Friday, May 29, 2009

Routine aspirin benefits questioned

Low-dose aspirin should not routinely be used to prevent heart attacks and strokes, contrary to official guidance, say researchers. Analysis of data from over 100,000 clinical trial participants found the risk of harm largely canceled out the benefits of taking the drug. Only those who have already had a heart attack or stroke should be advised to take a daily aspirin, they found. The Lancet study should help clarify a "confusing" issue.

Experts in the UK, US and Europe recommend aspirin for people who have not already had a heart attack or stroke, but are at high risk of cardiovascular disease because of factors such as age, blood pressure and cholesterol level. “ We don't have good evidence that, for healthy people, the benefits of long-term aspirin exceed the risks by an appropriate margin,” states study leader Professor Colin Baigent.

This latest research provides clearer evidence because it is based on data from individuals, the researchers said. They looked at heart attacks and strokes and major bleeds - a potential side effect of aspirin - in six primary prevention trials, involving 95,000 people at low to average risk and 16 trials involving 17,000 people at high risk - because they had already had a heart attack or stroke. Use of aspirin in the lower-risk group was found to reduce non-fatal heart attacks by around a fifth, with no difference in the risk of stroke or deaths from vascular causes. But it also increased the risk of internal bleeding by around a third.

"This important study does suggest people shouldn't take aspirin unless indicated by disease." Ellen Mason, senior cardiac nurse at the British Heart Foundation said: "It is better for doctors to weigh up the benefit and risk of prescribing aspirin on an individual basis, rather than develop a blanket guideline suggesting everyone at risk of heart disease is routinely given aspirin."

Bonnie - When I first read the study, I was elated and sad at the same time. My long-fought battle against the sweeping recommendation of aspirin in healthy individuals was a major personal victory. However, because I have seen long-term aspirin use cause such destruction in some of my clients, my heart went out to their suffering. I urge you to pass along this study's findings to friends, family, and co-workers. It is imperative that the message gets out.

Naturally, the question becomes, "what can I take now to prevent cardiovascular disease?" Most of you already take them: EPA/DHA omega-3 fatty acids and Vitamin E. They have always been better alternatives to aspirin.


I will be interested to see how much media coverage this study gets in the U.S. Even though it appears in one of the most prestigious journals in the world and covered 100,000 subjects, it goes against almost everything the U.S. public has been told over the last few decades.

Thursday, May 28, 2009

Following A Healthy Lifestyle Is On Decline In U.S.

Despite the well-known benefits of having a lifestyle that includes physical activity, eating a diet high in fruits and vegetables, maintaining a healthy weight, moderate alcohol use and not smoking, only a small proportion of adults follow this healthy lifestyle pattern, and in fact, the numbers are declining, according to an article published in the June 2009 issue of The American Journal of Medicine.

Investigators from the Department of Family Medicine, Medical University of South Carolina, Charleston compared the results of two large-scale studies of the US population in 1988-1994 and in 2001-2006. In the intervening 18 years, the percentage of adults aged 40-74 years with a body mass index greater than 30 has increased from 28% to 36%; physical activity 12 times a month or more has decreased from 53% to 43%; smoking rates have not changed (26.9% to 26.1%); eating 5 or more fruits and vegetables a day has decreased from 42% to 26%; and moderate alcohol use has increased from 40% to 51%. The number of people adhering to all 5 healthy habits has decreased from 15% to 8%.

Writing in the article, Dana E. King, MD, MS, states, "The potential public health benefits from promoting a healthier lifestyle at all ages, and especially ages 40-74 years, are substantial. Regular physical activity and a prudent diet can reduce the risk of premature death and disability from a variety of conditions including coronary heart disease, and are strongly related to the incidence of obesity. In the US, medical costs due to physical inactivity and its consequences are estimated at $76 billion in 2000 dollars. Research indicates that individuals are capable of adopting healthy habits in middle age, and making an impact on cardiovascular risk."

Steve - for public health professionals, these numbers could not be any more demoralizing. However, we can confidently say that the majority of our client network is bucking the trend. That said, our clients follow lifestyle ideals that are not the norm in the U.S. Drastic measures that "go against the mainstream" need to become "the mainstream" for positive lifestyle influences to trend upward. More on this to come.

Wednesday, May 27, 2009

Summer Shish Kebabs

All-Purpose Shish Kebab Formula

-1 ¼ lb. protein, cut into approximately 1 ½-inch pieces (except for shrimp and scallops, which are left whole)
-1 ¾ lb. vegetables and/or fruits, cut into approximately 1-inch chunks (except mushrooms which are halved or left whole)
-sea salt, to taste
- ½ tsp. pepper (optional)

Prepare one of the flavoring pastes and set aside. Sprinkle the chunks of protein and vegetables/fruits with salt and pepper, then marinate in selected paste for ½ hour or more. Make sure the entire kebab is covered with paste. Thread protein and vegetables/fruits on each of eight 12-inch or six 14-inch skewers, alternating between protein and 2 vegetable/fruit pieces and making sure not to thread too tightly. If using bamboo skewer, leave as little exposed wood as possible at each end to keep them from charring. Meanwhile, prepare gas grill, lighting all burners on high for at least 10 minutes, or prepare charcoal grill as usual. Before grilling kebabs, use a wire brush to clean grill grate, then use tongs to wipe an oil-soaked rag over grate to prevent kebabs from sticking. Place skewers on grill, close lid, and grill on high until brown, about 4 minutes. To turn skewers (particularly bamboo ones), grab as much of the kebab as possible from the side with tongs and turn them quickly and decisively. Grill until brown on the other side and the protein and vegetables/fruits are cooked through… about 2 minutes for shellfish, 3 minutes for chicken breasts and fish, and 4 minutes for pork, beef, and lamb. Let rest for a few minutes. If desired, serve with lemon or lime wedges and minced parsley or cilantro.

Combine your choice of…

Protein

chicken breasts (boneless and skinless)
pork tenderloin
beef tenderloin, rib eye or New York strip (preferably lean, grass fed)
lamb (from the rib)
firm fish (salmon, red meat trout, mahi mahi, etc.)
scallops, medium
shrimp, medium

Vegetables/Fruits
bell peppers (red, yellow)
eggplant
onions
fennel
white mushrooms
zucchini
yellow or orange squash
potatoes (baby red – ha lved, or sweet potato chunks; boil for 5 minutes to soften before grilling)
apples
pineapple
prunes
apricots
mango

The flavor is in the paste…

These pastes not only flavor the skewered meat, chicken, fish, and vegetables but also help them brown quickly and attractively. Any acid added to a marinade (fruit juice, vinegar, etc.) protects against harmful carcinogens being released during grilling. The technique for making the paste is simple: In each case, just heat the oil in a small skillet or saucepan over medium-high heat, add the herbs and/or spices and cook until they start to sizzle. Add remaining ingredients and bring to a simmer. Simmer until reduced to thick paste, 3 to 4 minutes. Set aside to cool.

Sweet and Sour Flavoring Paste
2 T. sesame oil
¼ cup organic fresh lemonade
¼ cup tamari or light teriyaki
½ T. fresh garlic minced
4 sliced fresh ginger

Asian-Style Flavoring Paste
2 T. sesame oil
2 tsp. garlic powder
2 tsp. ground ginger
1 tsp. hot pepper flakes (optional)
6 T. tamari or low sodium soy sauce
½ cup frozen pineapple juice concentrate, thawed

Jamaican Jerk-Style Flavoring Paste
1 T. canola oil
1 T. dried thyme leaves
1 T. dried oregano
1 tsp. ground coriander
1 tsp. allspice
1 T. Dijon mustard
¼ c. finely chopped scallions, green part removed
1 tsp. hot pepper sauce, optional
½ cup frozen organic limeade concentrate, thawed

Pineapple Cumin Flavoring Paste
1 T. canola oil
4 tsp. ground cumin
½ cup frozen pineapple juice concentrate, thawed

Curried Apple Flavoring Paste
1 T. safflower or sunflower oil
2 T. curry powder
1 shallot, finely minced
½ cup frozen organic apple juice concentrate, thawed

Orange Rosemary Flavoring Paste
1 T. canola oil
1 T. minced fresh rosemary
½ tsp. onion powder
½ cup frozen organic orange juice concentrate, thawed
1 tsp. Sucanat (brown sugar substitute) or pure maple syrup

Moroccan-Style Flavoring Paste
2 T. safflower or sunflower oil
1 tsp. paprika
½ tsp. each garlic powder, ground ginger, cumin
¼ tsp. each cinnamon, cloves
½ cup frozen organic limeade concentrate, thawed

Mediterranean-Style Flavoring Paste
2 T. extra virgin olive oil
¼ cup fresh parsley (stems removed) 2 large garlic cloves, finely chopped
½ cup frozen organic lemonade, thawed

Arnica approved in Europe for health claims

Much to the anger of conventional medicine, the homeopathic remedy Arnica has been officially recognized as a successful remedy for treating sprains and bruises in the United Kingdom.

