Increasing calcium intake is a common -- yet not always successful -- strategy for reducing bone fractures. But a study supported in part by the Agricultural Research Service (ARS) underscores the importance of vitamin D and its ability to help the body utilize calcium. The study also may explain why increasing calcium alone isn't always successful in dealing with this problem. Currently, calcium intake recommendations are not tied to vitamin D status, which may explain why markedly different recommended calcium intakes exist among countries. In the United States, the recommended calcium intake is 1,200 milligrams (mg) daily for adults aged 50 and older.
The study involved a close look at about 10,000 men and women aged 20 and older participating in a nationally representative survey. Blood levels of 25-hydroxyvitamin D are used as the primary indicator of vitamin D adequacy. Within the study sample of U.S. adults, a large fraction of younger and older adults were below a suggested desirable serum vitamin D concentration of at least 75 nanomoles-per-liter (nmol/L). The study supports the idea that correcting inadequate blood levels of vitamin D is more important than increasing dietary calcium intake beyond 566 mg a day among women and 626 mg a day among men for better bone mineral density. For example, a higher calcium intake beyond 566 mg a day may only be important among women whose vitamin D concentrations are low (less than 50 nmol/L), according to authors.
Bonnie - as we have known for a while, it is how the calcium is absorbed, not the actual amount. This is another crucial study that needs to be taken into account for any optimal bone protocol.
Monday, March 15, 2010
Friday, March 12, 2010
US doctors overtesting, overtreating
Courtesy of Associated Press
Too much cancer screening, too many heart tests, too many cesarean sections. A spate of recent reports suggest that too many Americans — maybe even President Barack Obama — are being overtreated. Is it doctors practicing defensive medicine? Or are patients so accustomed to a culture of medical technology that they insist on extensive tests and treatments? A combination of both is at work, but now new evidence and guidelines are recommending a step back and more thorough doctor-patient conversations about risks and benefits. As a medical journal editorial said this week about Obama's recent checkup, Americans including the commander in chief need to realize that "more care is not necessarily better care." Obama's exam included prostate cancer screening and a virtual colonoscopy. The PSA test for prostate cancer is not routinely recommended for any age and colon screening is not routinely recommended for patients younger than 50. Obama is 48. Earlier colon cancer screening is sometimes recommended for high-risk groups — which a White House spokesman noted includes blacks. Doctors disagree on whether a virtual colonoscopy is the best method. But it's less invasive than traditional colonoscopies and doesn't require sedation — or the possible temporary transfer of presidential power, the White House said. The colon exam exposed him to radiation "while likely providing no benefit to his care," Dr. Rita Redberg, editor of Archives of Internal Medicine, wrote in an online editorial.
Obama's experience "is multiplied many times over" at a huge financial cost to society, and to patients exposed to potential harms but no benefits. "People have come to equate tests with good care and prevention," Redberg, a cardiologist with the University of California at San Francisco, said in an interview Thursday. "Prevention is all the things your mother told you — eat right, exercise, get enough sleep, don't smoke — and we've made it into getting a new test." This week alone, a New England Journal of Medicine study suggested that too many patients are getting angiograms — invasive imaging tests for heart disease — who don't really need them; and specialists convened by the National Institutes of Health said doctors are too often demanding repeat cesarean deliveries for pregnant women after a first C-section.
Last week, the American Cancer Society cast more doubt on routine PSA tests for prostate cancer. And a few months ago, other groups recommended against routine mammograms for women in their 40s, and for fewer Pap tests looking for cervical cancer. Experts dispute how much routine cancer screening saves lives. It also sometimes detects cancers that are too slow-growing to cause harm, or has false-positive results leading to invasive but needless procedures — and some risks. Treatment for prostate cancer that may be too slow-growing to be life-threatening can mean incontinence and impotence. Angiograms carry a slight risk for stroke or heart attack.
Not all doctors and advocacy groups agree with the criticism of screening. Many argue that it can improve survival chances and that saving even a few lives is worth the cost of routinely testing tens of thousands of people. Dr. Peter Pronovost, a Johns Hopkins University patient safety expert, said routine testing is often based on bad science, or on guidelines that quickly become outdated as new science emerges. The recent shift in focus reflects evolving research on the benefits and risks of screening.
While some patients clearly do benefit from screening, others clearly do not, said Dr. Richard Wender, former president of the American Cancer Society. These include very old patients, who may unrealistically fear cancer and demand a screening test, when their risks are far higher of dying from something else, Wender said. "Sometimes it's kind of the path of least resistance just to order the test," he said. Doctors also often order tests or procedures to protect themselves against lawsuits — so-called defensive medicine — and also because the fee-for-service system compensates them for it, said Dr. Gilbert Welch, a Dartmouth University internist and health outcomes researcher. Some doctors think "it's always a good thing to look for things to be wrong," Welch said.
It also has become much easier to order tests — with the click of a mouse instead of filling out forms, and both can lead to overuse, he said. While many patients also demand routine tests, they're often bolstered by advertisements, medical information online — and by doctors, too, Welch said. "To some extent we've taught them to demand these things," he said. "We've systematically exaggerated the benefits of early diagnosis," which doesn't always improve survival. "We don't always tell people there might actually be downsides" to testing. Jennifer Traig, an Ann Arbor, Mich., author of a book about hypochondria, says patients like her often think, "I'm getting better care if we're checking for more things." Traig has had many costly high-tech tests, including an MRI and several heart-imaging tests, for symptoms that turned out to be nothing. She thinks doctors were right to order those tests, but that counseling could have prevented her from "wasting resources" and getting tests it turned out she didn't need.
