In depth look into agave

Agave Syrup May Not Be So Simple
By Laura Johannes
Wall Street Journal

Agave is not just for tequila anymore. The sap from the Mexican plant is now increasingly being sold as a natural sweetener called agave nectar. Companies that sell it say it saves calories and raises blood sugar less than conventional sugar. Doctors are skeptical that it is healthier, and a major testing lab issued a warning that it is not safe for diabetics.

Agave (pronounced ah gav ee), sometimes mistaken for a cactus because of its spiky, sword-shaped leaves, is a flowering plant in the lily family. Its nectar is popping up in beverages, baked goods and on restaurant menus; it is also gaining popularity as an all-purpose sweetener, often next to honey in supermarket aisles.

Agave-nectar composition varies, but typically is primarily fructose. It has about the same amount of calories as sugar, or slightly more, but companies say its sweeter flavor allows you to cut the amount, saving calories.

Agave's other claim to healthfulness is that it has a low glycemic index, meaning it breaks down more slowly creating less of a sugar rush. At least two companies have marketed their products as a good alternative for diabetics. But the Glycemic Research Institute, a Washington, D.C., laboratory, issued a warning Friday that diabetics experienced "severe and dangerous side effects" during testing of an agave nectar. "The diabetics passed out on the floor and had to be taken to the hospital," says Ann de Wees Allen, chief of biomedical research at the lab. She declined to say how much of the product the diabetics consumed during the test, saying that would be disclosed after a complete analysis of the results.

The product tested was a maple-flavored version of the Volcanic Nectar brand agave, sold by Global Goods Inc., of Highland, Utah. Company President Brian Oaks said the product, which has never been sold, had a significant amount of maple syrup in it, which likely caused the problems. Dr. Allen says the nectar had an extremely small amount of maple syrup in it and is almost identical to the company's flagship agave product.

Previous tests, in which diabetics consumed a small amount of Volcanic Nectar agave, had resulted in the lab awarding a "diabetic friendly" seal to the Volcanic Nectar product, which it has since rescinded. The lab has stopped testing agave on humans amid safety concerns. Also, Dr. Allen says the lab refused to test four other agave products after a chemical analysis it commissioned from another lab found they were mixed with high-fructose corn syrup, which was not disclosed on the label. She declined to name the brands. 'Free-for-All Food'

If you're hoping to use agave to lose weight, nutritionists warn it has as many, or more, calories as sugar. "I worry that people may get confused and start thinking it is a free-for-all food," says Gillian Arathuzik, a dietician at the Joslin Diabetes Center in Boston. Agave is 1.4 to 1.6 times as sweet as sugar, says Sabra Van Dolsen, president of Colibree Co., an Aspen, Colo., company that sells Nekutli brand agave nectar. Calories vary from brand to brand, but are typically more than sugar. Nekutli, for example, has 60 calories per tablespoon. A tablespoon of white sugar has 45 calories. Since agave is sweeter, you can use less, proponents say. Stephen Richards, chief executive of BetterBody Foods & Nutrition LLC of Salt Lake City and author of a self-published agave cookbook, says each cup of sugar can be replaced by one-half to two-thirds cup of agave.

But depending on how refined the product is, agave can have little or no flavor—or taste like honey or maple syrup, according to the companies and our subjective tests. Unscientific testing by a Wall Street Journal reporter found agave to be pleasant in tea, but it imparted a brownish tinge and odd taste to lemonade. When baking, oil can be reduced because agave is liquid, says Mr. Richards. Agave makes baked goods rise slightly faster, which can result in a "cakier" texture, he adds. In our test, blueberry bran muffins made with BetterBody's Xagave brand nectar were identical in flavor to a batch made with brown sugar, though the test muffins rose slightly more. The agave version was nine fewer calories a muffin, a 7% saving.

Bonnie - I would never recommend agave to hypoglycemic or diabetic individuals. For them, I put this into the same category as honey or pure maple syrup even though it is low glycemic.

Epigenetics and Autism

Researchers at Duke University Medical Center have uncovered a new genetic signature that correlates strongly with autism and which doesn't involve changes to the DNA sequence itself. Rather, the changes are in the way the genes are turned on and off. The finding may suggest new approaches to diagnosis and treatment of autism.

The researchers found higher-than-usual numbers of gene-regulating molecules called methyl groups in a region of the genome that regulates oxytocin receptor expression in people with autism.

"In both blood samples and brain tissue, the methylation status of specific nucleotides in the oxytocin receptor gene is significantly higher in someone with autism, about 70 percent, compared to the control population, where it is about 40 percent," said co-lead author Simon G. Gregory, Ph.D., assistant professor in the Duke Department of Medicine. The work appears in BMC Medicine journal online.

Oxytocin is a hormone secreted into the bloodstream from the brain, and also released within the brain, where it has a bearing on social interaction. Previous studies have shown that giving oxytocin can improve an autistic person's social engagement behavior and it is being explored as a potential treatment of the disorder. Higher methylation of the oxytocin receptor gene may make a person less sensitive to the hormone.

"These results provide a possible explanation of why social isolation forms part of the autism spectrum – because an autistic individual's ability to respond to oxytocin may be limited," Gregory said. " Oxytocin has been tied to levels of trust and ability to read social cues."

Although the methylation status of the OXTR gene is not a definitive diagnosis of autism by itself, a test for methylation might be used along with other clinical tests for diagnosing autism. Gregory said that methylation-modifying drugs also may be a new avenue for treatments.

Though not a change to the DNA sequence itself, methylation status can be inherited, by what is known as epigenetics - inherited changes in gene regulation.

"The epigenetic link to autism is extremely exciting as it provides another opportunity for us to explore the heritability of this disorder and argues the importance of exploring epigenetic markers in complex disease," said co-lead author Jessica J. Connelly, Ph.D., assistant professor in the Department of Medicine at the University of Virginia.

Steve - there is that buzzword again: epigenetics. If you recall what we have been saying for the last several years, environmental, dietary, and lifestyle choices all contribute to gene expression. If our choices are poor, such as exposing ourselves to poor diet and exposing ourselves and our unborn children to an excessive environmental toxic load, we overload methylation genes, thus negatively expressing genes we would rather keep latent. Soon enough, science will understand this connection and public health officials will have to take a long, hard look at the gigantic weight of toxicity that burdens the human population.

Confidence in supplements at all-time high.

Consumer confidence in dietary supplements reached a high point in 2009, with 84 percent of American adults indicating that they are confident in the safety, quality and effectiveness of dietary supplements compared to 81 percent last year, according to a new survey conducted by Ipsos-Public Affairs for the Council for Responsible Nutrition (CRN). In the last several years, confidence levels in dietary supplements have been on a gradual rise, with 80 percent of American adults indicating a favorable level of confidence in dietary supplements in 2007, and 79 percent of American adults responding similarly in 2006.

According to the results from the 2009 CRN Consumer Survey on Dietary Supplements, confidence in dietary supplements isn’t the only thing on the rise—the on-line survey also showed a slightly higher percentage of adults who label themselves as supplement users, with 65 percent classifying themselves as such. In 2008, 64 percent of American adults identified themselves as supplement users. These numbers are also consistent with previous years’ findings, as 68 percent and 66 percent of Americans identified themselves as supplement users in 2007 and 2006, respectively.

Consumers can also feel more confident given that in its first year of existence, the serious adverse event reporting system for dietary supplements demonstrated a strong safety profile when viewed within the context of similar reporting systems for other regulated industries.

Also up slightly this year is the percentage of consumers who regularly take a multivitamin; with 78 percent reporting they do so compared to 75 percent of supplement users who reported taking a multivitamin regularly in 2008.

1 in 5 kids vitamin D deficient

At least one in five U.S. children aged 1 to 11 don't get enough vitamin D and could be at risk for a variety of health problems including weak bones.

By a looser measure, almost 90 percent of black children that age and 80 percent of Hispanic kids could be vitamin D deficient — "astounding numbers" that should serve as a call to action, said Dr. Jonathan Mansbach, lead author of the new analysis and a researcher at Harvard Medical School and Children's Hospital in Boston.

