#97

Health Technology Research Synopsis 97th Issue Date 9 JAN 11

Compiled By Ralph Turchiano www.vit.bz

Editors Top Five:

To few articles to list

In this issue:

1. 1.       Not all infant formulas are alike: Differential effects on weight gain
2. 2.       Newborns with low vitamin D levels at increased risk for respiratory infections
3. 3.       Study shows vitamin D deficiencies may impact onset of autoimmune lung disease

4.  Birch bark ingredient comes with many metabolic benefits

1. 5.       Metabolic cost of human sleep deprivation quantified by University of Colorado team
2. 6.       New findings show vitamin D accelerates recovery from TB
3. 7.       Mother’s milk improves the physical condition of future adolescents
4. 8.       Exercise may lower risk of death for men with prostate cancer
5. 9.       Protective properties of green tea uncovered
6. 10.   Tomatoes found to contain nutrient which prevents vascular diseases
7. 11.   Evidence lacking for widespread use of costly antipsychotic drugs, says Stanford researcher

12. US says too much fluoride causing splotchy teeth Public release date: 27-Dec-2010

Not all infant formulas are alike: Differential effects on weight gain

PHILADELPHIA (December 27, 2010) – New findings from the Monell Center reveal that weight gain of formula-fed infants is influenced by the type of formula the infant is consuming. The findings have implications related to the infant’s risk for the development of obesity, diabetes and other diseases later in life.

“Events early in life have long-term consequences on health and one of the most significant influences is early growth rate,” said study lead author Julie Mennella, Ph.D., a developmental psychobiologist at Monell. “We already know that formula-fed babies gain more weight than breast-fed babies. But we didn’t know whether this was true for all types of formula.”

While most infant formulas are cow’s milk-based, other choices include soy-based and protein hydrolysate-based formulas. Protein hydrolysate formulas contain pre-digested proteins and typically are fed to infants who cannot tolerate the intact proteins in other formulas.

In adults, pre-digested proteins are believed to act in the intestine to initiate the end of a meal, thus leading to smaller meals and intake of fewer calories. Based on this, the authors hypothesized that infants who were feeding protein hydrolysate formulas would eat less and have an altered growth pattern relative to infants feeding cow’s milk-based formula.

In the study, published online in the journal Pediatrics, infants whose parents had already decided to bottle-feed were randomly assigned at two weeks of age to feed either a cow’s milk-based formula (35 infants) or a protein hydrolysate formula (24 infants) for seven months.

Both formulas contained the same amount of calories, but the hydrolysate formula had more protein, including greater amounts of small peptides and free amino acids.

Infants were weighed once each month in the laboratory, where they also were videotaped consuming a meal of the assigned formula. The meal continued until the infant signaled that s/he was full.

Overthesevenmonthsofthestudy,theproteinhydrolysateinfantsgained weight at a slower rate thaninfantsfed cow milk formula. Linear growth, or length, did not differ between the two groups, demonstrating that the differences in growth were specifically attributable to weight.

“All formulas are not alike,” said Mennella. “These two formulas have the same amount of calories, but differ considerably in terms of how they influence infant growth.”

When the data were compared to national norms for breast-fed infants, the rate of weight gain of protein hydrolysate infants was comparable to the breast milk standards; in contrast, infants fed cow’s milk formula gained weight at a greater rate than the same breast milk standards.

Analysis of the laboratory meal revealed the infants fed the protein hydrolysate formula consumed less formula during the meal.

“One of the reasons the protein hydrolysate infants had similar growth patterns to breast-fed infants, who are the gold standard, is that they consumed less formula during a feed as compared to infants fed cow’s milk formula” said Mennella. “The next question to ask is: Why do infants on cow’s milk formula overfeed?”

The findings highlight the need to understand the long-term influences of infant formula composition on feeding behavior, growth, and metabolic health. Future studies will utilize measures of energy metabolism and expenditure to examine how the individual formulas influence growth, and how each differs from breastfeeding.

Public release date: 27-Dec-2010

Newborns with low vitamin D levels at increased risk for respiratory

infections

The vitamin D levels of newborn babies appear to predict their risk of respiratory infections during   infancy and the occurrence of wheezing during early childhood, but not the risk of developing asthma. Results of a study in the January 2011 issue of Pediatrics support the theory that widespread vitamin D deficiency contributes to risk of infections.

“Our data suggest that the association between vitamin D and wheezing, which can be a symptom of many respiratory diseases and not just asthma, is largely due to respiratory infections,” says Carlos Camargo, MD, DrPH, of the Massachusetts General Hospital (MGH), who led the study. “Acute respiratory  infections are a major health problem in children. For example, bronchiolitis – a viral illness that affects small airway passages in the lungs – is the leading cause of hospitalization in U.S. infants.”

