Friday, September 27, 2013
Thursday, September 26, 2013
Postmenopausal Women: Pay Attention to This!
Back pain is a major public health problem due to its high frequency, to the resulting activity constraint, and the need for surgery in many cases. Back pain is more frequent in women than men, mainly in postmenopausal women. High prevalence of hypovitaminosis D has been detected in postmenopausal women, and it is associated with decreased bone mass, sarcopenia, vertebral fractures, and inflammation, which can be related to back pain.
The relation between back pain and hypovitaminosis D was evaluated in this study, as well the difference regarding the number of bedridden days, number of days away from work, and daily activities limitation between women with and without hypovitaminosis D. A study in the September issue of BMC Musculoskeletal Disorders reviewed data in low bone mass postmenopausal women.
Those with hypovitaminosis D, compared to those without hypovitaminosis D, reported more back pain, more cases of severe back pain, higher limitation in their daily activities, more fractures, and had more trouble to perform daily activities.
The relation between back pain and hypovitaminosis D was evaluated in this study, as well the difference regarding the number of bedridden days, number of days away from work, and daily activities limitation between women with and without hypovitaminosis D. A study in the September issue of BMC Musculoskeletal Disorders reviewed data in low bone mass postmenopausal women.
Those with hypovitaminosis D, compared to those without hypovitaminosis D, reported more back pain, more cases of severe back pain, higher limitation in their daily activities, more fractures, and had more trouble to perform daily activities.
Bonnie: What more do you need to see to make sure your vitamin D levels are ideal?!
Wednesday, September 25, 2013
Med students team up with chefs
One of our clients forwarded this to us. It's about time!
http://www.npr.org/blogs/thesalt/2013/09/18/223405641/just-what-the-doctor-ordered-med-students-team-with-chefs
http://www.npr.org/blogs/thesalt/2013/09/18/223405641/just-what-the-doctor-ordered-med-students-team-with-chefs
Tuesday, September 24, 2013
Consuming Dairy Doubles Risk of Huntington's Disease
Certain dietary choices may change the course of Huntington's disease, a new study from JAMA Neurology suggests. Researchers found that higher consumption of dairy products more than doubled the risk for onset, known as phenoconversion. Dairy may be a surrogate for lower urate levels, which are associated with faster progression in Huntington's, the authors speculate. Curtail dairy consumption if you have Huntington's disease in your family history.
Friday, September 20, 2013
Study: B-Vitamins Lowered Stroke Risk
Abstract from Neurology, September 18, 2013
Objective: To perform a meta-analysis on the effect of lowering homocysteine levels via B vitamin supplementation on cerebrovascular disease risk.
Methods: Using clinical trials published before August 2012 to assess stroke events, we used relative risks with 95% confidence intervals to measure the association between B vitamin supplementation and endpoint events. We included 14 randomized controlled trials with 54,913 participants in this analysis.
Results: We observed a reduction in overall stroke events resulting from reduction in homocysteine levels following B vitamin supplementation but not in subgroups divided according to primary or secondary prevention measures, ischemic vs hemorrhagic stroke, or occurrence of fatal stroke. There were beneficial effects in reducing stroke events in subgroups with more than 3 years follow-up time, and without background of cereal folate fortification or chronic kidney disease (CKD). Some trials that included CKD patients reported decreased glomerular filtration rate with B vitamin supplementation. We conducted detailed subgroup analyses for cyanocobalamin (vitamin B12) but did not find a significant benefit regarding intervention dose of vitamin B12 or baseline blood B12 concentration. Stratified analysis for blood pressure and baseline participant medication use showed benefits with more than 130 mm Hg systolic blood pressure and lower antiplatelet drug use in reducing stroke risk.
Conclusions: B vitamin supplementation for homocysteine reduction significantly reduced stroke events, especially in subjects with certain characteristics who received appropriate intervention measures.
Objective: To perform a meta-analysis on the effect of lowering homocysteine levels via B vitamin supplementation on cerebrovascular disease risk.