The findings add to mounting evidence about vitamin D deficiency in children, teens and adults, a concern because of recent studies suggesting the vitamin might help prevent serious diseases, including infections, diabetes and even some cancers.

Exactly how much vitamin D children and adults should get, and defining when they are deficient, is under debate. Doctors use different definitions, and many are waiting for guidance expected in an Institute of Medicine report on vitamin D due next year. The institute is a government advisory group that sets dietary standards.

The new analysis, released by the journal Pediatrics, is the first assessment of varying vitamin D levels in children aged 1 through 11.

Previous studies in the journal this year found low levels were prevalent in U.S. teens, and also showed kids with low levels had higher blood pressure and cholesterol levels, and were more likely to be overweight.

The new analysis uses data from a 2001-06 government health survey of nearly 3,000 children. They had blood tests measuring vitamin D levels.

Bonnie - there are actually updated levels as we reported last week in our eNewsletter.

What Risks Are Associated With High-Dose Crestor?

Jodi H. Walker, PharmD
Medscape Pharmacists

Rosuvastatin, a hydroxy-methylglutaryl coenzyme A reductase inhibitor, is approved in doses ranging from 5 mg to 40 mg daily. Rosuvastatin is a potent statin, about twice as potent as atorvastatin, 4 times as potent as simvastatin, and at least 8 times as potent as pravastatin and lovastatin. Dosing rosuvastatin at 80 mg exceeds the manufacturer's maximum daily dose and is not approved by the US Food and Drug Administration (FDA).

This dose has been evaluated in clinical trials, however. In fact, the manufacturer initially was developing an 80-mg dose. Although rosuvastatin 80 mg monotherapy resulted in the greatest reduction of low-density lipoprotein (LDL) cholesterol (65%) compared with other studied statins, it also was associated with increased risk for muscle toxicity (eg, myopathy, rhabdomyolysis) and renal toxicity (eg, proteinuria, hematuria, increased serum creatinine). According to preapproval documents, among patients receiving the 80-mg dose, the incidence rates of myopathy (1%) and rhabdomyolysis (0.4%) were higher than those reported in the original new drug application and labeling of approved statins.

Preapproval documents also noted a high frequency of elevated creatine kinase levels associated with rosuvastatin compared with other statins. The FDA ultimately denied approval of the 80-mg dose because of safety concerns and the limited additional benefit compared with the 40-mg dose.

Cases of rhabdomyolysis and renal failure have been reported since marketing of rosuvastatin, including a recent case of rhabdomyolysis associated with the 80-mg dose. Risk factors for rosuvastatin-induced myopathy and rhabdomyolysis include age 65 years or older, Asian ethnicity, hypothyroidism, renal impairment, and coadministration with cyclosporine, lopinavir/ritonavir (Kaletra®), fibrates, niacin, or gemfibrozil.

General risks for statin-induced rhabdomyolysis have been proposed and include hepatic dysfunction, hypertriglyceridemia, small body frame and frailty, metabolic muscle diseases, drugs affecting statin metabolism or elimination, postoperative status, and chronic alcohol use.

Due to risk for myopathy and rhabdomyolysis, the lowest effective rosuvastatin dose should be used. A lower initial dose of 5 mg is recommended for patients of Asian ethnicity, patients with severe renal impairment, and patients taking concomitant lopinavir/ritonavir. A reduced initial dose should be considered in patients receiving fibrates or niacin; coadministration with gemfibrozil should be avoided. The 40-mg dose is only recommended for patients who have not achieved their LDL goal with 20 mg.

Choosing to prescribe rosuvastatin 80 mg is influenced by several issues: patient risk factors for rhabdomyolysis, concomitant medications, comorbid conditions, and need for close monitoring. The benefits and risks inherent in such dosing depend on the individual patient. Patients who receive any dose of rosuvastatin should be monitored closely after any dosage adjustments. All patients on rosuvastatin should be counseled to seek immediate medical attention for signs and symptoms of rhabdomyolysis, including muscle pain, muscle weakness or cramps, and dark urine. If rhabdomyolysis is suspected, the statin should be discontinued immediately and supportive measures taken.

Living with gluten intolerance one year after diagnosis

No Pain, No Gain One Year After Diagnosis of Gluten Intolerance
By Erin Madison
Great Falls Tribune
http://www.greatfallstribune.com/article/20091021/LIFESTYLE/910210312/1024/rss04

Phytochemicals prevent oxidative stress

Eating more plant-based foods, rich in substances called phytochemicals, seems to prevent oxidative stress in the body, a process associated with obesity and the onset of disease, according to the Journal of Human Nutrition and Dietetics. To get enough of these protective phytochemicals, researchers suggest eating plant-based foods such as leafy greens, fruits, vegetables, nuts and legumes.

The researchers studied a group of 54 young adults, analyzing their dietary patterns over a three-day period, repeating the same measurement eight weeks later. The participants were broken into two groups: normal weight and overweight-obese. Although the adults in the two groups consumed about the same amount of calories, overweight-obese adults consumed fewer plant-based foods and subsequently fewer protective trace minerals and phytochemicals and more saturated fats. They also had higher levels of oxidative stress and inflammation than their normal-weight peers. These processes are related to the onset of obesity, heart disease, diabetes and joint disease.

Currently, there are no recommendations for how much of these plant compounds people should be getting each day. Using a phytochemical index could be a good way to come up with these recommendations.

Bonnie - most of my clients meet the phytochemical requirements, but for those who need a product rich in phytochemicals, we have Metagenics Phytoganix.

Analysis questions prostate and breast cancer screening methods

Courtesy of the New York Times

Two decades after the explosion in cancer screening fueled by reimbursement for mammography and prostate specific antigen (PSA) testing, a new analysis suggests that it is time to rethink the push for early detection of these two cancers. There is no argument that more cancers are being detected and at a much earlier stage, but that increase has not resulted in a decrease in metastatic disease, according to Laura Esserman, MD, MBA, of the University of California, San Francisco, and colleagues, who made their case in a special communication published in the October 21 issue of the Journal of the American Medical Association.

In broad strokes they painted a picture of increased detection and costly treatment of cancers that pose minimal risk, without making a dent in killer cancers. The researchers touched a nerve with the commentary and the American Cancer Society has already gone on record saying that it is reconsidering its position on the risks and benefits of breast and prostate cancer screening. Otis Brawley, MD, chief medical officer of the society, said that the benefits of screening have been exaggerated.

When prostate cancer mortality in the U.S. was compared with the rate in United Kingdom -- where PSA screening is not recommended -- there was no difference, although the incidence of prostate cancer was dramatically higher in the U.S. For breast cancer, seven randomized trials found a relative reduction in mortality ranging from 20% to 30%, but the "observed decrease in mortality is attributable to both screening and adjuvant therapy, with an estimated decrease of 7% to 23%, and 12% to 21%, respectively."

What is an effective screening technique is the detection of premalignant lesions, which is exactly what occurs with both colonoscopy and pap smears, two screening strategies that have significantly decreased invasive colorectal and cervical cancers.

Esserman argued that it is time to develop new screening strategies -- possibly new biomarkers -- that will be able to differentiate between "significant- and minimal-risk cancers." At the same time, she recommended new strategies to "reduce treatment for minimal-risk disease" and calls for the development of "clinical and patient tools to support informed decisions about prevention, screening, biopsy, and treatment and offer treatments tailored to tumor biology."

Bonnie - I anticipate that there are many health professionals and patients out there who are a bit peeved with this report.

10/22/09 Note: The American Cancer Society says it is not currently rethinking its stance on cancer screening, as was widely reported. "We are not redoing or rethinking our guidelines at this time, nor are we going to restate our guidelines to emphasize the inadequacies of screening," said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

Non toxic method helps keep fruit, vegetables and flowers fresh

Did you know that millions of tons of fruits and vegetables in the United States end up in the trash can before being eaten, according to the U.S. Department of Agriculture?

A Georgia State University professor has developed an innovative new way to keep produce and flowers fresh for longer periods of time. Microbiologist George Pierce's method uses a naturally occurring microorganism -- no larger than the width of a human hair -- to induce enzymes that extend the ripening time of fruits and vegetables, and keeps the blooms of flowers fresh. The process does not involve genetic engineering or pathogens, but involves microorganisms known to be associated with plants, and are considered to be helpful and beneficial to them.