The Medicines and Healthcare Products Regulatory Agency (MHPRA) has registered the product, which means that the manufacturer can now make claims for its effectiveness.

Steve - we can attest to arnica's effectiveness. We have recommended the clear gel by B&T for bruises, sprains, strains, muscle soreness, joint pain, etc. for years.

Green Tea May Benefit Leukemia Patients

Mayo Clinic researchers are reporting positive results in early leukemia clinical trials using the chemical epigallocatechin gallate (EGCG), an active ingredient in green tea. The trial determined that patients with chronic lymphocytic leukemia (CLL) can tolerate the chemical fairly well when high doses are administered in capsule form and that lymphocyte count was reduced in one-third of participants. The findings appear online in the Journal of Clinical Oncology.

“We found not only that patients tolerated the green tea extract at very high doses, but that many of them saw regression to some degree of their chronic lymphocytic leukemia,” said Tait Shanafelt, M.D., Mayo Clinic hematologist and lead author of the study. “The majority of individuals who entered the study with enlarged lymph nodes saw a 50 percent or greater decline in their lymph node size.”CLL is the most common subtype of leukemia in the United States.

The research has moved to the second phase of clinical testing in a follow-up trial—already fully enrolled—involving roughly the same number of patients. All will receive the highest dose administered from the previous trial. Doses ranged from 400mg to 2,000 mg administered twice a day. Researchers determined that they had not reached a maximum tolerated dose, even at 2,000 mg twice per day.

Bonnie - this is very encouraging data that seems to support what was found in animal studies.

Tuesday, May 26, 2009

Millions unaware that they are diabetic

Fact:
Twenty-three million Americans have diabetes and twenty five percent of them do not realize it.

Recommendation:
If an individual gets two blood glucose readings that are above 115, he/she needs to get a HgbA1C to determine whether they have diabetes.

Daily multivitamin linked with younger biological age

Does taking a daily multivitamin result in better health and longevity?

About two years ago, one of my articles described a study correlating the length of a person's DNA, his or her internal, or cellular, age and the person's health. The bottom line was that regardless of the person's actual age, shorter DNA correlated with an older internal age and longer DNA indicated a younger internal age.

Every time a cell replicates, it needs to make a new set of DNA. However, with each replication, a small piece of DNA is lost. This loss of DNA happens at the ends of the strands in a part of the DNA that does not code for any genes. These ends of the DNA are called telomeres. There are only a limited number of cellular replications that happen before important DNA is lost and the cell dies.

Imagine a spool of movie film. There is always blank film at the beginning of the movie and at the end of the movie. Now envision that a small piece of the blank film is removed every time the movie is played. If you played the movie enough times, all of the blank film would be lost and pieces of the movie itself would vanish.

This is similar to what happens to DNA and telomeres. The longer the telomere, the longer the cell can replicate. Telomere length has been hypothesized to be key to health and longevity.

Therefore, longer telomeres are better than shorter telomeres. In humans, it has been shown that telomere length can be improved through lifestyle changes such as stress reduction and exercise. In a recent study at the National Institute of Environmental Health Sciences, taking a daily multivitamin was associated with significantly longer telomeres.

In 586 women, the improvements in telomere length were 5.1 percent in multivitamin users compared to non-users, and that is a lot. In addition, vitamin E and vitamin C seemed to be most important. High dietary intake of vitamin C and vitamin E had a greater effect on telomere length than other vitamins.

The study, which appears in the American Journal of Clinical Nutrition, is also important because it underscores the effect of good nutrition on health. There is ample medical research indicating that the average American diet is woefully deficient in vitamins, minerals and other nutrients and that 10 percent to 15 percent of Americans do not get the minimum recommended amount of vitamins and minerals.

Several years ago, the Journal of the American Medical Association published research detailing the state of nutrition in American and is was strongly recommended that everybody have a daily multivitamin. With the recent research on telomere length and vitamins, there is increasing evidence that a good multivitamin may have a significant affect on health and longevity.

Contributor to the Daily Hearld, Patrick B. Massey, M.D., Ph.D., is medical director for alternative and complementary medicine for the Alexian Brothers Medical Network.

BPA found to leach into bottles

New research from the US suggests that people who drink from bottles made of polycarbonate plastic, such as that used to make hard-plastic drinking bottles and baby bottles, have a considerably higher level of the chemical bisphenol A (BPA) in their bodies compared to when they do not.

The finding confirms concerns expressed by consumer groups and public health experts, that polycarbonate plastic bottles are an important source of the BPA that finds its way into the human body. BPA has been shown to interfere with reproductive development in animals, and has been linked to cardivascular disease and diabetes in humans, among other things.

The study was the work of senior investigator Karin B Michels, associate professor of epidemiology atHarvard School of Public Health (HSPH) and colleagues, and was published online in the May 12 issue of Environmental Health Perspectives.

Bonnie - I wonder if the FDA will stop defending BPA now.

Kids who receive vaccine still get whooping cough

Results from a study involving 751 children enrolled in a Kaiser Permanente of Colorado health plan between 1996 and 2007, including 156 who got whooping cough, appear in the June edition of Pediatrics. 89 percent of the whooping cough cases were from those who were vaccinated while 11 percent were attributed to cases in which vaccines were refused.

Proteomics: Finding The Key Ingredients Of Disease

Many diseases have crucial proteins, which change the dynamics of cells from benign to deadly. New findings from an international collaboration, involving McGill University, the Research Institute of the McGill University Health Centre (MUHC) and the Human Proteome Organisation (HUPO) just made identifying these changes one step easier.

Their findings published in Nature Methods, show how to improve protein analysis to tease out relevant potential disease-causing molecules.

"Proteomics is the field that singles out the few significant proteins from the hundreds that may be present in a diagnostic sample," says co-author and recent new recruit of the Research Institute of the MUHC and of McGill Unversity, Dr. Tommy Nilsson. "It is important to associate the correct proteins with the correct condition. This process is incredibly complex. The aim of our study was to benchmark current analysis techniques worldwide and to identify potential bottlenecks."

Twenty-seven labs worldwide were sent a standard sample of proteins to analyze using their usual techniques. Only seven of the 27 participating labs were accurate in detecting all the proteins and in the more challenging part of the study, only one lab succeeded. However, further analysis of their raw data, showed that all the proteins had been initially detected by all the labs involved but they had been rejected in later analyses.

"Our centralized analysis showed us the problems encountered while conducting this type of testing," says Dr. John Bergeron, senior author from McGill University and HUPO. "We found that a major contributing factor to erroneous reporting is at the database level. We expect once databases and search engines improve, the accuracy of reporting will as well."

The goal of proteomics is to characterize all the proteins that are encoded from human DNA, similar to how all genes were identified as a result of the Human Genome Project. It is expected that proteomics will accelerate the identification of cause of many human diseases and that improved diagnosis and therapy will emerge using proteomic techniques.

"The new technology described in our paper will potentially enable clinicians to determine the causes of disease," adds Dr. Bergeron.

Steve - as we alluded to several years ago, proteomics is the third category of prevention (nutrigenomics and epigenetics as well) that will transform the way we approach our health.

Ghrelin increases appetite and abdominal fat

The ghrelin hormone not only stimulates the brain giving rise to an increase in appetite, but also favors the accumulation of lipids in visceral fatty tissue, located in the abdominal zone and considered to be the most harmful. This is the conclusion of research undertaken at Metabolic Research Laboratory of the University Hospital of Navarra, published recently in the International Journal of Obesity.