Too much cancer screening, too many heart tests, too many cesarean sections. A spate of recent reports suggest that too many Americans — maybe even President Barack Obama — are being overtreated. Is it doctors practicing defensive medicine? Or are patients so accustomed to a culture of medical technology that they insist on extensive tests and treatments? A combination of both is at work, but now new evidence and guidelines are recommending a step back and more thorough doctor-patient conversations about risks and benefits. As a medical journal editorial said this week about Obama's recent checkup, Americans including the commander in chief need to realize that "more care is not necessarily better care." Obama's exam included prostate cancer screening and a virtual colonoscopy. The PSA test for prostate cancer is not routinely recommended for any age and colon screening is not routinely recommended for patients younger than 50. Obama is 48. Earlier colon cancer screening is sometimes recommended for high-risk groups — which a White House spokesman noted includes blacks. Doctors disagree on whether a virtual colonoscopy is the best method. But it's less invasive than traditional colonoscopies and doesn't require sedation — or the possible temporary transfer of presidential power, the White House said. The colon exam exposed him to radiation "while likely providing no benefit to his care," Dr. Rita Redberg, editor of Archives of Internal Medicine, wrote in an online editorial.
Obama's experience "is multiplied many times over" at a huge financial cost to society, and to patients exposed to potential harms but no benefits. "People have come to equate tests with good care and prevention," Redberg, a cardiologist with the University of California at San Francisco, said in an interview Thursday. "Prevention is all the things your mother told you — eat right, exercise, get enough sleep, don't smoke — and we've made it into getting a new test." This week alone, a New England Journal of Medicine study suggested that too many patients are getting angiograms — invasive imaging tests for heart disease — who don't really need them; and specialists convened by the National Institutes of Health said doctors are too often demanding repeat cesarean deliveries for pregnant women after a first C-section.
Last week, the American Cancer Society cast more doubt on routine PSA tests for prostate cancer. And a few months ago, other groups recommended against routine mammograms for women in their 40s, and for fewer Pap tests looking for cervical cancer. Experts dispute how much routine cancer screening saves lives. It also sometimes detects cancers that are too slow-growing to cause harm, or has false-positive results leading to invasive but needless procedures — and some risks. Treatment for prostate cancer that may be too slow-growing to be life-threatening can mean incontinence and impotence. Angiograms carry a slight risk for stroke or heart attack.
Not all doctors and advocacy groups agree with the criticism of screening. Many argue that it can improve survival chances and that saving even a few lives is worth the cost of routinely testing tens of thousands of people. Dr. Peter Pronovost, a Johns Hopkins University patient safety expert, said routine testing is often based on bad science, or on guidelines that quickly become outdated as new science emerges. The recent shift in focus reflects evolving research on the benefits and risks of screening.
While some patients clearly do benefit from screening, others clearly do not, said Dr. Richard Wender, former president of the American Cancer Society. These include very old patients, who may unrealistically fear cancer and demand a screening test, when their risks are far higher of dying from something else, Wender said. "Sometimes it's kind of the path of least resistance just to order the test," he said. Doctors also often order tests or procedures to protect themselves against lawsuits — so-called defensive medicine — and also because the fee-for-service system compensates them for it, said Dr. Gilbert Welch, a Dartmouth University internist and health outcomes researcher. Some doctors think "it's always a good thing to look for things to be wrong," Welch said.
It also has become much easier to order tests — with the click of a mouse instead of filling out forms, and both can lead to overuse, he said. While many patients also demand routine tests, they're often bolstered by advertisements, medical information online — and by doctors, too, Welch said. "To some extent we've taught them to demand these things," he said. "We've systematically exaggerated the benefits of early diagnosis," which doesn't always improve survival. "We don't always tell people there might actually be downsides" to testing. Jennifer Traig, an Ann Arbor, Mich., author of a book about hypochondria, says patients like her often think, "I'm getting better care if we're checking for more things." Traig has had many costly high-tech tests, including an MRI and several heart-imaging tests, for symptoms that turned out to be nothing. She thinks doctors were right to order those tests, but that counseling could have prevented her from "wasting resources" and getting tests it turned out she didn't need.
Grass-Fed versus Grain-Fed Beef
Courtesy of New York Times
What’s the nutritional difference between beef from animals raised on grass compared with animals fattened in feedlots? New research from California State University in Chico breaks it down, reviewing three decades of research comparing the nutritional profiles of grass-fed and grain-fed beef. Over all, grass-fed beef comes out ahead, according to the report in the latest Nutrition Journal.
Beef from grass-fed animals has lower levels of unhealthy fats and higher levels of omega-3 fatty acids, which are better for cardiovascular health. Grass-fed beef also has lower levels of dietary cholesterol and offers more vitamins A and E as well as antioxidants. The study found that meat from animals raised entirely on grass also had about twice the levels of conjugated linoleic acid, or CLA, isomers, which may have cancer fighting properties and lower the risk of diabetes and other health problems.
What’s the nutritional difference between beef from animals raised on grass compared with animals fattened in feedlots? New research from California State University in Chico breaks it down, reviewing three decades of research comparing the nutritional profiles of grass-fed and grain-fed beef. Over all, grass-fed beef comes out ahead, according to the report in the latest Nutrition Journal.
Beef from grass-fed animals has lower levels of unhealthy fats and higher levels of omega-3 fatty acids, which are better for cardiovascular health. Grass-fed beef also has lower levels of dietary cholesterol and offers more vitamins A and E as well as antioxidants. The study found that meat from animals raised entirely on grass also had about twice the levels of conjugated linoleic acid, or CLA, isomers, which may have cancer fighting properties and lower the risk of diabetes and other health problems.
Thursday, March 11, 2010
Study: mammogram not as effective as MRI
A new Journal of Clinical Oncology study has discovered mammograms pick up just 33 per cent of breast cancers, whereas MRI screening – which is not currently used as part of national screening programs – detect up to 93 per cent of cancers. Even ultrasound is more sensitive than mammograms, and picks up around 37 per cent of cancers. MRI is especially good at picking up cancer in its earliest stages, and when it is more likely to be successfully treated, say German researchers. They made the discovery after screening 687 women with a slightly increased risk of developing breast cancer. The one downside is that women given an MRI are exposed to a much higher radiation level, and this may prove to be a health risk if the woman is at risk of breast cancer and so begins screening at a much earlier age. MRI is currently available only as a back-up to mammograms.