"These beneficial soil microorganisms serve essentially the same function as eating yogurt as a probiotic to have beneficial organisms living in the gastrointestinal system," Pierce said.

The process works by manipulating the organism's diet so that it will over express certain enzymes and activities that work in the ripening process and keeping the flower blooms fresh. Pierce analogizes this to using diet and exercise to improve the performance of an athlete.

In a very simple sense, climacteric plants -- such as apples, bananas, peaches and tomatoes -- respond to climactic change, and when they do, they produce increased levels of signal compounds like ethylene. For fruit such as peaches, ethylene causes the peach to ripen, increases aroma chemicals, but unfortunately, makes the peach very fragile.

The catalyst in this process can be distributed through various formulations and configurations. These include being incorporated into shipping boxes, packing materials or used to treat the air of shipping containers. It could be used either with individual fruits or vegetables or for larger, bulk quantities.

This new process could have a big impact on preventing waste, improving the consumption of healthy fruits and vegetables, allowing companies to ship produce longer distances.

The method also will allow for the storage of fruits, vegetables and flowers at room temperatures rather than refrigeration, thus helping to save energy, Pierce said.

The U.S. patents related to this invention are owned by the Georgia State University Research Foundation, Inc.

Steve - what a great idea. Unfortunately, for this to be accepted nationwide, a huge company would have to license the patent.

Mental inextricably linked to the physical

The true burden of mental ill health is unrecognized since many "physical" problems are really "mind" problems. Most lung cancers are caused by addiction to smoking, and some obesity by a brain-driven compulsion to eat, says UK psychiatrist Dr Peter Jones. And to tackle such problems experts need to go back to delving the mind. He and other leading mental health experts are calling for more research.

Mental illness in its "classic" sense, including depression and schizophrenia, affects one in four people in the United Kingdom each year but receives just 5% of total health research spending. Yet the economic, social and human cost of mental illness totals far more.

And many "physical" health problems involve a strong mental component. Professor Peter Jones, head of psychiatry at the University of Cambridge, said: "Mental health and illness are seen as separate from physical health and disorders but it's becoming increasingly clear that is wrong. We need to zip together physical and mental health. It is absurd to think that biological processes would stop at the neck."

People with severe mental illnesses are nearly three times more likely to develop diabetes and other cardiovascular disease risk factors and, on average, die 25-30 years younger.

Bonnie - we have discussed the Gut/Brian Connection repeatedly over the years. There is an absolute connection between the mental and the physical. However, it is not just a one-way street. You can definitely heal the mental by addressing the physical. This is what most mental experts miss.

Why is alternative medicine absent in health care debate?

A new survey indicates 12 percent of parents with children under the age of 18 have spoken to their child's doctor about complementary and integrative approaches to medicine, yet nearly 90 percent say they want to know more.

Parents should be aware that integrative alternative medicine can be helpful from the onset of the disease and can save time and money and improve a child's quality of life, said Timothy Culbert, MD, medical director of Pediatric Integrative Medicine Clinical Programs at Children's Hospitals and Clinics of Minnesota, which conducted the nationwide survey.

“This is true for all kinds of conditions including acute illnesses like cancer or chronic problems like migraines or behavioral issues.” he said.

The survey assessed parents' attitudes about various approaches to treating a child's illnesses. Integrative medicine combines the best conventional medical therapies like drugs, chemotherapy and surgery with complementary therapies like massage, acupuncture and proper nutrition.

Natural treatments, including non-drug, less invasive therapies like acupuncture, massage and relaxation, are being found to be effective in the management of a variety of children's health concerns. They're designed to help kids more effectively control pain, maintain mental health and improve quality of life.

According to the study:

• 68 percent of parents say integrative medicine is an effective treatment approach.
• Parents are concerned about the overuse of prescription medications; 85 percent feel it's important to minimize a child's dependence on drugs, especially for behavioral issues like attention deficit hyperactivity disorder (ADHD) or anxiety.
• More than three-fourths of parents agree combining conventional and complementary/alternative approaches to medicine is innovative and that hospitals should offer medical experts on both conventional and complementary/alternative therapies.
• Almost two-thirds of parents who have children with serious health issues haven't considered an integrative approach because they are unfamiliar with the subject.
• Of the parents who have used integrative medicine as part of their child's treatment, 95 percent have reported a positive experience.

"Parents need to consult and work with their child's physician to determine what integrative medicine options are available that may be helpful," said Culbert. "There are so many different kinds of complementary therapies, it's important to learn about options to find an approach that will work best for each patient. I see first-hand every day the difference it can make in a child's life."

Children's boasts the largest, longest-running pediatric clinical integrative medicine program in North America. The program offers a holistic approach to care and helps children and their families manage the everyday struggles of illnesses in a more comprehensive way. Currently more than half of patients at Children's use some sort of outpatient complementary or alternative medicine to help manage their conditions.

Bonnie - the problem here is that many physicians cannot have a conversation about integrative health options because they have never been educated about them. This is why there is little mention of alternative health options in the health care debate aside from a few senators and house reps who have had major successes through integrative therapies.

CRP predicts heart attack, death, but not stroke

People with high levels of a protein called C-reactive protein (CRP), a marker for inflammation in the blood, may be at higher risk for heart attack and death but not stroke, according to a study published in Neurology.

The study involved 2,240 people from the Northern Manhattan Study who were 40 years old or older and stroke-free. Of the group, 63 percent were Hispanic, 20 percent non-Hispanic black and 15 percent non-Hispanic white residents.

All participants had their blood tested for CRP levels and were evaluated for stroke and heart attack risk factors. They were followed for an average of eight years. In that time, there were 198 strokes, 156 heart-related events and 586 deaths.

The researchers found that people with CRP levels greater than three milligrams per liter were 70 percent more likely to suffer a heart attack and 55 percent more likely to die early compared to people who had levels of one milligram per liter or less of the protein in their blood. The protein was not associated with an increased risk of stroke once other risk factors were taken into account.

CRP protein levels are associated with such medical and lifestyle risk factors as diabetes, smoking, alcohol consumption and physical activity. "It appears that by living a healthy lifestyle, one may be able to lower these protein levels, thus lowering the risk of cardiac events and possibly early death," said one researcher.

New school lunch program recommendations

School meals must meet standards established in 1995. At the request of the United States Department of Agriculture (USDA), the Institute of Medicine convened a committee to provide recommenda­tions to revise standards and requirements so that school meals are more healthful. In its 2009 report School Meals: Building Blocks for Healthy Children, the committee recommends that the USDA adopt standards for menu planning, including:

• Increasing the amount and variety of fruits, vegetables, and whole grains
• Setting a minimum and maximum level of calories
• Focusing more on reducing saturated fat and sodium
  

In 2007, these national programs provided lunch to more than 30.5 mil­lion children and breakfast to 10.1 million children. If the IOM’s recommended changes are implemented, they will result in school meals that not only appeal to students but also better meet students’ nutritional needs.

Steve - we will have a comment when we review the full report.

Reduce fracture risk with fermented soy

Postmenopausal women (but not men) may lessen their chances of fracturing a hip 21 to 36 percent by adding moderate amounts of fermented soy-based foods to their diet, according to a report in the American Journal of Epidemiology.

Researchers surmise that the bone-protective effects of soy isoflavones may play a critical role in the bone health of postmenopausal women.

Bonnie - the key in this study is that the soy foods were fermented (tofu, tempeh, miso, natto).

Breast cancer risk reduced with Med Diet

Adherence to a Mediterranean diet along with avoidance of Western-type foods may contribute to a reduction in postmenopausal breast cancer risk, according to findings published in this month’s American Journal of Epidemiology.

Research was initiated in 1990 and involved 65,374 women living in France who were born between 1925 and 1950. 2,381 developed postmenopausal invasive breast cancer during a median follow-up period of 9.7 years. The findings indicate that a Mediterranean diet comprised of mostly fruits, vegetables, fish and olive/sunflower oil, was associated with a reduced risk of breast cancer only if energy intake remains within recommendations and if ‘unhealthy’ foods are not consumed in large quantities. The risk associated with the 'alcohol/Western' eating pattern was higher in the case of tumours that were estrogen receptor-positive/progesterone receptor-negative, added the researchers.