Besides stimulating the hypothalamus to generate appetite, ghrelin also acts on the tabula rasa cortex. They observed how this hormone favored the accumulation of lipids in visceral fatty tissue. In concrete, it causes the over-expression of the fatty genes that take part in the retention of lipids.

It is precisely this accumulated fat in the region of the abdomen that is deemed to be most harmful, as it is accompanied by comorbilities, visceral obesity being related to higher blood pressure or type 2 diabetes. Moreover, being located in the abdominal zone and in direct contact with the liver, this type of fatty tissue favors the formation of liver fat and increases the risk of developing resistance to insulin. Normally, on being associated with hypertension, high levels of triglycerides, resistance to insulin and hypercholesterolemia, visceral fat favors the metabolic syndrome, the researcher pointed out.

Bonnie - it is very important to rule out hunger hormones when one has cravings and/or weight issues. My "Kick the Craving Consults" address this issue directly.

Vaginal Infection Tied to Low Vitamin D

Bacterial vaginosis is the most common vaginal infection in women of childbearing age, and a new study has found that it is associated with vitamin D deficiency. The disorder is treatable with antibiotics, but it can lead to premature birth and is a major cause of infant mortality. The analysis, published in the June issue of The Journal of Nutrition, examined 209 white and 260 black pregnant women at a Pittsburgh clinic and found that more than half had vitamin D levels below 37 nanomoles per liter. A reading of 80 is generally considered adequate. After adjusting for other factors, a vitamin D level of 50 or less was associated with a 26 percent increase in the likelihood of bacterial vaginosis, and a reading under 20 was associated with a 65 percent increased risk. About 52 percent of black women had bacterial vaginosis, compared with 27 percent of white women, and black women were almost three times as likely to be vitamin D deficient, probably because darker skin prevents adequate synthesis of the vitamin.

Friday, May 22, 2009

Twins from fertility have higher risk of problems

Twins born as a result of assisted reproductive technology (ART) are more likely to be admitted to neonatal intensive care and to be hospitalized in their first three years of life than spontaneously conceived twins, according to new research published online in Europe's leading reproductive medicine journal Human Reproduction.

It is known already that ART twins are at higher risk of problems such as low birth weight and premature delivery than singletons around the time of their birth, but, to a large extent, these risks exist as part of the problems associated with multiple births in general. Up to now there has been conflicting evidence about whether assisted reproduction itself is responsible for adding to the number of problems seen in ART twins.

Tobacco companies lied, must change marketing

A federal appeals court on Friday largely endorsed a landmark ruling that found cigarette makers deceived the public for decades about the heath hazards of smoking.

The U.S. Court of Appeals in Washington upheld the major elements of a 2006 ruling that found the nation's top tobacco companies guilty of fraud and violating racketeering laws.

The ruling said manufacturers must change the way they market cigarettes. It bans labels such as "low tar," "light," "ultra light" or "mild," because such cigarettes have been found to be no safer than others because of how people smoke them.

It also said the companies must publish "corrective statements" on the adverse health effects and addictiveness of smoking and nicotine.

The changes have not taken affect while the case has been under appeal.

Throughout the 10 years the case has been litigated, tobacco companies have denied committing fraud in the past and said changes in how cigarettes are sold now make it impossible for them to act fraudulently in the future.

Steve - this case, which has been going on for almost a decade now, can finally come to a close. I would venture to say that this will add fuel to the govt's fire with regard to regulating cigarettes.

Preventable Causes of Death in the United States

Data appeared in PLoS Medicine that listed risk factor exposures in the US population from nationally representative health surveys and disease-specific mortality statistics from the National Center for Health Statistics. They estimated the number of disease-specific deaths attributable to all non-optimal levels of each risk factor exposure, by age and sex. In 2005, tobacco smoking and high blood pressure were responsible for an estimated 467,000 (95% confidence interval [CI] 436,000–500,000) and 395,000 (372,000–414,000) deaths, accounting for about one in five or six deaths in US adults. Overweight–obesity (216,000; 188,000–237,000) and physical inactivity (191,000; 164,000–222,000) were each responsible for nearly 1 in 10 deaths. High dietary salt (102,000; 97,000–107,000), low dietary omega-3 fatty acids (84,000; 72,000–96,000), and high dietary trans fatty acids (82,000; 63,000–97,000) were the dietary risks with the largest mortality effects. Although 26,000 (23,000–40,000) deaths from ischemic heart disease, ischemic stroke, and diabetes were averted by current alcohol use, they were outweighed by 90,000 (88,000–94,000) deaths from other cardiovascular diseases, cancers, liver cirrhosis, pancreatitis, alcohol use disorders, road traffic and other injuries, and violence.

Bonnie - these numbers are sobering.

Thursday, May 21, 2009

Vitamin D prevents mental decline

A study in the Journal of Neurology Neurosurgery and Psychiatry of over 3,000 European men aged 40-79 found those with high vitamin D levels performed better on memory and information processing tests. Researchers believe vitamin D may protect cells or key signaling pathways in the brain. Men with high vitamin D levels performed best, with those who had the lowest levels - registering poor scores.

In another article in the current issue of the Journal of Alzheimer's Disease (May 2009), researchers suggest that further investigation of possible direct or indirect linkages between Vitamin D and these dementia is needed.

Low serum levels of 25-hydroxyvitamin D [25(OH)D] have been associated with increased risk for cardiovascular diseases, diabetes mellitus, depression, dental caries, osteoporosis, and periodontal disease, all of which are either considered risk factors for dementia or have preceded incidence of dementia.

Writing in the article, the researchers state, "There are established criteria for causality in a biological system. The important criteria include strength of association, consistency of findings, determination of the dose-response relation, an understanding of the mechanisms, and experimental verification. To date, the evidence includes observational studies supporting a beneficial role of vitamin D in reducing the risk of diseases linked to dementia such as vascular and metabolic diseases, as well as an understanding of the role of vitamin D in reducing the risk of several mechanisms that lead to dementia."

Wednesday, May 20, 2009

From The Health Care Blog

Op-Ed: The True Measures of a “Good Doctor”

The author is chairman of the Department of Cardiology and director of the Ochsner Heart and Vascular Institute in New Orleans.

Measuring patient outcomes is one way to determine how “good” a doctor is – but it is far from the only way. In our obsession with measuring performance, we seem to have forgotten that.

In medicine we measure a lot of things. We measure procedure times, length of stay in the hospital, complication rates. As a chief of cardiology, I’m involved in measuring a wide range of metrics, from how quickly the patient receives treatment (door-to-balloon time) to major adverse cardiac event (MACE) rates, and numerous other measurements. The medical field has spent the last decade developing metrics to assess quality of health care, and certainly these measures have value.

But by themselves, these metrics are inadequate to answer the patient’s most essential question, “Do I have a good doctor?”

We seldom measure whether a doctor is available after hours when their patient has a concern. We seldom measure doctors’ ethics or whether they are able to meet the emotional needs of a patient. We seldom measure a doctor’s willingness to refer a patient to another physician if that person can better meet the patient’s needs. Yet to a patient, these things can be every bit as important as outcomes.

Most health care professionals know a “good doctor” when they encounter one. Being a good doctor is not the same as a career achievement award such as being named a “master clinician.” Often we recognize “good doctors” among younger physicians-in-training, or junior faculty members, as well as some, but not all, senior faculty members. Patients can identify “good doctors” without ever knowing what they scored on their Board exams.

I heard a lecture about “leadership” last year at the U.S. Naval Academy and was struck by how the qualities required of future military leadership could be adapted to the best qualities of a health care provider. At my hospital in New Orleans, we have a cardiology fellowship training program, and I try to communicate these measures of “physician quality” to these young physicians-in-training, which I call the “Five C’s”:

Character: Physician character can be measured by such traits as honesty, confidentiality, humanity, humor, candor and ethics.
Compassion: Compassionate physicians are emotionally driven to help their patients feel better. They treat their patients as they would treat a family member.
Commitment: These physicians are available when their patients need them, and considered hard-working by their peers. They take “ownership” of their patients’ problems, and work to resolve them.
Courage: Physicians who do what’s best for the patient even when it’s not in the best interest of the physician, such as making a referral or giving up a procedure. Physicians with courage have difficult conversations and are able to make judgments in the face of uncertainty to provide the best care for their patients.
Competence: Physicians who have the required knowledge and technical skills and work hard to keep themselves up to date.

