Happy Meal has staying power (but for 137 days!)

Salon.com explores the secret to immortality of McDonald's food in this article. The chain's burgers can resist rot for years. Scientists explain why they have the shelf life of the undead.

And as long as we are on this topic, Bonnie still has in her office a 28 year-old Hostess cupcake that does not look much worse for wear!

Salt water therapuetic for sore throat

Courtesy of the NY Times

THE FACTS
Nothing but time can cure the common cold, but a simple cup of salt water might ease the misery this winter. A sore, itchy throat and respiratory congestion are some of the more common symptoms of a cold, and gargling with salt water seems to help for several reasons. A saline solution can draw excess fluid from inflamed tissues in the throat, making them hurt less, said Dr. Philip T. Hagen, editor in chief of the “Mayo Clinic Book of Home Remedies,” which is due out in October. Dr. Hagen pointed out that gargling also loosens thick mucus, which can remove irritants like allergens, bacteria and fungi from the throat.

In a randomized study published in the American Journal of Preventive Medicine in 2005, researchers recruited almost 400 healthy volunteers and followed them for 60 days during cold and flu season. Some of the subjects were told to gargle three times a day. At the end of the study period, the group that regularly gargled had a nearly 40 percent decrease in upper respiratory tract infections compared with the control group, and when they did get sick, “gargling tended to attenuate bronchial symptoms,” the researchers wrote. Other studies have also found gargling helpful against sore throats and congestion. According to the Mayo Clinic, for best results, dissolve half a teaspoon of salt in a full glass of warm water and gargle the solution for a few seconds before spitting it out. Adults who want a more palatable remedy against cough and sore throat can try mixing warm water with lemon and honey. No need to spit it out.

THE BOTTOM LINE Gargling with a saline solution can ease symptoms of a cold.

Shocker: kids don't drink enough water

Children in the United States are not drinking as much water as they should, and the deficiency can have far-reaching implications. For instance, impaired cognitive and mental performance are linked to inadequate hydration. According to the study published in the American Journal of Clinical Nutrition, only 15 to 60 percent of boys and 10 to 54 percent of girls, depending on age, drink the minimum amount of water recommended by the U.S. Institute of Medicine. Children obtain much of their water from sweetened beverages rather than plain water, the researchers found. And those who drink the most plain water consume fewer sweetened beverages and eat fewer high-calorie foods.

Researchers suggest giving children water instead of sweetened beverages during the day and between meals. If you need to make it more appealing, put sliced cucumbers, oranges, lemons or strawberries in ice water, the researchers suggested. And if your child is hooked on sodas, she advised transitioning to sparkling or flavored unsweetened waters.

Celiac can occur at any stage of life

Celiac disease is showing an increasing presence among the elderly, says a study in the Annals of Medicine. The study followed 3,511 volunteers who submitted blood samples in 1974 and 1989, and updates every two to three years until 2007. This study adds weight to the concept that celiac disease can emerge at any age, because researchers surveyed the same people over time. Researchers found that the incidence of celiac disease doubled every 15 years since 1974 and that the incidence increased as subjects aged, with some developing the disease in their 50s or 60s. If someone can be gluten-tolerant for 40 or 50 years before developing celiac disease, then environmental factors may outweigh genetic causes for the disease, says Alessio Fasano, director of the Center for Celiac Research, which led the study. Fasano says that other unknown environmental changes and changes in "the composition of bacteria in our guts" may be causing gluten autoimmunity to present itself later in life.

Bonnie - for those of you who are of the belief that one can just "grow out" of an intolerance to gluten, this study begs to differ. If wheat continues to be a daily staple of the human diet, we will continue to see more cases of gluten intolerance and celiac.

FIR Sauna season is here again

As the air begins to cool in many areas of the country, our Rejuvenating Room, featuring a Far Infrared Sauna, is just heating up.

According to Dr. Susan Lark, the reason why sunlight feels so good even when your skin is covered is the result of infrared radiation. Not only does it penetrate clothing, but skin, muscle, and even bone, delivering benefits directly to your cells. For those living in cold climates who rarely get adequate sun exposure, a dry Far Infrared Sauna can be a relaxing and therapeutic experience.

Aside from increasing detoxification through deep, dermal sweating, FIR can enhance photobiostimulation, a recharging of the mitochondria. FIR is special for its ability to penetrate tissues to a depth of more than nine inches without burning. Recent research has shown positive effects for myriad maladies, including Parkinson's symptoms relief, pain associated with Rheumatoid Arthritis, and immunodeficient individuals with bacterial and fungal infections.

Click here for details about our Rejuvenating Room and Far Infrared Sauna Therapy

Feds files complaint against POM Wonderful.

The Federal Trade Commission filed a complaint that challenges the company's statements that pomegranate can prevent and treat everything from heart disease to erectile dysfunction.

The agency called the claims -- found in advertisements in print publications and on the Internet -- "false and unsubstantiated" and based on flawed medical research.

In a story this March, the Chicago Tribune named POM Wonderful as one of several products on the market that made health claims in its advertising that are permissible only for FDA-approved drugs.

The FTC is asking a judge to issue an order that would require the company to stop making claims that pomegranate products can cure, prevent or treat any disease unless the claims are first approved by the U.S. Food and Drug Administration.

Among the advertising claims the FTC is challenging are that the product has "super health powers," that drinking an 8 ounce glass of POM Wonderful slows the rate of prostate cancer, that the juice can treat erectile dysfunction and that it has been proven reduce arterial plaque by 30 percent.

The administrative complaint does not mean the company has violated the law, the FTC said. A hearing has been scheduled for eight months from now before an administrative law judge.

Steve - this is a very complex issue. DSHEA is very specific about what you can and cannot say in directly promoting the benefits of your product. Just because POM has invested tens of millions of research into the health effects of their product does not mean they can promote that research legally. The supplement industry recently won a huge lawsuit against the FTC on this very issue. However, unless the DSHEA law is modified, these will only be individual victories.

Unfortunately, I think things are going to get worse, not better. The European Union has basically eradicated the individual's right to choose their own natural products/supplements to the point where they are basically classified as drugs. Many in Congress want to see this happen in the US.

In our opinion, the benefits of pomegranate are not up for debate. Independent research outside of the POM company has confirmed this. That said, there is a huge turf war for market share between the government, Big Pharma, and the natural products industry. Because POM appears to have brazenly gone against the rules of DSHEA in the eyes of the FTC, they are a ripe target.

Note that POM is also suing the FTC. To be continued...

Prestigious studies cite vitamins, diet for dementia prevention

According to a study citing the most important principles for prevention of dementia, researchers stated in International Journal of Clinical Practice: "There is some evidence that natural or high intake of vitamins B, C and E from food decreases dementia risk; however, there is insufficient evidence to recommend for or against supplementation with vitamins B, C and E for the prevention of dementia. Adherence to the 'Mediterranean diet' may affect not only risk for Alzheimer disease, but also subsequent disease course. Frequent consumption of fruits and vegetables, fish, and omega-3 rich oils may decrease the risk of dementia and Alzheimer's disease. Avoidance of tobacco can be recommended. There are potential advantages of moderate consumption of wine (specific doses cannot be stated, although effects on diseases other than dementia suggest beneficial associations with 1–2 glasses per day for men, and up to 1 glass for women).

Bonnie - the fact that they even mention vitamins B, C, and E is a small victory. You cannot fathom how conservative and anti-supplement many of the dementia and Alzheimer's researchers are. Of course they would be when so much of their funding comes from Big Pharma.

The Times crow's about quinoa

http://well.blogs.nytimes.com/2010/09/24/theres-something-about-quinoa/?ref=health

Nearly everyone fails to meet Dietary Guidelines, suggests study

Nearly the entire US population fails to eat a diet in line with the Dietary Guidelines for Americans, according to new research published in the Journal of Nutrition. The researchers, from the National Cancer Institute and the National Center for Nutrition Policy and Promotion, examined 2001-2004 NHANES (National Health and Nutrition Examination Survey) data including 16,338 individuals’ dietary habits. They found that more than 80 percent of those aged 71 and above, and more than 90 percent of all other age groups of both sexes, overconsumed discretionary calories – those that come from solid fats, added sugars and alcohol. A majority did not meet MyPyramid recommendations for every food group except total grains and meat and beans, the researchers found. “Nearly everyone” failed to meet recommendations for dark green vegetables, orange vegetables, legumes, and whole grains, which were the groups with the lowest adherence to recommendations.