Although vitamin D is commonly associated with its role in developing and maintaining strong bones, recent evidence suggests that it is also critical to the immune system. Vitamin D is produced by the body in response to sunlight, and achieving adequate levels in winter can be challenging, especially in regions with significant seasonal variation in sunlight. Previous studies by Camargo’s team found that children of women who took vitamin D supplements during pregnancy were less likely to develop wheezing during childhood. The current study was designed to examine the relationship between the actual blood levels of vitamin D of newborns and the risk of respiratory infection, wheezing and asthma.

The researchers analyzed data from the New Zealand Asthma and Allergy Cohort Study, which followed more than 1,000 children in the cities of Wellington and Christchurch. Midwives or study nurses gathered a range of measures, including samples of umbilical cord blood, from newborns whose mothers enrolled them in the study. The mothers subsequently answered questionnaires – which among other items asked about respiratory and other infectious diseases, the incidence of wheezing, and any diagnosis of asthma – 3 and 15 months later and then annually until the children were 5 years old. The cord blood samples were analyzed for levels of 25-hydroxyvitamin D (25OHD) – considered to be the best measure of vitamin D status.

Cord blood samples were available from 922 newborns in the study cohort, and more than 20 percent of them had 25OHD levels less than 25 nmol/L, which is considered very low. The average level of 44 nmol/L would still be considered deficient – some believe that the target level for most individuals should be as high as 100 nmol/L – and lower levels were more common among children born in winter, of lower socioeconomic status and with familial histories of asthma and smoking. By the age of 3 month, infants with 25OHD levels below 25 nmol/L were twice as like to have developed respiratory infections as those with levels of 75 nmol/L or higher.

Survey results covering the first five years of the participants’ lives showed that, the lower the neonatal 25OHD level, the higher the cumulative risk of wheezing during that period. But no significant association was seen between 25OHD levels and a physician diagnosis of asthma at age 5 years. Some previous studies had suggested that particularly high levels of vitamin D might increase the risk for allergies, but no such association was seen among study participants with the highest 25OHD levels. Camargo notes that very few children in this study took supplements; their vitamin D status was determined primarily by exposure to sunlight.

An associate professor of Medicine at Harvard Medical School, Camargo notes that the study results do not mean that vitamin D levels are unimportant for people with asthma. “There’s a likely difference here between what causes asthma and what causes existing asthma to get worse. Since respiratory infections are the most common cause of asthma exacerbations, vitamin D supplements may help to prevent those events, particularly during the fall and winter when vitamin D levels decline and exacerbations are more common. That idea needs to be tested in a randomized clinical trial, which we hope to do next year.”

Publicreleasedate: 4-Jan-2011

Study shows vitamin D deficiencies may impact onset of autoimmune lung disease

CINCINNATI—A new study shows that vitamin D deficiency could be linked to the development and severity of certain autoimmune lung diseases.

These findings are being reported in the Jan. 4 edition of the journal Chest.

Brent Kinder, MD, UC Health pulmonologist, director of the Interstitial Lung Disease Center at the University of Cincinnati and lead investigator on the study, says vitamin D deficiencies have been found to affect the development of other autoimmune diseases, like lupus and type 1 diabetes.

“We wanted to see if lack of sufficient vitamin D would also be seen in patients who are diagnosed with  an autoimmune interstitial lung disease (ILD) and whether it was associated with reduced lung function,” he says.

Some ILD patients first discover they have an undifferentiated connective tissue disease, a chronic inflammatory autoimmune disease that affects multiple organ systems but is not developed enough for physicians to easily recognize and categorize.

Autoimmune diseases occur when the body produces abnormal cells that turn on the body and attack major organs and tissues. Connective tissue diseases include lupus, scleroderma, polymyositis, vasculitis, rheumatoid arthritis and Sjogren’s syndrome.

“ILD is a group of diseases that mainly affect the tissues of the lungs instead of the airways, like asthma and emphysema do,” says Kinder. “It causes scarring of the lungs, is more difficult to diagnosis and treat than other kinds of lung diseases and is often fatal.

“Since vitamin D deficiency has implications for other manifestations of autoimmune illnesses, we wanted to see it had an effect on the lungs of this patient population.”

Researchers evaluated 118 patients from the UC ILD Center database—67 with connective tissue disease- related ILD and 51 with other causes of lung fibrosis—for serum 25-hydroxyvitamin D levels, which indicate levels of vitamin D in the body. Then, they evaluated associations between these serum levels and the patients’ conditions.