Methods: Using clinical trials published before August 2012 to assess stroke events, we used relative risks with 95% confidence intervals to measure the association between B vitamin supplementation and endpoint events. We included 14 randomized controlled trials with 54,913 participants in this analysis.
Results: We observed a reduction in overall stroke events resulting from reduction in homocysteine levels following B vitamin supplementation but not in subgroups divided according to primary or secondary prevention measures, ischemic vs hemorrhagic stroke, or occurrence of fatal stroke. There were beneficial effects in reducing stroke events in subgroups with more than 3 years follow-up time, and without background of cereal folate fortification or chronic kidney disease (CKD). Some trials that included CKD patients reported decreased glomerular filtration rate with B vitamin supplementation. We conducted detailed subgroup analyses for cyanocobalamin (vitamin B12) but did not find a significant benefit regarding intervention dose of vitamin B12 or baseline blood B12 concentration. Stratified analysis for blood pressure and baseline participant medication use showed benefits with more than 130 mm Hg systolic blood pressure and lower antiplatelet drug use in reducing stroke risk.
Conclusions: B vitamin supplementation for homocysteine reduction significantly reduced stroke events, especially in subjects with certain characteristics who received appropriate intervention measures.
Thursday, September 19, 2013
Simple, Cheap Colon Cancer Screening Very Effective
Testing for blood in the stool reduced the risk of death from colorectal cancer by as much as 32 percent and it seemed to keep the death rate low even after testing stopped, according to a new study from New England Journal of Medicine. The test that looks for blood in the feces is the safest, cheapest and least complicated.
People were either screened for fecal blood annually, every two years or not at and followed them for two six year windows. The people who received annual screening during those initial periods ultimately saw a 32 percent reduction in their risk of dying from colorectal cancer. With biennial screening, the risk was cut by 22 percent.
In total, 732 of 33,020 deaths over the 30 years were from colorectal cancer. The fact that the effect was sustained through 30 years is remarkable. The study of fecal occult blood testing provides the longest follow-up of any colorectal cancer screening study to date - an impressive 30 years - and shows that the benefits of screening by this method endure for the lifetime of the patient.
It also costs 99% less than a colonoscopy!
People were either screened for fecal blood annually, every two years or not at and followed them for two six year windows. The people who received annual screening during those initial periods ultimately saw a 32 percent reduction in their risk of dying from colorectal cancer. With biennial screening, the risk was cut by 22 percent.
In total, 732 of 33,020 deaths over the 30 years were from colorectal cancer. The fact that the effect was sustained through 30 years is remarkable. The study of fecal occult blood testing provides the longest follow-up of any colorectal cancer screening study to date - an impressive 30 years - and shows that the benefits of screening by this method endure for the lifetime of the patient.
It also costs 99% less than a colonoscopy!
Giving out free antibiotics is so wrong
http://supermarketnews.com/pharmacy/giant-eagle-offers-free-antibiotics
Steve: It is astounding to me that given the public health outcry that antibiotic usage be curtailed because we are on the precipice of having no effective antimicrobials to fight off infection, that these practices are allowed to go on.
Steve: It is astounding to me that given the public health outcry that antibiotic usage be curtailed because we are on the precipice of having no effective antimicrobials to fight off infection, that these practices are allowed to go on.