“In conclusion, nearly the entire US population consumes a diet that is not on par with recommendations. These findings add another piece to the rather disturbing picture that is emerging of a nation’s diet in crisis,” the authors wrote.

Young adults were most likely to fall short of recommendations for fruits, milk and oils, and those aged 31 to 50 were most likely to drink too much alcohol. Moreover, the researchers applied their findings to the US food supply, which they said has oversupplied solid fats, added sugars, and sodium, and undersupplied fruits, vegetables, whole grains, and milk over at least the past several decades.

“The stark contrasts observed between the diets of Americans as well as the US food supply and current dietary guidance underscore the need for individual- and environmental-level interventions to facilitate healthier dietary intake patterns,” the authors concluded. “Without such interventions, the diets of most U.S. adults and children will continue to be markedly divergent from recommendations, a worrisome state in the context of the obesity epidemic and alarming rates of other diet-related chronic diseases.”

Bonnie - while disheartening to read as a public health professional, it once again sheds light on the major issues with the American diet's core infrastructure. The key word to take from this study is individual. While we wait...and wait...for a titanic shift of public policy, what can be accomplished quickly is dietary education and training on an individualized level. The new health care reform legislation makes taking advantage of this more palatable because it is now covered by insurance one hundred percent in most scenarios.

Finally. I can guarantee that the majority of my clients not only meet, but exceed and improve what is required from the Dietary Guidelines for Americans for fruits, vegetables, and legumes. The other aspects of the guidelines I do not support anyway.

Supplements reduce heart attack risk: large study

In a large study to be published in the American Journal of Clinical Nutrition, researchers looked at the multivitamin/mineral use of 34,000 female subjects aged 49-83 to gauge risk of myocardial infarction (heart attack) over a ten year period.

Researchers looked at 31,671 women with no history of MI and 2262 women with a history of MI. The multivitamin/mineral intake was estimated to be close to the recommended daily allowances. Results were very encouraging:

• In the group with no history of CVD, women using multivitamins alone, as compared with no use of supplements, was associated with a 27% lower risk of MI.
• Women using multivitamins together with other supplements had a 30% lower risk of MI.
• The lower risk was stronger among women who used supplements for five years or more.
• While a much smaller sample size, in women with a history of CVD, there was no association between supplements and MI.

Steve - we need more large studies with long-term follow-ups like this one when looking at the preventive effects of dietary supplements.

Similac recall

Illinois-based Abbott Laboratories says it is recalling about 5 million containers of its top-selling Similac powdered infant formula due to possible contamination by beetles or larvae of the bugs. The product being recalled is sold in cans and plastic containers, and that only the powdered versions of the popular infant formula is involved in its “proactive” action. Similac sold in liquid form is not part of the recall.

The company said in a news release posted on the web site of the FDA that an internal quality review detected the “remote possibility of the presence of a small common beetle in the product produced” in one of its manufacturing facilities. Abbott says the FDA had determined that while the formula containing the beetles “poses no immediate health risk, there is a possibility that infants who consume formula containing the beetles or their larvae could experience symptoms of gastrointestinal discomfort and refusal to eat as a result of small insect parts irritating the GI tract.”

It says consumers desiring more information or to find out if they have the product in their possession should go the web site similac.com and type in the lot number. Or people may call 800-986-8850.

Doc's health habits affect credibility with patients

Physician's confidence in their ability to counsel patients on a healthy diet and exercise may be related to their own personal habits. Factors that predicted confidence in counseling included the doctor's own exercise time, being overweight, and if the doctor had adequate training in counseling patients. The study, to be published in Preventive Cardiology, shows doctors' own health habits matter when it comes to patient counseling.

Both attending and trainee physicians subjects in this study reported low levels of confidence in their ability to effectively counsel patients regarding healthy lifestyle habits. However, greater degrees of self-confidence for counseling were seen with increased levels of personal exercise. Attending physicians were more likely to exercise four or more days a week and more than 150 minutes a week than trainees. In the survey, 69 percent talked to patients about exercise compared to only 38 percent of trainees who gave exercise counseling.

Few trainees or attending physicians were confident in their ability to change patients' behavior even though it's well-known that weight loss can prevent or alleviate obesity-related diseases such as hypertension and diabetes. Factors that predicted confidence in counseling included the doctor's own exercise time, being overweight, and if the doctor had adequate training in counseling, the study showed. Adequate training was the strongest predictor for confidence in talking about healthy eating habits, the survey showed. With the prevalence of obesity among adults in the U.S. increasing, many physicians lack confidence in their ability to counsel patients regarding lifestyle.

Bonnie - as we reported in another study recently, at least public health officials are beginning to recognize this problem.

Reimbursement for Nutritional Counseling Services

We are a cash practice. The method in which our clients are reimbursed by insurance for our services is bringing a prescription with diagnosis code from their physicians. Now that most of the Affordable Care Act has gone into effect, coverage for preventive care is front and center. Here are the best suggestions for reimbursement:

Private Insurance 
Most health care providers should have no-cost preventive services included in their insurance plans. Ask your provider if they differentiate how much they will reimburse for preventive services in-network or out-of-network. Ask your provider to specify how they quantify in-network or out-of-network and how much they reimburse for out-of-network. Every provider has their own interpretation of this issue.

The following services we provide should be reimbursed 100 percent, with no co-pays, and no questions asked by your insurance provider, as long as you have a prescription from your physician that includes the correct diagnosis code(s) and the words "for medical nutrition therapy."

• Diet counseling for adults with higher risk for chronic disease
• Obesity counseling for all adults
• Folic acid supplements for women who may become pregnant
• Iron supplements for children ages 6 to 12 months at risk for anemia
• Obesity counseling for children

Each provider will have their own procedure and diagnosis codes that they will attribute to these services.

There are many more preventive services that we did not mention that will be covered partially or in full as long as you have a prescription from your physician that includes diagnosis code(s) and the words "for medical nutrition therapy." Services with an "A" or "B" rating from the US Preventive Services Task Force are included. Here is a link to the full list.

Medicare
For our services, you would go through the same process as above. Then, you would submit the claim yourself to Medicare for reimbursement. Medicare is currently only covering counseling services for diabetes.

Disclaimer
As you know with private insurance and Medicare, there are never any guarantees! These tips are just to give you the best chance for coverage.

Paleolithic diet gathering steam

by Jess Halliday
Freelance Journalist for Food Industry Issues

There’s something incongruous about the hi-tech modern food industry sniffing around the Paleolithic era for the next big consumer trend. But hold the side order of cynicism. There might just be some logic to good old-fashioned instinctive eating. Unilever has unveiled a new research program that aims to re-create the diet of the caveman and apply modern biological science to it in the hope of unlocking some long-forgotten dietary knowledge that was instinctive to our ancestors.

The idea of eating like a caveman is nothing new. Gastroenterologist Walter Voegtlin first published The Stone Age Diet book in 1975, and other researchers have picked up the trail. US-based independent research group Paleobiotics Lab, has also been flagging up the heavy load of prebiotic fiber inulin in our ancestors’ diets, and the benefits it can bring. Like many off-beat new trends, it has been a way of life for a handful of health fanatics for decades. But are we ready for it to enter the mainstream? Your average caveman couldn’t have had a more different diet to the way we eat today. Tonight’s dinner may be a ready meal with an ingredients list as long as your arm – when once it would have been an armful of berries picked from a shrub.

Unilever’s new inspiration is not completely out of left-field. First, the natural trend has been gathering pace. We have started to snub those complex ingredients list, preferring them to feature foods we actually recognize as foods. How more natural can you get than to eat like your ancestors, who would have had no idea what an E-number is, let alone how to skin it. Nostalgic eating, too, has been a big hit. Especially in the recession, we have sought simplicity and savings by digging out our grandmothers’ old-fangled recipes. And once we have had our fill of braised offal and apple pie, what about Granny’s Granny’s recipes… and all the Great-Grannies going back 1200 generations?

