The Latest Health and Nutrition News

Intensive Blood Sugar Treatment Strategy in Clinical Trial of Diabetes and Cardiovascular Disease Changed

noreply@blogger.com (Unknown) — Sat, 09 Feb 2008 14:20:00 +0000

6 February 2008

The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health has stopped one treatment within a large, ongoing North American clinical trial of diabetes and cardiovascular disease 18 months early due to safety concerns after review of available data. The study will continue, but it will be slightly modified.

The study is the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study, which has enrolled 10,251 participants.

In the ACCORD study, adults with type 2 diabetes were recruited, especially people at higher risk for diabetes and stroke. These participants were divided into two groups and were treated in one of two ways (depending on which group they were in):

lowering of blood glucose (sugar) below current recommendations, by intensive methods
lowering of blood glucose (sugar) below current recommendations by a less-intensive method

After four years, the participants in the intensive method for lowering blood glucose levels had a slightly higher rate of death than the less-intensive group. The slightly higher death rate concerned the Data and Safety Monitoring Board (DSMB), who advised the research study lead, Elizabeth G. Nabel, M.D to stop the group receiving the higher intensity strategy for lowering blood glucose levels. This means that there is now only one group of participants, those receiving the less-intensive strategy to lower their blood glucose levels.

Of the participants, 257 in the intensive group died, while 203 in the standard treatment group died in the four years of treatment. The study researchers advise that the death rates of both groups (about 3 per 1,000) are lower than in other, similar studies.

The Data and Safety Monitoring Board (DSMB) are an independent advisory group of experts in diabetes, cardiovascular disease, epidemiology, patient care, biostatistics, medical ethics, and clinical trial design that has been monitoring ACCORD since it began.

“A thorough review of the data shows that the medical treatment strategy of intensively reducing blood sugar below current clinical guidelines causes harm in these especially high-risk patients with type 2 diabetes,” said Elizabeth G. Nabel, M.D., director, NHLBI. “Though we have stopped this part of the trial, we will continue to care for these participants, who now will receive the less-intensive standard treatment. In addition, we will continue to monitor the health of all participants, seek the underlying causes for this finding, and carry on with other important research within ACCORD.”

Resources
The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. For Safety, NHLBI Changes Intensive Blood Sugar Treatment Strategy in Clinical Trial of Diabetes and Cardiovascular Disease. Accessed 9 February 2008

Smoking Increases Risks of Sleep Disturbance

noreply@blogger.com (Unknown) — Sat, 09 Feb 2008 14:01:00 +0000

5 February 2008

New research by scientists at the Johns Hopkins University School of Medicine shows that cigarette smokers are four times as likely as non-smokers to report feeling tired and not rested after a night’s sleep. The study also revealed that smokers spend less time in REM (deep) sleep and more time in lighter sleep than non-smokers. Researchers think less restful sleep pattern is due to the withdrawal effects of nicotine when the smoker sleeps.

“It is possible that smoking has time-dependent effects across the sleep period,” said study author Naresh M Punjabi, MD, PhD, FCCP, Johns Hopkins University School of Medicine, Baltimore, MD. “Smokers commonly experience difficulty falling asleep due to the stimulating effects of nicotine. As night evolves, withdrawal from nicotine may further contribute to sleep disturbance.”

Dr Punjabi and his fellow researchers compared the sleep patterns of 40 smokers and 40 non-smokers with a home polysomnography. The participants of this study were healthy (free of any significant disease) and were not taking any medication, in order to remove all health factors that could contribute to bad sleep patterns.

The study was also analysed using both a conventional method - visual classification of electroencephalogram (EEG) patterns - and a non-conventional method - power spectral analysis of the EEG, which relies on a mathematical analysis of different frequencies contained within the sleep EEG. These two methods gave a better picture of the sleep patterns of the individuals in the study.

The participants were questioned about sleep quality:

22.5% of smokers reported lack of restful sleep
5.0% of non-smokers reported lack of restful sleep

The scientific results correlated with the participants report of lack of sleep and this supports the researchers theory that nicotine's effects are strongest in the early stages of sleep and potentially decrease throughout the sleep cycle. The researchers advised that this research may have implications in ways to help people stop smoking.

“The long-term effects of smoking on respiratory and cardiovascular health are well-known,” said Alvin V. Thomas, Jr., MD, FCCP, and President of the ACCP. “However, this study is significant because it suggests that smokers may also be deprived of the much-needed restorative effects of sleep. This study provides yet one more reason to stop smoking or to never start.”

The study appears in the February issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP).