Tuesday, September 17, 2013
My Story: Trying to Get a Virtual Colonoscopy
Dear Bonnie,I am writing in the hope that my experience might help your other clients. Based on the research you presented about colonography, I decided that my first colon cancer screening would be a virtual colonoscopy instead of traditional, invasive colonoscopy. You are often ahead of your time, and I believe this is one of those cases. Over the course of several weeks this summer, I spent the equivalent of two or three days on the phone trying to find someone who would do a CT scan of the colon. I learned some things that might shorten this search for your other clients.Tip Number One. Unbelievably, most medical offices and hospital personnel I spoke with did not know the terms colonography or virtual colonoscopy. Everyone understood CT scan of the colon. Save yourself some trouble and just inquire about CT scan. [I spoke with two doctors who of course knew all the terms; the people not in the know were the people answering phones.]Tip Number Two. Don’t waste time calling gastroenterologist offices. You might want a gastro specialist if the test comes back positive. But you don’t need one to order the test. All the gastro offices I talked with said they don’t recommend CT scans as a screening tool. The only time they want a CT scan of the colon is to follow up traditional colonoscopy. This seems backward to me, but that’s what a number of them told me.Tip Number Three. Find a facility that performs and reads the CT scan; get the radiology fax number for the order and scheduling phone number. Then ask your primary care doctor to fax in the order for the test for you. Then you call the facility to schedule.Tip Number Four. When calling facilities, ask for the GI Lab. I don’t know if that’s part of Radiology or what, but every hospital I called sent me to their GI Lab. I had been told by a number of gastro offices that if a CT scan of the colon is needed, they send all those patients to Northwestern Memorial Hospital in downtown Chicago. For convenience, I really wanted to find a Lake County hospital, but I couldn’t. My second-to-last call (before resigning myself to going into the city) was to Northwest Community Hospital in Arlington Heights. It’s not Lake County, but at least it’s familiar territory and an easy drive. They did my CT scan two weeks ago. They were wonderfully helpful and knowledgeable from my first phone call to them to the procedure itself.Tip Number Five. Paying for the test might be tricky depending on your hospital’s and your insurance company’s policies. I recommend calling your insurance company at least twice and asking different representatives if you’re covered. I was first told insurance covered colon cancer screenings 100 percent. Then I was told they cover diagnostic tests 100 percent, but for just a routine CT screening, I’d have a $100 copay. Another wrinkle was the hospital’s policy. If I had gone in for traditional colonoscopy, Northwest Community Hospital would have billed insurance directly. Since my colonoscopy was virtual, I would have to self-pay $867. Upon registration, I found because they list self-pays as uninsured, my cost would be $442.17. So that is what I will submit to my insurance company. It remains to be seen how much they’ll cover. I hope I will have no more than the $100 copay. The hospital gave me the procedure code so that I could call the radiologist company that would bill separately for reading the CT scan. Again, it took several phone calls and being told the virtual colonoscopy code wasn’t even in their system before I reached someone who said their charge would be about $335, exact amount depending on I’m not sure what, and they would bill my insurance directly. My insurance company would not commit on the second charge, because their coverage of the reading would depend on if the individual radiologist doing the reading was in-network. So I guess I’ll just have to wait to find out how much that might cost me.A general summary of my experience is that most involved parties do not really know how to handle virtual colonoscopy. They must not have had to deal with it much. Great news though: The two doctors I spoke with in my primary care practice were fairly enthusiastic about my request for this less invasive screening, and they both seemed familiar with positive research about colonography’s effectiveness. There is hope!Sincerely,Jane
Monday, September 16, 2013
Thursday, September 12, 2013
Health professionals knowledge about food allergy/intolerance
Researchers in the August issue of Clinical Nutrition evaluated the knowledge and practice of pediatricians, pediatric gastroenterologists, allergists and nutritionists regarding the primary prevention of food allergy.
Despite the lack of current recommendations, 17.1% of all professionals, mainly nutritionists, recommended a maternal exclusion diet during pregnancy. More professionals recommended a maternal exclusion diet during breastfeeding, and the rates of recommendation were higher in nutritionists and pediatricians compared to allergists and pediatric gastroenterologists.
Despite the lack of current recommendations, 17.1% of all professionals, mainly nutritionists, recommended a maternal exclusion diet during pregnancy. More professionals recommended a maternal exclusion diet during breastfeeding, and the rates of recommendation were higher in nutritionists and pediatricians compared to allergists and pediatric gastroenterologists.
41.9% of the professionals recommended modifying the age of food introduction to prevent the development of food allergy. The majority of the professionals believed that prebiotics (61.2%) and probiotics (44.4%) prevent the development of food allergy. The recommended age of introduction for the main allergenic foods was 12 months.
This study is the first to reveal that there are gaps in the knowledge of professionals about the primary prevention of food allergy.
This study is the first to reveal that there are gaps in the knowledge of professionals about the primary prevention of food allergy.