Overall, those with connective tissue disease-related ILD were more likely to have vitamin D deficiency— 52 percent versus 20 percent—and insufficiency—79 percent versus 31 percent—than other forms of ILD.

Among this same group of patients, reduced serum 25-hydroxyvitamin D levels were strongly associated with reduced lung function.

“These findings suggest that there is a high prevalence of vitamin D deficiency in patients with ILD, particularly those with connective tissue disease,” Kinder says. “Therefore, vitamin D may have a role in the development of connective tissue disease-related ILD and patients’ worsening lung function.

“One of the next steps is to see if supplementation will improve lung function for these patients.”

He adds that if these findings are confirmed and vitamin D supplementation is shown to be effective in clinical trials, this may also provide a more natural, inexpensive treatment for the illness.

“Vitamin D is known to be a critical dietary factor for bone and skin health,” he says. “Now, we’re learning that it could potentially be modified as a treatment to improve ILD as opposed to other, more toxic therapies.”

Public release date: 4-Jan-2011

Birch bark ingredient comes with many metabolic benefits

An ingredient found in abundance in birch bark appears to have an array of metabolic benefits, according to new studies in animals that are reported in the January issue of Cell Metabolism, a Cell Press publication. In mice, the compound known as betulin lowered cholesterol, helped prevent diet- induced obesity, and improved insulin sensitivity. Betulin-treated mice were also more resistant to developing atherosclerotic plaques in their arteries.

Betulin works by targeting so-called sterol regulatory element-binding proteins (SREBPs), transcription factors that are known to be important for activating the expression of genes involved in the biosynthesis of cholesterol, fatty acids, and triglycerides.

“Our study shows that the SREBP pathway is a good target for several metabolic diseases,” said Bao- Liang Song of the Shanghai Institutes for Biological Sciences. “We also identify a leading compound.”

In the new study, Song and his colleagues went in search of a compound that might act directly on SREBP. That chemical screen turned up betulin as a top contender. They then confirmed in cells that betulin lowered the activity of genes that are normally switched “on” by SREBP. It also lowered lipid levels within cells.

Song’s team then treated mice on a high-fat, Western diet with betulin, the cholesterol-lowering statin known as lovastatin, or a placebo (saline) for 6 weeks. Compared to placebo, both drugs led the mice to gain less weight on the high-fat diet, though by different means. Betulin caused the animals to burn more calories while lovastatin appeared to reduce the amount of lipid taken up from the diet.

Further investigations showed that betulin also lowered lipid levels in blood, liver, and fat tissue. Betulin also made the animals more sensitive to insulin. Mice with a mutation that makes them prone to develop atherosclerosis showed fewer plaques when treated with either lovastatin or betulin.

“Betulin has several major metabolic effects,” Song said.

Theresearchers say that their findings suggest that betulin may have similar or even better effects thanlovastatin, a member of the most widely prescribed drug class for treating high cholesterol. For instance, in their studies betulin decreased lipids in liver and fat to a greater extent than lovastatin did. Betulin also improved insulin resistance through its effects on fatty acid and triglyceride synthesis.

Song notes that betulin is a readily available compound and is already in use as a precursor in the manufacture of other drugs.

Although betulin appears to have very low toxicity, he says future studies will need to further investigate the safety of betulin and its metabolic effects. Researchers will also explore the possibility that a derivative of betulin might have even greater potency. “That may be the path forward to move this clinically,” Song said.

Public release date: 4-Jan-2011

Metabolic cost of human sleep deprivation quantified by University of Colorado team

In the first-ever quantification of energy expended by humans during sleep, a University of Colorado team has found that the metabolic cost of an adult missing one night of sleep is the equivalent of walking slightly less than two miles.

The new findings will help researchers further understand one of the important functions of sleep in humans, said CU-Boulder Associate Professor Kenneth Wright. Wright, who led the study, said the goal was to measure and quantify energy expenditure during both sleep and wakeful periods.

“We found that people do expend more energy when they are awake in bed than when they are asleep,” he said. The findings showed the eight hours of sleep saved roughly 135 calories over eight hours of wakefulness.

“While the amount of energy savings for humans during sleep may seem relatively small, it actually was a little more than we expected,” said Wright, a faculty member in CU-Boulder’s integrative physiology department and director of CU-Boulder’s Sleep and Chronobiology Laboratory.

A paper on the subject was published in the January issue of the Journal of Physiology. Co-authors included CU-Boulder’s Christopher Jung and Emily Frydenall, as well as Assistant Professor Edward Melanson, Dr. Leigh Perreault and Dr. Robert Eckel of the University of Colorado School of Medicine. Jung, first author on the paper, got his doctorate from CU-Boulder in 2009 and is now at the University of Alaska.