Resources
American College of Chest Physicians. Smoking linked to sleep disturbances. Accessed 8 February 2008

Insomnia Patients Denied Treatment if They Have Mental Disorder

noreply@blogger.com (Unknown) — Sat, 09 Feb 2008 13:42:00 +0000

5 February 2008

New researcher by scientists at Ohio State University, suggests that when patients have insomnia, but also have a mental health disorder, they are not prescribed medication for their sleep disorder, which could make the symptoms of their mental disorder (anxiety or depression), even worse.

The researchers at Ohio state university examined treatment data for insomniacs and found that many doctors were reluctant to prescribe even non-dependent sleep medication, if their patients also had depression, anxiety or any other mood disorder. On the other hand, it was discovered that psychiatrists were twice as likely as doctors to prescribe medication for insomnia.

“Insomnia can cause you to have anxiety and depression, and depression and anxiety can cause you to have insomnia. It’s a chicken-and-egg type of story. But research has shown that if one of the conditions is left untreated it can exacerbate the other condition,” said senior study author Rajesh Balkrishnan, the Merrell Dow professor of pharmacy at Ohio State University.

Dr Balkrishnan stated that new guidelines need to be formulated in the treatment of insomnia, which takes into account the different types of patients, because insomnia is a major public health problem. It is estimated that 20% of Americans have some type of sleep disorder, with about 10% of people having some type of chronic sleep disorder. These figures would correlate to other developed countries, such as Australia and the UK.

The major hesitation of primary care physicians (doctors) from prescribing sleep medication is that they can cause dependence, which could prove problematic for someone with an existing mental health disorder.

Older types of sleep medication, called benzodiazepines, have addictive properties and are often abused. New types of sleep medication, on the market, called non-benzodiazepines are not addictive and are effective sleep aids, which these patients should have ready access.

Dr Balkrishnan advised that the research highlights the fact that there are many patients with insomnia who also have a mental health disorder. He also cautioned that the presence of the psychiatric condition should not preclude these patients from proper treatment of the insomnia.

Resources
Ohio State University. Insomnia Patients Often Denied Sleep Treatment When They Have Mental Health Conditions. Accessed 9 February 2008

Baby Care Products are Associate with Phthalate Chemical

noreply@blogger.com (Unknown) — Sat, 09 Feb 2008 13:11:00 +0000

5 February 2008

Researchers at the Seattle Children’s Hospital Research Institute and University of Washington have recently completed a study which revealed that babies who were treated with regular infant personal care products such as lotion, shampoo and powder were more likely to have phthalates (pronounced "thah-lates"), synthetic chemicals, in their urine than babies not treated with these products. The study will appear in the February 2008 issue of the journal Pediatrics.

Phthalates are added to a variety of personal care and cosmetic products (for both adults and children), as well as many plastic and vinyl products. Phthalates are also found in children's toys, lubricants, infant care products, cosmetics and personal care products. Phthalates are not chemically inert, which means they can be released into the air or surrounding liquids, probably leading to exposure through breathing, skin contact and ingestion. Product labels on items containing phthalates are not required to list phthalate content.

Recent studies suggest that phthalates may adversely affect human reproduction and exposure to babies, either prenatally or through breast milk, can affect hormones (but the exposure and adverse reactions has not yet been studied in infants).

In the study by the researchers at the Seattle Children’s Hospital Research Institute and University of Washington wanted to find out if babies who were treated with baby-care products had any level of phthalates in their urine after treatment with the products and determine the amount of phthalate levels in the urine. They collected urine samples from 163 infants aged 2 months to 28 months, and measured the levels of nine different phthalates in those urine samples. They also requested the mothers to fill out a questionnaire about the baby care products used on the babies in the past 24 hours.

When the researchers analysed the data, they found an extremely strong correlation between use of baby care products and levels of phthalates in the baby's urine - babies who had been treated with the baby care products had a much higher level of the phthalates in their urine compared to the babies who were not treated with any baby care products. About 81% of the babies who had been treated with the baby care products had 7 or more different phthalates in their urine.

The researchers also discovered that the younger a baby was (up to 8 months old) and if the babies (of any age within the given age group) were treated with a lot of the baby care products, the more likely it was that there were phthalates in the urine.

“We found that infant exposure to phthalates is widespread, and that exposure to personal care products applied onto the skin may be an important source,” said the study’s lead author, Sheela Sathyanarayana, MD, MPH, a researcher with Seattle Children’s Hospital Research Institute and assistant professor of paediatrics at the University of Washington School of Medicine. “This is troubling, because phthalate exposure in early childhood has been associated with altered hormone concentrations as well as increased allergies, runny nose and eczema. Babies may be more at risk than children or adults because their reproductive, endocrine and immune systems are still developing.”

Parents who want to decrease their baby's exposure to phthalates, should limit the amount of baby care products they use on their infants and children and only use these products if they are medically required, but for a limited time only.