Exercise and Respiratory Tract Viral Infections

Moderate-intensity exercise reduces inflammation and improves the immune response to respiratory viral infections. Acute and chronic moderate exercise induces a level of stress hormones that downregulates excessive inflammation within the respiratory tract and aids in activating innate antiviral immunity.

Prolonged intense exercise may do this as well but may shift the balance too much, actually allowing the virus to gain a better foothold and cause greater pathology. Further research is necessary to examine cellular and molecular mechanisms through which exercise modulates immune function.

Based on the available evidence, moderate-intensity exercise training should be used as an adjunct to other preventive measures against respiratory tract viral infection.

Exercise and Sport Sciences Reviews

Steve - those who train for marathons, but have no intention of making it their profession, should take a look at this study.

Docs "in-the-know" prescribe fish oil

Numerous speakers at the Heart Failure Society of America 2009 Scientific Meeting commented on the shortage of new heart-failure agents to show a solid clinical benefit when given on top of the standard medications. A group of Northwestern University researchers decided to make their case for a substance already available, but much overlooked: fish oil.

"Omega-3 supplementation is very good, but we don't talk about it. The bulk of evidence suggests that this intervention is relatively simple, well accepted by the patient, with no side effects, and has an effect on cardiovascular mortality and heart failure."

"There are very few drugs that you can put on top of the standard medications and reduce cardiovascular death by ten percent."

Steve - the fact that it is overlooked is not surprising given the fact that Big Pharma cannot make any money off of fish oil. On the heels of this commentary, a British Journal of Nutrition study of over 57,000 Danish subjects over eight years may reduce unstable angina and chest pains by 27% in men who consume as little as .4 mg daily.

Has your pediatrician discussed vitamin D deficiency with you?

According to an October report in Pediatric Pharmacotherapy, new recommendations for addressing vitamin D deficiency in children is crucial for pediatricians to discuss with parents.

Not only do 25(OH)D levels need to be maintained within a normal reference range, but daily supplementation is required.

• 400IU vitamin D3 is required immediately after birth for all breastfed infants and for formula-fed infants that do not consume at least 1 liter of vitamin D-fortified milk each day.
  
• Premature infants, dark-skinned infants, and children who live in higher latitudes (cold weather climates), should supplement with 800IU daily.
  
  
• Children who have low 25(OH)D levels (out of reference range) need to supplement with the following:
  
  Less than one month old = 1000IU
  1-12 months old = 1,000IU to 5,000IU
  More than 12 months old = more than 5,000IU

Bonnie - please get the word out!

Study: popular antidepressant = suicidal thoughts in men

Nortriptyline (under the brand names Sensoval, Aventyl, Pamelor, Norpress, Allegron and Nortrilen) has been found to cause a ten-fold increase in suicidal thoughts in men when compared to its competitor escitalopram (under the brand names Lexapro and Cipralex). These findings are published in the open access journal BMC Medicine.

The research was carried out by Dr. Nader Perroud from the Institute of Psychiatry, Kings College London, who headed up GENDEP, an international team. Dr Perroud said "Suicidal thoughts and behaviors during antidepressant treatment have prompted warnings by regulatory bodies". He continued "the aim of our study was to investigate the emergence and worsening of suicidal thoughts during treatment with two different types of antidepressant."

The study was carried out on 811 individuals with moderate to severe unipolar depression. While an overall trend in reduction of suicidal thoughts was observed, men who took nortriptyline were found to have a 9.8-fold increase in emerging suicidal thoughts and a 2.4-fold increase in worsening suicidal thoughts compared to those who took escitalopram.

Perroud concludes, "Our findings that treatment-emerging and worsening suicidal thoughts may also be associated with psychomotor activation triggered by antidepressants needs to be investigated in future studies. The study also refutes the idea that newer antidepressants such as the SSRIs are worse than older medications in terms of increasing suicidal thoughts."

Antibiotic Resistance: An Ecological Perspective on an Old Problem

Steve - I think this is pragmatic way of looking at antibiotic resistance. The one thing they fail to mention, however, that optimizing the host will always be the best option for prevention.

Antibiotic resistance is never going to go away. No matter how many drugs we throw at it, no matter how much money and resources are sacrificed to wage a war on resistance, it will always prevail. Humans are forced to coexist with the fact of antibiotic resistance. Public health officials, clinicians, and scientists must find effective ways to cope with antibiotic resistant bacteria harmful to humans and animals and to control the development of new types of resistance.

The American Academy of Microbiology convened a colloquium October 12-14, 2008, to discuss antibiotic resistance and the factors that influence the development and spread of resistance. Participants, whose areas of expertise included medicine, microbiology, and public health, made specifi c recommendations for needed research, policy development, a surveillance network, and treatment guidelines. Antibiotic resistance issues specific to the developing world were discussed and recommendations for improvements were made.

Each antibiotic is injurious only to a certain segment of the microbial world, so for a given antibacterial there are some species of bacteria that are susceptible and others not. Bacterial species insusceptible to a particular drug are “naturally resistant.” Species that were once sensitive but eventually became resistant to it are said to have “acquired resistance.” It is important to note that “acquired resistance” affects a subset of strains in the entire species; that is why the prevalence of “acquired resistance” in a species is different according to location.

Antibiotic resistance, the acquired ability of a pathogen to withstand an antibiotic that kills off its sensitive counterparts, originally arises from random mutations in existing genes or from intact genes that already serve a similar purpose. Exposure to antibiotics and other antimicrobial products, whether in the human body, in animals, or the environment, applies selective pressure that encourages resistance to emerge favoring both “naturally resistant” strains and strains which have “acquired resistance.” Horizontal gene transfer, in which genetic information is passed between microbes, allows resistance determinants to spread within harmless environmental or commensal microorganisms and pathogens, thus creating a reservoir of resistance. Resistance is also spread by the replication of microbes that carry resistance genes, a process that produces genetically identical (or clonal) progeny.

Rapid diagnostic methods and surveillance are some of the most valuable tools in preventing the spread of resistance. Access to more rapid diagnostic tests that could determine the causative agent and antibiotic susceptibility of infections would inform better decision making with respect to antibiotic use, help slow the selection of resistant strains in clinical settings, and enable better disease surveillance. A rigorous surveillance network to track the evolution and spread of resistance is also needed and would probably result in significant savings in healthcare.

Controlling antibiotic resistant bacteria and subsequent infections more efficiently necessitates the prudent and responsible use of antibiotics. It is mandatory to prevent the needless use of antibiotics (e.g., viral infections; unnecessary prolonged treatment) and to improve the rapid prescription of appropriate antibiotics to a patient. Delayed or inadequate prescriptions reduce the efficacy of treatment and favor the spread of the infection. Prudent use also applies to veterinary medicine. For example, antibiotics used as “growth promoters” have been banned in Europe and are subject to review in some other countries.

There are proven techniques for limiting the spread of resistance, including hand hygiene, but more rapid screening techniques are needed in order to effectively track and prevent spread in clinical settings. The spread of antibiotic resistance on farms and in veterinary hospitals may also be significant and should not be neglected.

The important messages about antibiotic resistance are not getting across from scientists and infectious diseases specialists to prescribers, stakeholders, including the public, healthcare providers, and public officials. Innovative and effective communication initiatives are needed, as are carefully tailored messages for each of the stakeholder groups.

Download the full report.

Low income Americans now have more access to fruits and vegetables

Millions of women and children are eating more fruits, vegetables and whole grains in a public health campaign that all states had to join by his month. In the largest overhaul since it began in 1974, the federal Women, Infants and Children (WIC) nutrition program has begun giving vouchers for a wider variety of food to its 9.3 million low-income participants — mothers, infants and children up to 5 years old.