The study showed that compared to a typical night of sleep, the amount of energy expended by study subjects during 24 hours of sleep deprivation was up about 7 percent. In contrast, energy expenditure decreased by about 5 percent during the recovery episode, which included 16 hours of wakefulness following the sleep deprivation night, then eight hours of recovery sleep, Wright said.

“Understanding the function of sleep, especially in humans, is considered one of the most important scientific enigmas,” said Wright, who also is an adjunct faculty member at the University of Colorado School of Medicine.

The study, which included seven young adult subjects, was tightly controlled. All participants were required to stay in bed for the entire three-day study. Their diets met individual daily energy requirements, and the content and timing of each meal was exactly at the same time each day during the lab study. The subjects spent the sleep deprivation night in bed watching movies, reading and talking, said Wright.

The first day of the study consisted of a typical 16 hours of wakefulness followed by eight hours of sleep. Days two and three included 40 hours of total sleep deprivation followed by eight hours of recovery sleep.

As part of the study, the researchers studied the effects of sleep stages ranging from light sleep to rapid- eye movement sleep to deep, “slow wave” sleep and awakenings from sleep on whole body energy expenditure, Wright said. The study indicated the most energy was expended during natural arousals from sleep, which occurred less often during the eight-hour sleep episodes following sleep deprivation.

The amount of energy saved during sleep by the study subjects likely would have been higher if they were allowed to continue sleeping after the eight hours of recovery sleep rather than being awakened, which was the final step in the study, said Wright.

The study may have implications for those with sleep disorders such as insomnia or sleep apnea.

Insomnia, marked by difficulty going to and staying asleep, and sleep apnea, marked by frequent arousals from sleep, may mean such people “are burning the furnace at a higher rate at night because their sleep is disturbed,” said Wright. He noted that more research is needed to address this issue in patients with sleep disorders.

It’s likely that the metabolic costs of sleep deprivation would have been higher if the subjects had not been restricted to bed rest and had opportunities to walk around and perform various tasks, said Wright. Other studies have shown that sleep deprivation reduces the levels of leptin — a hormone responsible for telling the brain that the body is satiated — which could mean late-night snacking by “free-ranging” humans, he said.

“One question we have is why humans don’t conserve more energy during sleep,” he said. “We think there are multiple functions of sleep, and that some energy conserved during sleep may be redistributed to support other important physiological processes.” Some energy conserved by sleep might be used for nighttime physiological activities like immune-system function, the strengthening of connections between neurons in the brain as a result of daily learning and experience, and hormone synthesis and release.

One of the health areas scientists are very interested in is how sleep loss may contribute to weight gain   and obesity, said Wright. He stressed that energy expenditure during sleep deprivation is neither a safe or effective strategy for weight loss, and that other studies have shown chronic sleep deprivation is associated with impaired cognition. He said more research is needed to understand how short nighttime sleep schedules, typically six hours or less a night across many days, contribute to weight gain and obesity.

Wright said about a half dozen undergraduate research assistants helped in the study. The Sleep Research Society Foundation, the National Institutes of Health, CU-Boulder’s Undergraduate Research Opportunities Program and the Bioscience Undergraduate Research Skills and Training programs of the Biological Sciences Initiative at CU-Boulder funded the study.

A 2006 study by Wright and his colleagues showed that people awakened after eight hours of sound sleep have more impaired thinking and memory skills than they do after being deprived of 24 hours of sleep.

Public release date: 5-Jan-2011

New findings show vitamin D accelerates recovery from TB

New research findings which show that vitamin D can speed up antibiotic treatment of tuberculosis (TB) have been revealed by scientists at Barts and The London School of Medicine and Dentistry. The study – which gives fresh insight into how vitamin D may affect the immune response – is published today (6 January 2011) in The Lancet.

In a trial led by Dr Adrian Martineau of the Centre for Health Sciences at Barts and The London School   of Medicine and Dentistry – and funded by the British Lung Foundation – 146 patients with drug-sensitive TB were recruited from 10 National Health Service Trusts in London and randomly and evenly assigned  to receive either four oral doses of 2.5mg of vitamin D, or a placebo. All participants received standard antibiotic treatment for their condition.

The average time to clearance of TB from the lungs among all study participants was 6 weeks for patients taking standard therapy alone and 5 weeks for those taking additional vitamin D, although this difference was not large enough to sustain statistical significance. However, patients who had a particular genetic type of vitamin D receptor were much more vitamin D responsive than others and cleared TB bacteria much more quickly if they received vitamin D in addition to standard antibiotic treatment.