Parents are also advised to not heat any plastic products in the microwave, as these contain phthalates and use glass as an alternative for storage and heating whenever possible.

There are phthalate-free (mostly organic and chemical-free) baby care products that parents can use instead, which are better for their baby. Phthalate-free cosmetics and adult personal care products are also available.

Resources
University of Washington and Seattle Children's Hospital Research Institute. Use of Baby Personal Care Products Associated With Phthalates. Accessed 9 February 2008

Beetroot juice may lower high blood pressure

noreply@blogger.com (Unknown) — Fri, 08 Feb 2008 12:45:00 +0000

5 February 2008

Researchers at Barts and The London School of Medicine have discovered that drinking just 500ml of beetroot juice a day can significantly reduce blood pressure. The study, published online on 5 February 2008, in the American Heart Association journal Hypertension, could have major implications for the treatment of cardiovascular disease.

Lead by Professor Amrita Ahluwalia of the William Harvey Research Institute at Barts and The London School of Medicine, and Professor Ben Benjamin of Peninsula Medical School, the research reveals that it is the ingestion of dietary nitrate contained within beetroot juice - and similarly in green, leafy vegetables - which results ultimately in decreased blood pressure. Previously the protective effects of vegetable-rich diets had been attributed to their antioxidant vitamin content.

Professor Ahluwalia and her team found that in healthy volunteers blood pressure was reduced within just 1 hour of ingesting beetroot juice, with a peak drop occurring 3-4 hours after ingestion. Some degree of reduction continued to be observed until up to 24 hours after ingestion.

Researchers showed that the decrease in blood pressure was due to the chemical formation of nitrite from the dietary nitrate in the juice. The nitrate in the juice is converted in saliva, by bacteria on the tongue, into nitrite. This nitrite-containing saliva is swallowed, and in the acidic environment of the stomach is either converted into nitric oxide or re-enters the circulation as nitrite. The peak time of reduction in blood pressure correlated with the appearance and peak levels of nitrite in the circulation, an effect that was absent in a second group of volunteers who refrained from swallowing their saliva during, and for 3 hours following, beetroot ingestion.

More than 25% of people around the world have high blood pressure (hypertension) and it is estimated that this will increase to 29% of people by 2025. Hypertension is a known risk factor for cardiovascular disease and it is known as the silent killer as it often does not present with any symptoms until the person has a heart attack or stroke.

In demonstrating that nitrate is likely to underlie the cardio-protective effect of a vegetable-rich diet, the research of Professor Ahluwalia and her colleagues highlights the potential of a natural, low cost approach for the treatment of cardiovascular disease – a condition that kills over 110,000 people in England every year.

Professor Ahluwalia said: "Our research suggests that drinking beetroot juice, or consuming other nitrate-rich vegetables, might be a simple way to maintain a healthy cardiovascular system, and might also be an additional approach that one could take in the modern day battle against rising blood pressure."

Resources
Barts and the London, Queen Mary's School of Medicine and Dentistry. Research shows a daily dose of beetroot juice can beat high blood pressure. Accessed 8 Feb 08

Widespread vitamin and mineral use among cancer survivors

noreply@blogger.com (Unknown) — Fri, 08 Feb 2008 12:34:00 +0000

5 February 2008

A review of scientific literatature by researchers at Fred Hutchinson Cancer Research Center and published Feb. 1 in the Journal of Clinical Oncology, has determined that cancer survivors are using many vitamins and mineral supplements, despite inconclusive evidence about the benefit of doing so.

"Can vitamin and herbal supplements reduce the adverse effects of cancer treatment, decrease the risk of cancer recurrence or improve a patient's chances of survival? We don't really know. Research into these matters has been minimal," said senior author Cornelia (Neli) Ulrich, Ph.D., an associate member of the Hutchinson Center's Public Health Sciences Division. "While supplement use may be beneficial for some patients, such as those who cannot eat a balanced diet, research suggests that certain supplements may actually interfere with treatment or even accelerate cancer growth," she said.

A review of 32 studies conducted between 1999 and 2006 found that many of the nation's 10 million adult cancer survivors use nutritional supplements. The researchers (Cornelia Ulrich, PhD and Christine Velicer, PhD) found that 64-81% of cancer survivors overall reported using vitamins or minerals (excluding multivitamins), whereas in the general population only 50% of adults reported taking dietary supplements.

Survivors of breast cancer reported the highest use (75-87%), whereas prostate-cancer survivors reported the least (26-35%). Factors associated with the highest level of supplement use overall included a higher level of education and being female.

The researchers also found that many people (14-32%) start taking vitamins and supplements after they have been given a cancer diagnosis.

