Tuesday, June 30, 2009

C-Reactive Protein Further Defined?

C-reactive protein, or CRP, a marker of inflammation in the body, is unquestionably associated with heart disease. Multiple studies have found that the more CRP in a person’s blood, the greater the likelihood of heart disease. But in a study that appears in Journal of the American Medical Association, researchers analyzing genetic data from more than 100,000 people conclude that their study “argues against” the notion that the protein causes heart disease. CRP is “a biomarker — a marker of disease process — and not a risk factor,” said Dr. James A. de Lemos, an associate professor of medicine at the University of Texas Southwestern Medical Center, who wrote an editorial accompanying the study. Dr. David Altshuler, a professor of genetics and medicine at Harvard Medical School, said the distinction was important.

The real issue is inflammation. CRP goes along with inflammation, and it is inflammation that is likely to be causing heart disease.

The new study, by Dr. Paul Elliott of Imperial College in London and 35 co-authors, made use of a recently developed technique that can get answers quickly about causality. Without it, the only method was what is seen as the gold standard in medicine — large controlled clinical trials in which people are randomly assigned to take a drug, or not, and followed for years. The new method, Mendelian randomization, “is changing the way we think about causality,” Dr. Lauer said. It is a type of study that only recently became feasible as researchers found genetic variants associated with proteins like CRP and developed tools to analyze data from what was, in this case, more than 100,000 people. Different people produce different amounts of CRP, and the amount a person produces is determined by tiny inherited changes in the CRP gene. So in a population, there are people who just happen to produce more CRP throughout their lives and others who just happen to produce less. If CRP causes heart disease, those who make more CRP would have more heart disease. That, however, is not what the study found. “There was no association” between CRP genes and heart disease rates, Dr. Elliott said. People with genes that increased CRP production throughout life had no more heart disease than those with genes resulting in less CRP. The association between CRP and heart disease must be reflecting something else. For example, if CRP levels go up when heart disease begins, because there is inflammation in the arteries, CRP levels would be higher in people with incipient heart disease.

But CRP itself would be playing no role in heart disease risk — it was just marker of inflammation in the arteries.
An elevated CRP level indicates increased risk, even if the protein does not cause the risk.

Bonnie - I never consider CRP a direct risk factor. It simply indicates overall inflammation, which IS a major factor in heart disease and many other inflammatory diseases.

Monday, June 29, 2009

Roll out the next drug for weight-loss

Contrave, a new pill by Orexigen Therapeutics which combines naltrexone and bupropion (wellbutrin), will be coming soon to a pharmacy near you.

Bupropion is a norepinephrine-dopamine reuptake inhibitor that is used for the treatment of depression and smoking cessation, while naltrexone is an opioid antagonist that is approved for alcohol and opioid dependence.The combination of these two drugs is supposed to target hunger, fullness, and reward centers in the brain that control the balance of food intake and energy expenditure.

In one study after 56 weeks, results showed that patients in the medication treatment group lost 9.3% of their body weight, compared with a loss of 5.1% in the placebo patients. Both groups had to follow healthy dietary and lifestyle patterns.

The discontinuation rate due to adverse events was 26% in the medication treatment group, compared with 13% in the placebo group. The most frequent side effect was nausea (34% in the medication treatment group vs. 11% in the placebo group), headache (24% vs. 18%), and constipation (24% vs. 14%).

USDA buys what kids eat, despite food chart

Courtesy of the Des Moines Register

The government wants kids to eat more fruits and vegetables but doesn't seem to be putting its money where its advice is.

For every dollar that the U.S. Department of Agriculture spent buying commodities for school lunches last year, 55 cents went to beef, chicken and cheese vs. about 23 cents for fruits and vegetables.

Agriculture Secretary Tom Vilsack stumped a group of Iowa business leaders recently by asking them what was the single food item for schools that the USDA spent the most on. His answer: mozzarella cheese.

"Part of our challenge is to figure out how to make the kids' choice be the salad rather than the pizza slice," Vilsack said.

Critics have long linked the federal school lunch program to the nation's childhood obesity problem.

The Robert Wood Johnson Foundation produced a study last year of USDA food-buying practices that was illustrated with two pyramids. One was the traditional USDA food-guide pyramid, which recommends eating more fruits and vegetables than anything else. The other pyramid showed what USDA buys for schools. The pyramids were reversed.

The dairy industry, it should be no surprise, doesn't think the USDA is buying too much cheese.

"Kids need nutrition and mozzarella is a fairly cost-effective, high-nutrition food, and it's one that people, especially kids, like," said Chris Galen, a spokesman for the National Milk Producers Federation.

"If all you did was give kids salads you'd have a lot of wasted food, which is not what schools want, and you wind up with a lot of hungry kids."

No one is suggesting the USDA stop buying cheese or meat. But should the USDA stop providing so much meat and cheese to the schools and substitute produce?

Not necessarily, according to the people who run the school lunchrooms. They say the USDA purchasing patterns don't reflect what schools are actually serving kids. Taking meat and cheese from the USDA makes school budgets stretch farther, said Erik Peterson, a spokesman for the School Nutrition Association, which represents school nutrition directors. The schools then buy other foods, such as fruits and vegetables, elsewhere.

For that reason, nutrition activist Margo Wootan doesn't believe it's that big of a deal that the USDA tilts its purchases toward meat and cheese and not to produce. Moreover, the USDA in recent years reduced the fat content of the meat and cheese it supplies to the schools, she says. She wants the USDA to provide more cooking advice so schools know how to prepare healthful versions of popular foods, such as pizzas and chicken nuggets. Whole-grain crusts are a start.

"They can't afford to take the risk of trying a whole new way of processing their most popular item," said Wootan, director of nutrition policy at the Center for Science in the Public Interest. "What if the kids don't like it and they're stuck with cases and cases of food that kids won't eat?"

Congress is due to update rules for the school lunch program this year, and lawmakers are likely to consider giving schools incentives to buy more fruits and vegetables. But there's unlikely to be much appetite for cutting back on the meat and cheese.

"What's caused the obesity epidemic is not the school lunches and school breakfasts, it's the junk kids get in the a la carte lines and the school stores and the vending machines," said Iowa Democrat Tom Harkin, the chairman of the Senate Agriculture Committee.

Bonnie - the major food lobbies that dominate the USDA could give a hoot. They want to pawn off their excess, low-grade meat, cheese, and milk on the school lunch program. They get paid wonderful subsidies for doing this. What are chances we see a major chunk of the subsidies go from the grain, meat, and dairy lobbies to fruit and veggie growers? Until I see some definitive action, which is non-existent, Vilsack is just another blower of hot-air and false promises.

How to Roll Your Own Sushi (California Rolls)

-2 cups medium-grain brown rice, cooked
-1 tsp. sea salt (for cooking rice)
-2 sheets nori
-6 to 8 oz. fresh crab
-1 avocado
-1 cucumber, peeled
-bamboo mat
-sharp kitchen knife
-sesame seeds, optional
-wasabi low sodium soy sauce or wheat-free tamari

Sushi Vinegar Ingredients
-1/3 cup rice vinegar
-2 T. sweetener, such as Sucanat (1 tsp. Stevia may be used as a sugar substitute)
-dash of sea salt

Directions: Over medium heat, warm vinegar on stove and mix in sweetener and sea salt (don’t boil because sugar can burn). Mixture is done when all the ingredients have dissolved. Add 1 T. vinegar mix to every one cup of cooked rice.

Vinegar Rice Prep
  1. While the rice is cooking, prep the other ingredients. Cut up the crab, julienne the cucumber, and slice the avocado. Make sure to peel the cucumber. The skin does not go well with the sushi.
  2. Prepare the vinegar mixture (this will eventually be mixed with the rice). You can either buy it in the store and heat it up in a pot or make your own (see recipe above).
  3. Transfer the rice to a large mixing bowl.
  4. While the rice is hot, fold vinegar into rice. This is called “cutting the rice”. Be sure to fold and not stir, as you do not want to break the kernels and have the rice turn mushy. Let cool to room temperature.