Unilever is looking at a time when filling your stomach was a full time occupation. If you got the nutritional balance wrong or plumped for the wrong berry, the consequences were – a horrible death. Instinct, then, was a pretty crucial life skill. The Paleolithic era was also the time when the human genome was set. And by gum, evolution just hasn’t been able to keep up with fast moving consumer trends since then. We’re pretty much the same human beings as our ancient ancestor – just with worse spear skills but considerably better at maneuvering a supermarket trolley. The ability to eat instinctively for our genes has been largely crowded out by a sensual confusion of branding, tastes and textures.

The outcome? Well, heart disease and cancer aren’t pleasant ways to end your days. What we have instead of instinct is an armory of technologies that can be turned back to basics. Archeologists, anthropologists, evolutionary geneticists, food scientists, botanists… that’s the team of intrepid investigators Unilever has put together for its foray into diets past. We can’t turn back eating habits 12000 years and we probably wouldn’t want to. I would rather my local supermarket ran a special on mammoth chops any day than have to go out and hunt them myself. But we can certainly use today’s techniques to mine knowledge from the past, and use it to make better food in the future. Working together these scientists might, just might, unearth the long-lost secret of optimal nutritional need. If it comes with a cute picture of a caveman on the package, I’d buy it.

Don't count on evolution to eradicate diabetes

Gene variants associated with an increased risk for type-1 diabetes and rheumatoid arthritis may confer previously unknown benefits to their human carriers, say researchers at the Stanford. As a result, the human race may have been evolving in the recent past to be more susceptible, rather than less, to some complex diseases.

According to the lead researcher, "Everything we've been taught about evolution would indicate that we should be evolving away from developing type 1 diabetes. But instead, we've been evolving toward it. Why would we have a genetic variant that predisposes us to a deadly condition?" The researchers speculate that at least some of the risky changes may protect carriers against certain viruses and bacteria -- a trade-off that may have made evolutionary sense in the not-too-distant past when infectious diseases were devastating and largely untreatable.

According to the study, published in Science One, the idea that disease-causing genes can be beneficial is not new. The most clear-cut case involves a gene variant that, when present in two copies, causes sickle cell anemia, which can result in severe pain, organ damage and death. Although it seems that natural selection would work to eliminate the disorder, the variant remains prevalent in some areas of Africa because people with just a single copy are less susceptible to malaria. Evolutionarily the trade-off is worth it: Far more people are protected from malaria than ever develop sickle cell anemia even in today's environment. Unlike sickle cell anemia, which is caused by a mutation in just one gene, many complex diseases are associated with several variants -- specific locations in the DNA where the nucleotide "letters" vary between individuals. These locations are known as SNPs, for single nucleotide polymorphisms. Some of these SNPs are associated with an increased disease risk, while others protect against developing the disease.

When calculating an individual's overall genetic risk, it's necessary to consider the net effect of all of his or her variants. Researchers picked seven well-known conditions to study: type-1 and type-2 diabetes, rheumatoid arthritis, hypertension, Crohn's disease, coronary artery disease and bipolar disorder. Previous genome wide association studies have identified several hundred SNPs associated with each disorder. The Stanford researchers found that of the top SNPs associated with type-1 diabetes, 80 have been recently increasing in prevalence, meaning that they underwent positive selection. Of these, a surprising 58 are associated with an increased risk of the disorder, while 22 appear protective. Similarly, SNPs associated with an increased risk for rheumatoid arthritis were found to be positively selected. In contrast to type-1 diabetes and rheumatoid arthritis, we're evolving away from a tendency to develop Crohn's disease. Results for the other three disorders -- type-2 diabetes, coronary artery disease and bipolar disorder -- showed that protective and risky SNPs were positively selected in about equal proportions.

Regardless of the reason, some evolutionary tenets still apply. Healthier people are, presumably, more likely to reproduce and pass those same genes -- be they protective or risky -- to their offspring. When conditions changed because of differences in diet, exposures or location as populations move around the globe, carriers of the risky SNPs began to develop the conditions we struggle with today.

"Even though we've been finding more and more genetic contributions to disease risk," said researchers, "that's not really an appealing answer. There have got to be some other reasons why we have these conditions."

Bonnie - the reason is simple. Since agriculture was created, and humans began consuming grains approximately 10,000 years ago, we have been negatively expressing our genetic SNPs. Epigenetics, which deems how our genes are expressed, are driven by our lifestyle choices. Grain consumption is diametrically opposed to our genetic makeup. We are trying to genetically overcome millions of years of evolution based upon a paleolithic diet.

A new study in Journal Nature reveals that our use of stone tools to consume meat dates roughly one million years earlier than previously believed with Lucy's species, Australopithecus Afarensis. With this new discovery, we have a million more years of evolution to overcome in being able to tolerate grains.

These geneticists and paleontologists should get together with epigeneticists to produce a compelling argument for governments and the World Health Organization to curtail grain consumption worldwide. In its place, agriculture can grow more epigenetically harmonizing crops called vegetables and fruit!

If you must consume grains, one way to try to lower your risk from developing diabetes is to have a high level of magnesium, according to a study in the Journal of the American College of Nutrition.

For more on how epigenetics is key to evolution, here is a compelling article.

Inflammation affects intelligence and mortality

Inflammation is associated with lower intelligence and premature death, according to research published in Brain, Behavior and Immunity. In one of the largest, longest studies ever performed, data collected over several decades on inflammation and intelligence were measured at 18-20 years of age in nearly 50,000 young men, and deaths over the following 35 years were recorded.

Men with low-grade inflammation performed more poorly on standardized intelligence tests, even after excluding those with signs of current illness. Inflammation also predicted an increased risk of premature death, according to researchers. While researchers know inflammation is associated with infection, cardiovascular disease, and brain function impairment, this is the first time that similar associations have been shown in healthy young people. This suggests that even low levels of inflammation can have detrimental consequences for health and brain function. This is why we include C-Reactive Protein (CRP) in our initial blood panel for new clients, which can indicate cardiac and whole body inflammation.

One interesting finding was the role environmental factors played during childhood. Children of farmers had higher levels of inflammation than those whose fathers were non-manual workers, potentially because they were exposed to more pesticides.

Moreover, In European Heart Journal, experts admit the emerging status of biomarkers of inflammation is crucial to lead to advances in clinical care, but they must do better.

Clinicians must improve the number needed to treat and strive for further refinements in risk prediction to individualize interventions.

Clinicians must aim to assure that individuals targeted for medication do not lessen their adherence to a healthy lifestyle, believing that they enjoy pharmacological protection from unhealthy behaviors. Clinicians need to understand more about the mechanisms and clinical significance of unwanted actions of statins, including dysglycemia.

Most importantly, clinicians need to devise measures to optimize lifestyle change at both a medical and societal level. For individual patients, implementation of sustained lifestyle change, while very challenging in practice, is paramount for success.

The expects go on to say recognition that inflammation contributes to cardiovascular risk independent of LDL levels raises the possibility that other anti-inflammatory treatments might reduce cardiovascular events. But of those that are currently available, anti-inflammatory strategies have drawbacks in this regard.

Non-steroidal anti-inflammatory agents (NSAIDS) effectively combat inflammation, but if anything, seem to augment atherosclerotic complications. Moreover, NSAIDS tend to cause slight elevations in blood pressure that over time can adversely affect cardiovascular outcomes. Glucocorticoids also exert strong anti-inflammatory effects, yet may accelerate atherosclerosis rather than abate its consequences. This class of agents causes many metabolic perturbations that may mitigate their anti-inflammatory actions. For example, glucocorticoids cause dyslipidemia, hypertension, and insulin insensitivity, each an important risk factor for atherosclerotic events. Pharmacological inhibitors of certain other effectors of inflammatory pathways, such as the matrix metalloproteinases, have also exhibited undesired actions that render them unsuitable for prevention of atherosclerotic events. The continued search for selective anti-inflammatory agents remains a high priority for future research in this arena.

Unfortunately, the researchers never mention the myriad natural substances for lowering localized or whole body inflammation. Thankfully, we have vast experience in naturally reducing inflammation based upon individual needs. When vigilantly adhered to, clients get results.