"Cancer survivors report that they hope to strengthen their immune system with supplement use or gain a sense of control and empowerment," Ulrich said. However, many cancer survivors who use supplements do not let their doctors know; 31-68% of cancer patients and survivors who use supplements may not disclose this information or their doctors may fail to record it in their charts.

"This is disconcerting and suggests that many physicians may not recognize the importance of understanding whether their patients are taking supplements," Ulrich said.

Knowing about supplement use is crucial, she continues, because of potential adverse effects. "Evidence clearly suggests the need for caution," Ulrich said. "Some vitamins, such as folic acid, may be involved in cancer progression while others, such as St. John's wort, can interfere with chemotherapy. However, we really need more research to understand whether use of these supplements can be beneficial or do more harm than good."

Until research clarifies the effects of vitamin use in cancer survivors, the authors urge health care professionals to communicate openly with their patients about supplement use. "A simple explanation that medical studies show supplement use may not always be beneficial may help cancer survivors make well-informed decisions," the authors wrote.

References
Fred Hutchinson Cancer Research Center. Study finds widespread vitamin and mineral use among cancer survivors, although benefits of such use remain unclear. Accessed 8 Feb 08

Serotonin for advanced Parkinson's disease

noreply@blogger.com (Unknown) — Fri, 08 Feb 2008 12:16:00 +0000

5 February 2008

Most people with Parkinson’s disease use the drug L-DOPA to give relief from the symptoms such as tremors, rigidity and impaired movement associated with the progressive loss of their motor skills. Unfortunately, as Parkinson’s disease progresses, the drug L-DOPA can cause quite significant side effects that counter it's effectiveness.

Paul Greengard from Rockefeller University USA and colleagues in Sweden have determined that serotonin, a neurotransmitter involved in mood regulation, appetite, sexuality and sleep, also plays a crucial role in Parkinson’s disease. Greengard’s team showed that side effects associated with repeated L-DOPA treatment can be blocked by manipulating a specific serotonin receptor. Their findings, point to a new target for developing treatments for this disorder, which is the second most common neuro-degenerative disease after Alzheimer’s disease.

“Our study provides a scientific rationale for developing drugs that act on the serotonin 1B receptor for the treatment of advanced Parkinsonism,” says senior coauthor Per Svenningsson, a visiting professor in Greengard’s lab and a group leader at the Karolinska Institute in Sweden.

Parkinson’s disease is characterized by a progressive degeneration of dopamine-producing neurons, which causes tremors, rigidity and lack of movement control. The neurotransmitter dopamine has several functions in the brain, including the regulation of movement. These dopamine-producing neurons project from the midbrain to an area of the brain called the corpus striatum. Although dopamine signaling is impaired in Parkinson’s patients, serotonin production remains strong. In addition, several serotonin receptors are highly expressed in the striatum and available to modify the action of L-DOPA.

“Blocking the dopamine D1 receptor is not a treatment option for L-DOPA-induced side effects, since it would diminish the therapeutic efficiency of L-DOPA,” says Greengard, who is Vincent Astor Professor and head of the Laboratory of Molecular and Cellular Neuroscience at Rockefeller. “Developing compounds that target the serotonin 1B receptor may offer an alternative approach for treating advanced Parkinson’s disease.”

Resources
Rockefeller University, USA. For treating advanced Parkinson’s, new research points to serotonin. Accessed 8 February 2008

Folate deficiency triples risk for demential and Alzheimer's disease

noreply@blogger.com (Unknown) — Fri, 08 Feb 2008 11:38:00 +0000

4 February 2008

A study by Korean researchers suggests that a lack of folate (or folic acid) triples the risk of dementia (or Alzheimer's disease) in older people.

Researchers at Chonnam National University Medical School in Kwangju, Republic of Korea,

Blood tests were taken out at the start and end of the two year period to find out if they had a dementing illness. Blood tests were also taken to measure levels of folate, vitamin B12 and the protein homocysteine (which is associated with cardiovascular disease) and how these all factors changed over time.

At the beginning of the study, around 20% of the people had high levels of homocysteine, 17% had low levels of vitamin B12 and 3.5% had lows levels of folate. It was determined that the higher a person's blood levels of folate, the higher were vitamin B12 levels and homocysteine levels were lower.

By the end of the study, 45 people had developed dementia. Of these, 34 had Alzheimer’s disease, seven had vascular dementia, and four had “other” types of dementia.

The researchers discovered that dementia was higher in people who were older, relatively less educated, inactive and had deposits of the protein ApoE (which is a marker for dementia). In addition, those people whose folate levels fell lower over the two years and homocysteine rose, also were more significantly likely to develop dementia - people who were folate deficient at the start of the study, had a 3.5 times higher risk of developing dementia.