Sushi Roll Prep
  1. On a bamboo mat, place a ½ sheet of nori smooth side down, rough side up. Using 3 to 4 ounces, spread rice lightly across the rough side, completely covering the seaweed. If desired, sprinkle the sesame seeds across the rice.
  2. Flip the nori over so the smooth side of the seaweed is facing up. You can line the mat with plastic wrap if you prefer.
  3. Place a few pieces of cucumber and avocado lengthwise and add crab. Make sure to squeeze out any liquid out of the crab, otherwise it will make the roll soggy and possibly fall apart.
  4. Using the bamboo mat, begin to tightly roll the sushi. Start at the side closest to you and roll away from yourself. Also, make sure your hands are damp; if you touch the rice you don’t want it sticking to your hands.
  5. Using a very sharp knife, cut roll into 8 pieces. Serve with wasabi and sodium-reduced soy sauce or tamari.
YIELD: 4 rolls
HANDS ON TIME: 45 minutes
TOTAL TIME: 1 hour

Lean Mass Better For Developing Bones In Young People

A child with leaner body mass, or muscle, builds bigger bones than a child who weighs the same but has a greater percentage of fat.

“There’s a little bit of controversy because weight itself has a positive influence on bone,” said researchers. “Heavier individuals tend to have more bone just to support their weight.”

The findings were presented at the annual meeting of the Pediatric Academic Societies.

“A larger child is going to have larger bones just because he’s heavier,” they said. “But if you have two kids at the same weight, the one whose weight is dominated by fat mass is more likely to have smaller bones than the one whose weight is dominated by lean mass. Smaller bones are weaker than larger bones.”

“Kids with higher lean mass, or muscle, tended to have greater rates of change, and kids with higher fat mass tended to have lower rates of change.”

This new knowledge is one factor that can help the medical community in forming guidelines about diet and exercise to deal with health issues such as childhood obesity and the subsequent influence on adult disorders such as osteoporosis.

Want to see how high carb foods affect your arteries?

Research from Tel Aviv University shows exactly how high carbohydrate foods increase the risk for heart problems.

Researchers visualized exactly what happens inside the body when the wrong foods for a healthy heart are eaten. They found that foods with a high glycemic index distended brachial arteries for several hours. It is a first in medical history. The results were published in the Journal of the American College of Cardiology.

Elasticity of arteries anywhere in the body can be a measure of heart health. But when aggravated over time, a sudden expansion of the artery wall can cause a number of negative health effects, including reduced elasticity, which can cause heart disease or sudden death.

Like the uncomfortable medical warnings on packets of cigarettes, this new research could lead to a whole new way to show patients the effects of a poor diet on our body.

The researchers looked at four healthy groups. One group ate a cornflake mush mixed with milk, a second a pure sugar mixture, the third bran flakes, while the last group was given a placebo (water). Over four weeks, "brachial reactive testing" was performed on each group. The test uses a cuff on the arm, like those used to measure blood pressure, which can visualize arterial function in real time.

The results were dramatic. Before any of the patients ate, arterial function was essentially the same. After eating, except for the placebo group, all had reduced functioning.

Enormous peaks indicating arterial stress were found in the high glycemic index groups: the cornflakes and sugar group. During the consumption of foods high in sugar, there appears to be a temporary and sudden dysfunction in the endothelial walls of the arteries.

Bonnie - compelling stuff! I think this will be a great tool for physicians and cardiologists to use if they truly want their patients to practice prevention.

Drug-resistant ear infections

Emerging Infectious Diseases

Streptococcus pneumoniae 19A is a new "superbug" that is resistant to all Food and Drug Administration-approved antimicrobial drugs for treatment of acute otitis media (ear infection) in children.

In a new study, Serotype 19A accounted for 40% of the isolates and has emerged as the major serotype causing ear infections in children. Eight (50%) of the 16 isolates of 19A were highly penicillin resistant, and 8 others were also multidrug resistant.

Bonnie - I have been screaming to the mountaintops about the overuse of antibiotics for ear infections because of this very issue.

Cardiologist Gets 10 Years for Performing Unnecessary Interventions

An interventional cardiologist who implanted stents in patients who did not need them has been sentenced to 10 years in federal prison for healthcare fraud. Dr Mehmood Patel, formerly of Our Lady of Lourdes Hospital and Lafayette General Hospital in Louisiana, was convicted on 51 counts of billing private and government health insurers for unnecessary medical procedures and received the maximum sentence

Testimony during the trial also revealed that Patel falsified patient symptoms in medical records, including chest pain when patients never complained of such pain, and falsified findings on medical tests. From 1999 to 2003, Patel billed Medicare and private insurance companies more than $3 million, according to the Advocate, a Baton Rouge, LA newspaper. During this time, he was the top cardiology biller in the state and personally pocketed more than $500 000.

Steve - would it be in bad taste to suggest that you always should get a second and third opinion?

Recent advances (or lack thereof) in Celiac Disease

Current Opinion in Gastroenterology
Matthew J. Armstrong; Gerry G. Robins; Peter D. Howdle

Large multicenter studies have provided further evidence of the role of environmental and nonhuman leukocyte antigen genetic factors in celiac disease. Siblings of celiac patients carry a high risk, but those found to have negative celiac serology are very unlikely to develop the disease. Advances in the efficacy of serological antibody testing potentiate the possibility of future accurate screening programs in the community. Adherence to a gluten-free diet remains paramount as the recognition of celiac related complications increases.

Despite the encouraging progress that has taken place in our genetic and immunological knowledge of celiac disease, early introduction of a gluten-free diet remains the cornerstone of treatment. Alternatives, however, aimed at altering the toxicity of cereal proteins are now looking more promising.

Bonnie - they also mention in this study that one in 100 are now affected with celiac, which is up from one in 133 a decade ago.

How to feed your baby right, even before birth

Bonnie - I thought I would lend my expertise to this piece. Some of Ms. Ward's info is correct, and some is not.

Eating healthfully for two without gaining too much weight is a common problem for pregnant women. The Institute of Medicine has released new weight-gain guidelines for pregnancy. USA TODAY talked to Elizabeth Ward, a registered dietitian in Boston and the mother of three girls. Ward is the author of a new book, the American Dietetic Association's Expect the Best: Your Guide to Healthy Eating Before, During and After Pregnancy. She's also a nutrition blogger on dietchallenge.usatoday.com.

Q: Why is it important for women to maintain a healthy weight before, during and after pregnancy?

A: Being at a healthy weight increases a woman's chances of getting pregnant. If a woman has a lot of excess body fat at the time of conception, there is an increased risk of neural tube defects, such as spina bifida, even when she is consuming the recommended amount of folic acid, a B vitamin associated with a lower risk of these defects.

Starting a pregnancy at a healthy weight gives the child a better chance of developing normally. It also lowers the risk of several complications for mom during those nine months, including high blood pressure, gestational diabetes and delivering a baby that's too large and may require Cesarean delivery.

Gaining the suggested number of pounds during pregnancy helps to minimize complications for mother and child, and it helps women achieve a healthy weight after pregnancy. Studies show that women should try to take off the excess pregnancy pounds, in a safe manner, within one year of delivery. After that, they're likely to keep those pounds on.

Q: How many extra calories do women need each day when they're pregnant?

A: During the first trimester, a pregnant woman does not require any extra calories. This seems odd, given that the baby is growing by leaps and bounds. However, he or she is still far too small to require extra energy from the mother. Calorie needs increase during the second trimester. At that time, a woman should add about 350 calories to her pre-pregnancy diet and about 450 calories a day more during the third trimester. Women who begin pregnancy overweight may need fewer calories and those who are underweight may need more.

Q: What are the calcium and iron requirements for expectant mothers?

A: Calcium needs do not increase with pregnancy. That's because a woman's body becomes super efficient at absorbing calcium. However, many women begin pregnancy with a calcium shortage and need to increase their calcium consumption to make the 1,000 milligram-a-day quota. That's the amount found in about three 8-ounce glasses of milk. Fortified 100% orange juice contains as much calcium as milk, too. Other calcium-rich foods include yogurt, cheese and tofu processed with calcium sulfate. Women shouldn't rely on multivitamins or prenatal dietary supplements for calcium — they do not contain nearly enough. But if a woman can't achieve her calcium requirement with food, she should consider calcium supplements.

Bonnie - expectant mothers do need extra calcium (200-400 mg.). Otherwise, the mother may become deficient post partum. If deficient in vitamin D, the woman's body does not become super efficient in absorbing calcium. Of course, milk is the poorest source of calcium for absorption. Our Wellness Essentials for Pregnancy Prenatal provides 1/3 of what I recommend.