Until now, WIC vouchers bought only milk, cheese, juice and eggs."It's a huge change," says undersecretary Kevin Concannon of the U.S. Department of Agriculture, which runs the program. He says the improved mix of foods will lower health-care costs, partly by reducing obesity. Nearly half of U.S. newborns are in WIC, available to families with incomes up to $33,874 for a household of three — 185% of the federal poverty level. The change won't increase monthly benefits, which average $43 per person, but will provide a new cash-value voucher for produce that is worth $6 for each child and $10 for a breast-feeding mother. Other vouchers will allow the purchase of whole-grain foods and will reduce the amount of dairy products. Most states began issuing the new vouchers on Oct. 1.

A handful did so earlier."People are very excited," says Susan Greathouse of Oregon's WIC program, which began issuing produce vouchers in August. She says mothers have used more than 80% of those distributed. Delaware, which began in January, also reports 80% use. In New York, which began the federal vouchers in January after issuing state-funded ones, 85% are being used.Another benefit: Neighborhood stores are stocking produce because customers can buy it.

The change didn't come without controversy. Dairy and juice groups expressed concern because their products would be allowed in smaller quantities to offset the cost of adding produce and grains. Mothers are thrilled to be able to buy produce, but "some of the changes are not that popular," says Laurie True of the California WIC Association, a non-profit group representing local WIC agencies.

Bonnie - we reported on this change a while ago. Boy, is this a welcome change! Hopefully, those taking advantage of the changes can set an example for those in their community that do not qualify for WIC. This was sorely, sorely needed and I commend the government for their actions.

I am shocked and incredibly encouraged that they lowered the amount of dairy and juice vouchers. Maybe they are starting to understand that they are not as healthful as once believed.

This is an instance where I can say my tax dollars are being well spent.

Folate-blocking drugs produce birth defects

Drugs that interfere with the action of folic acid can produce a sharp increase in certain birth defects if taken during the first trimester of pregnancy, Israeli researchers reported today in the British Journal of Clinical Pharmacology. It is well-known that high levels of folate in pregnant women increase the chances of a healthy baby, and most medical authorities suggest that folate supplements be taken during pregnancy to minimize risks.

The new study is the largest ever to look at the issue, the authors said. A team from Ben-Gurion University of the Negev studied 84,832 babies born at the Soroka Medical Center in Beer-Sheva. The drugs increased the risk of spina bifida and malformations of the brain more than sixfold. The results are conservative, the researchers noted, because they were unable to include data about spontaneous abortions. Among the drugs that cause problems are dihydrofolate reductase inhibitors, such as trimethoprim (Proloprim, Triprim and Monoprim), sulfasalazine (Azulfadine and Salazopyrin) and methotrexate that prevent folate from being converted into active metabolites. Other drugs that are known to lower serum and tissue concentrations of folate include the antiepileptic drugs -- such as carbamazepine (Tegretol, Carbatrol and others), phenytoin (Phenytek and Dilantin), lamotrigine (Lamictal), primidone, valproic acid (Depakote) and phenobarbital (Luminal) -- and cholestyramine (Questran and Cholybar).

Thomas H. Maugh II, LA Times

Green tea for cancer prevention

Drinking green tea may lower your risk of developing certain blood cancers, but it will take about 5 cups a day. After gathering information on the diets and green tea drinking habits of a large group of Japanese adults aged 40 to 79 years old, Naganuma and colleagues followed the group for development of blood and "lymph system" cancers.

The 19,749 men and 22,012 women who participated in the study had no previous history of cancer, the authors note in the American Journal of Epidemiology.

During 9 years of follow up, 157 blood, bone marrow, and lymph system cancers developed in the study group. The overall risk for blood cancers was 42 percent lower among study participants who drank 5 or more, versus 1 or fewer, cups of green tea daily.

Drinking 5 or more cups of green tea daily was also associated with 48 percent lower risk for lymph system cancers.

These associations held up in analyses that allowed for age, gender, education, smoking status and history, alcohol use, and fish and soybean consumption.

The researchers also observed reduced risk for blood-related cancers among obese study participants, who are considered to have higher risk of these cancers.

Got water?

People who get much of their daily liquids from plain water rather than other beverages may have healthier diets overall.

Using data from a national health survey of more than 12,000 Americans, researchers found that people who drank more "plain water" tended to eat more fiber, less sugar and fewer calorie-dense foods.

The reverse was true of people who got much of their fluids from other beverages, according to a report of the study in the American Journal of Clinical Nutrition.

Bonnie - this should not come as a surprise to anyone. I would bet they would find the same stats if subjects also drank unsweetened tea and coffee, or stevia sweetened beverages. Notice that artificially sweetened beverages and milk did not encourage healthier diets.

Probiotics help reduce fiber’s anti-nutrient actions

Formulating bread with Bifidobacterium strains may reduce levels of a compound in high-fiber bread thought to be behind fiber’s impairment of mineral absorption. While the consumption of whole-grain bread or fiber-enriched bread is increasing on the back of consumer understanding of the benefits of a high-fiber diet, wholegrain foods are also reported to impair mineral absorption. The impairment is thought to be related to the phytate and phytic acid content of these products.

According to new findings published in the Journal of Agricultural and Food Chemistry, phytase enzymes produces by strains of bifidobacteria, could reduce phytate and phytic acid levels in bread. "Bifidobacterium strains or the enzyme preparations would be the best approach to reduce the content of phytic acid in fibre-rich products for human consumption.” Results showed that, compared to high-fibre bread baked traditionally, fermentation of the bread with the Bifidobacterium strains led to significantly lower phytic acid levels. Not all phytates were removed however, and residual amounts of myo-inositol triphosphates (InsP3) were recorded. This is important, say the researchers, since InsP3 may positively affect human health.

Steve - another very encouraging reason to take probiotics, especially bifidus.

Parents part of the problem, solution for obesity

"Parents might be contributing to the overweight epidemic," said Dr. Elsie Taveras, an assistant professor of pediatrics at Harvard Pilgrim Health Care and Harvard Medical School, who has researched the issue.

They do so unwittingly, of course, Taveras said. And the point is not to make parents feel guilty about contributing to their children's weight problems, she said, but to get the word out because the trend is headed in the wrong direction.

Today in the United States, infants up to 6 months old are 59 percent more likely to be overweight than were babies 20 years ago, according to a study published in Obesity.

"What we found was, those children who gained more weight and gained it more quickly in the first six months of life had a higher risk of obesity when they were 3 years old," Taveras said. Her study was reported in Pediatrics.

The way parents feed their infants might play a role in this weight gain, another study found.

Mothers who fed their babies formula eight times a day, on average, rather than seven and "who were less sensitive in reading their baby's satiety cues," Worobey said, had babies who gained more weight between ages 6 and 12 months. The findings were reported in the Journal of Nutrition Education and Behavior.

One solution, he said, is for parents to pay closer attention to their baby's cues, asking their pediatrician for help if they aren't certain how to read those cues.

"Pulling the head away from the bottle is the infant's way to signal, 'Hey, I don't want to do this anymore,'" Worobey said. But the cue is often not noticed.

One way to remedy that, he suggests, is for parents to avoid feeding their infants while watching television. "You may be paying more attention to the TV," he said. "It's better to make it one-on-one time."

There could be cultural myths at work, too, he said, with some cultures still believing that a chubby baby is a healthy baby.

Taveras urged parents to check in often about weight with their infant's pediatrician. With about four "well-baby" visits in the first six months, parents should remember to ask each time about their child's weight. "They should discuss with their clinician how their child is growing," she said.

But the parental link to youngsters' weight might start well before birth, perhaps even before pregnancy.

Reporting in the Maternal and Child Health Journal, researchers found that women who start pregnancy at a normal weight but gain more than 25 to 35 pounds increase their child's risk for being overweight at age 3.

Bonnie - these are all very valid points that need to be addressed when educating potential parents, parents-to-be, and new parents.

AMD predictor for CHD?

A large study in the October issue of Ophthalmology found strong evidence that older people who have age-related macular degeneration (AMD) are at increased risk for coronary heart disease (CHD), although not for stroke. This result adds to mounting evidence that AMD and cardiovascular disease may share some risk factors–smoking, high blood pressure, inflammatory indicators such as C-reactive protein, genetic variants such as complement factor H–and disease mechanisms.

The Cardiovascular Health Study (CHS) followed 1,786 white or African American participants, who were free of CHD or stroke at the study's outset, for about seven years. The CHS received funding from the National Heart, Lung and Blood Institute, a division of the National Institutes of Health.