The researchers suggested that changes in micronutrients could be linked with the other typical signs that precede dementia, including weight loss and low blood pressure.

Resources
Mental Health Foundation. Vitamin Deficiency Linked to Dementia. Accessed 8 Feb 2008
G Ravaglia, P Forti, et al. Homocysteine and folate as risk factors for dementia and Alzheimer disease. American Journal of Clinical Nutrition, Vol. 82, No. 3, 636-643, September 2005. Accessed 8 Feb 08
tracked the development of dementia in 518 people over two years from 2001 to 2003. All participants were over the age of 65 and lived in one rural and one urban area in the south of Korea.

Hot Liquids Release Potentially Harmful Chemicals in Polycarbonate Plastic Bottles

noreply@blogger.com (Unknown) — Fri, 08 Feb 2008 10:46:00 +0000

30 January 2008

Researchers at the University of Cincinnati have discovered that the chemical Bisphenol A, which is found in polycarbonate plastic bottles (and also a number of other manufactured products), leeches out of the plastic and into the liquid inside when the bottles are heated.

Scott Belcher, PhD, and his team found that this effect with the leeching out of the Bisphenol A (BPA) into the liquid happened to both old and new plastic bottles at a rate of 55 times more than when the bottle was not heated.

“Previous studies have shown that if you repeatedly scrub, dish-wash and boil polycarbonate baby bottles, they release BPA. That tells us that BPA can migrate from various polycarbonate plastics,” explains Belcher, UC associate professor of pharmacology and cell biophysics and corresponding study author. “But we wanted to know if ‘normal’ use caused increased release from something that we all use, and to identify what was the most important factor that impacts release.”

“Inspired by questions from the climbing community, we went directly to tests based on how consumers use these plastic water bottles and showed that the only big difference in exposure levels revolved around liquid temperature: Bottles used for up to nine years released the same amount of BPA as new bottles.”

BPA is an endocrine disruptor, which means it alters the function of the endocrine system by mimicking the body's natural hormones (which are released by endocrine glands).

BPA is widely used in re-usable water and other drink bottles, food can linings, chip packet linings, water pipes and dental sealants and has been shown to adversely affect reproduction in women and brain development in babies and small children.

“There is a large body of scientific evidence demonstrating the harmful effects of very small amounts of BPA in laboratory and animal studies, but little clinical evidence related to humans,” explains Belcher. “There is a very strong suspicion in the scientific community, however, that this chemical has harmful effects on humans.”

Belcher stresses that it is still unclear what level of BPA is harmful to humans. He urges consumers to think about how cumulative environmental exposures might harm their health.

“BPA is just one of many estrogen-like chemicals people are exposed to, and scientists are still trying to figure out how these endocrine disruptors—including natural phyto-estrogens from soy which are often considered healthy—collectively impact human health,” he says. “But a growing body of scientific evidence suggests it might be at the cost of your health.”

Resources
University of Cincinnati - Health News (full article)

Link Between Pregnant Women Smoking and SIDS

noreply@blogger.com (Unknown) — Tue, 05 Feb 2008 02:37:00 +0000

A new study by researchers at McMaster University USA, published online in the journal Federation of American Societies for Experimental Biology (FASEB) to be available in the May 2008 print issue, has shed some light on the relationship between women who smoke while pregnant, or are exposed to second-hand smoke, and an increased risk of Sudden Infant Death Syndrome (SIDS) to their babies.

Researchers found out that a specific mechanism is the reason a baby's ability to respond to oxygen deprivation after bith (called a hypoxic episode) is significantly reduced if they are exposed to even light to moderate amounts of nicotine in the womb.

"While cigarette smoke contains many different compounds, we found there is a direct impact of one component, nicotine, on the ability of certain cells to detect and respond to oxygen deprivation," says Josef Buttigieg, lead author and a PhD student in the Department of Biology. "When a baby is lying face down in bed, for example, it should sense a reduction in oxygen and move its head. But this arousal mechanism doesn't work as it should in babies exposed to nicotine during pregnancy."

The research explains the role that specific hormones from the adrenal glands - catecholamines - play in a baby's transition outside the womb and especially it's ability to breath properly.

During the birth, the baby is exposed to low oxygen, which tells the adrenal glads to release the catecholamines (that contain adrenaline), explains Buttigieg.

It is the catecholamines that instruct the baby's lungs to reabsorb fluid, to take its first breath and help the heart beat more efficiently. The adrenal glands still act as an oxygen sensor, for some months after birth, which helps the baby's arousal and breathing responses during periods of apnoea or asphyxia.

The baby's ability to release catecholamines during periods of apnoea or asphyxia (very critical to the baby's ability to survive outside the womb) is very impaired due to the baby's exposure to nicotine while in the womb.