Wednesday, March 10, 2010
COX-2 Inhibitors Blunt "Preconditioning" Effect of Statin
The COX-2 inhibitor celecoxib (Celebrex, Pfizer) completely abolished the beneficial preconditioning effect of rosuvastatin (Crestor, AstraZeneca) in a small mechanistic study in human volunteers according to the recent issue of the Journal of the American College of Cardiology.
Rosuvastatin prevented the development of ischemia and reperfusion-induced endothelial dysfunction, but pretreatment with celecoxib completely abolished this protective effect. It is the first look at the interaction between a statin and a selective COX-2 inhibitor. "Theoretically, there could be a net negative effect on a patient taking a COX-2 inhibitor who has an acute cardiac event who also happens to be on a statin or is given a statin acutely. We are a long way from clinical relevance here, because we've made just a mechanistic observation," researchers state.
Rosuvastatin prevented the development of ischemia and reperfusion-induced endothelial dysfunction, but pretreatment with celecoxib completely abolished this protective effect. It is the first look at the interaction between a statin and a selective COX-2 inhibitor. "Theoretically, there could be a net negative effect on a patient taking a COX-2 inhibitor who has an acute cardiac event who also happens to be on a statin or is given a statin acutely. We are a long way from clinical relevance here, because we've made just a mechanistic observation," researchers state.
Conquering Allergy & Intolerance Action Plan - ALL NEW!
Conquering Allergy & Intolerance:
Remove and Replace Action Plan for
Environmental Allergy, Food Allergy,
Food Intolerance, and Gluten Intolerance
Order Here
TABLE OF CONTENTS
-A Chronic Problem: Separating Food Allergy From Food Intolerance
-What is Food Allergy?
-List of Biological Food Families
Plant Foods
Animal Foods
Foods Without Relatives
-How to Avoid Your Food Reactors
Milk
Wheat and Gluten
Corn
Egg
Soy
Peanut
Tree Nut
Molds/Yeast
Minor Food Allergens
Common Ingredient Synonyms
-Foods That Cross-React with Environmental Allergens
Tree Pollen Foods: Remove and Replace
Grass Pollen Foods: Remove and Replace
Ragweed Foods: Remove and Replace
Mold Spore Foods: Remove and Replace
-What is Food Intolerance?
Cause(s), Symptoms, Diagnosis, Avoidance
Celiac, Gluten Intolerance
Tyramine Yeast
Lactose
Food Additives (including names for hidden MSG)
Salicylates
Psychological
-Food Substitutions for Common Allergens and Intolerances
-Options for Allergy, Intolerance Testing and Therapy
-GMOs: Emerging Allergy Threat?
-Additional Resources
Order Here
NOTE: this Action Plan replaces what was known as Food Allergy Handbook
Soba Thai Noodle Stir-Fry
-8.8 oz. package gluten-free Soba noodles (pure buckwheat; no added wheat flour)
-1 lb. large shrimp (shelled and deveined), large sea scallops OR chunks of chicken breast, tuna
-1/4 c. cold-pressed canola or grapeseed oil
-1 T. Asian sesame oil
-1/3 c. tamari teriyaki (wheat-free optional)
-2 tsp. organic agave syrup
-6 fresh ginger slices
-2 large shallots, sliced paper-thin, lengthwise
-6 cloves garlic, minced
-1 clove garlic, halved
-1 bunch scallions, chopped (remove most of green parts)
-1/4 filtered water
-1/2 lemon, optional
-large bag frozen stir-fry vegetables
Directions:
In a small, non-stick skillet, heat 1 T. canola oil. Add the shallots and cook over moderate heat, stirring until golden brown and crisp. Transfer to paper towels.
Squeeze lemon over rinsed shellfish. Marinate protein in 2 T. canola oil, 1/2 T. sesame oil, 3 T. teriyaki, 2 tsp agave nectar, ginger slices, 2 T. water, and halved garlic for at least one hour.
In a large pot, boil water and salt. Add noodles and cook until soft, about 6 minutes. Drain and rinse under cold water.
Heat a wok and stir-fry 1/2 of chopped garlic, 1/2 of the scallions, 3 T. teriyaki, 2 T. canola, 1/2 T. sesame oil, and 2 T. water with defrosted frozen vegetables. Add noodles blend with mixture until warmed. Remove to a serving bowl (may be reheated in the microwave, if necessary).
Wipe out wok, heat, and add remaining garlic, scallions, and protein with marinade mixture. Stir-fry until protein is cooked to desired doneness. Remove with a slotted spoon to a separate bowl or top the noodle mixture.
-1 lb. large shrimp (shelled and deveined), large sea scallops OR chunks of chicken breast, tuna
-1/4 c. cold-pressed canola or grapeseed oil
-1 T. Asian sesame oil
-1/3 c. tamari teriyaki (wheat-free optional)
-2 tsp. organic agave syrup
-6 fresh ginger slices
-2 large shallots, sliced paper-thin, lengthwise
-6 cloves garlic, minced
-1 clove garlic, halved
-1 bunch scallions, chopped (remove most of green parts)
-1/4 filtered water
-1/2 lemon, optional
-large bag frozen stir-fry vegetables
Directions:
In a small, non-stick skillet, heat 1 T. canola oil. Add the shallots and cook over moderate heat, stirring until golden brown and crisp. Transfer to paper towels.
Squeeze lemon over rinsed shellfish. Marinate protein in 2 T. canola oil, 1/2 T. sesame oil, 3 T. teriyaki, 2 tsp agave nectar, ginger slices, 2 T. water, and halved garlic for at least one hour.
In a large pot, boil water and salt. Add noodles and cook until soft, about 6 minutes. Drain and rinse under cold water.
Heat a wok and stir-fry 1/2 of chopped garlic, 1/2 of the scallions, 3 T. teriyaki, 2 T. canola, 1/2 T. sesame oil, and 2 T. water with defrosted frozen vegetables. Add noodles blend with mixture until warmed. Remove to a serving bowl (may be reheated in the microwave, if necessary).