Docs still know little about nutrition

Teaching Doctors About Nutrition and Diet
By Pauline W. Chen, M.D.
Excerpts from New York Times

Within days of being accepted into medical school, I started getting asked for medical advice. Even my closest friends, who should have known better, got in on the action. “Should I take vitamins?” “What do you think of this diet?” “Is yogurt good for me or not?” Each and every time someone posed such a query, I became immediately cognizant of one thing: the big blank space in my brain. After all, even with medical school acceptance in hand, I was no more a doctor than they were. But I also soon realized that many of their questions had nothing to do with medications or operations, or even diseases. With all the newspaper and television reports about newly discovered carcinogens and the latest diets and miracle nutrients, what my friends and acquaintances really wanted to know was just what they should or should not eat.

Years later, as a newly minted doctor on the wards seeing real patients, I found myself in the same position. I was still getting a lot of questions about food and diet. And I was still hesitating when answering. I wasn’t sure I knew that much more after medical school than I did before. One day I mentioned this uncomfortable situation to another young doctor. “Just consult the dietitians if you have a problem,” she said after listening to my confession. “They’ll take care of it.” She paused for a moment, looked suspiciously around the nursing station, then leaned over and whispered, “I know we’re supposed to know about nutrition and diet, but none of us really does.” She was right. And nearly 20 years later, she may still be.

Research has increasingly pointed to a link between the nutritional status of Americans and the chronic diseases that plague them. Between the growing list of diet-related diseases and a burgeoning obesity epidemic, the most important public health measure for any of us to take may well be watching what we eat. But few doctors are prepared to effectively spearhead or even help in those efforts. In the mid-1980s, the National Academy of Sciences published a landmark report highlighting the lack of adequate nutrition education in medical schools; the writers recommended a minimum of 25 hours of nutrition instruction. Now, in a study published this month, it appears that even two and a half decades later a vast majority of medical schools still fail to meet the minimum recommended 25 hours of instruction.

Researchers from the University of North Carolina at Chapel Hill asked nutrition educators from more than 100 medical schools to describe the nutrition instruction offered to their students. While the researchers learned that almost all schools require exposure to nutrition, only about a quarter offered the recommended 25 hours of instruction, a decrease from six years earlier, when almost 40 percent of schools met the minimum recommendations. In addition, four schools offered nutrition optionally, and one school offered nothing at all. And while a majority of medical schools tended to intersperse lectures on nutrition in standard, required courses, like biochemistry or physiology, only a quarter of the schools managed to have a single course dedicated to the topic. “Nutrition is really a core component of modern medical practice,” said Kelly M. Adams, the lead author and a registered dietitian who is a research associate in the department of nutrition at the university. “There may be some pathologists or other kinds of doctors who don’t encounter these issues later, but many will, and they aren’t getting enough instruction while in medical school.”

Eventually, practicing physicians may even be able to earn continuing medical education credits, a requirement of many hospitals, state licensing boards and specialty boards. “It’s extremely difficult to get people to change their diets and their habits around food,” Ms. Adams said. “Anything that improves a doctor’s confidence and skill set will go a long way in helping patients. You can’t just keep writing out script after script after script of new medications when diet is just as important as drugs or any other treatment a patient may be using."

Bonnie - I applaud Dr. Chen's honesty in writing this piece. Most doctors would not admit to this, especially in a public forum. This is an issue I have harped on for decades and little has changed. While increasing the amount of nutritional education for doctors is priority number one, the second issue is to teach them the right kind of nutrition. If educators are just re-hashing the food pyramid and dietary guidelines, then it is a complete waste.

Omega-3 from GM yeast “comparable to GRAS fish oil”: DuPont study

The safety of an EPA-rich oil from genetically modified yeast is “comparable to that of GRAS fish oil”, says a new study from DuPont. Results of a 90-day rat study with eicosapentaenoic acid (EPA)-rich oil produced from GM Yarrowia lipolytica yeast produced no adverse effects at doses up to 976 mg EPA per kilogram of body weight per day, according to findings published in Regulatory Toxicology and Pharmacology.

The safety profile of EPA oil was comparable to that of GRAS fish oil. These results support the use of EPA oil produced from yeast as a safe source for use in dietary supplements.

Fears about dwindling fish stocks, however, coupled with the putative risk of pollutants from oily fish, have pushed some in academia and industry to investigate the extraction of omega-3 from alternative sources. DHA extracted from non-GM microalgae is already on the market by Martek, as is plant-source alpha-linolenic acid (ALA), a shorter chain omega-3 that is less bioavailable for humans. However, this has not stopped a widening of the search for alternatives.

One such approach has been to utilize genetic engineering of plants to produce SDA (stearidonic acid), EPA and DHA, with biotech giants Monsanto, DuPont, and BASF reporting progress. Indeed, Monsanto teamed up with Solae in 2007 to commercialize the former’s soybean variety developed specially to be rich in SDA. The oil is being commercialized by Solae under the brand name Soymega, and GRAS status (generally recognized as safe) was attained in 2009. On the other hand, BASF Plant Science, in collaboration with Rothamsted Research and the University of York in the UK, has inserted genes from micro-organisms such as Thallasiosira pseudonana into rapeseed to produce EPA-containing vegetable oil. DuPont moves forward The new study shows the progress of DuPont in this field, as it moves to establish the safety of its EPA-rich oil from yeast.

Steve - while we support the search for alternatives to fish-derived EPA/DHA, aside from microalgae (which only produces DHA), we are not supportive of any of these potential discoveries until they show efficacy and safety. Some of the players involved in this search do not have the finest track record. We know that they are only interested in creating a product which they can patent for themselves.

For something as crucial as EPA/DHA, I would like to see the WHO form cooperative of sorts, where these companies can share their research so they can collectively come up with a product that is safe, viable, environmentally-friendly, and widely attainable. They can then equally share in the profits. Ah...wishful thinking.

Glucosamine/Chondroitin useless for arthritis?

The popular supplements glucosamine and chondroitin don't do much to relieve the pain associated with hip or knee osteoarthritis (OA), according to a new analysis of 10 studies. This is not the first time that research has cast doubt on the effectiveness of these two supplements. The heavily anticipated, government-funded Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) also showed that overall they did not improve knee OA pain. A follow-up arm of this study showed that they did not do any better than placebo in slowing loss of cartilage that occurs in osteoarthritis of the knee. A smaller subset of GAIT participants with moderate-to-severe OA pain, however, did get some relief with the combined supplements. Because this group was small, researchers said the findings were preliminary and needed to be confirmed in further studies. The new analysis of 10 studies, comprising 3,803 people, reinforces the negative findings of the GAIT trial.Glucosamine, chondroitin, or their combination are no better than placebo (dummy pill) when it comes to joint pain and joint space narrowing, the new study shows. But the supplements are safe, the study researchers write. The findings appear online in BMJ.

"We see no harm in having patients continue these preparations as long as they perceive a benefit and cover the cost of treatment themselves," write the researchers, who were led by Peter Jüni of University of Bern in Switzerland. Second Opinion "The jury is in, and we have given these supplements a fair try," says David Pisetsky, MD, chief of rheumatology at Duke University Medical Center in Durham, N.C. "I don’t think there is a strong impetus for more study." Pisetsky does have a number of patients who take, and will likely continue to take, these supplements. "If you want to take them and perceive a benefit, that's fine, but tell your doctor," he says.

According to supporters, the safety of these supplements has never been doubted. You have to ask yourself, would you take a supplement containing glucosamine and chondroitin, have about two-thirds of a chance of getting significant relief, with some evidence that you can slow your disease progression, or just numb your symptoms with acetaminophen or anti-inflammatory drugs and risk ulcers, allergies, kidney or liver damage, hypertension, heart attacks and possibly death. The risk/benefit for glucosamine and chondroitin far outweighs that of the FDA-approved drugs for osteoarthritis.

Marc C. Hochberg, MD, MPH, professor of medicine and head of the division of rheumatology and clinical immunology at the University of Maryland School of Medicine in Baltimore, points out that the statistical techniques used in the new study were really not designed to be applied to groups, which may cast some doubt on the way the findings are being interpreted. "These supplements did have a very small effect," he says. "This effect was very similar or identical to what is seen with acetaminophen, which is the first line treatment of OA according to the American College of Rheumatology and other professional organizations." His advice? "If patients want to use glucosamine, then they should discuss this with their physician who may recommend a particular brand and manufacturer."