122/126 patients in the trial (97per cent), had inadequate levels of vitamin D at baseline. Vitamin D

deficiency is a very common problem in TB patients – a characteristic which may arise due to lack of sunshine in the UK, or to diets low in vitamin D. It is also possible that TB can cause vitamin D deficiency by a mechanism which is not wholly understood at present.

Lead researcher Dr Adrian Martineau said: “Vitamin D is best known for its effects on bones – it prevents rickets and osteomalacia – but it also has important effects on the immune system. High dose vitamin D was used to treat TB in the days before antibiotics were available, but clinical trials have not previously been performed to find out how TB patients’ genetic make-up can affect their response to vitamin D supplementation. The finding that patients who have a particular type of vitamin D receptor are very responsive to vitamin D is new and gives us insights into how vitamin D can affect the immune response.”

Ian Jarrold, Research Manager for the British Lung Foundation, said: “The findings of this study, which was funded by the British Lung Foundation, show great promise in speeding up the antibiotic treatment of TB for those patients which are receptive to vitamin D. The treatment process is currently very long and can be costly so any headway made in the medical research field for this disease is welcome to improve outcomes for patients.”

Public release date: 5-Jan-2011

Mother’s milk improves the physical condition of future adolescents

Enrique García Artero, the principal author of the study and researcher at the University of Granada pointed out that, “Our objective was to analyse the relationship between the duration of breastfeeding babies and their physical condition in adolescence”. “The results suggest further beneficial effects and provide support to breast feeding as superior to any other type of feeding”.

The authors asked the parents of 2,567 adolescents about the type of feeding their children received at birth and the time this lasted. The adolescents also carried out physical tests in order to evaluate several abilities such as aerobic capacities and their muscular strength.

The paper, which was published in the Journal of Nutrition, shows that the adolescents who were breastfed as babies ha stronger leg muscles than those who were not breastfed. Moreover, muscular leg strength was greater in those who had been breastfed for a longer period of time.

This type of feeding (exclusively or in combination with other types of food) is associated with a better performance in horizontal jumping by boys and girls regardless of morphological factors such as fat mass, height of the adolescent or the amount of muscle.

Adolescents who were breastfed from three to five months, or for more than six months had half the risk of low performance in the jump exercise when compared with those who had never been breastfed.

García Artero stressed that, “Until now, no studies have examined the association between breastfeeding and future muscular aptitude”. “However, our results concur with the observations made as regards other neonatal factors, such as weight at birth, are positively related to better muscular condition during adolescence”.

What importance does breastfeeding have?

“If all children were exclusively breastfed from birth, it would be possible to save approximately 1.5 million lives”. This was stated by the UNICEF, which pointed out that breast feeding is the “perfect feed” exclusively during the first six months of life and additionally over two years.

As regards the new born, the advantages in the first years of life include immunological protection against allergies, skin diseases, obesity and diabetes, as well as a guarantee of the growth, development and intelligence of the baby.

The benefits also substantially involve the woman: reduction of post-birth haemorrhage, anaemia, maternity mortality, and the risk of breast and ovarian cancer, and it strengthens the affective link   between mother and child. “Let’s forget about the money saved by not buying other types of milk and baby bottles”, says García Artero.

Public release date: 5-Jan-2011

Exercise may lower risk of death for men with prostate cancer

Boston, MA – A new study of men with prostate cancer finds that physical activity is associated with a lower risk of overall mortality and of death due to prostate cancer. The Harvard School of Public Health and University of California, San Francisco researchers also found that men who did more vigorous activity had the lowest risk of dying from the disease. It is the first study in men with prostate cancer to evaluate physical activity after diagnosis in relation to prostate cancer-specific mortality and overall mortality.

The study appears in an advance online edition of the Journal of Clinical Oncology.

“Our results suggest that men can reduce their risk of prostate cancer progression after a diagnosis of prostate cancer by adding physical activity to their daily routine,” said Stacey Kenfield, lead author of the study and a Harvard School of Public Health researcher. “This is good news for men living with prostate cancer who wonder what lifestyle practices to follow to improve cancer survival.”

Prostate cancer is the most frequently diagnosed form of cancer among men in the United States and affects one in six U.S. men during their lifetime. More than 2 million men in the U.S. and 16 million men worldwide are prostate cancer survivors.

The study was conducted in 2,705 men diagnosed with prostate cancer in the Health Professionals Follow- Up Study over an 18-year period. The participants reported the average time per week they spent doing physical activity, including walking, running, bicycling, swimming and other sports and outdoor work.

The results showed that both non-vigorous and vigorous activity were beneficial for overall survival. Compared with men who walked less than 90 minutes per week at an easy pace, those who walked 90 or more minutes per week at a normal to very brisk pace had a 46% lower risk of dying from any cause.