The incidence of CHD was 25.76 percent in patients with AMD, compared with 18.9 percent in those without AMD. The association between AMD and CHD was somewhat stronger in people age 69 to 78 than age 79 and up. Data were adjusted to counter potentially confounding factors like hypertension, diabetes, and smoking.

Probiotics for eczema in children

Treating pregnant mothers, and then their infants, with select strains of probiotics may help prevent the skin condition eczema in children with a family history of allergies, particularly during the first 3 months of life, according to study in Allergy.

Eczema is an inflammatory skin condition thought to be related to allergies. Researchers gave more than 150 pregnant women with a family history of allergic diseases either a mixture of three probiotic bacteria or a placebo - inactive pill - during the last six weeks of pregnancy. They also gave the same treatment to the women's children for 12 months.

Neither the women nor their doctors knew whether they were receiving the probiotics or inactive pills.

They were able to follow up with 102 of the children born to the mothers who took part in the study. During the first 3 months of life, the parents of six in 50 of the subjects who received probiotics reported eczema in their children, compared to 15 or 52 of the placebo group.

Put another way, it would be necessary to treat approximately 6 mothers and children to prevent one case of eczema at the age of three months and 12 months, and closer to 7 children at two years.

One of the paper's 9 authors is employed by Winclove Bio Industries B.V., Amsterdam, which manufactures the probiotic supplements used in the study.

Coke Partners with Doctors Group

Can soft drinks ever be part of a healthy diet?
by Julie Deardorff
Chicago Tribune

Coca-Cola, whose sugar-laden products have contributed to a global obesity epidemic, has partnered with a leading medical group to promote healthy soft drink consumption.

The American Academy of Family Physicians (AAFP) announced this week that it will receive a six-figure grant from Coke to develop educational material to teach consumers about the role beverages and sweeteners can play in a healthy, active lifestyle, said AAFP president-elect Lori Heim.

Though the material will be co-developed, the AAFP retains editorial control over the content, which will appear on the group’s Web site, familydoctor.org, Heim said. “Coke shares common goals in the arena of consumer education,” said Heim, adding that the AAFP had been seeking a corporate sponsor and has worked with Coke before. “It’s consistent with our principles.”

But some outspoken critics now wonder what those principles are. They call the partnership an embarrassing conflict of interest and say the venture will—and should--undermine the credibility of the AAFP, one of the leading family doctor groups in the U.S.

"For someone trying to lose weight, the first piece of advice is to cut out soft drinks, cold turkey,” said Marion Nestle, a professor of nutrition at New York University, who called for dissenting AAFP members to make their voices heard. “Will the AAFP’s educational materials make that point? I doubt it. Expect to see ‘all foods can be part of healthful diets’ and averted eyes in conversations about taxing soft drinks,” she said.

The AAFP’s Heim disagreed that telling people to go cold turkey is effective and said Coke can be a helpful corporate influence.

“I spend a lot of my time trying to explain to people how to approach food and beverages as part of healthy lifestyle,” she said. “It doesn’t help if I say ‘abstinence. You can’t get behavior change by issuing edicts.

"People have to understand how to make smarter choices to have a healthy lifestyle," she added. "Developing educational materials will help people make those decisions.”

Coke’s venture with the AAFP comes as it aggressively fights against a federal tax on sugary beverages. In a recent Wall Street Journal piece, Coke’s Chief Executive Officer Muhtar Kent argued that Coke didn’t make America fat; a lack of exercise should be blamed. Moreover, why just target beverages?

“Even soft drinks with sugar, like Coca-Cola, contain no more calories (140 calories in a can) than some common snacks, breakfast food and most desserts served up daily in millions of American homes,” Kent wrote.

But sugary beverages—and perhaps even diet drinks--are still part of the problem, said Barry Popkin, director of the University of North Carolina’s Interdisciplinary Obesity Center and the author of “The World is Fat.” Around the world, consumers consume Coke products at a rate of 1.6 billion servings a day, according to Coke.

Though he commends Coke for shifting its product line—more than 25 percent of Coke’s global beverage portfolio is comprised of low or no-calorie beverages—he doesn’t buy the argument that the problem is a lack of exercise.

“The food industry for decades has funded movements to encourage exercise and tried to make us think there are no good or bad foods. This is false,” Popkin e-mailed from Bangkok, where he—along with representatives from Coke and Pepsi--is attending the International Congress of Nutrition Conference. “Fruits, vegetables, low fat dairy, poultry, beans and fish are good foods. Sugary beverages are linked with obesity, diabetes and heart disease.

“Their involvement with this physicians groups appears to be another attempt to make us think their sugary drinks are healthful rather than accepting the knowledge that their sugary drinks need to have less sugar,” he added.

Coke has also partnered with the American College of Sports Medicine to promote the group’s “exercise is medicine” campaign. The ACSM says Coke “supports the value of physical activity and exercise” and the partnership allows them “to bring the message to a much wider audience than we could otherwise reach.” In 2003 Coke announced a similar partnership with the American Academy of Pediatric Dentists.

Still, the corporate alliances with health and medical groups are a slippery slope, says Nestle.

“Food industry partnerships have destroyed the credibility of the American Dietetic Association--who pays any attention to anything they say?” she asked. “The Smart Choices program has made a laughing stock of the American Society of Nutrition. Froot Loops as a 'Smart Choice?' Give us all a break. No wonder people trust what they read on the Internet more than they trust what their family doctors say."

Bonnie - Marian and Julie, I could not have said any better myself.

The Skinny on Making 10 Quick Desserts.

1. Top sweet fruits (such as berries, nectarines, and cherries) with a sprinkle of granola or gluten-free flour with a little melted butter substitute. Microwave until warm.
   
   
2. Sauté sliced, peeled sweet apples, pears, bananas with a little pure maple syrup with melted butter/no trans fat butter substitute.
   
   
3. Sprinkle honey, agave, or pure maple syrup and cinnamon on top of ½ red grapefruit and broil until the grapefruit is warm and the sugar has caramelized.
   
   
4. Cut a banana in half lengthwise (but leave the skin on). Sprinkle with optional cinnamon. Broil it until the banana begins to carmelize.
   
   
5. Core an apple (but leave skin on). Drip enough melted butter/butter substitute and honey/pure maple syrup into the center to fill it. Sprinkle with an optional dash of cinnamon and bake or microwave until the apple flesh is soft.
   
   
6. Puree frozen mango or pineapple chunks in a blender. Add a dash of stevia for sweetness. Serve immediately.
   
   
7. Microwave frozen cherries until warm. Take out of the microwave, add a dash of Chambord or other berry liquor and torch the liquor for “cherries flambé”.
   
   
8. Mix berries into lowfat Greek yogurt. Sprinkle the top with a dash of pure maple syrup, honey, or raw sugar. Use a match (or preferably) a cooking torch to brown the sugar for “crème brulee”.
   
   
9. Mix soft tofu with a small amount of raw sugar or stevia and cocoa powder to taste to make “chocolate mousse”. Top with optional fresh raspberries or sliced strawberries.
   
   
10. Melt 70% or greater dark chocolate. Cool. Coat banana slices or whole bananas in chocolate. Roll in finely minced nuts, if desired. Freeze until chocolate is firm.

Would you like other scrumptious recipes from Bonnie Minsky? Get Recipes to Live By.

EPA/DHA im proves eyesight

Increased intakes of omega-3 fatty acids may reduce the risk of developing age-related blindness by 30 per cent, says a new study from the US National Eye Institute. A subsection of the Age-Related Eye Disease Study (AREDS) supported the beneficial effects of omega-3 consumption for preventing age-related macular degeneration.

Over 12 years of study, the researchers found that participants with the highest omega-3 intakes, equivalent to about 0.11 per cent of their total energy intakes, had a 30 per cent lower risk of developing both types than people with the lowest intakes. “The 12-year incidence of central geographic atrophy and neovascular AMD in participants at moderate-to-high-risk of these outcomes was lowest for those reporting the highest consumption of omega-3 fatty acids,” concluded the researchers.