Wipe out wok, heat, and add remaining garlic, scallions, and protein with marinade mixture. Stir-fry until protein is cooked to desired doneness. Remove with a slotted spoon to a separate bowl or top the noodle mixture.
Gut health linked to excessive weight gain during pregnancy
The link between gut microflora populations and weight may also extend to pregnancy, with a new study revealing that women who gain excessive weight during pregnancy have different microfloral profiles. Women who experienced excessive weight gain during pregnancy had more Escherichia coli bacteria in their gut, and fewer Bifidobacteria (a beneficial probiotic strain) than women with normal weight gain during pregnancy, according to findings published in the British Journal of Nutrition. “Therefore, gut microbiota composition is related to body weight, weight gain and metabolic biomarkers during pregnancy, which might be of relevance to the management of the health of women and infants,” wrote the researchers.
The new study looked at gut microbiota populations in normal weight and overweight women at the 24th week of their pregnancies. Data showed that overweight women had fewer Bifidobacterium and Bacteroides and more Staphylococcus, Enterobacteriaceae and E. coli than normal-weight women. Increased Bacteroides levels were seen as beneficial as they were associated with higher levels of HDL-cholesterol and improved folic acid levels, while higher Bifidobacterium levels were also associated with increased levels of the B vitamin. Furthermore, women with excessive weight gain had higher levels of E.coli and lower levels of Bifidobacterium and Akkermansia muciniphila than women with normal weight gain, said the researchers. This new research points to yet another potential role for pre and probiotics.
Hemoglobin A1c Outperforms Fasting Glucose for Risk Prediction
Measurements of hemoglobin A1c (HbA1c) more accurately identify persons at risk for clinical outcomes than the commonly used measurement of fasting glucose, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health. HbA1c levels accurately predict future diabetes, and they better predict stroke, heart disease and all-cause mortality as well. The study appeared in the issue of New England Journal of Medicine.
As a diagnostic, "HbA1c has significant advantages over fasting glucose," said Elizabeth Selvin, PhD, MPH, the study's lead author. The A1c test has low variability from day to day, levels are not as affected by stress and illness, it has greater stability and the patient is not required to fast before the test is performed. This study is published on the heels of a major change in the way doctors diagnose diabetes.
In January, the American Diabetes Association (ADA) published revised recommendations for the screening and diagnosis of diabetes. The revised recommendations include, for the first time, recommendations to use HbA1c to diagnose diabetes and also to identify people at risk of developing diabetes in the future, also known as "pre-diabetes." The new findings can help doctors and patients interpret HbA1c test results. In the study, people with HbA1c levels between 5.0 to 5.5 percent were identified as being within "normal" range. The majority of the U.S. adult population is within this range. With each incremental HbA1c increase, the study found, the incidence of diabetes increased as well; those at a level of 6.5 percent or greater are considered diabetic, and those between 6.0 and 6.5 percent are considered at a "very high risk" (9 times greater than those at the "normal" range) for developing diabetes.
The revised ADA guidelines classify people with HbA1c levels in the range of 5.7 to 6.4 percent as "at very high risk" for developing diabetes over 5 years. The range of 5.5 to 6 percent, according to the ADA guidelines, is the appropriate level to initiate preventive measures.
Bonnie - for clients with potential blood sugar imbalances, I very often recommend that they get an HgbA1C through their physician to further explore potential risk.
As a diagnostic, "HbA1c has significant advantages over fasting glucose," said Elizabeth Selvin, PhD, MPH, the study's lead author. The A1c test has low variability from day to day, levels are not as affected by stress and illness, it has greater stability and the patient is not required to fast before the test is performed. This study is published on the heels of a major change in the way doctors diagnose diabetes.
In January, the American Diabetes Association (ADA) published revised recommendations for the screening and diagnosis of diabetes. The revised recommendations include, for the first time, recommendations to use HbA1c to diagnose diabetes and also to identify people at risk of developing diabetes in the future, also known as "pre-diabetes." The new findings can help doctors and patients interpret HbA1c test results. In the study, people with HbA1c levels between 5.0 to 5.5 percent were identified as being within "normal" range. The majority of the U.S. adult population is within this range. With each incremental HbA1c increase, the study found, the incidence of diabetes increased as well; those at a level of 6.5 percent or greater are considered diabetic, and those between 6.0 and 6.5 percent are considered at a "very high risk" (9 times greater than those at the "normal" range) for developing diabetes.
The revised ADA guidelines classify people with HbA1c levels in the range of 5.7 to 6.4 percent as "at very high risk" for developing diabetes over 5 years. The range of 5.5 to 6 percent, according to the ADA guidelines, is the appropriate level to initiate preventive measures.
Bonnie - for clients with potential blood sugar imbalances, I very often recommend that they get an HgbA1C through their physician to further explore potential risk.
Tuesday, March 09, 2010
Osteoporosis drugs causing odd fractures
According to a study in Clinical Endocrinology, long-term bisphosphonate therapy may increase the risk of unusual long bone mid-shaft fractures. The researchers believe that this is probably due to prolonged suppression of bone turnover, which could lead to accumulation of microdamage and development of hypermineralized bone. The complication in the larger context of patients remains unknown.
Bonnie - osteoporosis drugs only maintain weak, brittle bone. Where have we heard this before?
Bonnie - osteoporosis drugs only maintain weak, brittle bone. Where have we heard this before?
Vitamin D for SAD: what a surprise!
A daily dose of vitamin D may just be what people in northern climates need to get through the long winter, according to researchers at Loyola University Chicago Marcella Niehoff School of Nursing (MNSON). This nutrient lifts mood during cold weather months when days are short and more time is spent indoors. "Vitamin D deficiency continues to be a problem despite the nutrient's widely reported health benefits," said Sue Penckofer, PhD, RN, professor, MNSON. "Chicago winters compound this issue when more people spend time away from sunlight, which is a natural source of vitamin D."
Diet alone may not be sufficient to manage vitamin D levels. A combination of adequate dietary intake of vitamin D, exposure to sunlight, and treatment with vitamin D3 supplements can decrease the risk of certain health concerns.