Bonnie - we have commented on this issue numerous times. Our clients only see benefits for minimizing the degradation of cartilage over time, not for treating pain unless the OA is mild. It does not do anything for moderate to severe OA pain.

Another study shows probiotics stop diarrhea

Compared to conventional rehydration therapy, probiotic administration shortened bouts of diarrhea in children, according to a randomized double-blind controlled clinical study published in a recent issue of BMC Infectious Diseases. The trial involved children aged one to 23 months who were hospitalized for acute rotovirus diarrhea. The children were randomly assigned to receive one of three treatments: oral rehydration solution plus placebo; oral rehydration plus Saccharomyces boulardii; or oral rehydration plus a probiotic combination (Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium longum and S. boulardii). Researchers measured the duration of diarrhea, fever, vomiting and hospitalization.

Median duration of diarrhea (58 hours) was shorter in children who received single-species product than in controls. Children on the single-species probiotic also has a shorter duration of fever compared to controls and of vomiting. The researchers concluded both products decreased the duration of diarrhea compared to oral rehydration solution alone. While the single species product reduced fever, the multiple species product cut vomiting subsequent to the initiation of treatment. They noted the “quantity of probiotic bacteria needed for optimum treatment of gastroenteritis remains to be determined, particularly when multiple species are included in the product.”

Zinc a boon for immunity and reflux

The solution to painful acid reflux may lie in something as simple as zinc. Yale School of Medicine reports that zinc salts can effectively treat gastric reflux. In some patients, it may work within seconds. Researchers first studied lab rats and discovered the zinc worked. Then they tested it on healthy human study participants. No side effects were reported. The report, published in the American Journal of Gastroenterology, indicated nearly 50 million Americans suffer from acid reflux.

Bonnie - for years, we have used zinc carnosine for reflux as well as H. Pylori.

Bone drugs: femur fracture side effect revisited

Courtesy of WSJ

A widely prescribed class of drugs for osteoporosis might be associated with a very rare but serious type of fracture in the thigh bone when used long-term, according to a new report. The American Society of Bone and Mineral Research task force recommends in the report that the Food and Drug Administration rewrite the labels for the drugs, called bisphosphonates, to warn doctors and patients about the possibility of atypical femur fractures. The report will be published in the Journal of Bone and Mineral Research.

Dr. Elizabeth Shane, co-chair of the task force and a professor of medicine at Columbia University, said people currently taking the drugs who experience persistent pain in the thigh or groin should talk to their doctor because it could be a sign of an atypical femur fracture.

House calls ready to go national

A new Medicare project hopes to expand on the success of community healthcare groups that use home visits for the frail and elderly to improve lives and save money too.

By Michelle Andrews, Special to the Los Angeles Times September 13, 2010From the back window of his row house, Karl Schwengel can see the U.S. Capitol. But the 11 blocks might as well be so many miles, because he can barely walk across his bedroom, let alone go for a stroll.

Schwengel, 79, has congestive heart failure and arthritis. And though he lost 60 pounds during a recent hospital stay, he still weighs 260 pounds.

Last year he was retaining so much fluid that his calves were "almost the size of basketballs," he says, and walking became nearly impossible. When he traveled to a clinic or the hospital for medical treatment — an ordeal in and of itself — he relied on neighbors and an unofficial godson to take him.

All that began to change about six months ago, when a community group put him in contact with the Medical House Call Program at Washington Hospital Center. Now a doctor or nurse practitioner visits him every month to check his vital signs and medications and work with him to improve his health. A physical therapist recently joined the Schwengel team, and now he's practicing using a walker at home.

"The doctor says we're going to work on one problem at a time," he says.

In this era of assembly-line appointments, when you're lucky to get 10 minutes of face time with a physician, the idea of doctors making house calls seems old-fashioned. But for frail, elderly people with multiple health problems, bringing the medical establishment to the patient makes sense.

Because it's hard for these patients to get to the doctor, small problems languish and turn into larger ones. Eventually these patients land in the emergency room or hospital. If they recover, all too often the cycle starts again.

Home visits make financial sense as well, notes Jim Pyles, a Washington lawyer and member of the board of directors of the American Academy of Home Care Physicians. "We found that you could afford to treat a patient for a whole year at home by avoiding just one hospitalization," he says.

Washington Hospital Center's program, which started 11 years ago and serves roughly 600 patients, has reduced expected hospitalizations among participating patients by almost two-thirds, says Dr. George Taler, a gerontologist and co-director of the program.

Now that program and similar ones may get their turn on a national stage.

The healthcare overhaul signed into law this year creates a three-year Medicare demonstration project to test the home visit concept on 10,000 Medicare enrollees who were the sickest and most expensive to treat. To be eligible for the project, called Independence at Home, patients must have multiple chronic conditions and be unable to perform normal daily activities such as bathing and dressing. They must also have been hospitalized or in need of other high-cost care in the last year.

Healthcare organizations that participate in the project won't receive any money up front. If they succeed in cutting treatment costs by 5%, improving health outcomes and getting positive patient reviews, the groups share in any further savings. The program is slated to begin by January 2012, but some are pushing for a faster start.

Supporters say the project is a recognition of the increasing importance placed on growing old at home rather than in institutions. "It will help expand these programs and acknowledge Medicare's role in them," says Elinor Ginzler, a senior vice president at AARP.

But making a success of these program is not simple. Although Medicare pays practitioners more for home visits than for clinic visits, it doesn't pay for time spent traveling or for coordinating patients' care.

Clinicians working for Chicago-based Home Physicians see just 10 or 11 patients a day, far fewer than the 30 or more patients an office-based doctor would typically see, says Chief Executive Craig Reiff. His 15-year-old private company has 60 clinicians — including primary care doctors, podiatrists, nurse practitioners and physician assistants — who serve 12,000 patients in Chicago and Baltimore.

To make the visits pay, Reiff says he has to schedule his clinicians' visits carefully. And he notes that they make calls in tight geographic areas. "It could be very difficult to make it work in rural areas."

Practitioners have had no trouble reaching Karl Schwengel's home in Washington.

"They've done everything in the world for me," he says. With their help, he hopes to keep losing weight and to be able to walk again. "There are so many things I want to do. I want to take my dog for a walk across the park."

Or maybe to the Capitol.

Bonnie - what a great idea. This is the forward-type thinking we need to correct the great disparity in health care quality in this country.

News about breast feeding in US good and bad

In 2007, three-quarters of babies born in the USA were breast-fed at least briefly, continuing a decade-long increase, but the proportion still being breast-fed at 6 months and 12 months old had stalled, according to a "report card" Monday from the Centers for Disease Control and Prevention. The percentage of babies who had ever been breast-fed met the goal set by the government's Health People 2010. But the proportion still being breast-fed at 6 months, 43%, and 12 months, 22%, fell short of the Healthy People 2010 goals of 50% and 25%, respectively, the CDC's fourth annual Breastfeeding Report Card said.

Bonnie - these numbers are slowly trending upwards, which is a great sign. I highly recommend to all my clients who are new mothers to breast feed for at least one year. However, even several months of breast feeding is huge. For many in today's world, breast feeding is difficult to stick with, but the positive affect not just on your child, but for several future generations, makes the struggle very worthwhile.

Antioxidants Essential to Cardiac Health

Effect of Long-term Treatment with Antioxidants (Vitamin C, Vitamin E, Coenzyme Q10 and Selenium) on Arterial Compliance, Humoral Factors and Inflammatory Markers in Patients with Multiple Cardiovascular Risk Factors Nutrition and Metabolism, September 2010

Oxidative stress has been considered as a potential pathogenic mechanism for initiation and progression of atherosclerotic disease. Excessive production of reactive oxygen species, a mediator of the oxidative stress cascade, leads to release of inflammatory cytokines, oxidation of LDL and prothrombotic state, and finally results in endothelial dysfunction and atherosclerotic vascular lesions. Adequate dietary, enzymatic and nonenzymatic antioxidant supplementation may be effective in lowering oxidative stress. Although most trials with antioxidants in experimental models of atherosclerosis have demonstrated that this treatment is able to retard the progression of atherosclerosis, the results of clinical trials are equivocal. Differences in the definition criteria of patients who are potential candidates for antioxidant treatment, type and dosage of antioxidant supplementation, as well as outcome measures may explain this variability. Since oxidative stress is activated by many cardiovascular risks factors such as hypertension, hyperglycemia, dyslipidemia and smoking, patients with multiple cardiovascular risk factors could obtain beneficial effect from antioxidant treatment. Additionally, combinations of dietary antioxidants (vitamin C and vitamin E) with carrier in mitochondrial oxidative phosphorylation (coenzyme Q10) and trace elements essential for adequate function of many antioxidant enzymes (selenium) may underlie the synergism between them and amplify the positive antioxidant effect.