"At birth, the nervous control of the adrenal gland is not active and so a baby relies on these direct oxygen sensing mechanisms to release catecholamines," says Colin Nurse, academic advisor on the study and a professor in the Department of Biology. "But nicotine causes premature loss of these mechanisms, which would normally occur later in development after nervous control is established. Thus, the infant becomes much more vulnerable to SIDS."

The study was funded in part by the Heart & Stroke Foundation of Ontario, Canadian Institutes of Health Research and Focus on Stroke.

References
McMaster University Press Release - 29 January 2008

Soft Drinks (Soda) Linked To Increased Risk Of Gout In Men

noreply@blogger.com (Unknown) — Sat, 02 Feb 2008 08:22:00 +0000

A study published in the British Medical Journal by researchers in the US and Canada to examine the relation between intake of sugar sweetened soft drinks and fructose and the risk of gout, has advised that consuming of sugar sweetened soft drinks and fructose is strongly associated with an increased risk of gout in men.

The researchers followed over 46,000 men aged 40 years and over with no history of gout. The men completed regular questionnaires on their intake of more than 130 foods and beverages, including sugar sweetened soft drinks and diet soft drinks, over a period of 12 years. Different types of fruits and fruit juices (high in natural fructose) were also assessed.

At the onset of the study and each two years, the men's statistics, including weight, regular use of medications and medical conditions were recorded. Gout was diagnosed according to American College of Rheumatology criteria. In the 12 years during follow-up, 755 new cases of gout were diagnosed.

The researchers discovered that the risk of developing gout increased with increasing intake of sugar sweetened soft drinks and the risk of gout significantly increased in those men who had the highest consumption of sugar-sweetened soft drinks per day compared to those who consumed less than one serving per month.

The risk of developing gout, the researchers discovered, was independent of other risk factors for gout such as body mass index, age, diuretic use, high blood pressure, alcohol intake, and dietary factors.

Diet soft drinks were not associated with the risk of gout.

Gout is a health condition of the joints which causes extreme pain and swelling and is most common in men older than 40. Gout is caused when there is an excess of uric acid in the blood (hyperuricaemia) and this eventually leads the blood to depositing the uric acid crystals around the joints, which is how they become swollen and painful.

It is believed that in the USA in particular, new cases of gout have doubled over the last few decades and this coincides with the increased consumption of fructose-sweetened soft drinks and other processed foods. Incidentally, fructose is the only carbohydrate known to increase uric acid levels.

People diagnosed with gout are advised to change their diet to restrict meat and meat products (especially liver and kidney) and alcohol, but have not been advised to cut out soft drinks.

The authors found that high intakes of fruit juices and fructose-rich fruits such as apples and oranges on a daily basis had a higher risk of developing gout - these findings need to be balanced against the need to eat vegetables and fruit.

References
T Nakagawa, KR Tuttle, RA Short and RJ Johnson. Hypothesis: fructose-induced hyperuricemia as a causal mechanism for the epidemic of the metabolic syndrome. Accessed 2 February 2008

FDA Warning about Anti-Epileptic Drugs

noreply@blogger.com (Unknown) — Sat, 02 Feb 2008 04:52:00 +0000

The US Food and Drug Administration (FDA) issued a health alert on 31 January 2008, to provide new information to health care professionals to let them know there is an increased risk of suicidal thoughts and behaviours in patients who take drugs called antiepileptics - these drugs are used to treat epilepsy, bipolar disorder, migraine headaches, and other conditions.

The FDA have analysed reports from the controlled studies of 11 anti-epileptic drugs and have determined that the patients who took these drugs were at twice the risk of suicidal thoughts and behaviours (suicidality) compared to the placebo group (who took no drugs). This risk means that 2.1% more patients per 1,000, who take the antiepileptics are at increased risk for suicidality.

The analysis of the data from the reports, included 27,863 patients in drug treatment groups and 16,029 patients in placebo groups. Four patients in the drug treatment groups attempted suicide and none in the placebo groups. There were 105 reports of suicidal thoughts or behaviour in the drug-treated patients and only 35 in the placebo-treated patients.

The higher risk of suicidal thoughts and behaviours started around one week after drug treatment and continued on through the drug treatment. All the different antiepileptic drugs had the same risk of suicidal thoughts and behaviours in the drug-treated patients, across all age groups.

"We want health care professionals to have the most up to date drug safety information," said Russell Katz, M.D., director of the Division of Neurology Products in FDA's Centre for Drug Evaluation and Research. "This is an example of FDA working with drug manufacturers throughout products' lifecycles to keep health care professionals informed of new safety data."

