geiser, who also is director of Penn State’s Fusarium Research Center, which houses the world’s largest collection of Fusarium.
“The species involved offer significant potential for studying host-microbe interactions, novel metabolic activities — including the production of mycotoxins and antibiotics — and the roles of microbes in indoor environments,” he said.
JAMA commentary contends vitamin therapy can still reduce stroke
A commentary by Dr. David Spence of The University of Western Ontario and Dr. Meir Stampfer of the Harvard School of Public Health in today’s Journal of the American Medical Association (JAMA) argues that vitamin therapy still has a role to play in reducing stroke.
Vitamin B therapy was once widely used to lower homocysteine levels. Too much of this amino acid in the bloodstream was linked to increased risk of stroke and heart attack. But several randomized trials found lowering homocysteine levels with B vitamins did not result in a cardiovascular benefit. And a study by Dr. Spence, a scientist with the Robarts Research Institute at Western’s Schulich School of Medicine & Dentistry, found Vitamin B therapy actually increased cardiovascular risk in patients with diabetic nephropathy.
Dr. Spence says this commentary provides insights that overturn the widespread belief that “homocysteine is dead.” He says two key issues have been overlooked in the interpretation of the clinical trials: the key role of vitamin B12, and the newly recognized role of renal failure.
“It is now clear that the large trials showing no benefit of vitamin therapy obscured the benefit of vitamin therapy because they lumped together patients with renal failure and those with good renal function. The vitamins are harmful in renal failure, and beneficial in patients with good renal function, and they cancel each other out,” says Dr. Spence, the author of “How to Prevent Your Stroke.” The authors also contend most of the trials did not use a high enough dose of vitamin B12.
Virgin Olive Oil & Fish Fatty Acids Help Prevent Acute Pancreatitis
Scientists at the University of Granada have shown that oleic acid and hydroxytyrosol –present in a particularly high concentration in virgin olive oil– and n-3 polyunsaturated fatty acids –found in fish– relieve the symptoms of pancreatitis.
The researchers evaluated the role of Mediterranean diet ingredients in the prevention and mitigation of cell damage.
Oleic acid and hydroxytyrosol –present in a particularly high concentration in virgin olive oil– and n-3 polyunsaturated fatty acids –found in fish– affect the cellular mechanisms involved in the development of acute pancreatitis, a disease of oxidative-inflammatory etiology. Therefore, oleic acid and hydroxytyrosol can be considered potential functional ingredients, as they may prevent or mitigate this disease.
Such was the conclusion drawn in a study conducted by a research group at the University of Granada Physiology Department, where the researchers examined the role of the Mediterranean diet ingredients in the prevention and mitigation of cell damage.
An In Vitro Experimental Model
These scientists developed an in vitro experimental model that allows scientist to evaluate how changes in the membrane fatty acid composition in vivo –caused by a change in the type of fat ingested– affect the ability of cells to respond to induced oxidative-inflammatory damage with cerulein (acute pancreatitis).
This is the first study to examine how fatty acids and antioxidants affect the cellular mechanisms that respond to local inflammation in the pancreas. The University of Granada scientists have evaluated the role of antioxidants from a preventive approach, that is, by using an experimental model in mice in which cell damage is induced after pretreatment with these nutritional components.
The author of this study, María Belén López Millán affirms that “there is increasing evidence that there are oxidative-inflammatory processes involved in the origin of chronic diseases and that diet plays an important role in such processes. The antioxidant (phenolic compounds) and antiinflammatory (omega-3 fatty acids) effects of diet components (nutrients and bioactive compounds) prevent/mitigate the pathological incidence of oxidative-inflammatory processes”.
The author reminds us that the Mediterranean diet has been recognized by the UNESCO as Intangible Cultural Heritage “and it is important to provide scientific evidence that explains its beneficial effects on health”.
The results of this study –which has been coordinated by professors Mariano Mañas Almendros, María Dolores Yago Torregrosa and María Dolores Mesa García– have been partially published in the journal Proceedings of the Nutrition Society.
Fish oil may hold key to leukemia cure
|IMAGE:The compound shown above is D12-PGJ2, which closely resembles delta-12-protaglandin J3, or D12-PGJ3, a compound that targeted and killed the stem cells of chronic myelogenous leukemia, or CML, in mice…|
A compound produced from fish oil that appears to target leukemia stem cells could lead to a cure for the disease, according to Penn State researchers. The compound — delta-12-protaglandin J3, or D12-PGJ3 — targeted and killed the stem cells of chronic myelogenous leukemia, or CML, in mice, said Sandeep Prabhu, associate professor of immunology and molecular toxicology in the Department of Veterinary and Medical Sciences. The compound is produced from EPA — Eicosapentaenoic Acid — an Omega-3 fatty acid found in fish and in fish oil, he said.