The present study was designed to determine the effect of antioxidant supplementation with vitamin C, vitamin E, coenzyme Q10 and selenium on arterial compliance, inflammatory and metabolic parameters in patients with multiple cardiovascular risk factors.

In a randomized, placebo-controlled study 70 patients with at least two cardiovascular risk factors were recruited for study participation. Participants were randomly assigned to two groups. Group 1 received oral antioxidant supplementation with 2 capsules per day. Each capsule contained vitamin C (500 mg) vitamin E (200 iu), co-enzyme Q10 (60 mg) and selenium (100 mcg), Group 2 received matching placebo for 6 months.

The present randomized, placebo controlled study demonstrated that antioxidant supplementation significantly increased large and small artery elasticity in patients with multiple cardiovascular risk factors. This beneficial vascular effect was associated with an improvement in glucose and lipid metabolism as well as significant decrease in blood pressure. No major prospective study associating arterial elasticity with cardiovascular events has ever been performed.

The findings of the present study concur with those of previous studies that have shown substantial reduction in blood pressure and improvement in long-term glycemic control with oral CoQ supplementation, reduction in plasma glucose and insulin resistance with high doses of vitamin E supplementation and significant reduction in blood pressure levels with vitamin E as well as vitamin C in hypertensive patients.

The study has several limitations. First, the present study contains relatively small number of participants and larger studies are required to establish the beneficial vascular effect of antioxidant supplementation. Second, the researchers did not measure plasma levels of the antioxidants which would have added the information regarding treatment compliance and would have elucidated the pathophysiology for vascular action of antioxidants. Furthermore, since the present study has focused on patients with multiple cardiovascular risk factors, the application of our findings to other patient populations remains uncertain.

What the researchers did demonstrate is that combined antioxidant supplementation with vitamin C, vitamin E, coenzyme Q10 and selenium has beneficial effect on glucose and lipid metabolism, blood pressure and arterial compliance in patients with multiple cardiovascular risk factors. The findings of the present study justify investigating the overall clinical impact of antioxidant treatment in this population.

Bonnie - while a small sample size, the study was extremely well-controlled and one of the first to show major improvement in those with cardiovascular risk factors.

B vitamins found to halve brain shrinkage in elderly

Courtesy of Reuters

Daily tablets of large doses of B vitamins can halve the rate of brain shrinkage in elderly people with memory problems and may slow their progression toward dementia. Scientists from Oxford University said their two-year clinical trial was the largest to date into the effect of B vitamins on "mild cognitive impairment" -- a major risk factor for Alzheimer's disease and other forms of dementia.

Experts commenting on the findings said they were important and called for larger, longer full-scale clinical trials to see if the safety and effectiveness of B vitamins in the prevention of neurodegenerative conditions could be confirmed. "This is a very dramatic and striking result. It's much more than we could have predicted," said David Smith of Oxford's department of pharmacology, who co-led the trial. "It is our hope that this simple and safe treatment will delay development of Alzheimer's in many people who suffer from mild memory problems."

Smith and colleagues conducted a two-year trial with 168 volunteers with MCI who were given either a vitamin pill containing very high doses of folic acid, vitamin B6 and vitamin B12, or a placebo dummy pill. These B vitamins are known to control levels of an amino acid called homocysteine in the blood, and high blood levels of homocysteine are linked to an increased risk of developing Alzheimer's disease. Helga Refsum, who also worked on the trial, stressed that vitamins were given in extremely high doses. "This is a drug, not a vitamin intervention," she said. The pills, called contained around 300 times the recommended daily intake of B12, four times daily advised folate levels and 15 times the recommended amount of B6.

Brain scans were taken at the beginning and the end of the trial to monitor the rate of brain shrinkage, or atrophy. The results, published in the Public Library of Science (PLoS) One journal, showed that on average the brains of those taking the vitamin treatment shrank at a rate of 0.76 percent a year, while those taking the dummy pill had an average brain shrinkage of 1.08 percent. People who had the highest levels of homocysteine at the start of the trial benefited the most from the treatment, with their brains shrinking at half the rate of those on the placebo. Although the trial was not designed to measure cognitive ability, the researchers found those people who had lowest rates of shrinkage had the highest scores in mental tests.

Commenting on the study, Paul Matthews, a professor of clinical neurology at Imperial College London said that although the vitamins used are generally safe and inexpensive, the study "should not drive an immediate change in clinical practice" "Instead, it sets out important questions for further study and gives new confidence that effective treatments modifying the course of some dementias may be in sight," he said.

Bonnie - while a small study and of short duration, B-vitamins have long been linked to a reduction in homocysteine, so these results should not come as a surprise.

Prescriptions drug use continues to explode

Courtesy of Associated Press

Prescription drug use in the U.S. has been rising steadily in the past decade and the trend shows no signs of slowing, says a new study published in the CDC’s National Center for Health Statistics Data Brief No. 42.

The percentage of Americans who took at least one prescription drug rose from 43.5% in 1999-2000 to 48.3% in the 2007-2008 period. The use of two or more drugs increased from 25.4% to 31.2% over the same decade, and the use of five or more prescription medications jumped from 6.3% to 10.7%.

The report also says that in the 2007-2008 period:

• One of every five children and nine out of 10 older Americans reported using at least one prescription drug in the month prior to being surveyed.
• 22.4% of kids up to age 11 used at least one prescription drug.
  
• 29.9% of young people 12-19 used at least one prescription drug.
  
• 48.3% of people between 20 and 59 used at least one prescription medication.
  
• 88.4% of Americans age 60 and over used at least one prescription drug, more than 76% used two or more prescription drugs in the past month, and 37% used five or more.
  
• People without health insurance or a regular place to go for medical problems had less prescription drug use compared to those with such benefits.
  
• Prescription drug use increased with age, that women were more likely to use such medications than men, 53.3% to 43.2%, and the non-Hispanic white population had the highest prescription drug use at 54.3%, compared to 42% of black non-Hispanics and 33.9% of Mexican-Americans.
  
• People with a regular place for health care were 2.7 times as likely to have used prescription drugs in the past month compared to those without the benefit. People with health insurance were about twice as likely to have used at least one prescription medication in the past month as those without health insurance.
  
• People with prescription drug benefits in their health insurance plans were 22% more likely to use prescription medications than those who did not have that benefit.
  

Most Commonly Prescribed Drugs:

• Bronchodilators for children up to age 11.
• Central nervous system stimulants for youths 12-19.
• Antidepressants for people 20-59.
• Cholesterol lowering drugs for adults 60 and older.
• Among kids under age 6, penicillin antibiotics were the most frequently use prescription drugs.

SOURCES: National Center for Health Statistics: "NCHS Data Brief No. 42, September 2010."

Bonnie - the increase in overall medication intake is not a surprise. As long as Big Pharma rules health care, the rate will trend upward.

The fact that antidepressants are the most commonly prescribed drugs for Americans aged 20-59 is surprising, especially in light of recent data concerning side effects and lack of efficacy. It is an indictment on our health professionals for acquiescing to a "quick fix." Looking at the bigger picture, it shows how stressed and unhappy the American public really is.

Swine flu complications same seasonal flu: study

A US study of flu cases in adults and children living in Wisconsin concluded that the risk of serious complications from 2009 H1N1 swine flu was no higher than the risk of serious complications from recent seasonal flu strains, according to JAMA.

Researchers from the Marshfield Clinic Research Foundation, Marshfield, Wisconsin, and the Influenza Division at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, also found that patients who contracted the 2009 swine flu tended to be younger than those who contracted seasonal flu.