Bonnie: I am surprised the percentages are that high. ,The study did not even cover food intolerances.
Don't expect probiotic benefit from yogurt
Probiotic yogurt increases the presence of certain probiotic strains, but does not change the overall microbiota makeup, according to research in the journal PharmaNutrition. Volunteers were told to eat either commercial probiotic yogurts or a placebo daily for four weeks. Fecal sample analysis showed no difference in profile variation between the placebo and probiotic yogurt consumption. The finding supports earlier research which found that probiotic yogurt did not modify the composition of gut microbial communities.
Wednesday, September 11, 2013
Does imposing sitting a good thing for school-age kids?
The behavioral impact of an imposed bout of prolonged sitting is yet to be investigated in the pediatric population. The objective of a British Journal of Nutrition study was to determine the acute effect of prolonged sitting on food intake and spontaneous physical activity (PA) levels in healthy children and youth. Kids aged 10–14 years of normal weight were exposed to three experimental conditions in a random order: (1) a day of uninterrupted sitting (Sedentary); (2) a day of sitting interrupted with a 2 min light-intensity walk break every 20 min; (3) a day of sitting interrupted with a 2 min light-intensity walk break every 20 min as well as 2 × 20 min of moderate-intensity PA.
Despite significant differences in sedentary behavior and activity levels during the three in-laboratory sessions, the researchers did not observe any differences in food intake immediately following exposure to each experimental condition or any changes in the levels of sedentary behavior or PA in the 24 hours following exposure to each experimental condition. These findings suggest that children and youth may not compensate for an imposed bout of sedentary behavior by reducing subsequent food intake or increasing PA levels, which is yet another example of why youth are in the throws of an obesity epidemic.
Despite significant differences in sedentary behavior and activity levels during the three in-laboratory sessions, the researchers did not observe any differences in food intake immediately following exposure to each experimental condition or any changes in the levels of sedentary behavior or PA in the 24 hours following exposure to each experimental condition. These findings suggest that children and youth may not compensate for an imposed bout of sedentary behavior by reducing subsequent food intake or increasing PA levels, which is yet another example of why youth are in the throws of an obesity epidemic.
Tuesday, September 10, 2013
Monday, September 09, 2013
Friday, September 06, 2013
Probiotics help diabetics immensely
Researchers in a new Annals of Nutrition and Metabolism study are aware of no study that has indicated the effects of daily consumption of multispecies probiotic supplements on metabolic profiles, high-sensitivity C-reactive protein (hs-CRP), and oxidative stress in diabetic patients.
The randomized double-blind placebo-controlled clinical trial was performed on diabetic patients aged 35-70 years. They were randomly assigned to take either a multispecies probiotic supplement or placebo for 8 weeks. The multispecies probiotic supplement consisted of 7 viable and freeze-dried strains: Lactobacillus acidophilus, L. casei, L. rhamnosus, L. bulgaricus, Bifidobacterium breve, B. longum, Streptococcus thermophilus, and 100 mg fructo-oligosaccharide.
The multispecies probiotic supplementation, compared with placebo, prevented a rise in fasting plasma glucose and resulted in a decrease in serum hs-CRP and an increase in plasma total glutathione.
The randomized double-blind placebo-controlled clinical trial was performed on diabetic patients aged 35-70 years. They were randomly assigned to take either a multispecies probiotic supplement or placebo for 8 weeks. The multispecies probiotic supplement consisted of 7 viable and freeze-dried strains: Lactobacillus acidophilus, L. casei, L. rhamnosus, L. bulgaricus, Bifidobacterium breve, B. longum, Streptococcus thermophilus, and 100 mg fructo-oligosaccharide.
The multispecies probiotic supplementation, compared with placebo, prevented a rise in fasting plasma glucose and resulted in a decrease in serum hs-CRP and an increase in plasma total glutathione.
One-third of world has low vitamin D
A new study in British Journal of Nutrition is one of the first to focus on patterns of vitamin D status worldwide and in key population subgroups, using continuous values for 25(OH)D to improve comparisons. More than one-third of the studies reviewed reported mean serum 25(OH)D values below 50 nmol/l.