“Research in the past on fatty acids has shown the health benefits of fatty acids on cardiovascular system and brain development, particularly in infants, but we have shown that some metabolites of Omega-3 have the ability to selectively kill the leukemia-causing stem cells in mice,” said Prabhu. “The important thing is that the mice were completely cured of leukemia with no relapse.”
The researchers, who released their findings in the current issue of Blood, said the compound kills cancer-causing stem cells in the mice’s spleen and bone marrow. Specifically, it activates a gene — p53 — in the leukemia stem cell that programs the cell’s own death. “p53 is a tumor suppressor gene that regulates the response to DNA damage and maintains genomic stability,” Prabhu said.
|IMAGE:Penn State researchers initially tested a compound produced from fish oil on a type of leukemia found in mice called the Friend Virus. This slide shows a Friend Virus Leukemia…|
Killing the stem cells in leukemia, a cancer of the white blood cells, is important because stem cells can divide and produce more cancer cells, as well as create more stem cells, Prabhu said.
The current therapy for CML extends the patient’s life by keeping the number of leukemia cells low, but the drugs fail to completely cure the disease because they do not target leukemia stem cells, said Robert Paulson, associate professor of veterinary and biomedical sciences, who co-directed this research with Prabhu.
“The patients must take the drugs continuously,” said Paulson. “If they stop, the disease relapses because the leukemia stem cells are resistant to the drugs.”
Current treatments are unable to kill the leukemia stem cells, Paulson noted. “These stem cells can hide from the treatment, and a small population of stem cells give rise to more leukemia cells,” said Paulson. “So, targeting the stem cells is essential if you want to cure leukemia.”
|IMAGE:Penn State researchers Sandeep Prahbu (right) and Robert Paulson (left) sketch out a delta-12-protaglandin J3, or D12-PGJ3. The compound, derived from fish oil, targeted and killed the stem cells of…|
During the experiments, the researchers injected each mouse with about 600 nanograms of D12-PGJ3 each day for a week. Tests showed that the mice were completely cured of the disease. The blood count was normal, and the spleen returned to normal size. The disease did not relapse.
In previous experiments, the compound also killed the stem cells of Friend Virus-induced leukemia, an experimental model for human leukemia.
The researchers focused on D12-PGJ3 because it killed the leukemia stem cells, but had the least number of side effects. The researchers currently are working to determine whether the compound can be used to treat the terminal stage of CML, referred to as Blast Crisis. There are currently no drugs available that can treat the disease when it progresses to this stage.
Unhealthy eating: a new form of occupational hazard?
The poor diet of shift workers should be considered a new occupational health hazard, according to an editorial published in this month’s PLoS Medicine. The editorial draws on previous work published in the journal, which showed an association between an increased risk of type 2 diabetes and rotating patterns of shift work in US nurses.
Shift work is now a very common pattern of work in both the developed and developing world, with around 15-20% of the working population in Europe and the US engaged in shift work. It is particularly prevalent in the health care industry. Shift work is notoriously associated with poor patterns of eating, which is exacerbated by easier access to junk food compared with more healthy options.
The editors argue that working patterns should now be considered a specific risk factor for obesity and type 2 diabetes, which are currently at epidemic proportions in the developed world and likely to become so soon in the less-developed world. They go on to suggest that firm action is needed to address this epidemic, i.e. that “governments need to legislate to improve the habits of consumers and take specific steps to ensure that it is easier and cheaper to eat healthily than not”. More specifically, they suggest that unhealthy eating could legitimately be considered a new form of occupational hazard and that workplaces, specifically those who employ shift workers, should lead the way in eliminating this hazard.
ELDERLY CAN BE AS FAST AS YOUNG IN SOME BRAIN TASKS, STUDY SHOWS
COLUMBUS, Ohio – Both children and the elderly have slower response times when they have to make quick decisions in some settings.
But recent research suggests that much of that slower response is a conscious choice to emphasize accuracy over speed.
In fact, healthy older people can be trained to respond faster in some decision-making tasks without hurting their accuracy – meaning their cognitive skills in this area aren’t so different from younger adults.
“Many people think that it is just natural for older people’s brains to slow down as they age, but we’re finding that isn’t always true,” said Roger Ratcliff, professor of psychology at Ohio State University and co-author of the studies.