Loyola faculty members plan to take vitamin D research a step further by evaluating whether weekly vitamin D supplements improve blood sugar control and mood in women with diabetes. Depression is associated with increased insulin resistance, so people with diabetes have a greater risk for the disease than those without depression. Women also tend to have greater rates of depression and poorer blood sugar control than men with diabetes. "There is evidence to suggest that vitamin D supplementation may decrease insulin resistance," said Dr. Penckofer. "If we can stabilize insulin levels, we may be able to simply and cost effectively improve blood sugar control and reduce symptoms of depression for these women."
Loyola is currently enrolling women in this clinical trial. In order to enter the study, they must be 18 to 70 years of age, have stable type 2 diabetes, signs of depression and no other major medical illness. Eighty women with type 2 diabetes and signs of depression will be given a weekly dose of vitamin D2 (50,000 IU) for a period of six months. Study participants will be evaluated at three points during this time. "Vitamin D has widespread benefits for our health and certain chronic diseases in particular," Dr. Penckofer said. "Our research may shed greater light on the role this nutrient plays in managing two conditions that impact millions of Americans. If proven to be successful, vitamin D may an important addition to care for diabetes and depression."
Bonnie - most of my clients would not qualify for the study because they are already taking vitamin D and their levels are within range :)
Diet alone may not be sufficient to manage vitamin D levels. A combination of adequate dietary intake of vitamin D, exposure to sunlight, and treatment with vitamin D3 supplements can decrease the risk of certain health concerns.
Loyola faculty members plan to take vitamin D research a step further by evaluating whether weekly vitamin D supplements improve blood sugar control and mood in women with diabetes. Depression is associated with increased insulin resistance, so people with diabetes have a greater risk for the disease than those without depression. Women also tend to have greater rates of depression and poorer blood sugar control than men with diabetes. "There is evidence to suggest that vitamin D supplementation may decrease insulin resistance," said Dr. Penckofer. "If we can stabilize insulin levels, we may be able to simply and cost effectively improve blood sugar control and reduce symptoms of depression for these women."
Loyola is currently enrolling women in this clinical trial. In order to enter the study, they must be 18 to 70 years of age, have stable type 2 diabetes, signs of depression and no other major medical illness. Eighty women with type 2 diabetes and signs of depression will be given a weekly dose of vitamin D2 (50,000 IU) for a period of six months. Study participants will be evaluated at three points during this time. "Vitamin D has widespread benefits for our health and certain chronic diseases in particular," Dr. Penckofer said. "Our research may shed greater light on the role this nutrient plays in managing two conditions that impact millions of Americans. If proven to be successful, vitamin D may an important addition to care for diabetes and depression."
Bonnie - most of my clients would not qualify for the study because they are already taking vitamin D and their levels are within range :)
Monday, March 08, 2010
Lipoic acid used as part of experimental pancreatic cancer treatment
by Patrick B. Massey, M.D., Ph.D
Daily Herald
Every once in a while, a piece of medical research crosses my desk that I feel has the potential to change how medicine is practiced. Today is one of those days. A recent medical article revealed that patients with end stage pancreatic cancer and treated with an antioxidant and narcotic-like medication lived longer than expected.
The pancreas is located in the abdomen, behind the stomach. It has multiple functions, including secreting enzymes that help digestion and regulating blood sugar levels by releasing insulin. Unfortunately, cancer can also begin in the pancreas. According to the National Institutes of Health, about 42,000 new cases of pancreatic cancer were diagnosed in 2009. Unfortunately, early stage pancreatic cancer rarely has symptoms and most cases are diagnosed at a late stage. As a result, the five-year survival rate is only 5 to 6 percent.
According to an article in the medical journal Integrative Cancer Therapies, a group of physicians in New Mexico used a powerful antioxidant (alpha-lipoic acid) and a medication used primarily for alcohol and drug dependence (naltrexone). Three patients with end-stage pancreatic cancer were treated intravenously and orally with alpha-lipoic acid and took naltrexone at night. The patients improved significantly over the course of therapy. All had radiologic proof of the tumors getting smaller. All lived longer than expected. Since most pancreatic cancers are found in a late stage, traditional medical approaches like surgery, chemotherapy and radiation therapy are less effective.
What is remarkable about the alpha-lipoic acid and naltrexone protocol is that it worked on patients with end-stage cancer. One patient is still alive 61/2 years after he was told that his "-prognosis was hopeless." In cancer cells, both alpha-lipoic acid and naltrexone suppress a specific cancer cell protein, NF KB. It is one of the proteins that allows cancer cells to grow rapidly. In the test tube, suppression of NF KB results in cancer cell death. From the clinical results above, it is possible that the combination of alpha-lipoic acid and naltrexone results in cancer cell death.
Of note, suppressing production of NF KB is also a hot area of cancer drug research. A new anti-cancer drug, bortezomib, is showing promise. Are these clinical results a breakthrough in cancer treatment? It may too early to tell and I must stress that there is a big difference between a positive result with a few patients and a real clinical trial. However, medical breakthroughs often start with a positive result in a few patients. Overall, there do not seem to be significant side effects and few contraindications for the alpha-lipoic acid and naltrexone therapy. It is worthy of more research.
Daily Herald
Every once in a while, a piece of medical research crosses my desk that I feel has the potential to change how medicine is practiced. Today is one of those days. A recent medical article revealed that patients with end stage pancreatic cancer and treated with an antioxidant and narcotic-like medication lived longer than expected.
The pancreas is located in the abdomen, behind the stomach. It has multiple functions, including secreting enzymes that help digestion and regulating blood sugar levels by releasing insulin. Unfortunately, cancer can also begin in the pancreas. According to the National Institutes of Health, about 42,000 new cases of pancreatic cancer were diagnosed in 2009. Unfortunately, early stage pancreatic cancer rarely has symptoms and most cases are diagnosed at a late stage. As a result, the five-year survival rate is only 5 to 6 percent.