Many women enter pregnancy with low iron stores. Pregnancy boosts iron needs because your body produces more iron-rich red blood cells to support a growing baby. That depletes the supply of stored iron in a woman's body, so she must eat an iron-rich diet to keep up with pregnancy demands. Even with a balanced diet that includes such iron-rich foods as fortified grains, beef, poultry, pork and seafood, it's difficult for most women to achieve the 27 milligrams of iron they need every day during pregnancy.

Bonnie - I recommend 27-40 mg. in a prenatal or separately. If iron deficient during pregnancy, we add more.

That's why it's a good idea to take a multivitamin with 100% of the daily value for iron and other essential minerals and vitamins to fill in any nutrient gaps.

You are a good candidate for a prescription or over-the-counter prenatal multivitamin if:

• Your diet was poor at the outset of pregnancy, or is at any time during your pregnancy.

• Your diet had been inadequate for months or years before conception.

• You are carrying more than one child.

Bonnie - the prescription prenatals I have seen are far from complete.

Q: What are some beverages that pregnant women should avoid consuming and why?

A: Pregnant women should completely avoid alcohol. Alcohol can cause irreversible harm to a developing child. It deprives a baby of oxygen and nutrients that are required for the development of every organ, most notably the brain. Heavy drinking during pregnancy increases the risk of mental retardation, learning disabilities, birth defects and emotional and behavioral problems. There is no known safe amount of alcohol during pregnancy, and studies show even modest consumption of alcohol during pregnancy can cause problems in children.

According to the March of Dimes, pregnant women should limit caffeine to 200 milligrams a day, about the amount found in 10 ounces of brewed coffee. Caffeine has been linked to a higher risk of miscarriage in some studies but not all.

Q: Why is exercise important during pregnancy?

A: Exercise helps to foster weight control, keep blood pressure in check, reduce stress that may lead to overeating and improve circulation and strength. It may also help women sleep better. I exercised during my pregnancies because it made me feel good, and strong.

Most women with uncomplicated pregnancies can work out throughout their pregnancies, and they can start a program (most likely walking) while pregnant even if they have not worked out in the recent past. Always ask your doctor about exercise.

Bonnie - no pounding activities.

Thursday, June 25, 2009

Some foods from Meditteranean Diet more effective than others

It’s been clear for a while now that adhering to a Mediterranean diet can lower the risk of death.

But the diet has many components, and it hasn’t been clear which elements of the diet are responsible for this benefit. An analysis published this week in the British Medical Journal aimed to find out.

Researchers based at Harvard and the University of Athens looked at data collected from more than 20,000 Greek men and women who were followed for an average of more than eight years as part of a study of nutrition and health.

They assessed participants’ adherence to nine components of the Mediterranean diet. They found that overall, people who adhered more closely to the diet were less likely to die during the study. They also parsed the data to see which elements of the diet were most strongly associated with this benefit. Here, in descending order of importance, are the keys:

  • A moderate amount of alcohol (usually wine)
  • A small amount of meat
  • Lots of vegetables
  • Lots of fruits and nuts
  • A high ratio of monounsaturated to saturated fats
  • Lots of legumes

Off-label morning sickness drug deemed safe for fetuses

Metoclopramide, a drug approved in the U.S. for nausea, vomiting and heartburn poses no significant risks for the fetus according to a large cohort study published in the June 11 issue of the prestigious New England Journal of Medicine. According to the pediatrician and clinical pharmacologist, principal investigator Dr. Rafael Gorodischer, prof. emeritus at Ben-Gurion University of the Negev, "Metoclopramide is the drug of choice in Europe and Israel for "morning sickness-like" symptoms of nausea and vomiting, which are common in pregnant women. In the U.S. however, it is only used in the most severe cases, as it is an "off-label" use for nausea and vomiting during pregnancy.

The findings of this very large cohort study examining infants born to mothers who were exposed to metoclopramide during the first trimester provide significant reassurance for the safety of the fetus when the drug is given to women to relieve nausea and vomiting during pregnancy." Between 50 percent to 80 percent of pregnant women experience nausea and vomiting during the first trimester and beyond, which can be severe.

In the study, 3,458 (or 4.2 percent) were exposed to metoclopramide during the first trimester of pregnancy of the 81,703 infants born to mothers during the study period. The rate of major congenital malformations identified in the group that was exposed to metoclopramide during the first trimester was 5.3 percent% (182 of 3458 infants), as compared with a rate of 4.9 percent (3834 of 78,245 infants). As a result, exposure to metoclopramide among this group was not associated with significantly increased risks of major congenital malformations. The results were unchanged when therapeutic abortions of exposed fetuses were included in the analysis. In addition, infants exposed in utero had no increased risk of perinatal mortality, low birth weight or premature birth. Data of this study support the labeling of metoclopramide for nausea and vomiting during pregnancy.

Bonnie - this is what they said about Thalidomide until babies were born without limbs. I would not want any pregnant woman to be a guinea pig for an off-label drug.

Wednesday, June 24, 2009

Eating healthy pays off in longevity

Those with the best diets reduced their risk of death by up to 25 percent over a 10-year follow-up, said study author Ashima Kant, a professor of nutrition at Queens College of the City University of New York.

Kant and her colleagues extracted information from a National Institutes of Health/AARP database including more than 350,000 men and women, evaluating the link between dietary habits and their risk of death during the follow-up period.

"If you had the highest fifth of these scores, your risk of dying over the follow-up period was 20 to 25 percent lower," Kant said. She found gender differences, with women eating the healthiest reducing their risk of death by 25 percent and men reducing it by 20 percent.

Kant's team asked the participants about six components of a healthy diet, including intake of fruits, vegetables, low-fat dairy, whole grains, lean meat and poultry, and fat.

People didn't have to eat perfectly to get a top score, she said. For instance, "if a person had five or six servings of vegetables a week, that would get them the top score [for that question]," she said.

"It's not that you have to do everything [recommended under the dietary guidelines] to have any health benefits," she said, noting that participants in the groups with lower (but not the lowest) scores also tended to live longer. For instance, women who were in the second-from-the-highest group on dietary scores were 20 percent less likely to die and men in that group were 17 percent less likely.

The study is published in the July issue of The Journal of Nutrition.

Smoking Linked To Brain Damage

New research which suggests a direct link between smoking and brain damage will be published in the July issue of the Journal of Neurochemistry. Researchers have found that a compound in tobacco provokes white blood cells in the central nervous system to attack healthy cells, leading to severe neurological damage.

The research centers on a compound known as NNK, which is common in tobacco. NNK is a procarinogen, a chemical substance which becomes carcinogenic when it is altered by the metabolic process of the body.

Unlike alcohol or drug abuse NNK does not appear to harm brain cells directly, however, the research team believe it may cause neuroinflamation, a condition which leads to disorders such as Multiple Sclerosis.

While other harmful side effects of smoking, such as lung disease, usually derive from tar or smoke this research suggests damage is not confined only to smoking. NNK is present in all forms of tobacco and therefore it can also enter the body through chewing.

The study also suggests that second hand smoking may lead to the same neuroinflamation conditions. Concentrations of NNK in tobacco can vary from 20-310 nanograms in cigarettes. However, NNK is also present in the smoke itself, meaning that smoke-filled air indoors may contain up to 26 nanograms of NNK. This means that both direct and second-hand smoking can lead to substantial measures of NNK intake.

Steve - like you needed another reason to stop smoking right? You know who you are. Do us all a favor and stop smoking!

Monsanto, Dole to collaborate on veggies

Monsanto Co and Dole Fresh Vegetables Inc are formalizing a partnership to breed vegetables that are more attractive to consumers.

The five-year collaboration will focus on creating variations of broccoli, cauliflower, lettuce and spinach, the companies said on Tuesday.

The results could include vegetables that are more colorful, tastier, less susceptible to bruising and have a longer shelf-life.

"If I buy broccoli on Saturday or Sunday and try to cook it on Wednesday, it'll get wilty," said Monsanto spokeswoman Riddhi Trivedi-St. Clair.

She also stressed that these new variants will not be genetically modified like the company's much larger corn seed and soybean products.

Also known for its herbicide business, Monsanto has been aggressively growing its vegetable business with recent moves such as the 2005 acquisition of Seminis, which gave Monsanto control over more than 30 percent of the North American vegetable seed market.