The FDA warns that patients who are currently taking antiepileptic drugs, should not stop taking their medicine, but should talk to their doctor about their concerns. In addition, the FDA also advises that health care providers should discuss the risks and benefits of the antiepileptic drugs with their patients and their families, given this new information.

Antiepileptic drugs in the analyses included the following:

Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR)
Felbamate (marketed as Felbatol)
Gabapentin (marketed as Neurontin)
Lamotrigine (marketed as Lamictal)
Levetiracetam (marketed as Keppra)
Oxcarbazepine (marketed as Trileptal)
Pregabalin (marketed as Lyrica)
Tiagabine (marketed as Gabitril)
Topiramate (marketed as Topamax)
Valproate (marketed as Depakote, Depakote ER, Depakene, Depacon)
Zonisamide (marketed as Zonegran)

Some of these drugs are also available in generic form.

The drugs listed above were the only ones used in the studies, but the FDA believes that all types of anti-epileptics, even if they are not on the list above, also increase the risk of suicidality.

FDA Health Alert
FDA Alerts Health Care Providers to Risk of Suicidal Thoughts and Behavior with Anti-Epileptic Medications (31 January 2008)

Daily exercise lowers men's risk of dying

noreply@blogger.com (Unknown) — Fri, 01 Feb 2008 10:55:00 +0000

Researchers have reported in Circulation: Journal of the American Heart Association that men who exercise reduce their risk of death. This reduction in risk applies to both African-American and Caucasian men (the research being conducted in the USA).

The study, funded by the Department of Veteran's Affairs included 15,660 participants and is the largest known study to assess the link between fitness and mortality.

The lead researcher, Dr Peter Kokkinos, PhD, who is also director of the Exercise Testing and Research Lab in the cardiology department at the Veterans AffairsMedical Center in Washington, DC stated, “It is important to emphasize that it takes relatively moderate levels of physical activity — like brisk walking — to attain the associated health benefits. Certainly, one does not need to be a marathon runner. This is the message that we need to convey to the public.”

Dr Kokkinos and his researchers studied the exercise capacity of the large study group of men (African-Americans - 6,749 and Caucasians - 8,911) as an independent predictor of overall mortality. They also looked at whether racial differences in exercise capacity had any influence over risk of death. The men's fitness was tested by a standardised treadmill test to assess exercise capacity between May 1983 and December 2006 at Veterans Affairs medical centres in Washington, DC, and Palo Alto, California. The men were encouraged to exercise until they felt tired and could not exercise any longer. If any of the study subjects developed any detrimental cardiac symptoms, they stopped the exercise and this was noted. The men in the study were also observed for 7.5 years, to record their death rates (when applicable).

The researchers classified the study subjects into various fitness categories based on their performance on the treadmill, by the peak metabolic equivalents (METs) achieved. Basically the MET is a measure of oxygen used by the body per minute and the higher the MET the more fit the individual. One MET is equivalent to the amount of oxygen a person uses at rest.

Based on the METs, the researchers divided the study participants into four categories, based on their level of fitness, from 5 METs (“low fit”), 5-7 METs (“moderately fit”), 7.1-10 METs (“highly fit”) and over 10 METs (“very highly fit”).

The researchers found that the “highly fit” men had about half the risk of death compared to the “low fit” men and the “very highly fit”men had a 70% lowered risk of death compared to the “low fit” men in the intervening 7.5 years. The researchers also found that for every 1 MET increase in exercise capacity, there was a subsequent 13% decrease of death from all causes.

Kokkinos said, “These findings are important for several reasons: First, we were able to quantify the health benefits per unit increase in exercise capacity. Second, this is the first study to provide information on physical activity and mortality in African Americans, information lacking until now. Keep in mind that death rates in African Americans are much higher when compared with Caucasians, in part because race and income negatively influence access to healthcare.”

“The Veterans Affairs’ health system is unique in that it ensures equal access to care regardless of a patient’s financial status,” he added. “Thus, it provides us with a unique opportunity to assess the impact of exercise or physical activity on death without the influence of healthcare differences.”

According to Kokkinos, most middle-age and older individuals can attain fitness levels with a brisk walk, 30 minutes per day, five to six days each week. “I do not advocate that everyone can start with 30 minutes of physical activity. In fact, 30 minutes may be too much for some people. If this is the case, split the routine into 10-15 minutes in the morning and another 10-15 minutes in the evening. The benefits will be similar if the exercise volume accumulated is similar,” he said

“Our findings show that the risk of death is cut in half with an exercise capacity that can easily be achieved by a brisk walk of about 30 minutes per session 5-6 days per week,” he added. “Physicians should encourage individuals to initiate and maintain a physically active lifestyle, which is likely to improve fitness and lower the risk of death. Individuals should also discuss exercise with their physician before embarking on an exercise program.”