6.874 screened patients were tested for influenza A during the 2007-08 and the 2008-09 flu seasons, and also from May to November 2009. Among this population, they identified 545 patients of median age 10 years had been infected with 2009 H1N1 swine flu, 221 of median age 11 years with seasonal H1N1, and 632 patients of median age 25 years with H3N2, another serotype influenza A virus. When they compared these case numbers to outcomes in the patients' medical records, researchers found that: During the 30 days of follow up, compared with seasonal H1N1 and H3N2, the 2009 H1N1 swine flu was not linked to higher rates of hospital admission or pneumonia among children.

In adults, a similar picture emerged, with no significantly higher rates of hospital admissions or pneumonia for 2009 H1N1 swine flu than for seasonal flu. Also, during the 30 days of surveillance follow up, there were no significant differences by strain among the proportion of children or adults with serious outcomes (ie hospital admissions or pneumonia).

"Our results suggest that the clinical manifestations and risk of hospital admission are similar for 2009 H1N1 and other seasonal influenza A strains among those presenting for medical care and documented to have influenza infection."

Overall, they found that while more children appeared to contract 2009 H1N1 swine flu, the perceived severity of complications, as measured by counting hospital admissions and cases of pneumonia, were no worse in swine flu cases than in seasonal flu cases of the A viruses.

FDA okays GMO salmon for food supply

Courtesy of Andrew Pollack at WSJ

A salmon genetically engineered to grow quickly is safe to eat and poses little risk to the environment, the Food and Drug Administration said Friday. The assessment makes it more likely that the fish will become the first genetically modified animal to enter the American food supply. Food from the salmon “is as safe as food from conventional Atlantic salmon,” the F.D.A. said in its analysis, which was posted on its Web site Friday.

“There is a reasonable certainty of no harm from consumption of food from this animal.” The salmon can grow to market size in 16 to 18 months instead of the 30 required for a regular farmed Atlantic salmon, according to its developer, AquaBounty Technologies of Waltham, Mass. AquaBounty has been trying for years to win approval for the salmon, a goal that now appears within reach. The analysis by the F.D.A. staff was in preparation for three days of public meetings on the salmon that will start on Sept. 19. The F.D.A. is expected to make a final decision on approval in the weeks after the meetings.

The company has said it will take two to three years after approval for the fish to reach American supermarkets. A coalition of 31 consumer, animal welfare, environmental and fisheries groups announced opposition to the approval last week, citing, in particular, concerns that the salmon could escape and possibly outcompete wild salmon for food or mates. But AquaBounty said the fish would be grown only inland. And only sterile females will be sold, limiting any ability to reproduce. The F.D.A., in its analysis, basically agreed that the chance of escape or ecological disruption was small. The salmon “are not expected to have a significant impact on the quality of the human environment,” it concluded. But the analysis is not likely to satisfy critics, in part because much of the data upon which the F.D.A. based its conclusions was submitted by AquaBounty.

Jaydee Hanson, a policy analyst at the Center for Food Safety, a Washington advocacy group, said that only a handful to a few dozen fish were used for some of the studies on the safety of the fish flesh or its potential to cause allergic reactions. “We’re actually pretty amazed at how small their samples were,” he said. He also pointed to information in the documents suggesting that up to 5 percent of the fish might not be sterile because the process is not perfect.

The AquAdvantage Atlantic salmon contains a growth hormone gene from the Chinook salmon that is kept active all year round by a genetic on-switch from a different fish, the ocean pout. Normally, salmon produce growth hormone only in warm weather. So with the hormone produced year round, the AquAdvantage salmon grow faster. One issue that might attract some discussion at the public meetings is that the engineered salmon have slightly higher levels of insulinlike growth factor 1, a hormone related to growth hormone. Some studies suggest that high levels of the insulinlike hormone in the bloodstream are associated with greater cancer risk, though it is not clear how much food contributes to hormone levels in the blood.

However, the F.D.A. did an analysis that concluded that even if people ate a lot of the salmon, it would not make a significant difference in the amount of the hormone they would consume. Genetically engineered animals are regulated by the F.D.A. under rules covering animal drugs. The agency’s Veterinary Medicine Advisory Committee will discuss the application on Sept. 19 and 20 in Rockville, Md. The next day the agency will hold a public meeting to discuss whether or how food from the salmon should be labeled.

Steve - here we go again. We did not learn enough about the negative effects from growth hormones in cows, now we have to deal with salmon? If you would like to make your voice heard, you had better do it quickly at http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm224089.htm

More infants should receive iron

Giving iron supplements to children with marginally low birth weights (2000-2500 grams) dramatically reduces the risk of developing iron deficiency and anemia, according to Pediatrics. It has recently been discovered that both birth weight and the infants' nutrition supply are important risk factors for later morbidity in adulthood. Due to high nutritional requirements, infants with low birth weight are at risk of developing nutrient deficiencies during their first year of life, including iron deficiency. Iron is necessary for the production of hemoglobin for the blood, and also for the development of the brain. Iron deficiency in infants has been shown to be associated with poor neurological development.

285 children with marginally low birth weights (2000-2500 g) were randomly divided into three groups that were given different amounts of iron drops (0, 1, or 2 mg per kg daily) from the age of 6 weeks to 6 months. Among children who were given placebo drops (no iron) 36% had iron deficiency and 10% iron-deficiency anemia at the age of 6 months, whereas the corresponding figures for children who received 2 mg of iron were 4% and 0%. At greatest risk of developing iron deficiency were those children who were fully breast-fed at the age of 6 weeks. They ran an 18% risk of developing iron-deficiency anemia by the age of 6 months if they did not receive iron drops.

The study indicates no negative effects from iron drops on the children's growth, infections, or other morbidity.

Bonnie - iron is a crucial mineral for infants and is something often overlooked by pediatricians and nutritionists alike.

Osteoporosis drugs' cancer link

A new study released in British Medical Journal suggests that long-term use of oral bisphosphonates may raise the risk of esophageal cancer. The study led by researchers from the University of Oxford's Cancer Epidemiology Unit found people who took oral bisphosphonates for bone disease over a five-year period were twice as likely to be diagnosed with esophageal cancer or cancer of the gullet.

Oral bisphosphonates are indicated for treatment of osteoporosis and other bone diseases and are most commonly recommended to treat these conditions. The study involved 2,954 patients with esophageal cancer, 2,018 patients with stomach cancer and 10,641 patients with colorectal cancer, who were diagnosed with the diseases at the age of 40 or older between 1995 and 2005. The researchers compared the data from the cancer patients who took oral bisphosphonates for more than five years or were given 10 or more prescriptions were twice as likely to develop esophageal cancer. The drugs did not seem to affect the risk of stomach cancer or colorectal cancer.

Bonnie - this is certainly not the first, and surely will not be the last, major, debilitating side effect attributed to bisphosphonates. The list of side effects just keeps growing as more research is compiled.

Choosing the right protein is key

American women who ate more protein-rich foods instead of red meat had a significantly lower risk of developing heart disease, according to a study reported in Circulation: Journal of the American Heart Association. Eating more fresh red meat, processed red meat and high-fat dairy carried an increased risk of heart disease in the study. Women who had two servings per day of red meat compared to those who had half a serving per day had a 30 percent higher risk of developing coronary heart disease.

"Our study shows that making substitutes for red meat or minimizing the amount of red meat in the diet has important health benefits," said Adam M. Bernstein, M.D., Sc.D., the study's first author from the Department of Nutrition at Harvard School of Public Health in Boston.

The data also showed that eating more servings of poultry, fish and nuts was significantly associated with a decreased risk of coronary heart disease. Compared to one serving each day of red meat, women who substituted other protein-rich foods experienced significantly lower risk of coronary heart disease:

• 30 percent lower risk with one serving each day of nuts
• 24 percent lower risk with one serving each day of fish19 percent lower risk with one serving each day of poultry
• 13 percent lower risk with one serving each day of low-fat dairy products
  

"There are good protein-rich sources that do not involve red meat," Bernstein said. "You don't need to have hot dogs, hamburgers, bologna or pastrami, which are all fresh or processed meats." The study examined 84,136 women, 30 to 55 years old, in the Nurses' Health Study over 26 years, from 1980 to 2006. The majority of women were Caucasian. Researchers examined the medical history and lifestyles of these women, including diet, with questionnaires issued regularly throughout 26 years. The primary endpoint of the study was non-fatal heart attack and fatal coronary heart disease, from 1980 up to June 1, 2006. During that time, researchers documented 2,210 non-fatal heart attacks and 952 deaths from coronary heart disease.