In 2008, Monsanto acquired Netherlands-based De Ruiter Seeds, whose focus is in greenhouse vegetable growers as opposed to the open-field expertise of Seminis.

Dole had been Monsanto's customer for decades before announcing the partnership on Tuesday, said Dole spokesman Marty Ordman.

Last year, Monsanto also entered into an agreement with Landec Corp's packaged food-maker Apio to develop broccoli and cauliflower products.

If new products are created under the collaboration, they could be sold by Dole in North America.

Steve - now do you see why Monsanto wants legislation passed that wiill allow them to corner the market on every seed sold in the United States. They see the trend towards greater fruit and vegetable consumption and they want to shove the small farmers and invidual growers out of the picture.

Can Supporting Mitochondrial Function Promote Cognitive Health?

by Dr. Alan Gaby MD

Mitochondrial function declines with advancing age, and there is evidence from animal studies that mitochondrial dysfunction may contribute to brain aging and neurodegeneration. Several different factors appear to play a role in mitochondrial decay, including oxidative damage to mitochondrial lipids, proteins, and DNA, and a decrease in the activity of enzymes involved in ATP production. Antioxidants such as vitamin E, vitamin C, selenium, and alpha-lipoic acid have the potential to protect mitochondrial integrity; magnesium, riboflavin, niacinamide, and coenzyme Q10 may improve mitochondrial energy production by directly activating enzymes involved in the electron-transport chain; and L-carnitine may improve mitochondrial energy production by facilitating the transport of fatty acids into mitochondria. It is one of the axioms of nutritional therapy that combinations of nutrients are often more supportive than any one nutrient by itself. The possibility that using various combinations of the nutrients mentioned above could slow age-related cognitive decline and other manifestations of aging is an exciting area for future research.

Tuesday, June 23, 2009

Can vitamin D, fish oil prevent cancer, heart disease? Study to target blacks in particular

Vitamin D and fish oil will be tested in a large, government-sponsored study to see whether either nutrient can lower a healthy person's risk of getting cancer, heart disease or having a stroke.

It will be one of the first big nutrition studies ever to target a specific racial group — blacks, who will comprise one quarter of the participants.

People with dark skin are unable to make much vitamin D from sunlight, and researchers think this deficiency may help explain why blacks have higher rates of cancer, stroke and heart disease.

The new study, which will start later this year, will enroll 20,000 people with no history of heart attacks, stroke or a major cancer — women 65 or older and men 60 or older. They will be randomly assigned to take vitamin D, fish oil, both nutrients or dummy pills for five years.

The daily dose of vitamin D will be about 2,000 international units of D-3, also known as cholecalciferol, the most active form. For fish oil, the daily dose will be about one gram — five to 10 times what the average American gets.

Participants' health will be monitored through questionnaires, medical records and in some cases, periodic in-person exams.

Researchers also plan to study whether these nutrients help prevent memory loss, depression, diabetes, osteoporosis and other problems, Buring said.

The $20 million study will be sponsored by the National Cancer Institute, with the National Heart, Lung and Blood Institute and other federal agencies. Pharmavite LLC of Northridge, Calif., is providing the vitamin D pills, and Ocean Nutrition Canada Ltd. of Dartmouth, Nova Scotia, is providing the omega-3 fish oil capsules.

Steve - leave it to the government to put together another flawed study.

1) Five years is not long enough for a prevention study.
2) Why they are choosing adults over 65 years and older is beyond belief. Even if they have no history of disease, they should start much younger.
3) How will they know if it is the vitamin D or fish oil that is beneficial, harmful, or neutral if taken together?

However, I will give them credit for targeting the black population, which needs a study with these nutrients. They also are using adequate nutrient doses and sources for the study.

Ritalin: the next brain-booster?

Healthy people should be able to take the anti-hyperactivity drug Ritalin to boost brain power. Bioethics expert Professor John Harris, of the University of Manchester, said if the drug was safe for children, adults should also be able to take it. Writing in the British Medical Journal, he said many students were already using the drug - which is illegal without prescription in the UK. US experts said there were too many risks for it to be more widely used.

Ritalin, also known as methylphenidate, is given to children with ADHD - attention deficit hyperactivity disorder. Many doctors say it can help children control their behavior and perform better at home and school. There is increasing evidence that healthy adults, especially students, are using it to enhance their mental ability.

Professor Harris said Ritalin's benefits included enhanced study skills and concentration. He said it was "unethical" to stop healthy people from taking the drug and that there was evidence it was safe to use. And he added: "Safe always means safe enough and since no drugs are free of side effects, that always means the consumer has judged the risks of adverse effects worth taking, given the probable benefits." Professor Harris said that if it was safe for children to use Ritalin over a long period of time for a condition that was not usually life-threatening, there was no reason to prevent healthy adults using it too. He said it was "not rational" to be against human enhancement and likened using drugs to enhance brain power to the use of "synthetic sunlight" - firelight, lamplight and electric light. "Before synthetic sunshine people slept when it was dark and worked in the light of day. "With the advent of synthetic sunshine, work and social life could continue into and through the night, creating competitive pressures and incentives for those able or willing to use it to their advantage."

Professor Anjan Chatterjee, of the University of Pennsylvania, said there were too many risks in taking Ritalin unless a person was actually ill. He said the US Food and Drug Administration had labeled it with a "black box" - the most alarming of possible warnings - because of its high potential for abuse, dependence, risk of sudden death and serious adverse effects on the heart. “ It is not acceptable to recommend that healthy people take drugs to enhance performance ”

Professor Anjan Chatterjee, University of Pennsylvania Professor Chatterjee questioned whether children at top schools would take Ritalin in "epidemic proportions" and if people such as pilots, police officers and on-call doctors would be pressurized into taking the drug to perform better.

Bonnie - while it may seem obvious that Dr. Harris is a mouthpiece for Big Pharma, he has no known ties to the industry. So this is what our society has come to? As an ethicist, has he taken into account the ramifications of this conclusion? What is crazy is that he is not the only scientists to come out and say this.

Did Dr. Harris look at the long-term data on stimulant medication? He couldn't have, because until recently there has been very little. There are cases of sudden, unexplained deaths of adolescents that are now being linked to ADHD medication. And Dr. Harris wants to make this available to entire population?

I have never gotten in the way of innovation if I believe it is for the greater good, but as I blogged in April, I feel confident that making attention deficit medicine as readily available as caffeine will not advance us as a society.

Monday, June 22, 2009

Gluten sensitivity: A long road toward discovery.

This story by Mary Montali that appears in the LA Times expresses the difference between diagnosing gluten sensitivity and celiac disease. As I have said, even if the celiac test come back negative, it can still mean mean that you have a gluten sensitivity. And it takes a long time, if ever, to diagnose. Mary explains this very well.

Friday, June 19, 2009

Higher Purpose Reduces Risk Of Death Among Older Adults

Possessing a greater purpose in life is associated with lower mortality rates among older adults according to a new study by researchers at Rush University Medical Center.

Patricia A. Boyle, PhD, and her colleagues from the Rush Alzheimer’s Disease Center, studied 1,238 community-dwelling elderly participants from two ongoing research studies, the Rush Memory and Aging Project and the Minority Aging Research Study. None had dementia. Data from baseline evaluations of purpose in life and up to five years of follow-up were used to test the hypothesis that greater purpose in life is associated with a reduced risk of mortality among community-dwelling older persons.

Purpose in life reflects the tendency to derive meaning from life’s experiences and be focused and intentional, according to Boyle.

After adjusting for age, sex, education and race, a higher purpose of life was associated with a substantially reduced risk of mortality. Thus, a person with high purpose in life was about half as likely to die over the follow-up period compared to a person with low purpose. The association of purpose in life with mortality did not differ among men and women or whites and blacks, and the finding persisted even after controlling for depressive symptoms, disability, neuroticism, the number of medical conditions and income. During the study period, 151 participants died.

“The finding that purpose in life is related to longevity in older persons suggests that aspects of human flourishing—particularly the tendency to derive meaning from life’s experiences and possess a sense of intentionality and goal-directedness—contribute to successful aging,” said Boyle.