Unfortunately, most of our quality measures today focus solely on the final quality – competence – and fail to truly measure many of the qualities that make a good doctor.

What do patients look for in a “good doctor”? First and foremost are strong intellectual skills. Good doctors are life-long learners. Good doctors must have the emotional maturity, clinical experience and judgment to make difficult and complex decisions under conditions of uncertainty and ambiguity. Among all health care professionals, good doctors must be willing to accept ultimate responsibility for medical decisions the guidelines will not address.

Securing the trust of a patient and of one’s colleagues is what “good doctors” do. And they do the right thing for the patient, even if it isn’t always the best thing for their hospital, their practice or themselves. It’s not that good doctors never make mistakes – they do. It’s not that they are all knowing or all seeing – they aren’t. They may not have the highest exam scores or be the most efficient, but they are the doctors we trust to care for us.

Good doctors are an absolute requirement for delivering high-quality health care to a patient, but even a good doctor in a poorly organized or poorly financed health care system may not be able to deliver good quality outcomes.

As our national health reform discussion continues and we decide to seriously embrace quality of health care issues, it’s time we focus on teaching our medical students and physicians-in-training what physician quality truly means. And it’s time we develop a broader assessment of what makes a “good doctor.”


Christopher J. White, MD, FSCAI, is chairman of the Department of Cardiology and director of the Ochsner Heart and Vascular Institute in New Orleans. He serves as secretary of the Society for Cardiovascular Angiography and Interventions (SCAI). Dr. White graduated AOA from Case Western Reserve University and completed his specialty training in internal medicine and cardiology at Letterman Army Medical Center in San Francisco. He has been elected to Fellowship in the American College of Cardiology, the American Heart Association, the European Society of Cardiology, the Society of Vascular Medicine and Biology, and the Society for Cardiovascular Angiography and Interventions. He is editor-in-chief of the interventional cardiology journal Catheterization and Cardiovascular Interventions.

Magnesium may benefit blood pressure in hypertensives

According to findings published online in Nutrition, Metabolism and Cardiovascular Diseases, magnesium supplementation may help prevent the progression of hypertension in normo-magnesemic non-diabetic overweight people with higher BP. The study adds to findings from epidemiological studies which reported that more magnesium, potassium and calcium may reduce the risk of hypertension in certain populations.

Bonnie - I would say this research may be a little late...we've known this for 15-20 years!

Malnutrition may be common among older adults

Up to one in six older adults living on their own may not be getting adequate nutrition, a study from Sweden suggests. Researchers found that among 579 adults ages 75 to 80 years, nearly 15 percent were at risk of malnutrition, based on their diet, weight and recent weight loss, and physical and mental well-being. Women were more likely to be undernourished than men; nearly 19 percent were at risk of malnutrition, compared with almost 11 percent of men. In addition, men and women who were depressed or described themselves as unhealthy were more likely than others to become at risk of malnutrition over the next two to four years, as reported in the Journal of Clinical Nursing.

Bonnie - this is a preventative issue which we have harped on for decades. Unfortunately, there has been little improvement. Even if adequate nourishment standards were met in older persons, it would greatly reduce health care costs.

Multivitamins may prolong life

Multivitamins may help women live longer by preventing parts of their DNA from shortening. Telomeres, or the end portion of chromosomes, protect chromosomes from damage. Because telomeres shorten slightly when cells divide, researchers speculated that preventing this shortening could protect new cells and thus reduce the effects of aging. "This study provides the first epidemiological evidence that multivitamin use is associated with longer leukocyte telomeres among women," said lead researcher Dr. Honglei Chen, head of the Aging & Neuroepidemiology Group at the U.S. National Institute of Environmental Health Sciences.The report appears in the June issue of the American Journal of Clinical Nutrition.

For the study, Chen's team analyzed data on 586 women participating in the Sisters Study, which included women who had breast cancer and their cancer-free siblings. As part of that study, the women were asked about their use of vitamin supplements over a 12-year span. The researchers also took blood samples and tested DNA. "We found that multivitamin use was associated with longer leukocyte telomeres," Chen said. "Compared with nonusers, daily multivitamin users had, on average, 5.1 percent longer leukocyte telomeres." This corresponds to about 9.8 years less age-related telomere shortening, the researchers noted.

More cancer treatments focus on food to combat weight loss

Excerpts from USA Today

The statistic is shocking: severe malnutrition and weight loss play a role in at least one in five cancer deaths. Yet nutrition too often is an afterthought until someone's already in trouble. A move is on to change that. At diagnosis, up to a quarter of patients already have their appetite sapped, and most treatments can bring side effects that worsen the problem. Aside from the well-known nausea, vomiting and diarrhea, some cancers inhibit absorption of the nutrients patients force down. Not to mention strangely altered taste, mouth sores, dry mouth, difficulty swallowing and constipation. About half of all cancer patients eventually suffer serious weight loss and malnutrition, a wasting syndrome called cachexia where they don't just lose excess fat but vital muscle.

A healthy person's body adjusts when it doesn't get enough calories, slowing metabolism to conserve nutrients. A cancer patient's body doesn't make that adjustment; metabolism even may speed up. The National Cancer Institute estimates cachexia is the immediate cause of death for at least 20% of cancer patients, although advanced cancer might have eventually claimed many of them. How much weight loss is too much? The institute defines patients as at-risk when they've lost more than 10% of their usual weight. Other research suggests that patients who lose more than 5% of their pre-cancer weight have a worse prognosis than people who can hang onto the pounds. For their best shot at doing that, the American Cancer Society urges patients to ask to be assessed by a licensed dietitian or nutritionist up front, right at diagnosis. While that's common at designated cancer centers, it's not routine elsewhere and surveys suggest just a third of patients have access to cancer nutritionists where they're being treated. "Patients who are well-nourished as they're going through treatment have shorter hospital stays, are better able to tolerate treatment," not to mention have better quality of life, says Colleen Doyle, nutrition chief at the society.

Bonnie - I have seen many cancer patients over the years and almost every one of them have better outcomes and a much easier time during treatment when they are vigilant about their individualized food and nutrient intakes. It is paramount that they are given the right advice. If someone gets a cancer diagnosis, seeing a licensed nutrition professional should be one of their first calls.

Monday, May 18, 2009

Fibersure now Metamucil Clear & Natural

Metamucil Clear & Natural
Fibersure(R) Is Becoming Metamucil(R) Clear & Natural

New name, new look, same great clear-mixing fiber benefits**

Fibersure soon will become Metamucil Clear & Natural. It's still the easy way to add 100% natural inulin fiber to your diet—every day. Inulin fiber is harvested from chicory roots, a natural vegetable fiber, making it both taste-free and clear-mixing. So you can add Metamucil Clear & Natural to many of your favorite beverages and foods daily—without adding flavor, taste, or grit.

Keep working 'to avoid dementia'

Keeping the brain active by working later in life may be an effective way to ward off Alzheimer's disease, research suggests. Researchers analyzed data from 1,320 dementia patients, including 382 men. They found that for the men, continuing to work late in life helped keep the brain sharp enough to delay dementia taking hold. The study was featured in the International Journal of Geriatric Psychiatry.

Experts believe one way to guard against it is to build up as many connections between cells as possible by being mentally active throughout life. This is known as a "cognitive reserve". There is evidence to suggest a good education is associated with a reduced dementia risk. And the latest study suggests there can also be a positive effect of mental stimulation continued into our later years. Those people who retired late developed Alzheimer's at a later stage than those who opted not to work on. Each additional year of employment was associated with around a six week later age of onset. Researcher Dr John Powell said: "The possibility that a person's cognitive reserve could still be modified later in life adds weight to the "use it or lose it" concept where keeping active later in life has important health benefits, including reducing dementia risk."