Osteoporosis and Celiac Link Confirmed

People with celiac disease may develop osteoporosis because their immune system attacks their bone tissue, a new study has shown. It is the first time an autoimmune response – a condition whereby the body can attack itself – has been shown to cause damage to bones directly.

Researchers from the University of Edinburgh studied a protein called osteoprotegerin (OPG) in people with celiac disease – a digestive condition that affects 1 in 100 people.

The latest research shows that 20 per cent of celiac patients produce antibodies that attack the OPG protein and stop it working properly. This results in rapid bone destruction and severe osteoporosis.

It was previously thought that osteoporosis – a known complication of celiac disease –develops in celiac patients because they cannot properly absorb calcium and vitamin D from their diet. Both nutrients are essential for healthy bone development. The team found that although this new form of osteoporosis did not respond to calcium and vitamin D supplements, it can be easily treated with drugs that prevent bone loss.

The research is published in the New England Journal of Medicine.

Bonnie - testing for these antibodies could make a real and important difference to the lives of people with celiac disease. However, as the study showed, avoiding gluten and repairing the gut so that nutrients can be absorbed is essential to preventing osteoporosis.

Investigation into corn pesticide

Courtesy WSJ

The Environmental Protection Agency said Wednesday it is launching an investigation into whether the herbicide atrazine, popular among U.S. corn farmers, causes cancer and birth defects.

"Our examination of atrazine will be based on transparency and sound science, including independent scientific peer review, and will help determine whether a change in EPA's regulatory position on this [herbicide] is appropriate," said Steve Owens, an EPA assistant administrator.

But agribusiness giant Syngenta AG, maker of atrazine for 50 years, said the chemical has already been proved safe. The company, in a recent statement, said the EPA, the World Health Organization and others have previously reviewed the drug and pronounced it safe.

Sherry Ford, a spokeswoman for Syngenta, said the EPA re-licensed atrazine for sale in the U.S. in 2006 and said the chemical wasn't likely to cause cancer.

U.S. corn farmers have come to rely on the herbicide to control weeds in their fields. Ken McCauley, former president of the National Corn Growers Association, said Wednesday that atrazine is used on most corn fields in the U.S.

Syngenta's Ms. Ford said about 60% of the corn, 75% of the sorghum and 90% of sugarcane grown in the U.S. is done so with the aid of atrazine.

"When EPA re-registered it in 2006...they estimated that atrazine saves corn farmers about $28 per acre in herbicide costs and yield advantages," Ms. Ford said.

Mr. McCauley, who farms 4,500 acres in Kansas, said he relies on the herbicide to "enhance" the effects of other chemicals. While he and many farmers rely heavily on atrazine, they use less of it than when the chemical was first sold on the market. Initially, atrazine was used as a primary herbicide and farmers would use about three to five pounds per acre. Now, Mr. McCauley said, it is common practice to use about a pound or less.

Use of the herbicide makes it possible for many corn producers to conduct "no-till" farming, Mr. McCauley said, a practice that eliminates plowing to protect against soil erosion.

U.S. farmers are currently in the midst of harvest and are expected to produce about 13 billion bushels of corn on 80 million acres of land, according to USDA data.

Atrazine is already regulated by the EPA, which warns of human health threats from contamination of drinking water. The EPA said atrazine may cause "congestion of heart, lungs and kidneys; low blood pressure; muscle spasms; weight loss; damage to adrenal glands" if "people are exposed to it at levels above [three parts per billion] for relatively short periods of time."

Depression's link to heart disease

Which comes first, depression or inflammation?

To help solve this long standing chicken and egg conundrum, researchers led by Jesse Stewart, Ph.D., assistant professor of psychology at Indiana University-Purdue University Indianapolis asked two critical questions. Does depression lead to elevated inflammatory proteins in the human body? Or does an increase in these proteins lead to depression? They found that the answer to the first question appears to be "yes," and the answer to the second question may be "no" among healthy adults. The researchers report that depressive symptoms are associated with increases over time in interleukin-6, an inflammatory protein that predicts cardiovascular events. In contrast, levels of interleukin-6 were not related to later increases in depressive symptoms.

According to the new study, published in the October 2009 issue of the journal Brain, Behavior and Immunity, the strength of the association of depression with future heart disease is similar to that of traditional risk factors like smoking, high blood pressure and elevated cholesterol.

Folate may prevent hearing loss in men

Increased intakes of folate and folic acid may reduce the risk of hearing loss in men by 20 per cent, according to researchers at the 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting. Researchers led by Boston-based Josef Shargorodsky used the most recent figures from the Health Professionals Follow-up Study cohort from years 1986 to 2004, a group consisting of 51,529 male health professionals. The study identified 3,559 cases of men with hearing loss. When the nutritional data was analyzed, men over the age of 60 with high folate intake from foods and supplements had a 20 per cent decrease in risk of developing hearing loss.

In 2007 scientists from Wageningen University reported that folic acid supplements delayed age-related hearing loss in the low frequency region in a study of 728 men and women between the ages of 50 and 70 (Annals of Internal Medicine, Vol. 146, pp. 1-9). Another study, published earlier this year indicated a role for beta carotene and vitamins C and E, and the mineral magnesium in preventing prevent both temporary and permanent hearing loss in guinea pigs and mice.

Mediterranean Diet helps depression

People who follow a Mediterranean-style diet rich in vegetables, fruits, nuts, whole grains and fish are less likely to become depressed. Spanish researchers studied 11,000 people and found that those who followed the Mediterranean diet most closely had a more than 30 percent reduction in the risk of depression than those whose diet had few of the crucial Mediterranean elements.

The researchers suggested that elements of the diet may improve blood vessel function, fight inflammation and repair oxygen-related cell damage -- all of which could reduce the chances of developing depression.

The study, published in the Archives of General Psychiatry journal, adds to an existing body of evidence showing the health benefits of a Mediterranean diet, including reduced risks of health disease, diabetes, asthma and cancer.

Steve - why should this come as a shock to anyone. When you consistently feed your body the proper fuel, it is going to function optimally. That includes your emotions.

Our Best of the Mediterranean Diet Action Plan is a great place to start.

Antidepressants no help for autistic kids

An antidepressant commonly prescribed to help autistic children control their repetitive behaviors is actually no better than a placebo.

Roughly a third of all children diagnosed with autism in the U.S. now take citalopram (Celexa), the antidepressant examined in the study. The results of the nationwide trial, published in Archives of General Psychiatry.

Because very few medications have been tested on autistic children in large, rigorous studies, doctors have looked to drugs that treat similar symptoms in other conditions, such as obsessive-compulsive disorder or attention-deficit hyperactivity disorder. That's what led physicians to a class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs, that help adults with obsessive-compulsive disorder.

Dr. Bryan King, director of psychiatry and behavioral medicine at Seattle Children's Hospital and leader of the study, said he was shocked to find that citalopram didn't help patients. Not only was the placebo slightly more effective, but the drug's side effects -- such as impulsivity and insomnia -- were at least twice as bad, the study found.

"I personally would have a healthy dose of skepticism about" prescribing citalopram or other SSRIs, King said.

The study underscores the value of evaluating drugs in randomized, double-blind, placebo-controlled studies, which are considered the gold standard of medical research, Dr. Fred R. Volkmar, director of the Yale Child Study Center in New Haven, Conn., wrote in a commentary that accompanied the study.

Bonnie - this is an ideal example of why doctors should not be allowed to use drugs off-label without rigorous trials.

Does a spoonful of sugar help the flu take hold?

Courtesy of USA Today

When one of pediatrician Jim Sears' kids asks for a soda or other sweet treat, he sometimes asks them a question: "Is this a good time to be suppressing your immune system?" Sears, who is co-host of The Doctors TV show and a contributor to the popular AskDrSears parenting website, is a firm believer in a widespread idea: A big dose of sugar can immediately suppress your immune system and make you more vulnerable to colds, flu and other infections. So, at a time when people are especially keen to protect themselves from H1N1, or swine flu, it's worth asking: Is it true?