Significant associations with mortality were found with three specific items on the purpose of life questionnaire to determine the study participants’ agreement with the following statements: “I sometimes feel as if I’ve done all there is to do in life;” “I used to set goals for myself, but that now seems like a waste of time;” and “My daily activities often seem trivial and unimportant to me.”

“We are excited about these findings because they suggest that positive factors such as having a sense of purpose in life are important contributors to health,” said Boyle.

The study is published in Psychosomatic Medicine.

Bonnie - boy is this study right on. Especially for those in their twilight years, finding a purpose or refusing to give up on a lifelong purpose is essential.

Thursday, June 18, 2009

Appetite-stimulating Hormone Is First Potential Medical Treatment For Frailty In Older Women

Older women suffering from clinical frailty stand to benefit from the first potential medical treatment for the condition, according to a study presented today by Penn Medicine researchers. Ghrelin, a hormone that stimulates appetite, was administered to older women diagnosed with frailty, a common geriatric syndrome characterized by unintentional weight loss, weakness, exhaustion and low levels of anabolic hormones which increases risk of falls, hospitalizations, disability, and death.

Those who received ghrelin infusions consumed 51 percent more calories than the placebo group, with an increase in carbohydrate and protein intake, not fat. Their growth hormone levels were also higher throughout the ghrelin infusion.

Bonnie - as we know ghrelin and leptin ae the hunger hormones. As we age, our ghrelin hormones begin to fade. It would make perfect sense to try to increase those levels, or compenaste with extra leptin. The question remains as with every synthetic medication, does the drug's effectiveness supercede the side effects (if any, which is unknown as of now)?

Personality Linked to Ability to Withstand Stress

Our ability to withstand stress-related, inflammatory diseases may be associated, not just with our race and sex, but with our personality as well, according to a study published in the July issue of the journal Brain, Behavior and Immunity. Especially in aging women, low levels of the personality trait extraversion may signal that blood levels of a key inflammatory molecule have crossed over a threshold linked to a doubling of risk of death within five years.

An emerging area of medical science examines the mind-body connection, and how personality and stress contribute to disease in the aging body. Long-term exposure to hormones released by the brains of people under stress, for instance, takes a toll on organs. Like any injury, this brings a reaction from the body's immune system, including the release of immune chemicals that trigger inflammation in an attempt to begin the healing process. The same process goes too far as part of diseases from rheumatoid arthritis to Alzheimer's disease to atherosclerosis, where inflammation contributes to clogged arteries, heart attacks and strokes.

The current study found that that extroverts, and in particular those high "dispositional activity" or engagement in life, have dramatically lower levels of the inflammatory chemical interleukin 6 (IL-6). Swiss psychiatrist Carl Jung defined extroverts as focused on the world around them and most happy when active and surrounded by people. Extraversion is a personality trait with three parts: a tendency toward happy thoughts, a desire to be around others and "dispositional energy," a sense of innate vigor or active engagement with life ("I'm bursting with energy; my life is fast-paced"). Other dimensions of extraversion, such as sensation-seeking, have also been proposed. Introverts looked inward and were shy.

While it may difficult for patients to change their nature, part of the solution may be physical exercise as a therapy. The activity component of extraversion has been linked with exercise by past studies, as has daily physical activity with lower IL-6 levels in the aging. Still, the team is not convinced that exercise represents the whole answer.

Bonnie - very interesting stuff. The recent finding linking older adult health with having a purpose in life shows once again the innate between emotional and physical health.

Wednesday, June 17, 2009

Higher risk of blood disoreder for pesticide appliers

A study that appears in Blood. involving 678 individuals who apply pesticides, culled from a U.S. Agricultural Health Study of over 50,000 farmers, recently found that exposure to certain pesticides doubles one's risk of developing an abnormal blood condition called MGUS (monoclonal gammopathy of undetermined significance) compared with individuals in the general population. The disorder, characterized by an abnormal level of a plasma protein, requires lifelong monitoring as it is a pre-cancerous condition that can lead to multiple myeloma, a painful cancer of the plasma cells in the bone marrow.

The researchers also evaluated the potential association between MGUS prevalence and 50 specific pesticides. Of the chemicals studied, a significantly increased risk of MGUS was observed among users of dieldrin (an insecticide), carbon-tetrachloride/carbon disulfide (a fumigant mixture), and chlorothalonil (a fungicide). The MGUS risk for these agents increased 5.6-fold, 3.9-fold, and 2.4-fold, respectively. Several other insecticides, herbicides, and fungicides were associated with MGUS, but not significantly.

Tuesday, June 16, 2009

Loss of Sense of Smell with Zicam Intranasal Cold Remedies

FDA is alerting consumers that Zicam Cold Remedy Nasal Gel, Zicam Cold Remedy Nasal Swabs, and Zicam Cold Remedy Swabs, Kids Size, a discontinued product that consumers may still have in their homes, have all been associated with long lasting or permanent loss of smell (referred to as anosmia). These products, marketed by Matrixx Initiatives, are zinc-containing, nasal cold remedies used to reduce the duration and severity of cold symptoms. However, these products have not been shown to be effective in the reduction of the duration and severity of cold symptoms.

This advisory does not concern oral zinc tablets and lozenges taken by mouth.

FDA recommends that consumers stop using these products and throw them away. See the FDA website for How to Dispose of Unused Medicines.

Since the introduction of Zicam Cold Remedy Nasal Gel to the market in 1999, FDA has received more than 130 reports of anosmia associated with the use of Zicam zinc-containing intranasal products. The reports vary. Many people state that the loss of sense of smell occurred with the first dose of the Zicam product, although some people report it happened after later doses. The loss of sense of smell may be long-lasting or even permanent in some people.

FDA recommends that consumers contact their healthcare provider if they experience loss of the sense of smell or taste, or experience other problems after using any zinc-containing nasal products.

Adverse reactions or quality problems experienced with the use of this Product may be reported to the FDA's MedWatch Adverse Event Reporting program either online, by regular mail or by fax, using the contact information at the bottom of this sheet.

Bonnie - I recommended this product years ago and never received a complaint. However, based upon the reports several years ago about the loss of sense of smell, I stopped recommending it.

Chemistry of cooking

Bonnie - I thought there were some interesting tidbits in this article:

A biochemist and cook explains that cooking is all about chemistry and knowing some facts can help chefs understand why recipes go wrong. Because cooking is essentially a series of chemical reactions, it is helpful to know some basics. For example, plunging asparagus into boiling water causes the cells to pop and result in a brighter green. Longer cooking, however, causes the plant's cell walls to shrink and releases an acid. This turns the asparagus an unappetizing shade of grey.

You love to cook, but have you whipped up some disasters? Even the best recipes can sometimes go terribly wrong. A nationally recognized scientist and chef says knowing a little chemistry could help.

Long before she was a cook, Shirley Corriher was a biochemist. She says science is the key to understanding what goes right and wrong in the kitchen.

"Cooking is chemistry," said Corriher. "It's essentially chemical reactions."

This kind of chemistry happens when you put chopped red cabbage into a hot pan. Heat breaks down the red anthocyanine pigment, changing it from an acid to alkaline and causing the color change. Add some vinegar to increase the acidity, and the cabbage is red again. Baking soda will change it back to blue.

Cooking vegetables like asparagus causes a different kind of reaction when tiny air cells on the surface hit boiling water.

"If we plunge them into boiling water, we pop these cells, and they suddenly become much brighter green," Corriher said.

Longer cooking is not so good. It causes the plant's cell walls to shrink and release acid.

"So as it starts gushing out of the cells, and with acid in the water, it turns cooked green vegetables into [a] yucky army drab," Corriher said.

And that pretty fruit bowl on your counter? "Literally, overnight you can go from [a] nice green banana to an overripe banana," Corriher said.

The culprit here is ethylene gas. Given off by apples and even the bananas themselves, it can ruin your perfect fruit bowl -- but put an apple in a paper bag with an unripe avocado, and ethylene gas will work for you overnight.

"We use this as a quick way to ripen," Corriher said. Corriher says understanding a little chemistry can help any cook.

"You may still mess up, but you know why," she said. When it works, this kind of chemistry can be downright delicious.

WHAT ARE ACIDS AND BASES? An acid is defined as a solution with more positive hydrogen ions than negative hydroxyl ions, which are made of one atom of oxygen and one of hydrogen. Acidity and basicity are measured on a scale called the pH scale. The value of freshly distilled water is seven, which indicates a neutral solution. A value of less than seven indicates an acid, and a value of more than seven indicates a base. Common acids include lemon juice and coffee, while common bases include ammonia and bleach.