Only vigorous activity—defined as more than three hours per week—was associated with reduced prostate cancer mortality. Men who did vigorous activity had a 61% lower risk of prostate cancer-specific death compared with men who did less than one hour per week of vigorous activity.

“We observed benefits at very attainable levels of activity and our results suggest that men with prostate cancer should do some physical activity for their overall health, even if it is a small amount, such as 15 minutes of activity per day of walking, jogging, biking or gardening,” said Kenfield. “However, doing vigorous activity for three or more hours per week may be especially beneficial for prostate cancer, as well as overall health,” she said.

Public Release: 5-Jan-2011

Protective properties of green tea uncovered

Regularly drinking green tea could protect the brain against developing Alzheimer’s and other forms of dementia, according to latest research by scientists at Newcastle University.

The study, published in the academic journal Phytomedicine, also suggests this ancient Chinese remedy could play a vital role in protecting the body against cancer.

Led by Dr Ed Okello, the Newcastle team wanted to know if the protective properties of green tea – which have previously been shown to be present in the undigested, freshly brewed form of the drink – were still active once the tea had been digested.

Digestion is a vital process which provides our bodies with the nutrients we need to survive. But, says Dr Okello, it also means that just because the food we put into our mouths is generally accepted to contain health-boosting properties, we can’t assume these compounds will ever be absorbed by the body.

“What was really exciting about this study was that we found when green tea is digested by enzymes in the gut, the resulting chemicals are actually more effective against key triggers of Alzheimer’s development than the undigested form of the tea,” explains Dr Okello, based in the School of Agriculture, Food and Rural Development at Newcastle University.

“In addition to this, we also found the digested compounds had anti-cancer properties, significantly slowing down the growth of the tumour cells which we were using in our experiments.”

As part of the research, the Newcastle team worked in collaboration with Dr Gordon McDougall of the Plant Products and Food Quality Group at the Scottish Crop Research Institute in Dundee, who developed technology which simulates the human digestive system.

It is this which made it possible for the team to analyse the protective properties of the products of digestion.

Two compounds are known to play a significant role in the development of Alzheimer’s disease – hydrogen peroxide and a protein known as beta-amyloid.

Previous studies have shown that compounds known as polyphenols, present in black and green tea, possess neuroprotective properties, binding with the toxic compounds and protecting the brain cells.

When ingested, the polyphenols are broken down to produce a mix of compounds and it was these the Newcastle team tested in their latest research.

“It’s one of the reasons why we have to be so careful when we make claims about the health benefits of various foods and supplements,” explains Dr Okello.

“There are certain chemicals we know to be beneficial and we can identify foods which are rich in them but what happens during the digestion process is crucial to whether these foods are actually doing us any good.”

Carrying out the experiments in the lab using a tumour cell model, they exposed the cells to varying concentrations of the different toxins and the digested green tea compounds.

Dr Okello explained: “The digested chemicals protected the cells, preventing the toxins from destroying the cells.

“We also saw them affecting the cancer cells, significantly slowing down their growth.

“Green tea has been used in Traditional Chinese medicine for centuries and what we have here provides the scientific evidence why it may be effective against some of the key diseases we face today.”

The next step is to discover whether the beneficial compounds are produced during digestion after healthy human volunteers consume tea polyphenols. The team has already received funding from the Biotechnology and Biological Sciences Research Council (BBSRC) to take this forward.

Dr Okello adds: “There are obviously many factors which together have an influence on diseases such as cancer and dementia – a good diet, plenty of exercise and a healthy lifestyle are all important.”

Public release date: 6-Jan-2011

Tomatoes found to contain nutrient which prevents vascular diseases

They are the most widely produced fruit in the world and now scientists in Japan have discovered that tomatoes contain a nutrient which could tackle the onset of vascular diseases. The research, published in the journal Molecular Nutrition & Food Research, reveals that an extracted compound, 9-oxo- octadecadienoic, has anti-dyslipidemic affects.

The team led by Dr Teruo Kawada, from Kyoto University and supported by the Research and Development Program for New Bio-industry Initiatives, Japan, focused their research on extracts which tackle dyslipidemia, a condition which is caused by an abnormal amount of lipids, such as cholesterol or fat, in the blood stream.

“Dyslipidemia itself usually causes no symptoms,” said Kawada, “however; it can lead to symptomatic vascular diseases, such as arteriosclerosis and cirrhosis. In order to prevent these diseases it is important to prevent an increased build up of lipids.”

Tomato is already known to contain many compounds beneficial to health. In this study the team analyzed 9-oxo-octadecadienoic acid, to test its potential anti-dyslipidemia properties.