Stress: Center-based Child Care And Insensitive Parenting May Have Lasting Effects

A growing number of American children are enrolled in child care and questions remain about how these settings may affect them in both positive and negative ways. A new study finds that early interpersonal experiences—center-based child care and parenting—may have independent and lasting developmental effects.

The study draws on the large, longitudinal Study of Early Child Care and Youth Development in the United States, which was carried out in collaboration with the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

The NICHD study has followed about 1,000 children from 1 month through mid-adolescence to examine the effects of child care in children's first few years of life on later development. The researchers observed children in and out of their homes, and when the children were 15, they measured their levels of awakening cortisol—a stress-responsive hormone that follows a daily cycle (cortisol levels are usually high in the morning and decrease throughout the day).

Children who, during their first three years, (a) had mothers who were more insensitive and/or (b) spent more time in center-based child care—whether of high or low quality—were more likely to have the atypical pattern of lower levels of cortisol just after awakening when they were 15 years of age, which could indicate higher levels of early stress. These findings held even after taking into consideration a number of background variables (including family income, the mothers' education, the child's gender, and the child's ethnicity), as well as observed parenting sensitivity at age 15. The associations were small in magnitude, and were not stronger for either boys or girls.

Children's Use Of Psychiatric Drugs Begins To Decelerate

Courtesy of The Wall Street Journal

The growth in antipsychotic-drug prescriptions for children is slowing as state Medicaid agencies heighten their scrutiny of usage and doctors grow more wary of the powerful medications.

The softening in sales for children is the first sign that litigation, reaction to improper marketing tactics, and concern about side effects may be affecting what had been a fast-growing children's drug segment.

The slowdown is more pronounced among younger children. The nation's second largest pharmacy-benefits manager, Medco Health Solutions Inc., which handles 586 million prescriptions a year, estimates that prescriptions for antipsychotics for patients under 10 fell 4% last year. From 2001 through 2007, use in that age group increased 85%, Medco says.

Antipsychotics have faced heightened scrutiny and investigation over the past year. In November, a Food and Drug Administration advisory committee asked the FDA to research children's use of the drugs and expressed concern about possible side effects such as weight gain and increased diabetes risk. And 11 state attorneys general are investigating alleged marketing of Eli Lilly & Co.'s antipsychotic Zyprexa for uses the FDA hasn't approved.

In January, Eli Lilly agreed to pay $1.4 billion to settle allegations it improperly marketed Zyprexa. The company also agreed to plead guilty to a criminal charge of promoting the drug for unapproved uses.

Bristol-Myers Squibb Co. agreed to pay $515 million in September 2007 to settle allegations it promoted Abilify for use in children. The FDA didn't approve of the use of the drug in children older than 10 until 2008.

Bonnie - this is an encouraging sign.

Low vitamin D may boost metabolic syndrome

Insufficient and deficient levels of vitamin D may increase the risk of metabolic syndrome by 52 per cent, according to findings published in Diabetes Care. A study with 3,262 Chinese people aged between 50 and 70 showed that 94 per cent were vitamin D deficient or insufficient, and 42 per cent of these people also had metabolic syndrome.

While the study was conducted in elderly Chinese people, Dr Franco said the results are consistent with the findings of other studies in Western populations. Metabolic syndrome (MetS) is a condition characterized by central obesity, hypertension, and disturbed glucose and insulin metabolism. The syndrome has been linked to increased risks of both type-2 diabetes and cardiovascular disease (CVD).

Vitamin D levels were calculated using serum concentrations of 25-hydroxyvitamin D (25(OH)D), the non-active 'storage' form of the vitamin in the body. Subjects with the lowest average 25(OH)D levels were 52 per cent more likely to have metabolic syndrome than people with the highest average 25(OH)D levels.

Friday, May 15, 2009

Probiotics may reduce eczema risk by 60 per cent

Daily supplements of a multi-species probiotic food may reduce the risk of eczema by 58 per cent, according to a new study published in the European Journal of Allergy and Clinical Immunology. The eczema-reducing properties were sustained until the age of two, according to results of a double-blind, randomized placebo-controlled trial with mothers and subsequently their babies with a family history of allergic disease. The study used one billion colony forming units (CFU) of each Bifidobacterium bifidum W23, Bifidobacterium lactis W52, and Lactococcus lactis W58.

157 pregnant women were randomly assigned to receive the probiotic mixture, or placebo, for the last two weeks of pregnancy. The infants subsequently received the supplements for their first year of life. The Dutch researchers report that parental-reported eczema was 58 per cent lower in the intervention group compared with placebo during the first three months of life. In vitro testing showed that production of IL-5, one of the protein-like cytokines produced by white blood cells called T-helper type 2 (Th2) lymphocytes during the immune response to allergy, was significantly lower in the probiotic-group compared with the placebo-group.

Ginger Found to Ease Nausea of Cancer Treatment

A randomized clinical trial has confirmed what many people suspect — that ginger can decrease nausea caused by chemotherapy. The effect goes beyond that provided by standard anti-vomiting drugs. The results will be presented at the annual meeting of the American Society of Clinical Oncology, which begins May 29 in Orlando, Fla.

The trial, financed by the National Cancer Institute, involved 644 patients, mostly women with breast cancer, who were undergoing chemotherapy at 23 oncology practices in the United States. All patients took a standard anti-vomiting drug on each day of chemotherapy. They also took specially made capsules containing either extracts of ginger root or a placebo for six days, starting three days before each round of chemotherapy. They then rated the severity of their nausea four times a day. Those taking the ginger had a reduction of about 45 percent in severity compared with a previous round of chemotherapy in which they did not take the ginger. Those on the placebo had almost no change.
A quarter to a half teaspoon of ground ginger was given before chemotherapy.

Bonnie - for those of you who have followed our data tracking for a while, you should already be aware that ginger reduces nausea.

Thursday, May 14, 2009

Summer Safety: Nutritional Concepts Style

Our summer safety suggestions may stray a bit from the norm, but would you expect anything less? Combining these preventative measures along with the conventional makes it the best of both worlds for summer safety.

Vitamin D

  • How much you need supplementally during the summer months is dependent on how much sun (or lack thereof) you get. Fifteen minutes of sun exposure without sunscreen five times weekly is the minimum. If you are unable to accomplish this, then stick with your current dosage. If you get the minimum sun exposure, cut your vitamin D dose in half until early fall. For those with clinically low vitamin D3 levels, it may be warranted to stay with your winter supplemental dose even with sun exposure. Refer to your health professional for individualized advice.
Hydration
  • It is very easy to become dehydrated if outdoors for long periods of time (especially if playing sports or exerting yourself for an extended period of time). Make sure you carry water with you wherever you go. Reusable plastic bottle are acceptable if #2, #4, or #5 (look at the bottom of the bottle). Stainless steel is the preferred alternative. New Wave is a reputable brand that does not line the inside with aluminum or BPA.
Pool Safety
  1. Do not swallow pool or lake water at all costs. Besides the high content of chlorine ((which is toxic), public swimming areas are loaded with water-borne pathogens. If you have children, reinforce the idea of keeping the mouth closed as much as possible when in the water. Pathogens are becoming more chlorine-resistant each season, and most public works departments have not installed the latest technology (for example, ultraviolet radiation machines) to adequately kill them off.

  2. Shower before and after entering a pool or lake. If everybody could adhere to this rule, the risk of picking up a pathogen would be much less. Not to be disgusting, but showering removes any fecal remnants from the body and does not make it into the pool. Showering after helps remove anything lingering on your skin as well as removes chlorine residue, which is especially for asthmatics.

  3. Do not enter a pool if you have an open sore or wound. If you do, pathogens and bacteria have an easy entry into your body and can infect the wound or fester elsewhere.