The study differs from others in the field because the analysis has a 26-year follow-up, greater precision in dietary measurements due to a great number of cases and repeated dietary questionnaires. It also differs because of the emphasis on substitution patterns and substitution of other protein-rich foods for red meat. "Although this study included only women, our overall knowledge of risk factors for heart disease suggests that the findings are likely to apply to men as well," Bernstein said. "Those who are concerned and want to reduce their risk of heart disease should consider replacing red meat with other protein-rich foods including fish, poultry, low-fat dairy products and nuts," Bernstein said. Co-authors are Qi Sun, M.D., Sc.D; Frank B. Hu, M.D., Ph.D.; Meir J. Stampfer, M.D., Ph.D.; JoAnn E. Manson, M.D., Ph.D.; and Walter C. Willett, M.D., Ph.D.

Bonnie - the amount of red meat consumed in this study far exceeded suggested servings. I usually recommend no more than two servings weekly from grass-fed beef, which contains heart-healthy omega-3 fats.

Nuts and seeds, although very heart-healthy, need to be counted as fats, not proteins.

What fruit should only be consumed if organic?

Side-by-side comparisons of organic and conventional strawberry farms and their fruit found the organic farms produced more flavorful and nutritious berries while leaving the soil healthier and more genetically diverse. "Our findings have global implications and advance what we know about the sustainability benefits of organic farming systems," said John Reganold, Washington State University Regents professor of soil science and lead author of a paper published in the peer-reviewed online journal, PLoS ONE. "We also show you can have high quality, healthy produce without resorting to an arsenal of pesticides." The study is among the most comprehensive of its kind, analyzing 31 chemical and biological soil properties, soil DNA, and the taste, nutrition and quality of three strawberry varieties on more than two dozen commercial fields -- 13 conventional and 13 organic. "There is no paper in the literature that comprehensively and quantitatively compares so many indices of both food and soil quality at multiple sampling times on so many commercial farms," said Reganold.

All the farms in the current study were in California, home to 90 percent of the nation's strawberries and the center of an ongoing debate about the use of soil fumigants. Conventional farms in the study used the ozone-depleting methyl bromide, which is slated to be replaced by the highly toxic methyl iodide over the protests of health advocates and more than 50 Nobel laureates and members of the National Academy of Sciences. In July, California Sen. Dianne Feinstein asked the EPA to reconsider its approval of methyl iodide.

On almost every major indicator, they found the organic fields and fruit were equal to or better than their conventional counterparts. Among their findings: The organic strawberries had significantly higher antioxidant activity and concentrations of ascorbic acid and phenolic compounds.The organic strawberries had longer shelf life.The organic strawberries had more dry matter, or, "more strawberry in the strawberry."

The researchers also found the organic soils excelled in a variety of key chemical and biological properties, including carbon sequestration, nitrogen, microbial biomass, enzyme activities, and micronutrients. DNA analysis found the organically managed soils had dramatically more total and unique genes and greater genetic diversity, important measures of the soil's resilience to stress and ability to carry out essential processes.

Steve - it is well known that conventional strawberries have the highest pesticide content of any fruit or vegetable. It is the only fruit that we simply do not recommend consuming unless organic.

SAMe boosts antidepressant therapy

Patients with major depressive disorder who fail to respond to treatment with serotonin reuptake inhibitors (SRIs) may benefit from the addition of the nutritional supplement S-adenosyl methionine (SAMe), according to results of the first placebo-controlled trial of the supplement in refractory depression.

"The results of this study provide preliminary evidence suggesting that SAMe can be an effective, relatively well-tolerated, and safe adjunctive treatment strategy for SRI nonresponders with major depressive disorder and our findings warrant replication," the study authors conclude in the August issue of the American Journal of Psychiatry. Included in the single-center, 6-week study were 73 adults with major depressive disorder in whom a prior selective SRI trial had failed at an adequate dose for at least 6 weeks. Thirty-nine were randomly assigned to SAMe (at a target dose of 800 mg twice a day) and 34 to matching placebo, added to their ongoing antidepressant regimen. Fifty-five patients (75.3%) completed the 6-week study: 31 (79.4%) in the SAMe arm and 24 (70.5%) in the placebo arm.

According to the investigators, during the study, significantly more SAMe-treated than placebo-treated patients (36.1% vs 17.6%) experienced a clinical response on the 17-item Hamilton Depression Rating Scale (HAM-D), which was the primary study outcome. Remission rates were also higher with SAMe than with placebo (25.8% vs 11.7%).

An increase in SAMe concentrations has been linked to improvement in depressive symptoms. Low SAMe levels may limit synthesis of brain neurotransmitters such as serotonin, norepinephrine, and dopamine. This may directly contribute to depressive symptoms or interfere with or limit the action of other antidepressants. Administration of SAMe may ameliorate these deficiencies or augment antidepressants and facilitate neurotransmission. The study was funded by a grant from the National Institute of Mental Health.

Importance of probiotics for children

The positive effects of probiotics in children are not limited to the gastrointestinal tract. Various probiotics are used to support immune health. Many of you already know that we are ardent supporters of probiotics for immune support.

A double-blind, placebo-controlled study published in Pediatrics showed significantly reduced symptoms of cold and flu in children 3 to 5 years old using two probiotic strains we commonly recommend. The studies' highlights:

• Aimed to evaluate probiotic consumption effects on cold and flu-like symptom incidence and duration in healthy children during the winter season.

• 326 children ages 3 to 5 were randomly assigned Lactobacillus acidophilus NCFM alone, in combination with Bifidobacterium lactis, or placebo twice daily for six months.

• Reduced fever incidence by 53% in acidophilus alone and 73% in the acidophilus/bifidus combination compared to placebo. Reduced coughing incidence of 41% alone and 62% in combo. Reduced runny nose incidence of 28% alone and 59% in combo.

• All cold and flu symptoms decreased significantly compared to placebo (32% alone and 48% in combo). Antibiotic use incidence was reduced by 68% alone and 84% in combo compared to placebo. Children receiving probiotics had a 32% reduction in school days absent alone and 27% in the combo.

In short, the researchers state "daily dietary probiotic supplementation for 6 months was a safe and effective way to reduce fever, runny nose, and cough incidence and duration and antibiotic prescription incidence, as well as number of missed school days attributable to illness, for children 3 to 5 years of age."

Of course, this is music to our ears. With the world in a constant battle with infectious disease, why would you take the chance and not supplement with a probiotic? Beyond preventing infection, probiotics have myriad other benefits that Steve and I have extensively explored.

This study yet again reaffirms that when provided with the proper fuel, an optimally functioning immune system can be achieved. Note that these recommendations not only apply to kids, but adults as well.

Blueberries' has effect on heart, metabolic syndrome

Among all fruits, berries have shown substantial cardio-protective benefits due to their high polyphenol content. However, investigation of their efficacy in improving features of metabolic syndrome and related cardiovascular risk factors in obesity is limited. Researchers publishing a Journal Nutrition study examined the effects of blueberry supplementation on features of metabolic syndrome, lipid peroxidation, and inflammation in obese men and women.

Decreases in systolic and diastolic blood pressures were greater in the blueberry-supplemented group than in controls, whereas the serum glucose concentration and lipid profiles were not affected. The decreases in plasma oxidized LDL were greater in the blueberry group than in the control group.

The study concludes that blueberries may improve selected features of metabolic syndrome and related cardiovascular risk factors at dietary achievable doses.

Med diet linked to lower breast cancer risk

Researchers followed up 14,807 women for an average of 9.8 years and identified 240 incident breast cancer cases. Increasing conformity to the Mediterranean diet had a marginally significant inverse association among postmenopausal women. In short, the American Journal of Clinical Nutrition study stated that conformity to the traditional Mediterranean diet may be associated with lower breast cancer risk among postmenopausal women and could explain, in part, the lower incidence of this disease in Mediterranean countries.