Can a few spoonfuls of sugar really help make you sick? Denver nutrition therapist Kate Pfeiffer has no doubt. "Limiting sugar should be the first line of defense against infectious disease," she says. She wrote a column for Examiner.com titled: "Worried about the Swine Flu? Avoid Sugar!" In it she cites a 1973 study, published in the American Journal of Clinical Nutrition. The same study is cited at AskDrSears.com and on many alternative-medicine sites. In the study, researchers at Loma Linda University gave volunteers 100 grams of sugar (20 teaspoons, roughly the amount in a liter of soda). The researchers then drew blood from the volunteers and mixed in some bacteria. They found that infection-fighting white blood cells from people who had just gorged on sugar gobbled up many fewer bacteria than those who had just fasted or eaten an unsweetened starch.

But that's not evidence that would convince most doctors, says Aaron Glatt, an infectious-disease specialist who is president and chief executive officer of New Island Hospital in Bethpage, N.Y. Glatt says he has heard of the sugar theory, but as far as he knows, there are no studies showing people who eat a lot of sugar actually get more cases of colds and flu. He says: "There are numerous other reasons people should be concerned about sugar intake," including the prevention and control of obesity and diabetes. But, he says, "there's no reason not to drink a glass of soda just because someone next to you is sniffling."

Robert Frenck, professor of pediatrics at Cincinnati Children's Hospital Medical Center and a spokesman for the American Academy of Pediatrics, agrees: "I have not found any (studies) that show sugar changes your resistance to infection."

Christine Gerbstadt, a registered dietitian and physician who is a spokeswoman for the American Dietetic Association, combed through hundreds of studies and came to the same conclusion. She even found a recent study that suggested a sugar surge might boost immunity — at least in mice forced to run on treadmills and fed various diets. But it's unlikely any one food is the key to a strong or weak immune system, she says. Instead, she says, "we can optimize the building blocks for immune system by eating a healthy, balanced diet." Sears says he agrees wholeheartedly that overall nutrition is more important than any one substance. But he still says there's something about a sugar overdose that makes people vulnerable. He says he expects to see some evidence soon — when his office fills up with sick kids after Halloween.

Bonnie - should it be a surprise that the ADA is refuting the sugar suppressing the immune system. Take a look at some of their main sponsors: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/home_10575_ENU_HTML.htm. Many of their sponsors sport a multitude of sugar-laden foodstuffs.

Vitamin C for H. Pylori

Supplementation with vitamin C enhances the success of Helicobacter pylori eradication efforts.

Vitamin C has been shown to inhibit the growth of H. pylori in vitro, the authors explain, suggesting that addition of vitamin C to the eradication regimen could increase the eradication rate.

Dr. H. Zojaji and colleagues from Shahid Beheshti University of Medical Sciences, Tehran, evaluated the effect of adding 500 mg vitamin C to a regimen of metronidazole, amoxicillin, bismuth, and omeprazole (OMAB) on H. pylori eradication rates in 312 patients with dyspeptic symptoms and gastritis.

The researchers report their findings in the September issue of Digestive and Liver Disease.

The H. pylori eradication rate was significantly higher in the OMAB plus vitamin C group than in the OMAB-only group: 83% vs. 56.4% on per protocol analysis and 78% vs. 48.8% on intention-to-treat analysis.

New Autism statistics not surprising

Two new government studies indicate about 1 in 100 children have autism disorders — higher than a previous U.S. estimate of 1 in 150 two years ago.

Greater awareness, broader definitions and spotting autism in younger children may explain some of the increase, federal health officials said.

"The concern here is that buried in these numbers is a true increase," said Dr. Thomas Insel, director of the National Institute of Mental Health. "We're going to have to think very hard about what we're going to do for the 1 in 100."

Figuring out how many children have autism is extremely difficult because diagnosis is based on a child's behavior, said Dr. Susan E. Levy of the Children's Hospital of Philadelphia and a member of the American Academy of Pediatrics subcommittee on autism.

"With diabetes you can get a blood test," said Levy. "As of yet, there's no consistent biologic marker we can use to make the diagnosis of autism."

The new estimate would mean about 673,000 American children have autism. Previous estimates put the number at about 560,000.

One of the studies stems from the 2007 National Survey of Children's Health. The results were released Monday, and published in October's Pediatrics.

The other government estimate has not been formally released yet. But because of the new published findings, officials from the Centers for Disease Control and Prevention decided to announce Friday during an embargoed press briefing that their preliminary findings also show about 1 in 100 children have the disorders.

Steve - while everyone is in agreement that there is a much greater awareness of ASD, which leads to a greater possibility of diagnosis, this only tells part of the story. The other part is a cauldron of environmental factors that we will explore at another time in the near future.

October Research Highlights

Nutrition Reviews

• Micronutrient deficiencies have been found in obese individuals across age groups worldwide. An examination of the available literature suggests associations exist between micronutrient deficiencies and obesity in different populations. These associations and possible mechanisms of the deficiencies' metabolic effects, such as their influence on leptin and insulin metabolism, are evident.

• Reduced bone mineral density is frequently found in individuals with untreated celiac disease (CD), possibly due to calcium and vitamin D malabsorption, release of pro-inflammatory cytokines, and misbalanced bone remodeling. A gluten-free diet (GFD) promotes a rapid increase in BMD that leads to complete recovery of bone mineralization in children. Children may attain normal peak bone mass if the diagnosis is made and treatment is given before puberty, thereby preventing osteoporosis in later life. A GFD improves, but rarely normalizes, BMD in patients diagnosed with CD in adulthood. In some cases, nutritional supplementation may be necessary.
  

American Journal of Clinical Nutrition

• Sweetened beverage intake at age 5 y, but not milk or fruit juice intake, was positively associated with adiposity from age 5 to 15 y. Greater consumption of sweetened beverages at age 5 y (2 servings/d) was associated with a higher percentage body fat, waist circumference, and weight status from age 5 to 15 y.

• There is no clear support to the hypothesis that a moderately increased intake of dairy products beneficially affects aspects of the metabolic syndrome. The apparently positive effects on waist circumference and sagittal abdominal diameter in subjects with a low calcium intake suggest a possible threshold in relation to effects on body composition.

• Protein intake significantly blunts the effects of a high fat diet on IHCLs (intrahepatocellular lipids) and insulin activity through effects presumably exerted at the level of the liver, thus preventing weight gain and abnormal blood sugar. Protein-induced increases in bile acid concentrations may be involved.

• On the basis of Dietary Reference Intakes, an iron supplement of 16 mg/d throughout pregnancy is justified as both efficacious and safe for healthy women living in Canadian households. This does not preclude the need for therapeutic iron doses for some individuals on the basis of iron status.

• Iodine supplementation alleviated the moderate iodine deficiency and reduced elevated thyroglobulin concentrations in older New Zealand persons.
  

• A diet high in fiber is significantly associated with decreased hormone concentrations and a higher probability of ovulation. Further study of the effect of fiber on reproductive health and of the effect of these intakes in reproductive-aged women is warranted.

Food and Chemical Toxicology

• Fluorides, when taken in amounts exceeding the standard therapeutic dosage, are regarded as toxic substances. Recent studies show that fluorides may affect the oxidoreductive processes of cells. The aim of is to investigate the effect of antioxidative vitamins A and E and coenzyme Q on the morphological picture of the lungs and pancreata of rats exposed to high doses of sodium fluoride. The results confirmed that the administration of vitamins A and E and coenzyme Q has a counteracting influence upon the degenerative changes seen in the examined organs of rats.

Vitamin D and fracture risk

High-dose vitamin D supplementation may reduce the risk of falling among older people, according the October 2 issue of the BMJ.

"Supplemental vitamin D in a dose of 700-1000 IU a day reduced the risk of falling among older individuals by 19% and to a similar degree as active forms of vitamin D," the study authors write. "Doses of supplemental vitamin D of less than 700 IU or serum 25-hydroxyvitamin D concentrations of less than 60 nmol/l may not reduce the risk of falling among older individuals."

"Doses of 700 IU to 1000 IU supplemental vitamin D a day could reduce falls by 19% or by up to 26% with vitamin D3," the study authors conclude. "This benefit may not depend on additional calcium supplementation, was significant within 2-5 months of treatment, and extended beyond 12 months of treatment....Active forms of vitamin D do not appear to be more effective than 700-1000 IU of supplemental vitamin D for fall prevention in older persons."