  4. If you have or had diarrhea recently, do not enter a pool under any circumstances. This is the easiest way to transmit a pathogen to everyone else who joins you!
Grilling
  • Do not char your food, especially animal products. The black, chalky stuff contains carcinogenic substances called heterocyclic amines (HCA). A competent grillmaster can properly cook food thoroughly without HCA's. Marinating your poultry, fish, and meat will greatly reduce any carcinogenic effect.
  • Keep grilling utensils clean. Besides undercooked meat, the easiest way to pick up salmonella/food poisoning is using dirty utensils.
Sunscreen

Many sunscreens contain harsh chemicals that are thought to exhibit estrogenic effects. The two active, chemical-free ingredients we suggest to protect your skin are titanium dioxide and zinc oxide. Please refer to The Environmental Working Group's Database to find out where your brand stacks up.

Avoiding common mistakes that parents make when using sun block can help you avoid painful sunburns. These mistakes include:

  1. Not using sun block. This is especially common early in the spring or summer, when you don't think it is sunny enough to get a burn.

    People sometimes forget to use sunscreen when it is late in the day, when they underestimate how long their kids will be outside, or when it is cloudy outside.

  2. Not using enough sun block. The average person uses less than half the recommended amount of sun block. So apply a thick layer to each section of your child's body, to the point that it is actually hard to work it all in.

  3. Missing areas of their child's body when they apply sun block. Many kids, especially younger ones, don't like to have sun block put on them. This can make applying sun block quite the battle, making it easy to miss a shoulder, thigh, or nose.

  4. Not reapplying sun block every few hours, especially when your kids are in the water or sweating a lot. Even sun block that is waterproof should be reapplied often.

  5. Waiting too long to put sun block on. Remember, to be effective, sun block should be applied about 30 minutes before your kids go outside. If you wait until your kids are already outside, they will be unprotected for about 30 minutes until the sun block is most effective, which is more than enough time to get a tan or sun burn.
Insects

Preventing mosquitoes is job one: Control starts at home.

  • Avoid shaded areas where mosquitoes may be resting.
  • If possible, schedule your activities to avoid the times when mosquitoes are most active – usually dawn and dusk.
  • If you have a deck or patio, light it using General Electric yellow “Bug Lights”. These lights are not repellent, per se, but do not attract mosquitoes like other incandescent lights.
  • Mosquitoes are relatively weak fliers, so placing a large fan on your deck or patio can provide an effective low-tech solution.
  • Wear protective clothing such as long pants and long sleeve shirts when outdoors.
  • Taking 100 mg. of vitamin B-1 orally has been shown in some cases to be a preventative.
  • Use insect repellents properly. Besides DEET, which we do not suggest, Picaridin and Oil of Lemon-Eucalyptus are proven to be the most effective. We have heard accounts from clients that Skin-so-Soft by Avon is effective as well. Limit the use of chemical repellents as much as possible.
  • Check your door and window screens for holes and tears that mosquitoes can use to enter your home.
  • Eliminate all standing water on your property. Don't forget to remind your neighbors, too. Their mosquitoes may also be your mosquitoes.
  • Don't use scented soaps, perfumes or hair sprays on your child..
  • Avoid dressing your child in clothing with bright colors or flowery prints
Ticks, which can carry Lyme's Disease, have increasingly been a problem over the last decade:
  • Check yourself before going back into the house (humans as well as pets) after being outdoors. Scrutinize your hair and scalp, in particular.
  • If you discover a tick attached to your body, follow the proper procedure to remove it.
Energy Conservation

In a sense, helping to conserve energy will help our long-term safety by reducing the negative effects of climate change. Here are a few easy-to-implement suggestions:
  • Keeps shades down during the hottest daylight hours. In turn, your house will stay cooler without excess use off the A/C.
  • Turn the A/C off during peak hours of use (3PM-7PM). You'll save $ on your electric bill to boot!
  • Do not water your lawn plants between 10AM-5PM. It is wasteful for water conservation. It is the worst time for your plants to receive water and it costs you the most.
  • Invest in rain barrels. They usually come in 50 or 100 gallon tanks. Rain barrels catch rain water from your home's downspouts. You can use to water your bed areas, pots, or hook up a hose and water your trees. It can take a bite out of your water bill as well.

Poison Ivy, Oak, and Sumac

Rashes from poison ivy, oak, or sumac are all caused by urushiol, a substance in the sap of the plants. Poison plant rashes can't be spread from person to person, but it's possible to pick up a rash from urushiol that sticks to clothing, tools, balls, and pets.

  • What you can do: Learning what poison ivy looks like and avoid it. According to the American Academy of Dermatology, while "leaves of three, beware of me," is the old saying, "leaflets of three, beware of me" is even better because each leaf has three smaller leaflets. Hikers who have a difficult time avoiding poison ivy may benefit from a product called Ivy Block. It's the only FDA-approved product for preventing or reducing the severity of rashes from poison ivy, oak, or sumac. The OTC lotion contains bentoquatam, a substance that forms a clay-like coating on the skin.

    If you come into contact with poison ivy, oak, or sumac, wash the skin in cool water as soon as possible to prevent the spread of urushiol. If you get a rash, oatmeal baths and calamine lotion can dry up blisters and
    bring relief from itching. Treatment may include OTC or prescription corticosteroids and antihistamines.
Playgrounds
  • If you are at a playground with a wood apparatus, check to see if the wood has a greenish tint to it. If it does, go to the next playground. Chances are the wood is treated with Chromated Copper Arsenate (CCA), an arsenic treatment compound.

Chicago First Major City To Ban BPA

Chicago on Wednesday became the first U.S. city to adopt a ban on the sale of baby bottles and sippy cups containing the chemical BPA.

The Chicago City Council approved the ban on a 48-0 vote and a spokeswoman for Mayor Richard M. Daley said he intends to sign it. The ban is slated to take effect Jan. 31, 2010.

"This is an important step in a landmark consumer protection initiative. This legislation will protect Chicago's children and send a clear message to other jurisdictions considering similar legislation," said Alderman Manny Flores, co-sponsor of the measure.

BPA, or bisphenol A, is used to harden plastics in many consumer products including CDs, sports safety equipment and reusable bottles. It's also present in some food container linings.

Study adds to stevia Reb A safety

Rebaudiside A does not pose any safety questions regarding genotoxicity, according to a new study in Food and Chemical Toxicology: “These studies provide additional evidence that Reb A is not genotoxic at the doses tested and further support the generally recognized as safe determination of Reb A.” Researchers tested high purity (over 95 per cent) Reb A according to Organization for Economic Co-operation and Development (OECD) and FDA Redbook guidelines for genotoxicity studies. The study supports findings from published in the same journal last year (Food and Chemical Toxicology, July 2008, Vol. 46, Supplement 1, Pages S1-S92), which found that rebiana - a high-purity Rebaudioside A from stevia - is safe for use as a sweetener for foods and beverages. According to tests using Salmonella typhimurium, Escherichia coli, mouse lymphoma and Chinese Hamster V79 cells the sweetener was non-mutagenic. Further studies using bone marrow from mice showed that Reb A was non-genotoxic at doses up 750 mg per kg of body weight. In a DNA synthesis test in rats the sweetener was found to be safe up to a dose of 2000 mg per kg of body weight.

Wednesday, May 13, 2009

Massachusetts sets "tough fast-food menu rules"

Massachusetts approved the toughest statewide restaurant menu labeling rules in the United States on Wednesday, requiring major chain restaurants to display the calorie content of the food they sell.

The regulations, designed to combat rising obesity, are more comprehensive than those in California, which in September became the first state with menu labeling rules for fast-food restaurant chains such as McDonald's Corp and Yum Brands' KFC, advocates of healthy foods say.

Approved by the Massachusetts Public Health Council, the rules will require restaurant chains with 20 or more in-state locations to post calorie counts next to each item on their menus or menu boards, including those at drive-throughs.

The requirements take effect November 1, 2010, and will apply to 50 restaurant chains with a combined 5,800 locations.

Steve - I wouldn't exactly say this is "tough." To begin with, most Americans have no idea how many calories they should be eating daily. The statute does not require them to post a % of daily calorie value. There are no listings for sodium, saturated fat, or sugar. I bet this legislation took forever to pass. Unfortunately, it really does not mean a whole lot.