WHY DOES FOOD SPOIL? Processing and improper storage practices can expose food items to heat or oxygen, which causes deterioration. In ancient times, salt was used to cure meats and fish to preserve them longer, while sugar was added to fruits to prevent spoilage. Certain herbs, spices and vinegar can also be used as preservatives, along with anti-oxidants, most notably Vitamins C and E.

Multivitamins reduce risk of low birth weight

Prenatal multivitamin supplements are associated with a significantly reduced risk of babies with a low birth weight, compared with prenatal iron-folic acid supplementation, according to a study in the Canadian Medical Association Journal.

The World Health Organization currently recommends iron-folic acid supplements for all pregnant women. “Low birth weight and related complications are considered the most common cause of global infant mortality under the age of 5 years,” wrote Prakash Shah of Mount Sinai Hospital in Toronto. “With the possibility of reducing low birth weight rates by 17%, micronutrients supplementation to pregnant women … offers the highest possible return for the investment,” he added. The authors suggest that approximately 1.5 million babies born with a low birth weight could be avoided each year globally, out of the estimated 20.6 million low-weight births.

Anti-depressants damage sperm while CoQ10 boost sperm

A study published online by the journal Fertility & Sterility states that as many as half of men taking the anti-depressant paroxetine (brand names, Seroxat and Paxil) have higher levels of sperm fragmentation. “It’s fairly well known that SSRI anti-depressants negatively impact erectile function and ejaculation. This study goes on step further, demonstrating that they can cause a major increase in genetic damage to sperm,” said Dr. Peter Schlegel, the study’s senior author and professor of reproductive medicine at Weill Cornell Medical College in New York. “Although this study doesn’t look directly at fertility, we can infer that as many as half of men taking SSRIs have a reduced ability to conceive. These men should talk with their physicians about their treatment options,” he added.

In another study, supplements of co-enzyme Q10 (CoQ10) may improve the motility and density of sperm in infertile men, according to a study in Journal of Urology. 212 infertile men were randomly assigned them to receive a daily CoQ10 supplement (300 mg.) or placebo for 26 weeks. This was followed by 30 weeks with no intervention. The researchers reported a significant improvement in both sperm density and motility following supplements of the coenzyme. A positive association was also found with regards to sperm count. Further analysis showed an increase in the percent of normal forms of sperm. Finally, an increase in the acrosome reaction of over 100 per cent was observed in the CoQ10 group, compared to a 1 per cent increase in the placebo group. The acrosome reaction aids in egg penetration, and subsequently fertilization.

Steve - this is a nice cross-section of how two substances can alter the body in a positive and negative fashion.

Monday, June 15, 2009

ADHD drugs under fire for unexplained child deaths

After years of speculation and rare case reports, a study suggests that stimulant medication -- mostly used to treat attention deficit hyperactivity disorder -- may have played a role in a handful of cases of sudden, unexplained death in children and adolescents.

"The association is significant in that it's real, but that doesn't mean it's not a very low risk," says lead author Madelyn S. Gould, Ph.D., a professor of psychiatry and public health at Columbia University, in New York. "There probably does need to be more careful monitoring, but the bottom line is that parents should not take their children off stimulant medication they're currently on and should not be scared to have their child go on a stimulant if that's what they and their doctors decide is the best thing for their child."

The study, published this week in the American Journal of Psychiatry, is the first to suggest that the stimulants may pose a risk -- albeit remote -- in children without underlying heart problems. About 2.5 million children in the United States take such medications.

Gould and her colleagues compared medical records and parent interviews of children and adolescents who had died between the years of 1985 and 1996, including 564 who had died from an unexplained heart-rate abnormality or other causes, and 564 who died as passengers in motor vehicle accidents. They excluded cases with other known possible causes of death, such as asthma or congenital heart diseases.

Of all the unexplained cases, the researchers found that 10 children, or 1.8 percent of the group, had had stimulant medication prescribed. This compared with only two cases of stimulant use, or 0.4 percent, among healthy children who had died in motor vehicle accidents -- a group used to represent a general population of healthy children and adolescents.

In all 10 cases, the children were taking methylphenidate, the active ingredient in Ritalin and Concerta. A similar drug, Adderall, is composed of mixed amphetamine salts and was not included in the study results because it was first approved in 1996.

The study was funded by a grant from the NIMH and a contract with the FDA.

Bonnie - what this study shows is that the laissez aire attitude in prescribing of these medications should come to an end.

Research Highlights - June

Journal Nutrition

Several dietary substances have been hypothesized to influence the risk of preeclampsia. The aim of this study was to estimate the association between dietary patterns during pregnancy and the risk of preeclampsia in 23,423 nulliparous pregnant women taking part in the Norwegian Mother and Child Cohort Study. Principal component factor analysis identified 4 primary dietary patterns that were labeled: vegetable, processed food, potato and fish, and cakes and sweets. Women with high scores on a pattern characterized by vegetables, plant foods, and vegetable oils were at decreased risk. Women with high scores on a pattern characterized by processed meat, salty snacks, and sweet drinks were at increased risk.

These findings suggest that a dietary pattern characterized by high intake of vegetables, plant foods, and vegetable oils decreases the risk of preeclampsia, whereas a dietary pattern characterized by high consumption of processed meat, sweet drinks, and salty snacks increases the risk.

American Journal Preventative Medicine

College students maintain a wide array of food and beverages in their dormitory rooms. Parents purchased a substantial amount of food for their children's dormitory rooms, and these food items were less healthful than the food that students purchased. The foods observed in college students' living spaces may have an important impact on eating habits. Overall, young adult–oriented obesity prevention efforts are needed, and improving the various facets of campus food environments may mark an important component of such strategies.

Journal of Allergy and Clinical Immunology

Serum folate levels were inversely associated with total IgE levels. The odds of a high total IgE level, atopy, and wheeze decreased across quintiles of serum folate levels, indicating a dose-response relationship between serum folate levels and these outcomes. Each of these associations remained statistically significant after adjusting for age, sex, race/ethnicity, and poverty index ratio. Higher folate levels were also associated with a lower risk of doctor-diagnosed asthma.

Another study sought to evaluate whether 18-year-old offspring are likely to have the same allergic sensitizations as their parents. Eighteen-year-old participants in an unselected birth cohort and their parents were tested for total and increased levels of allergen-specific IgE to 6 allergens: Dermatophagoides farinae, dog, cat, grass, ragweed, and Alternaria alternata.

In 316 parent-teen triads parental sensitization to any of 6 allergens was associated with teen sensitization to any of those same allergens. An increased risk of matched sensitization was found after adjusting for the spouse's sensitivities and adjusting for other allergens. Risk of maternal matched sensitization with their teen to cat, grass, and A alternata was increased when compared with that seen in teens without parental allergen-specific sensitization. Similarly, a higher than expected risk of paternal matched sensitization with their teen to dog was observed.

In conclusion, parental allergen-specific IgE increases the likelihood of sensitization to the same allergen in young adult offspring.

Bariatric surgery increases fracture risk

After weight loss surgery, people have nearly twice the expected risk of breaking a bone and an even higher risk of a foot or hand fracture.

"This finding is unexpected," said study co-author Jackie Clowes, MD, PhD, assistant professor of medicine at Mayo Clinic, Rochester, Minn. "The established opinion is that obesity protects against osteoporosis and, therefore, fractures."

Past research shows that bariatric surgery results in an increased bone turnover, the rate of bone breakdown and bone formation.

The researchers therefore reviewed the medical records of patients who had bariatric surgery to treat medically complicated obesity, performed at Mayo Clinic between 1985 and 2004, and looked at data, including postoperative fractures. So far, the authors have analyzed data for 97 of the 292 patients whose records are available.

Bonnie - why would this be unexpected? Unless the patient eats perfectly and takes the correct supplements after surgery, there will be bone loss issues.

Red wine's benefits detailed once again

The benefits of alcohol are all about moderation. Low to moderate drinking – especially of red wine – appears to reduce all causes of mortality, while too much drinking causes multiple organ damage. A mini-review of recent findings on red wine's polyphenols, particularly one called resveratrol, will be published in the September issue of Alcoholism: Clinical & Experimental Research.