The compound was found to enhance fatty acid oxidation and contributed to the regulation of hepatic lipid metabolism. These findings suggest that 9-oxo-octadecadienoic acid has anti- dyslipidemia affects and can therefore help prevent vascular diseases.

“Finding a compound which helps the prevention of obesity-related chronic diseases in foodstuffs is a great advantage to tackling these diseases”, concluded Kawada. “It means that the tomato allows people to  easily manage the onset of dyslipidemia through their daily diet.”

Public release date: 7-Jan-2011

Evidence lacking for widespread use of costly antipsychotic drugs, says Stanford researcher

STANFORD, Calif. — Many prescriptions for the top-selling class of drugs, known as atypical antipsychotic medications, lack strong evidence that the drugs will actually help, a study by researchers at the Stanford University School of Medicine and University of Chicago has found. Yet, drugs in this class may cause such serious effects as weight gain, diabetes and heart disease, and cost Americans billions of dollars.

“Because these drugs have safety issues, physicians should prescribe them only when they are sure

patients will get substantial benefits,” said Randall Stafford, MD, PhD, associate professor of medicine at the Stanford Prevention Research Center, who is senior author of the study to be published online Jan. 7 in Pharmacoepidemiology and Drug Safety. “These are commonly used and very expensive drugs.”

Prescriptions for these drugs have risen steadily since they first came on the U.S. market in 1989, largely replacing the first generation of antipsychotics, which were mainly used to treat schizophrenia. The U.S. government’s original stamp of approval for the new drugs was for treating schizophrenia, but they’re used more today for other conditions, including other psychoses, autism, bipolar disorder, delirium, dementia, depression and personality disorders. And while some of these uses have recently been approved by the

U.S. Food and Drug Administration, many have not.

For example, the FDA has approved quetiapine (brand name, Seroquel), the antipsychotic with the biggest

U.S. sales, for treating schizophrenia and some aspects of bipolar disorder and depression, but the drug is also often used for anxiety and dementia, among other conditions.

These new drugs accounted for more than $10 billion in retail pharmacy U.S. prescription drug costs in 2008, representing the largest expenditure for any single drug class — nearly 5 percent of all drug spending, surpassing even blockbusters like statin cholesterol medications. According to a 2004 study, a quarter of all residents of U.S. nursing homes had taken them. Among the drugs are quetiapine, aripoprazole (brand name, Abilify), olanzapine (Zyprexa) and risperidone (Risperdal), each with annual U.S. sales exceeding $1 billion.

Stafford’s new study adds to concerns about the drugs, which have been the focus of thousands of lawsuits, and as a class make up the single largest target of litigation filed under the federal False Claims Act. All major companies selling new-generation antipsychotics have either recently settled cases for hundreds of millions of dollars or are currently under investigation for skewing results or using questionable   marketing tactics.

In 2005, the FDA issued its strongest type of caution, the “black box” warning, for use of new-generation antipsychotics, because of increased risk of death for dementia patients.

“Most people think, ‘If my doctor prescribed this, the FDA must have evaluated whether this drug was safe and effective for this use.’ That’s not true,” said Stafford. When doctors prescribe drugs for purposes other than those approved by the FDA, it’s called “off-label” use. Though it’s riskier for patients, there’s nothing illegal about it, and can make sense medically in some instances, Stafford said, especially if there are no approved treatments or if a patient has not responded to approved drugs.

Previous studies had shown that antipsychotic drug use is ballooning. Stafford’s new study not only corroborated and updated these findings but also identified the fraction of off-label use that is based on uncertain evidence.

The researchers’ first step was to analyze the results of a physicians’ survey conducted by health-care information company IMS Health. The IMS Health National Disease and Therapeutic Index survey gives a snapshot of the conditions doctors treated and drugs they prescribed. About 1,800 physicians participate each calendar quarter and each is randomly assigned two days per quarter to provide data.

After identifying which antipsychotics were being used, and for what, the researchers assessed the strength of the evidence supporting those that lacked FDA approval, using efficacy ratings from the widely used drug compendium, Drugdex.

Lead author Caleb Alexander, MD, assistant professor of medicine at the University of Chicago, and colleagues conducted the analysis. Stafford supervised the project and with Alexander interpreted the data. Stanford clinical assistant professor of psychiatry Anthony Mascola, MD, provided expertise on the

treatment of psychiatric conditions. Among their findings:

•Antipsychotic treatment prescribed during the surveyed doctors’ visits nearly tripled from 6.2 million in 1995 to 16.7 million in 2008, the most recent year for which they had data. During this period, prescriptions for first-generation antipsychotics decreased from 5.2 million to 1 million.