According to an article in the medical journal Integrative Cancer Therapies, a group of physicians in New Mexico used a powerful antioxidant (alpha-lipoic acid) and a medication used primarily for alcohol and drug dependence (naltrexone). Three patients with end-stage pancreatic cancer were treated intravenously and orally with alpha-lipoic acid and took naltrexone at night. The patients improved significantly over the course of therapy. All had radiologic proof of the tumors getting smaller. All lived longer than expected. Since most pancreatic cancers are found in a late stage, traditional medical approaches like surgery, chemotherapy and radiation therapy are less effective.
What is remarkable about the alpha-lipoic acid and naltrexone protocol is that it worked on patients with end-stage cancer. One patient is still alive 61/2 years after he was told that his "-prognosis was hopeless." In cancer cells, both alpha-lipoic acid and naltrexone suppress a specific cancer cell protein, NF KB. It is one of the proteins that allows cancer cells to grow rapidly. In the test tube, suppression of NF KB results in cancer cell death. From the clinical results above, it is possible that the combination of alpha-lipoic acid and naltrexone results in cancer cell death.
Of note, suppressing production of NF KB is also a hot area of cancer drug research. A new anti-cancer drug, bortezomib, is showing promise. Are these clinical results a breakthrough in cancer treatment? It may too early to tell and I must stress that there is a big difference between a positive result with a few patients and a real clinical trial. However, medical breakthroughs often start with a positive result in a few patients. Overall, there do not seem to be significant side effects and few contraindications for the alpha-lipoic acid and naltrexone therapy. It is worthy of more research.
Vitamin D essential to fight off infection
Researchers in the Netherlands said in a recent report that vitamin D is essential in activating the human immune defense system.The researchers, from the University of Copenhagen, said that without vitamin D, T-cells, which fight off serious infection in the body, cannot do their job. Vitamin D activates T-cells to detect and kill foreign pathogens. It transforms the cells from harmless immune cells into what the researchers called "killer cells," which search for and destroy all traces of a foreign pathogen. Without vitamin D, the researchers said the T-cells would remain dormant and do nothing to protect the body against illness. The study appears in the latest edition of the journal Nature Immunology.
Magnesium suppresses bone turnover, depression?
Two Biological Trace Element Research studies tout the benefits of magnesium.
- Magnesium has been shown to increase bone mineral density when used in the treatment of osteoporosis, yet its mechanism of action is obscure. In their study, the effects of daily oral magnesium supplementation on biochemical markers of bone turnover were investigated. Twenty postmenopausal women have been divided into two groups. Ten patients were given magnesium (1,830 mg/day) orally for 30 days. Ten postmenopausal women of matching age, menopause duration, and BMI were recruited as the control group and followed without any medication. Fasting blood and first-void urine samples were collected on days 0, 1, 5, 10, 20, and 30, respectively. Total magnesium, calcium, phosphorus, iPTH and osteocalcin were determined in blood samples.
Thirty consecutive days of oral magnesium supplementation caused significantly decrease in serum iPTH levels in the Mg-supplemented group. Serum osteocalcin levels were significantly increased and urinary deoxypyridinoline levels were decreased in the Mg-supplemented group. This study has demonstrated that oral magnesium supplementation in postmenopausal osteoporotic women suppresses bone turnover. - According to a Korean study, serum magnesium (Mg) and serum calcium/magnesium (Ca/Mg) ratio may be involved in the mechanism for the progression of depressive mood or stress perception in relatively healthy, adult women. The cross-sectional study was conducted in 112 relatively healthy, adult women without psychiatric disorders, recruited from the outpatient clinic in a university hospital setting. Serum Ca and Mg levels were measured and indicators of mental health such as depression, anxiety and stress were evaluated using two validated questionnaires. Women in the middle tertile of serum Ca/Mg ratio had significantly lower scores on depression and stress scales and a lower odds ratio for the risk of depressive mood disorder than those in the highest tertile. The odds ratio for the risk of depressive mood disorder was higher in women in the lowest tertile of serum Mg than in those in the highest tertile.
Steve - please note that these are very small studies. The dosage administered in the osteoporosis is way above a daily maintenance dose, and this amount of magnesium should never be taken without a physician's okay. That said, it shows how amazing magnesium can be and is an important part of any osteoporosis and depression prevention protocol.
Friday, March 05, 2010
Common flavoring recalled for salmonella contamination
The flavoring -- hydrolyzed vegetable protein -- is used in soups, sauces, hot dogs, snack foods, dressings and dips and is made by privately held Basic Food Flavors Inc of Las Vegas, Nevada.
"At this time there are no known illnesses associated with this contamination and obviously we'd like to keep it that way," FDA Commissioner Dr. Margaret Hamburg told reporters in a teleconference."The manufacturer had many first-level consignees who obviously had individuals who had firms that they sold to who sold to the other firms," said Dr. Jeff Farrar, associate commissioner for food safety at FDA's Office of Foods."We expect this to get larger over the next several days, actually several weeks," Farrar said. Farrar said officials believe the risk to consumers is very low.
A list of the products that use this flavor are listed and updated at http://www.foodsafety.gov/
Bonnie - I hope our clients do not consume products with this flavoring because when hydrolyzing protein, monosodium glutamate (MSG) is almost always used during the process.
"At this time there are no known illnesses associated with this contamination and obviously we'd like to keep it that way," FDA Commissioner Dr. Margaret Hamburg told reporters in a teleconference."The manufacturer had many first-level consignees who obviously had individuals who had firms that they sold to who sold to the other firms," said Dr. Jeff Farrar, associate commissioner for food safety at FDA's Office of Foods."We expect this to get larger over the next several days, actually several weeks," Farrar said. Farrar said officials believe the risk to consumers is very low.
A list of the products that use this flavor are listed and updated at http://www.foodsafety.gov/
Bonnie - I hope our clients do not consume products with this flavoring because when hydrolyzing protein, monosodium glutamate (MSG) is almost always used during the process.