“At least in some situations, 70-year-olds may have response times similar to those of 25-year olds.”
Ratcliff and his colleagues have been studying cognitive processes and aging in their lab for about a decade. In a new study published online this month in the journal Child Development, they extended their work to children.
Ratcliff said their results in children are what most scientists would have expected: very young children have slower response times and poorer accuracy compared to adults, and these improve as the children mature.
But the more interesting finding is that older adults don’t necessarily have slower brain processing than younger people, said Gail McKoon, professor of psychology at Ohio State and co-author of the studies.
“Older people don’t want to make any errors at all, and that causes them to slow down. We found that it is difficult to get them out of the habit, but they can with practice,” McKoon said.
Researchers uncovered this surprising finding by using a model developed by Ratcliff that considers both the reaction time and the accuracy shown by participants in speeded tasks. Most models only consider one of these variables.
“If you look at aging research, you find some studies that show older people are not impaired in accuracy, but other studies that show that older people do suffer when it comes to speed. What this model does is look at both together to reconcile the results,” Ratcliff said.
Ratcliff, McKoon and their colleagues have used several of the same experiments in children, young adults and the elderly.
In one experiment, participants are seated in front of a computer screen. Asterisks appear on the screen and the participants have to decide as quickly as possible whether there is a “small” number (31-50) or a “large” number (51-70) of asterisks. They press one of two keys on the keyboard, depending on their answer.
In another experiment, participants are again seated in front of a computer screen and are shown a string of letters. They have to decide whether those letters are a word in English or not. Some strings are easy (the nonwords are a random string of letters) and some are hard (the nonwords are pronounceable, such as “nerse”).
In the Child Development study, the researchers used the asterisk test on second and third graders, fourth and fifth graders, ninth and tenth graders, and college-aged adults. Third graders and college-aged adults participated in the word/nonword test.
The results showed that there was a rise in accuracy and decrease in response time on both tasks from the second and third-graders to the college-age adults.
The younger children took longer than older children and adults to respond in the experiment, Ratcliff said. They, like the elderly, were taking longer to make up their mind. But the younger children were also less accurate than younger adults in this study.
“Younger children are not able to make as good of use of the information they are presented, so they are less accurate,” Ratcliff said. “That improves as they mature.”
Older adults show a different pattern. In a study published in the journal Cognitive Psychology, Ratcliff and colleagues compared college-age subjects, older adults aged 60-74, and older adults aged 75-90. They used the same asterisk and word/nonword tests that were in the Child Development study. They found that there was little difference in accuracy among the groups, even the oldest of participants.
However, the college students had faster response times than did the 60-74 year olds, who were faster than the 75-90 year olds.
|“If you look at aging research, you find some studies that show older people are not impaired in accuracy, but other studies that show that older people do suffer when it comes to speed. What this model does is look at both together to reconcile the results.”|
But the slower response times are not all the result of a decline in skills among older adults. In a previous study, the researchers encouraged older adults to go faster on these same tests. When they did, the difference in their response times compared to college-age students decreased significantly.
“For these simple tasks, decision-making speed and accuracy is intact even up to 85 and 90 years old,” McKoon said.
That doesn’t mean there are no effects of aging on decision-making speed and accuracy, Ratcliff said. In a study in the Journal of Experimental Psychology: General, Ratcliff, McKoon and another colleague found (like in studies from other laboratories) that accuracy for “associative memory” does decline as people age. For example, older people were much less likely to remember if they had studied a pair of words together than did younger adults.
But Ratcliff said that, overall, their research suggests there should be greater optimism about the cognitive skills of seniors.
“The older view was that all cognitive processes decline at the same rate as people age,” Ratcliff said.
“We’re finding that there isn’t such a uniform decline. There are some things that older people do nearly as well as young people.”
Diet patterns may keep brain from shrinking
ST. PAUL, Minn. – People with diets high in several vitamins or in omega 3 fatty acids are less likely to have the brain shrinkage associated with Alzheimer’s disease than people whose diets are not high in those nutrients, according to a new study published in the December 28, 2011, online issue of Neurology®, the medical journal of the American Academy of Neurology.
Those with diets high in omega 3 fatty acids and in vitamins C, D, E and the B vitamins also had higher scores on mental thinking tests than people with diets low in those nutrients. These omega 3 fatty acids and vitamin D are primarily found in fish. The B vitamins and antioxidants C and E are primarily found in fruits and vegetables.