Kids Take More Drugs for Diabetes, Attention Deficit

By Sarah Rubenstein
WSJ

Pharmacy-benefits manager Medco came out today with its annual report on drug spending by its clients. One item that caught our attention: Kids aged 19 and below were the ones who had the greatest increase in spending, at about 4.5%. In contrast, spending actually fell among seniors 65 and older, by just over 1%. Medco’s chief medical officer, Rob Epstein, pointed to increased use of drugs for diabetes and attention deficit hyperactivity disorder among youngsters as drivers of the increase among that group. Medco noticed the trend with diabetes drugs a while back, as did rival Express Scripts. The trend is often linked to obesity among kids. ADHD drugs, meantime, have been a mainstay for a while.

Chemical cocktail threat to male fertility

Chemicals found in many food, cosmetic and cleaning products pose a real threat to male fertility, a leading scientist has warned.

Professor Richard Sharpe, of the Medical Research Council, warned these hormone-disrupting chemicals were "feminizing" boys in the womb.

He linked them to raising rates of birth defects and testicular cancer and falling sperm counts.

Chemicals in consumer products and food that have been reported to disrupt the sex hormones include:
  • Phthalates: Found in vinyl flooring, plastics, soaps, toothpaste
  • Bisphenol : Found in babies' bottles, food can linings. mobile phones, computers
  • Pesticides: Including pyrethroids, linuron, vinclozolin and fenitrothion
  • Professor Sharpe's report was commissioned by the CHEM Trust, a charity which works to protect humans and wildlife from harmful chemicals.

    There is evidence that male reproductive health is deteriorating, with malformations of the penis becoming more common, rates of testicular cancer rising, and sperm counts falling.

    Professor Sharpe said: "Because it is the summation of effect of hormone disrupting chemicals that is critical, and the number of such chemicals that humans are exposed to is considerable, this provides the strongest possible incentive to minimise human exposure to all relevant hormone disruptors, especially women planning pregnancy, as it is obvious that the higher the exposure the greater the risk."

    New EU chemicals legislation, called REACH (Registration, evaluation, authorisation and restriction of chemicals) puts the onus on the chemical industry to prove that its products are safe.

    Courtesy of BBC News

    Bonnie - there over literally tens of thousands of chemicals in our environment that have never been examined from a safety perspective and thousands more that enter the marketplace with little oversight. Ugh.

    Iron Deficiency In Womb May Delay Brain Maturation In Preemies

    Iron plays a large role in brain development in the womb, and new research shows an iron deficiency may delay the development of auditory nervous system in preemies. This delay could affect babies ability to process sound which is critical for later language development in early childhood.

    The study evaluated 80 infants over 18 months, testing their cord blood for iron levels and using a non-invasive tool -- auditory brainstem-evoked response (ABR) -- to measure the maturity of the brain's auditory nervous system soon after birth. The study presented at the Pediatric Academic Society Annual Meeting found that the brains of infants with low iron levels in their cord blood had abnormal maturation of auditory system compared to infants with normal cord iron levels.

    Bonnie - as I have said for a long time, iron is critical during prenatal, pregnancy, and early childhood stages of development. One way to ensure that a deficiency does not occur? A prenatal vitamin and early childhood supplementation.

    Women worry more about looks than health

    There's a big disconnect between body image and true physical condition, a new Associated Press-iVillage poll suggests. A lot of women say they're dieting despite somehow avoiding healthy fruits and veggies. Many others think they're fat when they're not.

    "The priorities are flipped," says Dr. Molly Poag, chief of psychiatry at New York's Lennox Hill Hospital.

    About 60 percent of Americans are overweight or obese. The AP-iVillage poll of 1,000 adult women mirrors the government's count on that. More surprising, perhaps, are women's attitudes and actions.

    Half don't like their weight, even 26 percent of those whose body mass index or BMI -- a measure of weight for height -- is in the normal range. But just a third don't like their physical condition, even though being overweight and sedentary are big risk factors for Type 2 diabetes, heart disease and other ailments.

    The poll found women putting in a median of 80 minutes of exercise a week -- meaning half do even less. The average adult is supposed to get 2½ hours of exercise a week for good health.

    And just 8 percent of women ate the minimum recommended servings of fruits and vegetables -- five a day. A staggering 28 percent admit they get that recommended serving once a week or less.

    About a quarter of the women surveyed said they'd consider plastic surgery to feel more beautiful. Their overwhelming choice: a tummy tuck.

    At the other end of the spectrum, the poll found 16 percent of normal-weight women who nonetheless are dieting to drop pounds. Eating disorders aside, normal-skinny doesn't automatically mean healthy, stresses University of Houston sociologist Samantha Kwan.

    Courtesy of Associated Press

    Bonnie - what a sad state of affairs. Results from a poll such as this is a direct result of how our society puts such an emphasis on appearance and beauty. Until these perceptions change, we will continue to fight an uphill battle to make this country healthier. The fruit and veggie stat was absolutely dumbfounding.

    Meditation May Increase Gray Matter

    In a study published in the journal NeuroImage, UCLA researchers used MRI brain scans to report that certain regions in the brains of long-term meditators were larger than in a similar control group.

    Specifically, meditators showed significantly larger volumes of the hippocampus and areas within the orbito-frontal cortex, the thalamus and the inferior temporal gyrus — all regions known for regulating emotions.

    "We know that people who consistently meditate have a singular ability to cultivate positive emotions, retain emotional stability and engage in mindful behavior," said Eileen Luders, lead author and a postdoctoral research fellow at the UCLA Laboratory of Neuro Imaging. "The observed differences in brain anatomy might give us a clue why meditators have these exceptional abilities."

    Research has confirmed the beneficial aspects of meditation. In addition to having better focus and control over their emotions, many people who meditate regularly have reduced levels of stress and bolstered immune systems. But less is known about the link between meditation and brain structure.

    Steve - meditation...what a simple concept. It only takes about twenty minutes once or twice daily and provides so many benefits.

    Sorghum a growing gluten alternative

    According to Dr. Jeff Dahlberg, research director for National Grain Sorghum Producers in Lubbock, food-grade sorghum is becoming an increasingly popular gluten-free alternative.

    That's good news for people with Celiac disease. Dahlberg said there are several different types of sorghum, and the one that works best for flour is white sorghum. It has little or no taste, so it doesn't mask the flavor of other ingredients.

    The researcher explained, however, that sorghum flour faces a couple of challenges. The first is that like many other alternative flours, it is available primarily through the Internet. Second, because sorghum flour does not contain gluten, it is necessary to incorporate some type of binder, such as xanthan gum or cornstarch, in the flour mix (suggests adding 1/2 teaspoon of xanthan gum per cup of sorghum flour for cookies and cakes or one teaspoon per cup of flour for breads.)

    Steve - we wish more products were made with sorghum flour, especially for the corn-sensitive, so they can eat something besides quinoa.

    Look before you flush

    It may not be a topic you are used to discussing around the dinner table or at social gatherings, but it should be one to take seriously.

    Let's talk about stool. In my profession, it is a topic that comes up several times daily. Here is a brief synopsis of why it is essential to monitor your digestive health by taking the "look before you flush" approach. You will be surprised at what you will learn.

    Stool is the end product of digestion. After all the "good stuff" has been broken down and absorbed to be used by the body, stool is the waste that's left over. Mostly, stool comprises of fiber, microbes, and water. Slight changes in consistency, color, size, and shape are all signs as to what is happening on the inside.

    Because proper digestion is an essential part to good health, it makes sense to monitor changes in stool on a daily basis.

    One of the most important characteristic to note about your bowel movements is the frequency. Constipation can lead to major health problems and should be addressed immediately. Think of the bowel as a holding tank for waste that needs to be emptied at least daily. Otherwise, toxins that your body has worked so hard to eliminate can be reabsorbed into the blood stream. Even if you are having regular (i.e. daily) bowel movements, if the stool is hard to pass or looks like pellets, you still may be constipated.

    The opposite to constipation, diarrhea, can also create problems, especially if it lasts longer than a couple days. Diarrhea indicates that something is irritating the bowel, causing forced elimination. Following a bland diet and avoiding food intolerances as well as known bowel irritators (caffeine is a big one) may eliminate the problem. However, dehydration and poor absorption are major concerns with chronic constipation and anyone who has had diarrhea for any length of time should consult a professional.