Omega-3 Fatty Acids in Preventing Psychotic Disorders
This Archives of General Psychiatry study was a randomized, double-blind, placebo-controlled, 12-week trial of long-chain omega-3 polyunsaturated fatty acids (PUFAs) in adolescents and young adults aged 13-25 years with subthreshold psychosis. The objective was to determine whether PUFAs reduce the rate of progression to first-episode psychotic disorder.
By study's end at 12 months, 2 of 41 individuals in the PUFA group and 11 of 40 in the placebo group had transitioned to psychotic disorder. The incidence of adverse effects did not differ between the treatment groups.
It is unknown how many adolescents and young adults actually present for treatment with subthreshold psychosis. When they do, we have limited means of treating them. Interventions typically employed are antipsychotics, antidepressants, and cognitive-behavioral therapy. The use of antipsychotics is particularly controversial because of their adverse-effect profile and the knowledge that a substantial proportion of patients in a pre-psychotic state never go on to develop psychosis. These researchers proposed that PUFAs can be used and achieve similar effect sizes in the prevention of progression to psychosis compared to potentially more toxic agents. Number needed to treat to avoid an additional progression to psychosis was 5 calculated from all randomly sampled patients, putting it in the range of agents that are routinely accepted as efficacious for psychiatric disorders in general.
By study's end at 12 months, 2 of 41 individuals in the PUFA group and 11 of 40 in the placebo group had transitioned to psychotic disorder. The incidence of adverse effects did not differ between the treatment groups.
It is unknown how many adolescents and young adults actually present for treatment with subthreshold psychosis. When they do, we have limited means of treating them. Interventions typically employed are antipsychotics, antidepressants, and cognitive-behavioral therapy. The use of antipsychotics is particularly controversial because of their adverse-effect profile and the knowledge that a substantial proportion of patients in a pre-psychotic state never go on to develop psychosis. These researchers proposed that PUFAs can be used and achieve similar effect sizes in the prevention of progression to psychosis compared to potentially more toxic agents. Number needed to treat to avoid an additional progression to psychosis was 5 calculated from all randomly sampled patients, putting it in the range of agents that are routinely accepted as efficacious for psychiatric disorders in general.
Can You Help to Avoid Food Allergies in Babies?
If one child has food allergies, how can a pregnant woman help ensure her next child won't be affected too? By avoiding exposure to the food her child is allergic is to -- starting in the third trimester and continuing into the second year of life, say researchers from Royal Prince Alfred Hospital in Camperdown, Australia. The findings were presented at the 2010 Annual Meeting of the American Academy of Allergy, Asthma & Immunology. Seven out of 10 babies born to mothers who took avoidance measures had no food allergies vs. 45% of babies whose moms did not follow the doctors' advice.
That means eliminating the offending food not only from the diet but also from the environment, they say. "Take peanut allergies, for example. If someone eats a lot of peanuts in your house, there is going to be aerosolized peanut protein in the environment. You need a clean household."
The researchers say they undertook the study because "parents of kids with food allergies came to us asking, 'What can we do so this doesn't happen again?' They were desperate." The study involved 274 pregnant mothers of children with peanut, egg, or milk allergies. "We didn't tell them what to do, but gave them a lot of advice about how to avoid the food [their child was allergic to]. We started in the third trimester so everything would be in place when the baby was born," they said.
The women were also encouraged to breastfeed, which has been shown to protect against the development of allergies in some studies. About two-thirds of the women followed their advice. At 1 and 1/2 and 3 years of age, the babies were evaluated for symptoms of allergic disease and given skin prick tests to determine if they showed susceptibility to the same food allergies as their older siblings. "The results were dramatic," research says.
Thirty percent of babies born to mothers who took avoidance measures had one or more food allergies vs. 55% of babies whose moms didn't take those avoidance measures, Babies born to mothers who took avoidance measures were less likely to develop symptoms of asthma: Only 11% exhibited symptoms by the age of 3, compared with 43% of babies whose mothers didn't avoid the offending foods.
Bonnie - a very compelling study that shows once again how important it is to be cognizant of what women put into their bodies during pregnancy.
That means eliminating the offending food not only from the diet but also from the environment, they say. "Take peanut allergies, for example. If someone eats a lot of peanuts in your house, there is going to be aerosolized peanut protein in the environment. You need a clean household."
The researchers say they undertook the study because "parents of kids with food allergies came to us asking, 'What can we do so this doesn't happen again?' They were desperate." The study involved 274 pregnant mothers of children with peanut, egg, or milk allergies. "We didn't tell them what to do, but gave them a lot of advice about how to avoid the food [their child was allergic to]. We started in the third trimester so everything would be in place when the baby was born," they said.
The women were also encouraged to breastfeed, which has been shown to protect against the development of allergies in some studies. About two-thirds of the women followed their advice. At 1 and 1/2 and 3 years of age, the babies were evaluated for symptoms of allergic disease and given skin prick tests to determine if they showed susceptibility to the same food allergies as their older siblings. "The results were dramatic," research says.
Thirty percent of babies born to mothers who took avoidance measures had one or more food allergies vs. 55% of babies whose moms didn't take those avoidance measures, Babies born to mothers who took avoidance measures were less likely to develop symptoms of asthma: Only 11% exhibited symptoms by the age of 3, compared with 43% of babies whose mothers didn't avoid the offending foods.
Bonnie - a very compelling study that shows once again how important it is to be cognizant of what women put into their bodies during pregnancy.
Thursday, March 04, 2010
Eco-Dentistry Association
This organization offers certification to dentists who wish to go green. They also have a search feature for "green" dentists in your area.
http://www.ecodentistry.org/
http://www.ecodentistry.org/
Wednesday, March 03, 2010
Lawsuit claims some fish oil products contain PCB contaminants
Steve - Two environmentalists are utilizing a California law, Proposition 65, to sue specific manufacturers of fish oil for exceeding the amount of PCBs allowed in California in some of their products. While the PCB levels considered safe in California lower than federal standards, we applaud the efforts of these two individuals to put fish oil manufacturers on notice.