The study's key findings include:
- 37.3% of the studies reviewed reported mean serum 25(OH)D values below 50 nmol/l, values considered inadequate by health authorities worldwide.
- Only a limited number of studies for Latin America were available.
- Vitamin D values were higher in North America than in Europe or the Middle-East, but still were lower than they should be.
- Age-related differences were observed for the Asia-Pacific and Middle East regions, but not elsewhere.
Eat Your Blueberries Men
Researchers from Wednesday's American Journal of Clinical Nutrition investigated the impact of blueberry flavonoid intake in healthy men and found that they acutely improve vascular function in a time-dependent manner. These benefits may be linked to the actions of circulating phenolic metabolites on neutrophil NADPH oxidase activity. The researchers assessed polyphenol absorption and metabolism at 1, 2, 4, and 6 hours after consumption of blueberry containing 766, 1278, and 1791 mg total blueberry polyphenols or a macronutrient- and micronutrient-matched control drink (0 mg total blueberry polyphenols). Significant increases were observed at 1–2 and 6 hours after consumption of blueberry polyphenols.
Thursday, September 05, 2013
Omega-3 status improves sleep quality in children
Preliminary data suggests a possible link between blood omega-3 status, behavior, and sleep quality. Speaking at the Food And Behavior Research (FAB Research) symposium, the DOLAB research project involved both wider population data to look for associations in addition to data on supplementation outcomes. Findings from both arms of the study have shown that omega-3 - and particularly docosahexaenoic acid (DHA) - is associated with sleep quality in children.
The researchers stated it was striking just how many children in the study had been found to have clinical signs of sleep disorders, and that blood levels of DHA were significantly correlated with sleep scores. Further findings found that supplementation with the DHA increased measures of sleep quality from baseline significantly.
The researchers stated it was striking just how many children in the study had been found to have clinical signs of sleep disorders, and that blood levels of DHA were significantly correlated with sleep scores. Further findings found that supplementation with the DHA increased measures of sleep quality from baseline significantly.
Steve: This should not come as a surprise. The less inflamed you are, the better you sleep.
Wednesday, September 04, 2013
Not sure about PPI hypersensitivity? You should do this.
Researchers in the August issue of European Journal of Allergy and Clinical Immunology for the first time assessed the role of skin testing in the diagnosis of Proton Pump Inhibitor (PPI)-related immediate hypersensitivity reactions and the cross-reactivity patterns among PPIs.
Standardized skin prick and intradermal tests were carried out with a panel of PPIs. The suspected PPIs were lansoprazole, esomeprazole, pantoprazole, rabeprazole, and omeprazole. The sensitivity, specificity, and negative and positive predictive values of the skin tests with PPIs were 58.8%, 100%, 70.8%, and 100%, respectively. Half of the patients with a hypersensitivity reaction to lansoprazole had a positive oral provocation result or skin test result with at least one of the alternative PPIs.
Considering the high specificity, skin testing seems to be a useful method for the diagnosis of immediate-type hypersensitivity reactions to PPIs and for the evaluation of cross-reactivity among PPIs. However, oral provocation tests should be performed in case of negativity on skin tests.
Bonnie: Reactions to PPIs are very common and this is something that could conceivably be performed at a doctor's office.
Standardized skin prick and intradermal tests were carried out with a panel of PPIs. The suspected PPIs were lansoprazole, esomeprazole, pantoprazole, rabeprazole, and omeprazole. The sensitivity, specificity, and negative and positive predictive values of the skin tests with PPIs were 58.8%, 100%, 70.8%, and 100%, respectively. Half of the patients with a hypersensitivity reaction to lansoprazole had a positive oral provocation result or skin test result with at least one of the alternative PPIs.
Considering the high specificity, skin testing seems to be a useful method for the diagnosis of immediate-type hypersensitivity reactions to PPIs and for the evaluation of cross-reactivity among PPIs. However, oral provocation tests should be performed in case of negativity on skin tests.
Bonnie: Reactions to PPIs are very common and this is something that could conceivably be performed at a doctor's office.
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