    It is not normal to see undigested food in the stool, although some foods high in insoluble fiber, such as whole corn kernels, often will show up in the stool.

    If undigested food particles are common, you may not be chewing your food properly or it may be a sign that you may be lacking digestive enzymes.

    Mucus is a sign of inflammation in the bowel and is common with conditions such as irritable bowel and food intolerances.

    Stool color will depend on diet, however other factors also come into play in determining stool hue.

    Bright red is a sign of blood from the lower end of the digestive tract, such as hemorrhoids. Red blood can also be the result of constipation, which can cause tearing and fissures in the anus.

    Pale stools may indicate insufficient bile. Bile is made in the liver, stored in the gallbladder, and released to help emulsify fats. Poor fat digestion may also result in stools that look greasy. Conditions such as gallstones may lead to poor bile flow.

    When is comes to texture, a healthy stool should be toothpaste like; soft, but in one piece. Stool that easily breaks apart in the toilet bowl may indicate food sensitivity and/or inflammation.

    It is normal for stool to have some odor, but if it is a recent change or if you are having a hard time standing the smell, you may want to access the problem. Usually, an increase in odor indicates dysbiosis, or altered gut flora. We need some good bacteria in order to balance the digestive system. If this balance is thrown off (antibiotics and a diet high in refined foods are big culprits), the "ugly" bugs can overwhelm the good guys, creating an odorous gas as their by-product. Supplementing with probiotics will go a long way at re-balancing the system.

    Another possibility is that the food is not properly being broken down. This allows larger molecules to remain in the gut while bacteria do the work.

    A normal, healthy bowel movement is one that is easily passed without straining or pain, with a medium brown color and minimal gas and odor. The stool should be consistent in size and shape.

    May is Better Sleep Month

    May is Better Sleep Month, and the Council for Responsible Nutrition (CRN) and Better Sleep Council (BSC) are promoting healthy steps consumers can take to improve their sleep. Particularly in today’s stressful economy, committing to a healthy lifestyle that includes a balanced diet, healthy exercise and appropriate supplements can combat stress and enhance sleep quality.“Herbals and other dietary supplements can be safe and effective ways to help individuals achieve quality sleep,” said Douglas MacKay, N.D., vice president, scientific and regulatory affairs, CRN. Among MacKay’s top choices for supplements to help reduce stress or promote healthy sleep—melatonin, magnesium, calcium, valerian and 5-HTP.

    Steve - Our Improve Your Mood Action Plan outlines an extensive, non-pharmacological sleep protocol.

    Vitamins Found to Curb Exercise Benefits

    If you exercise to improve your metabolism and prevent diabetes, you may want to avoid antioxidants like vitamins C and E.

    Researchers found that in the group taking the vitamins there was no improvement in insulin sensitivity and almost no activation of the body’s natural defense mechanism against oxidative damage.

    The reason, they suggest, is that the reactive oxygen compounds, inevitable byproducts of exercise, are a natural trigger for both of these responses. The vitamins, by efficiently destroying the reactive oxygen, short-circuit the body’s natural response to exercise.

    “If you exercise to promote health, you shouldn’t take large amounts of antioxidants,” researchers said. A second message of the study, he said, “is that antioxidants in general cause certain effects that inhibit otherwise positive effects of exercise, dieting and other interventions.” The findings appear in this week’s issue of Proceedings of the National Academy of Sciences.

    The advice does not apply to fruits and vegetables, according to researchers. Even though they are high in antioxidants, the many other substances they contain presumably outweigh any negative effect.

    Steve - it is ridiculous that this study was structured the way it was and even more ridiculous that the media would pay so much attention to it, given how tiny the subject size was (39 men).

    I would never put an “untrained” person, no matter what their BMI or age, into a program that requires 85 minutes of exercise 5 days per week for 4-weeks, as required in this study. The body needs to accommodate an increase in physical activity to build up its endogenous antioxidant defenses to the anticipated increase in ROS. There are far more nutrients and phytochemicals found in the diet and available supplements and antioxidant-rich foods and juices that would be needed to anticipate the degree of oxidative stress an individual would experience with such an exercise program (as opposed to the 1000 mg vitamin C and 400Iu vitamin E they received).

    Athletic clubs that sell memberships have long realized that individuals who sign up and begin at an intense level of exercise can feel defeated due to the side effects they experience in the first month and for this reason often stop their exercise program and revert to a more sedentary lifestyle.

    Skeletal muscle biopsies were obtained from the right vastus lateralis muscle of study subjects. But some of the data is missing for a number of subjects, and reported as such by the authors.

    The authors noted that biopsies for the ‘early’ time-point were only obtained from five people in the vitamin group, and four in the placebo group. Yet the authors conclude a “strong induction of PGCl-alpha, PGCl-beta, and PPAR-gamma expression in skeletal muscle following 4 weeks of exercise training in previously untrained, antioxidant na├»ve individuals” and “markedly reduced exercise-related induction” in those taking antioxidants, based on these limited number of biopsies.

    In addition, the authors flippantly say antioxidant-rich fruits and vegetables are not an issue. How do they know this without doing the research?

    Study links formaldehyde to more common cancers

    New research raises additional concerns about the harmful effects of formaldehyde, a common chemical found in everything from plywood to nail polish, car exhaust and cigarette smoke.

    Factory workers exposed to high levels of formaldehyde were more likely to die of cancers of the blood and lymphatic system than workers with low-level exposures, according to a study by researchers at the National Cancer Institute.

    But the risk of dying of these cancers diminished over time after the exposure stopped, said Laura E. Beane Freeman, lead author of the study, which was published online Tuesday in The Journal of the National Cancer Institute.

    The research looked at some 14,000 deaths among 25,619 workers, most of them white men, who began working before 1966 at 10 plants that produced formaldehyde and formaldehyde resin.

    In the four ensuing decades, the researchers found, workers with the highest peak exposures to formaldehyde had a 37 percent greater risk of death from all blood and lymphatic cancers combined than those with lower peak exposures.

    “You usually don’t develop cancer right away — there’s a latency period,” Dr. Freeman said. “Then, after you’re not exposed to whatever it is — after people stop smoking for a while, for example — the risk returns down to that of the base-line population.”

    The study's authors acknowledge that they don't know the mechanism by which formaldehyde might cause cancer. Authors do note, though, that people exposed to formaldehyde have higher rates of chromosome abnormalities in their lymphocytes, a type of white blood cell that fights infection.

    Formaldehyde is widely used in manufacturing and as a preservative and disinfectant, although workplace exposures have decreased over time because of tighter regulations. The chemical has long been suspected of playing a role in the unusual number of leukemia deaths among pathologists and embalmers, who are periodically exposed to high levels. Indeed, formaldehyde is also associated with nasopharyngeal cancer, a disease of the upper part of the throat, behind the nose.

    Dangerously high formaldehyde levels have been found in trailers provided by the Federal Emergency Management Agency to Gulf Coast residents displaced by Hurricane Katrina. A March report from the Campaign for Safe Cosmetics, an environmental advocacy group, also found formaldehyde in more than 80% of bath and shampoos tested.

    The Environmental Protection Agency listed formaldehyde as a "probable human carcinogen" in 1987. In 2004, the International Agency for Research on Cancer went further, classifying formaldehyde as a "known human carcinogen" based partly on research suggesting a link to leukemia.

    Avoiding controversial chemicals at the supermarket could be a daunting task, the report says. Baby bath products tested in the Campaign for Safe Cosmetics' new report list formldehyde and 1,4-dioxane on their labels, since they're formed as manufacturing byproducts and aren't added intentionally.

    The group says consumers can look out for ingredients that are likely to contain either of the chemicals, though, including: peg-100 stearate, sodium laureth sulfate, polyethylene and ceteareth-20, quaternium-15, DMDM hydantoin, imidazolidinyl urea, diazolidinyl urea and sodium hydroxymethoylglycinate.

    Bonnie - what ever-present 800 pound gorilla looms over formaldehyde research, yet is never explored or even mentioned...vaccines. Formaldehyde and its derivatives are present in almost every vaccine produced. There have been no safety studies performed on its short and long-term effects when INJECTED into the blood stream, which bypasses the majority of immune system resistance.