While these charges will be decided in a court of law, independent laboratory testing performed found these manufacturers to have products exceeding CA standards:
CVS Pharmacy
GNC
Nature Made (from Pharmavite and Rite Aid)
NOW Foods
Omega Protein
Solgar
Twinlab
We have said for a long time that not all fish oils are created equal. Some companies test for PCBs and contaminants a lot more rigorously than others. None of the fish oil brands we recommend are mentioned in this lawsuit.
While there is no fish oil product, or fish product for that matter, that can be 100% free of contaminants (just as the air we breathe and the water we drink cannot be 100% free of contaminants), high quality manufacturers produce fish oil that have levels considered virtually undetectable and are way below California and federal levels considered unsafe.
While these charges will be decided in a court of law, independent laboratory testing performed found these manufacturers to have products exceeding CA standards:
CVS Pharmacy
GNC
Nature Made (from Pharmavite and Rite Aid)
NOW Foods
Omega Protein
Solgar
Twinlab
We have said for a long time that not all fish oils are created equal. Some companies test for PCBs and contaminants a lot more rigorously than others. None of the fish oil brands we recommend are mentioned in this lawsuit.
While there is no fish oil product, or fish product for that matter, that can be 100% free of contaminants (just as the air we breathe and the water we drink cannot be 100% free of contaminants), high quality manufacturers produce fish oil that have levels considered virtually undetectable and are way below California and federal levels considered unsafe.
Tuesday, March 02, 2010
Research Highlights - March
Nutrition Reviews
- The objectives of this review were to determine whether the long-chain omega-3 fatty acids EPA and/or DHA dose-dependently reduce fasting serum triglycerides (TG) and, if so, to create a mathematical model that may be used to predict potential percent reductions in fasting serum TG levels at the recommended intakes. Using the equation of the dose-response curve, predicted reductions in fasting serum TG levels at the recommended long-chain omega-3 fatty acid intakes of 200–500 mg/day are 3.1 to 7.2%.
- Berries are a good source of polyphenols, especially anthocyanins, micronutrients, and fiber. In epidemiological and clinical studies, these constituents have been associated with improved cardiovascular risk profiles. Human intervention studies using chokeberries, cranberries, blueberries, and strawberries (either fresh, or as juice, or freeze-dried), or purified anthocyanin extracts have demonstrated significant improvements in LDL oxidation, lipid peroxidation, total plasma antioxidant capacity, dyslipidemia, and glucose metabolism. Benefits were seen in healthy subjects and in those with existing metabolic risk factors. Underlying mechanisms for these beneficial effects are believed to include upregulation of endothelial nitric oxide synthase, decreased activities of carbohydrate digestive enzymes, decreased oxidative stress, and inhibition of inflammatory gene expression and foam cell formation. Though limited, these data support the recommendation of berries as an essential fruit group in a heart-healthy diet.
- Although substitution of dietary polyunsaturated fat for saturated fat has been shown to lower CVD risk, there are few epidemiologic or clinical trial data to support a benefit of replacing saturated fat with carbohydrate. Furthermore, particularly given the differential effects of dietary saturated fats and carbohydrates on concentrations of larger and smaller LDL particles, respectively, dietary efforts to improve the increasing burden of CVD risk associated with atherogenic dyslipidemia should primarily emphasize the limitation of refined carbohydrate intakes and a reduction in excess adiposity.
- There is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.
- A low-salt diet can reduce calcium excretion in hypercalciuric stone formers.
- In persons with normal absorption, data indicates that an intake of 4–7 µg vitamin B-12/d is associated with an adequate vitamin B-12 status, which suggests that the current RDA of 2.4 µg vitamin B-12/d might be inadequate for optimal biomarker status even in a healthy population between 18 and 50 y of age.
- Elevated lipoprotein-associated phospholipase A2 (Lp-PLA2) may be positively associated with risk of coronary artery disease, yet little is known about potentially modifiable factors related to Lp-PLA2. We found that not smoking, use of postmenopausal hormones, having a body mass index (in kg/m2) 25, increased alcohol consumption, and increased protein consumption all represent potential modifiable factors that may favorably influence Lp-PLA2 activity.
- 2 grams of EPA/DHA supplements exerted a protective vascular effect compared with placebo in type 2 diabetic subjects.
- Maternal folate and cobalamin status exerts a long-term positive effect on infant vitamin status. The effect of smoking, parity and female sex on cobalamin status did not persist beyond the newborn period. Maternal holoTC was the superior predictor of newborn cobalamin status, while holoHC could be a valuable marker for predicting cobalamin status later in infancy.
- Cross-sectional data from the Insulin Resistance Atherosclerosis Study showed that whole grain, as well as refined grain intake, were negatively associated with the inflammatory PAI-1 and CRP plasma concentrations in non-diabetic, healthy subjects.
- Flavonols are strong antioxidants in plant foods and tea is a major dietary source. Multiple data sources confirm that flavanols may reduce stroke risk.
- When counseling was free, approximately one in five patients with an unhealthy behavior and an was referred for intensive counseling. However, when patient charges were instituted, referrals decreased by 97%. Clinicians asked fewer patients about health behaviors. Clinicians offered fewer patients referrals and patients were less interested in accepting referrals.
In interviews, patients and clinicians cited cost as a major barrier. Coverage for intensive health behavior counseling is important to utilization, particularly for interventions that involve clinician–community partnerships. The potential public health benefits of such collaborations to reduce unhealthy behaviors justify the elimination of financial barriers (e.g., copayments) by payers.
- Silybum marianum (SIlymarin) for liver disorders: Mechanism of action for silymarin conducted mainly to the antiradical and anticarcinogenic roles. Ethyl acetate and ethanol seed extracts for S. marianum were tested against the injection by carbon tetrachloride the inducer of liver damage. Their activity were compared with standard hepatic drug hepaticum for 10 days. Ethanolic extract showed the most significantly decrease in the liver enzymes. For the oxidative experiments, ethyl acetate showed the most increase for glutathione level and the risk factor HDL/LDL significantly. Hepaticum was the most powerful group for the significant decreasing for malondialdehyde and fucosidase activity. Some equal improvements were noticed in the histopathological studies for the protective groups.
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