American Heart Association

Diet and lifestyle critical to recovery from illness

noreply@blogger.com (Unknown) — Fri, 01 Feb 2008 10:47:00 +0000

In a study by researchers from the University of Manchester UK, published in the Journal of Nature Genetics on 17 January 2008, it appears that diet and lifestyle play a much bigger role in a person's ability to recover from certain drug therapies, including cancer therapy.

Writing in Nature Genetics, University of Manchester researchers have shown how the nutrients in the environment are critical to the fitness of cells that carry genetic mutations caused by diseases.

The findings for the first time provide a scientific insight into why some people might respond better to certain medications than others and form the foundations for more individualised drug therapy in the future.

The team used baker's yeast — a model organism studied by biologists to reveal molecular processes in higher organisms — to explore the relationship between environment and genetic background.

The large-scale study involved removing one of the two copies of all yeast genes — similar to removing one parent's set of genes in a human — and analysing the resulting fitness under different dietary restrictions.

"If the gene targeted is quantitatively important, you would normally expect the yeast to show a reduction in fitness," said Dr Daniela Delneri, who carried out the research in the University's Faculty of Life Sciences.

"But what we found was that in certain environmental conditions, removing one copy of certain genes actually produced the opposite effect and surprisingly the yeast cells grew more quickly and were healthier."

The team further established that this effect was mainly occurring in genes involved in the proteasome — the quality-control system within the cell that degrades unwanted proteins.

"The proteasome is important as it maintains the equilibrium of the cell," said Dr Delneri. "When this equilibrium is lost it can result in a number of diseases, including cancer, diabetes, Huntingdon's, Alzheimer's and Parkinson's.

"For example, in rapidly-growing cancerous cells the high proteasome activity renders the tumour cells immortal, so drugs that block or inhibit the proteasome's actions are currently used as therapeutic compounds.

"Our study shows that reduced proteasome activity could be either advantageous or damaging to the cell depending on the nutrients available to it in the surrounding environment."

The findings suggest that, ideally, when therapeutic drugs are administered to alter the proteasome activity, the environment — governed by the type of tissue or a person's diet and lifestyle — should be taken into consideration to assure the correct beneficial effect.

University of Manchester Press Release

Undernourished Stroke Patients Tend to Have Poor Outcomes

noreply@blogger.com (Unknown) — Fri, 01 Feb 2008 08:36:00 +0000

A recent Korean university study has shown that if acute ischemic stroke patients are undernourished at the time they are admitted to hospital, they tend to remain underfed while undergoing surgery and treatment and usually have poorer outcomes as a result of their undernourishment. The study found that when acute ischemic stroke patients who were properly nourished when they were admitted to hospital, had much more positive outcomes and less complications.

The undernourishment of ischemic stroke patients increased the risks of possible complications after surgery.

In terms of ischemic stroke patients, undernourishment is a common problem, with about 16% of all patients showing signs and symptoms of being undernourished when they are taken to hospital.

Undernourishment is defined when the patient did not consume enough overall calories, or did not consume enough of one or more nutrients (vitamins, minerals) in their daily diet. The study authors have asserted that while undernourishment is a common factor in stroke patients, the effect of undernourishment in these patients (and others with medical problems) has not been effectively studied to determine exactly what the impact is on the patient's overall outcome from their condition. The researchers have advised that it is necessary to treat undernourishment of an ischemic stroke patient while they are undergoing treatment, to ensure a better recovery. Sung-Hee Yoo, R.N., M.S., University of Ulsan College of Medicine, Seoul, South Korea, the lead researcher and his team studied 131 ischemic stroke patients within 24 hours of their admittance to hospital and about seven days after their release from hospital. The research team then looked at the patients overall outcome at three months after they were released from hospital.

The researchers discovered that those patients who were undernourished at the time of admittance to hospital continued to be undernourished after they were released too and that there was a significant link between undernutrition at the moment of hospitalization and continued undernutrition one week later and complications following the stroke.

The conclusion of the research was that strategic nutritional support, particularly in patients with baseline undernutrition, could improve clinical outcomes for patients with suffering acute ischemic stroke.

Other research has also concluded that better nutrition is required to assist the body with recovering from ischemic stroke and that undernourishment leads to much worse outcomes for the patient following treatment. They have also advised that these patients be treated for the undernourishment at the same time they are treated for ischemic stroke to prevent unwanted complications from the stroke.

References
Undernutrition as a Predictor of Poor Clinical Outcomes in Acute Ischemic Stroke Patients - published in Archives of Neurology, January 2008
Nutritional Support After Ischemic Stroke - More Food For Thought - published in Archives of Neurology, January 2008