In another finding, the study showed that people with diets high in trans fats were more likely to have brain shrinkage and lower scores on the thinking and memory tests than people with diets low in trans fats. Trans fats are primarily found in packaged, fast, fried and frozen food, baked goods and margarine spreads.
The study involved 104 people with an average age of 87 and very few risk factors for memory and thinking problems. Blood tests were used to determine the levels of various nutrients present in the blood of each participant. All of the participants also took tests of their memory and thinking skills. A total of 42 of the participants had MRI scans to measure their brain volume.
Overall, the participants had good nutritional status, but seven percent were deficient in vitamin B12 and 25 percent were deficient in vitamin D.
Study author Gene Bowman, ND, MPH, of Oregon Health & Science University in Portland and a member of the American Academy of Neurology, said that the nutrient biomarkers in the blood accounted for a significant amount of the variation in both brain volume and thinking and memory scores. For the thinking and memory scores, the nutrient biomarkers accounted for 17 percent of the variation in the scores. Other factors such as age, number of years of education and high blood pressure accounted for 46 percent of the variation. For brain volume, the nutrient biomarkers accounted for 37 percent of the variation.
“These results need to be confirmed, but obviously it is very exciting to think that people could potentially stop their brains from shrinking and keep them sharp by adjusting their diet,” Bowman said.
The study was the first to use nutrient biomarkers in the blood to analyze the effect of diet on memory and thinking skills and brain volume. Previous studies have looked at only one or a few nutrients at a time or have used questionnaires to assess people’s diet. But questionnaires rely on people’s memory of their diet, and they also do not account for how much of the nutrients are absorbed by the body, which can be an issue in the elderly.
Monsanto GMO Seeds Use to Further Expand Within US
Mike Barrett Natural Society December 30, 2011
While genetically modified foods are continually being banned in other countries, the US is slow to follow the very necessary trend. The USDA has chosen to step back and give Monsanto even more power over GMO seeds, and now some states are taking similar action. A bill which could be passed in Lansing, Michigan could make Michigan the 15th state to allow for the expansion of GMO seed use, causing Michigan farms to be plagued with disease-riddled, genetically modified crops.
Calling for the Expansion of GMO Seeds
In order to pave way for the expansion of GMO seeds in Michigan, a slight modification must be made to Sen. Bill 777, which has been in the Senate Agriculture, Forestry and Tourism Committee since Septrember 2005. The change seeks to prevent anti-GMO laws, giving biotech corporations even more room to wreak havoc on the environment and humankind alike. The new bill seeks to remove the following:
“Any authority local governments may have to adopt and enforce ordinances that prohibit or regulate the labeling, sale, storage, transportation, distribution, use, or planting of agricultural, vegetable, flower or forest tree seeds.”
It is interesting to see how some areas encourage the expansion of GMO crops while others, such as Colorado’s Boulder County, recognize the dangers and choose to heed the warnings. Jeff Cobb, legislative aid to GOP Sen. Gerald Van Woekom, the sponsor of the legislation, says that his boss feels local governments don’t have the scientific capacity to determine the safety of GM seeds. The Food and Drug Administration, Environmental Protection Agency, and the United States Department of Agriculture are the three government entities which have the power to regulate GMO seeds, and Cobb, along with others, feels that local government should not play a role
The USDA and FDA are Failing to ‘Protect the People’
But if there is any hope for the massive decline of GMO crops, these government entities should be the last to have the power and control. Just recently, the USDA decided to deregulate two of Monsanto’s genetically modified seed varieties, giving the company a further grasp on the food supply of the nation. This is also the same organization that has continually pushed for the approval of genetically modified salmon, which was rejected by Congress due to health concerns. The USDA is so dedicated, in fact, that they decided to help forward the approval of genetically modified salmon by generously funding the cause with nearly $500,000. Not only that, but the organization also illegally approved Monsanto’s GMO sugarbeets, which were to be destroyed some time after.
The FDA is another government entity which doesn’t seem to be doing a great job at protecting the people. The FDA is seeking to outlaw the majority of supplements created after 1994 until they have been heavily proven to be 100% effective and free of any slight side effects, meanwhile the organization allows for harmful genetically modified ingredients to fill the world’s food supply. In another vein, despite seafood showing extremely high levels of contamination, the FDA decided that the food was still safe for consumption
These reports are done with the appreciation of all the Doctors, Scientist, and other
Medical Researchers who sacrificed their time and effort. In order to give people the
ability to empower themselves. Without the base aspirations for fame, or fortune. Just honorable people, doing honorable things.