•Antipsychotic use for indications that lacked FDA approval by the end of 2008 increased from 4.4 million prescriptions during surveyed doctors’ visits in 1995 to 9 million in 2008.

•In 2008, more than half — 54 percent — of the surveyed prescriptions for the new-generation antipsychotics had uncertain evidence.

•An estimated $6 billion was spent in 2008 on off-label use of antipsychotic medication nationwide, of which $5.4 billion was for uses with uncertain evidence.

•Prescriptions for antipsychotics began dropping slightly in 2006, shortly after the FDA issued a warning about their safety.

Stafford suggests the upswing in prescriptions for antipsychotics despite the absence of good evidence for their value in many instances is the result of marketing — whether legal or illegal — and ingrained cultural tendencies. “Physicians want to prescribe and use the latest therapies — and even when those latest therapies doesn’t necessarily offer a big advantage, there’s still a tendency to think that the newest drugs must be better,” he said.

Physicians could benefit from more feedback on what percentage of their prescriptions is for off-label uses, said Stafford. “In many cases, physicians don’t realize they’re prescribing off-label,” he said.

In fact, in a previous survey of physicians, Alexander found that the average respondent accurately identified the FDA-approval status of drugs for a given condition just over half the time.

Public release date: 7-Jan-2011

US says too much fluoride causing splotchy teeth

By MIKE STOBBE, AP Medical Writer Mike Stobbe, Ap Medical Writer

ATLANTA – In a remarkable turnabout, federal health officials say many Americans are now getting too much fluoride because of its presence not just in drinking water but in toothpaste, mouthwash and other products, and it’s causing splotches on children’s teeth and perhaps more serious problems.

The U.S. Department of Health and Human Services announced plans Friday to lower the recommended level of fluoride in drinking water for the first time in nearly 50 years, based on a fresh review of the science.

The announcement is likely to renew the battle over fluoridation, even though the addition of fluoride to drinking water is considered one of the greatest public health successes of the 20th century. The U.S. prevalence of decay in at least one tooth among teens has declined from about 90 percent to 60 percent.

The government first began urging municipal water systems to add fluoride in the early 1950s. Since then, it has been put in toothpaste and mouthwash. It is also in a lot of bottled water and in soda. Some kids  even take fluoride supplements. Now, young children may be getting too much.

“Like anything else, you can have too much of a good thing,” said Dr. Howard Pollick, a professor at the University of California, San Francisco’s dental school and spokesman for the American Dental Association.

One reason behind the change: About 2 out of 5 adolescents have tooth streaking or spottiness because of too much fluoride, a government study found recently. In extreme cases, teeth can be pitted by the mineral — though many cases are so mild only dentists notice it. The problem is generally considered cosmetic and not a reason for serious concern.

The splotchy tooth condition, fluorosis, is unexpectedly common in youngsters ages 12 through 15 and appears to have grown more common since the 1980s, according to the Centers for Disease Control and Prevention.

But there are also growing worries about more serious dangers from fluoride.

The Environmental Protection Agency released two new reviews of research on fluoride Friday. One of the studies found that prolonged, high intake of fluoride can increase the risk of brittle bones, fractures and crippling bone abnormalities.

Critics of fluoridated water seized on the proposed change Friday to renew their attacks on it — a battle that dates back to at least the Cold War 1950s, when it was denounced by some as a step toward Communism. Many activists nowadays don’t think fluoride is essential, and they praised the government’s new steps.

“Anybody who was anti-fluoride was considered crazy,” said Deborah Catrow, who successfully fought a ballot proposal in 2005 that would have added fluoride to drinking water in Springfield, Ohio. “It’s amazing that people have been so convinced that this is an OK thing to do.”

Dental and medical groups applauded the announcement.

“This change is necessary because Americans have access to more sources of fluoride than they did when water fluoridation was first introduced,” Dr. O. Marion Burton, president of the American Academy of Pediatrics, said in a statement.

The fluoridated water standard since 1962 has been a range of 0.7 parts per million for warmer climates where people used to drink more water to 1.2 parts per million in cooler regions. The new proposal from HHS would set the recommended level at just 0.7. Meanwhile, the EPA said it is reviewing whether to lower the maximum allowable level of fluoride in drinking water from the current 4 parts per million.

“EPA’s new analysis will help us make sure that people benefit from tooth decay prevention while at the same time avoiding the unwanted health effects from too much fluoride,” said Peter Silva, an EPA assistant administrator.

Fluoride is a mineral that exists in water and soil. About 70 years ago, scientists discovered that people whose supplies naturally had more fluoride also had fewer cavities.