Key points of the review include:

  • Resveratrol exhibits therapeutic potential for cancer chemoprevention as well as cardioprotection.

"It sounds contradictory that a single compound can benefit the heart by preventing damage to cells, yet prevent cancer by causing cell death, said researchers. "The most likely explanation for this, still to be rigorously proved in many organs, is that low concentrations activate survival mechanisms of cells while high concentrations turn on the in-built death signals in these cells."

  • Resveratrol may aid in the prevention of age-related disorders, such as neurodegenerative diseases, inflammation, diabetes, and cardiovascular disease.

"The simplest explanation is that resveratrol turns on the cell's own survival pathways, preventing damage to individual cells," said researchers. "Further mechanisms help, including removing very reactive oxidants in the body and improving blood supply to cells."

  • Low doses of resveratrol improve cell survival as a mechanism of cardio- and neuro-protection, while high doses increase cell death.

"The key difference is probably the result of activation of the sirtuins in the nucleus," said researchers. "Low activation reverses age-associated changes, while high activation increases the process of apoptosis or programmed cell death to remove cellular debris. Similar changes are seen with low-dose versus high-dose resveratrol: low-dose resveratrol produces cellular protection and reduces damage, while high-dose resveratrol prevents cancers."

In summary, noted researchers, current scientific research is starting to explain reports from the last 200 years that drinking red wine improves health. "It is a cliché that 'nature is a treasure trove of compounds,' but studies with resveratrol show that this is correct! We need to understand better the vast array of compounds that exist in nature, and determine their potential benefits to health."

"There is one particular point that deserves fleshing out," added researchers. "Resveratrol is largely inactivated by the gut or liver before it reaches the blood stream, where it exerts its effects – whatever they may be – good, bad, or indifferent. Thus, most of the reseveratrol in imbibed red wine does not reach the circulation. Interestingly, absorption via the mucous membanes in the mouth can result in up to around 100 times the blood levels, if done slowly rather than simply gulping it down. Of course, we don't know if these things matter yet, but issues like this are real and generally ignored by all."

Steve - this review also puts into question the viability of extraction into more potent supplemental or drug forms.

FDA strengthens warning on asthma drug and vaccine

The Food and Drug Administration strengthened warnings on Merck & Co.'s Gardasil (HPV virus) vaccine about fainting after receiving reports of "traumatic injuries" among some vaccine recipients.

The asthma medication Singulair, and similar medicines should come with a caution about reports of psychiatric problems in some patients. The F.D.A. requested a precaution in the prescribing instructions for Singulair, Accolate from AstraZeneca and Zyflo and Zyflo CR from Cornerstone Therapeutics.

Local physician comments on recent negativity towards alternative medicine

Dr. Patrick Massey's column in the Daily Herald.

Friday, June 12, 2009

Think Thyroid

"I would love to see an article on hypothyroidism. Over 20 years ago, after several miscarriages, I was put on natural Armour thyroid extract because I was told I had an underactive thyroid. After five very early miscarriages, I successfully carried through with my two pregnancies (one a twin pregnancy). After that I stopped taking the Armour although I probably should have continued because I felt the best I ever had with lots of energy while on it." Fran, eNewsletter subscriber

Your thyroid is a small, butterfly-shaped gland located at the base of the front of your neck, just below your Adam's apple. Hormones produced by the thyroid gland have an enormous impact on your health, affecting
all aspects of your metabolism. Thyroid maintains the rate at which your body uses fats and carbohydrates, helps control your body temperature, influence your heart rate and helps regulate the production of protein. Thyroid gland also produces calcitonin, a hormone that regulates the amount of calcium in your blood.

Most of us know about hyperthyroidism - where the thyroid gland becomes over-active. The usual treatment is radioactive iodine to reduce and normalize thyroid function.

Hypothyroidism is much more common than hyperthyroidism, yet most sufferers don’t even know they have the problem. An underactive thyroid develops when the thyroid gland produces too little thyroxine, and it is becoming more prevalent because of our aging population. Typical symptoms include extreme fatigue, aches, constipation, gaining weight (or being unable to take it off), feeling cold, and losing head and eyebrow hair.

Thyroid Disorders Often Misdiagnosed
Approximately 11 million Americans, particularly women over 50, have an underactive thyroid, which can be diagnosed with a simple blood test (we always recommend testing for T3, T4, T-Uptake, and most importantly, TSH). Because symptoms of hypothyroidism can mimic other conditions, incorrect diagnosis and treatment can be serious. If the aforementioned thyroid tests are normal, but symptoms persist, an autoimmune thyroid panel, usually ordered by an endocrinologist, may be necessary.

Iodine Deficiency
One reason for the recent increase in hypothyroidism is the gradual reduction of iodine in our diet. Many people avoid iodine-rich foods, such as salt and eggs, for health reasons. Heavily processed foods may also contain less iodine.

If an iodine deficiency has been detected, and provided it’s not too severe, the patient can reverse the problem with a self-help program that involves consuming more iodine-rich foods, and supplementing with iodine and selenium.

If medication is warranted, we always suggest trying a natural form of thyroxine (such as Armour), before going to synthetic. Natural thyroid medication also addresses T3, while most synthetics do not.

If you have been on synthetic thyroxine (such as Synthroid) for one year, your own thyroid will diminish so that continuation of medication needs to be forever. Most people don't realize this until it is too late. I have had many patients do very well with the natural form. It always leaves the possibility for you to reestablish thyroid function without assistance.

Celiac Disease Linked to Thyroid Disorders
Individuals with celiac disease or even mild gluten intolerance are at significantly increased risk for developing thyroid disorders. Researchers studied the long-term risk of thyroid disease in more than 14,000 individuals diagnosed with celiac disease between 1964 and 2003 and some 68,000 subjects without celiac disease. They found that people with celiac disease had a greater than fourfold increased risk of being diagnosed with hypothyroidism, a threefold increased risk of suffering hyperthyroidism, and a 3.6-fold increased risk of developing thyroiditis. The association was seen in all strata (males, females, children, and adults) according to the study in Journal of Clinical Endocrinology and Metabolism.

Ruling out celiac or gluten intolerance is incredibly important. We have seen this with many clients. Once the damage is done, it is very hard to reverse, so early diagnosis and prevention is of the utmost importance.

Environmental Chemicals May Interfere With Thyroid Function
Over the years, numerous chemicals have been removed from production because of their role in endocrine disruption. Because the Environmental Protection Agency has no long-term studies on most chemicals, thousands more may be affecting us.

Recently, hormone experts at The Endocrine Society said they have gathered a growing body of evidence to show Bisphenol A, also known as BPA, might damage human health through negative epigenetic expression.

BPA, used to stiffen plastic bottles, line cans and make smooth paper receipts. Of course, the FDA's official position is that there is not enough evidence that BPA shows harm. As the evidence mounts, the FDA is beginning to cave.

We all house numerous environmental chemicals in our bodies. The key is to assure that we are passing those chemicals through our bodies (detoxification) and not letting them build up. When excess build up occurs, thyroid dysfunction may result.

Numerous human and animal studies have demonstrated that psychological and physiologic stressors induce various immunologic changes. Stress affects the immune system either directly or indirectly through the nervous and endocrine systems. These immune modulations may contribute to the development of autoimmunity as well as the susceptibility to autoimmune disease in genetically predisposed individuals. Thus, stress can be one of the environmental factors for thyroid autoimmunity.

Miscellaneous Tidbits
  • Raw cruciferous vegetables contain thyroid inhibitors known as goitrogens. People who have hypothyroid dysfunction should limit consumption or steam the vegetables, which significantly reduces the goitrogenic content.
  • Excess intake of soy may interfere with thyroid function and thyroid medication, especially for individuals who are iodine deficient. Fish is a great food choice for all thyroid deficiencies.
  • If supplementing with selenium above what is in a multivitamin/mineral, its important to also supplement with extra iodine. Click here for our suggestions for recommended amounts of iodine.
  • If you are taking thyroid medication, all minerals, fiber supplements, and foods containing large amounts of minerals and fiber must be taken at least one hour away from thyroid medication.
We should have a detailed Thyroid Action Plan available in the near future.

Healthcare focus should be on nutrition

Nearly 96% of primary care physicians believe the nation’s healthcare system should place more emphasis on nutrition to treat and manage chronic disease, according to a new survey. Based on the 400 physicians surveyed, primary care physicians were almost unanimous in their belief that nutrition is a key role in chronic disease.“Nutrition is more than just eating a healthy diet; for patients with chronic disease nutrition acts as therapy to help them heal faster, respond better to medical care and control their disease,” said Jane V. White, PhD, LDN, RD, FADA, with the department of Family Medicine at the University of Tennessee Graduate School of Medicine, who partnered with the American Dietetic Association on the survey.

Nearly half of all adults in the United States have at least one chronic disease and survey showed that physicians believed two-in-three of their adult patients who have chronic disease would benefit from nutrition services. Nevertheless, 80% of physicians admit they refrain from addressing nutrition more frequently as part of chronic disease prevention and management due to the lack of direct reimbursement for nutrition services. As the focus on healthcare reform and preventative care becomes more concentrated, physicians are pushing for governmental action.

Bonnie - the comment I highlighted is at the core of what is wrong with our health care system. Doctors admitting they do not discuss nutrition because it does not bring financial gain! I have known this forever, but I cannot understand how they can live with themselves. Implementing and utilizing prevention brings such a better quality of life than our current "dog chasing its tail" model.

Empty carbs raise CVD risk

Eating a diet rich in carbohydrates that boost blood sugar levels -- foods such as cornflakes or white bread -- may hamper the functioning of your blood vessels and raise your risk of developing cardiovascular disease, according to a new study suggests in Journal of the American College of Cardiology. And another study, released Thursday at the Endocrine Society's annual meeting in Washington, D.C., found that people might actually feel fuller -- and might therefore eat less -- if they cut back a bit on carbohydrates in their diet.

Bonnie - what a shocker!

Thursday, June 11, 2009

Exercise, Education Keep You Sharp in Old Age

If you want your mind to stay sharp when you're 90, here's what you'll need to do. Exercise moderately or vigorously at least once a week, live with someone, avoid smoking and continue to volunteer or work into your 70s or 80s. A new study shows that seniors with at least a high school education and a ninth-grade literacy level who followed such a lifestyle were more likely to stay mentally fit than those who didn't. The study appears in the June 9 issue of Neurology.

As time passed, many of the participants showed decline in cognitive function -- about 53 percent experienced minor cognitive decline and 16 percent showed major cognitive decline. But about 30 percent of the participants showed no cognitive decline -- and a few even improved their scores on cognitive tests. So, what separated those who experienced mental decline from those who stayed sharp? Seniors who exercised moderately to vigorously at least once a week were 30 percent more likely to maintain their cognitive function than those who didn't exercise that often, according to the study. Those who had at least a high school education were nearly three times as likely to stay sharp as those who had less education, while older adults with a ninth-grade literacy level or higher were nearly five times as likely to avoid mental decline as those with lower literacy levels. Nonsmokers were nearly twice as likely to stay sharp as those who smoke. And seniors still working or volunteering were 24 percent more likely to maintain cognitive function, as were people who didn't live alone.

Bonnie - seems like an easy model to follow right? Unfortunately, many seniors do not adhere to this criteria. Get up off the couch and away from the television!

Prevention as Most Important Health Reform Priority

Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) released a new public opinion survey, which finds that Americans rank prevention as the most important health care reform priority, and overwhelmingly support increasing funding for prevention programs to reduce disease and keep people healthy. In the poll, conducted by Greenberg Quinlan Rosner Research and Public Opinion Strategies, 70 percent of Americans ranked investing in prevention between an eight and 10 on a scale of zero to ten, where zero means not at all an important health care priority and 10 means very important. Forty-six percent rated prevention as a 10 out of 10. Overall, prevention was rated higher than all other proposals, including providing tax credits to small businesses and prohibiting health insurers from denying coverage based on health status.

More than three-quarters of Americans (76 percent) support increasing funding for prevention programs that provide people with information and resources and creating policies that help people make healthier choices. Investing in prevention is popular across the political spectrum, with 86 percent of Democrats, 71 percent of Republicans, and 70 percent of Independents supporting investing more in prevention.

While Americans believe that prevention will save money (77 percent agree with the statement that "prevention will save us money"), they strongly support prevention regardless of its impact on costs. Rather, they point clearly to keeping people healthy as the best reason to invest in prevention, with 72 percent agreeing with the statement that "investing in prevention is worth it even if it doesn't save us money, because it will prevent disease and save lives."

Additionally, 57 percent agree more with the statement "we should invest in prevention to keep people healthier and improve quality of life" than the statement "we should invest in prevention to lower health care costs" (21 percent). Americans believe the nation needs to put more emphasis on prevention (59 percent) rather than thinking there needs to be more emphasis on treatment (15 percent), by nearly a four to one ratio. This represents a significant shift toward prevention over the last two decades -- in 1987, only 45 thought there should be greater emphasis on prevention. The poll reflects the responses from 1,014 registered voters, was conducted by Greenberg Quinlan Rosner Research and Public Opinion Strategies from May 7 to 12, 2009. The margin of error was +/- 3.1 percent.

Steve - can we count on our political leaders to respond to the public's desires instead of the Pharmacological, Insurance, and Medical lobbies?

Health Risks Of Nanotechnology

Scientists have identified for the first time a mechanism by which nanoparticles cause lung damage and have demonstrated that it can be combated by blocking the process involved, taking a step toward addressing the growing concerns over the safety of nanotechnology.

Nanotechnology, the science of the extremely tiny (one nanometer is one-billionth of a meter), is an important emerging industry with a projected annual market of around one trillion US dollars by 2015. It involves the control of atoms and molecules to create new materials with a variety of useful functions, including many that could be exceptionally beneficial in medicine. However, concerns are growing that it may have toxic effects, particularly damage to the lungs. Although nanoparticles have been linked to lung damage, it has not been clear how they cause it.

In a study published online June 11 in the newly launched Journal of Molecular Cell Biology Chinese researchers discovered that a class of nanoparticles being widely developed in medicine - ployamidoamine dendrimers (PAMAMs) – cause lung damage by triggering a type of programmed cell death known as autophagic cell death. They also showed that using an autophagy inhibitor prevented the cell death and counteracted nanoparticle-induced lung damage in mice.

Nanomaterials are now used in a variety of products, including sporting goods, cosmetics and electronics. The fact that unusual physical, chemical, and biological properties can emerge in materials at the nanoscale makes them particularly appealing for medicine. Scientists hope nanoparticles will be able to improve the effectiveness of drugs and gene therapy by carrying them to the right place in the body and by targeting specific tissues, regulating the release of drugs and reducing damage to healthy tissues. They also envision the possibility of implantable nano devices that would detect disease, treat it and report to the doctor automatically from inside the body. The US Food and Drug Administration has approved some first generation nanodrugs. One example is Abraxane, a nanoformulation of the anti-cancer chemotherapy paclitaxel.

Lung damage is the chief human toxicity concern surrounding nanotechnology, with studies showing that most nanoparticles migrate to the lungs. However, there are also worries over the potential for damage to other organs.

In the study, the researchers first showed, through several independent experiments, that several types of PAMAMs killed human lung cells in the lab. They did not observe any evidence that the cells were dying by apoptosis, a common type of programmed cell death. However, they found that the particles triggered autophagic cell death through the Akt-TSC2-mTOR signalling pathway. Autophagy is a process that degrades damaged materials in a cell and plays a normal part in cell growth and renewal, but scientists have found that sometimes an overactivity of this destruction process leads to cell death.

The researchers also found that treating the cells with an autophagy inhibitor known as 3MA significantly inhibited the process, increasing the number of cells that survived exposure to the nanoparticles.

"Those results, taken together, showed that autophagy plays a critical role in the nanoparticle-induced cell death," said Dr. Jiang.

The scientists then tested their findings in mice. They found that introducing the toxic nanoparticles significantly increased lung inflammation and death rates in the mice, but injecting the mice with the autophagy inhibitor 3MA before introducing the nanoparticles significantly ameliorated the lung damage and improved survival rates.

It is not clear whether other types of nanoparticles would cause lung damage via the same mechanism, but some may, Dr. Jiang said.

Steve - this is why we have abstained from recommending foods or dietary supplements that incorporate nanotechnology. There are too many unknowns at this time. We know the science has an incredible future, but as with most rapidly advancing science, the safety studies come after the fact.