Regular exercise is recommended for middle-aged and older people, but the effect of exercise on the development of osteoarthritis (OA) in older people is unclear, especially if they are overweight. Some studies have suggested that exercise has a protective effect, but few studies have been conducted where patients are asked about physical activity and followed to find out what develops. Meanwhile, obesity is a major risk factor for knee OA, and the question has been raised as to whether weight-bearing activity may be harmful to people who are overweight. A new study published in the February 2007 issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritiscare) examined the effects of physical activity over a long period in older adults, many of whom were overweight, and found that exercise neither protects against nor increases the risk of knee OA.
Led by David T. Felson of the Boston University School of Medicine in Boston, MA, researchers conducted a study of 1,279 subjects from the Framingham Offspring cohort, which consists of the offspring of the original Framingham cohort. Persons were questioned about recent physical activity they had engaged in on a regular basis, and between one and two years later (1993-1994) had knee X-rays. They were also asked questions about knee symptoms such as pain, aching or stiffness. Between 2002 and 2005 they were called back for a follow-up exam, during which they underwent the same knee X-rays and were asked the same questions about symptoms, but not about physical activity. They were also weighed initially and at follow-up, when X-rays were read by a bone and joint radiologist and a rheumatologist.
Analysis of the results showed no relationship between recreational walking, jogging or other self-reported activity and the development of knee OA. Even though the overweight patients had an increased risk of developing OA, physical activity did not contribute to this risk. Also, despite previous studies that suggested that exercise may prevent joint space loss, the study did not find this to be the case. "This suggests that in middle-aged and older adults who do not have OA, exercise does not protect against disease development," the authors state.
The study attempted to examine all the ways in which OA might appear by looking at X-rays that indicated the development of structural disease using a well-known index (the Kellgren and Lawrence scale), by looking at joint space loss, which is thought to indicate cartilage loss, and also by examining symptoms. The authors conclude: "Physical activity can be done safely without concerns that persons will develop OA as a consequence."
In another study in the same issue, researchers led by J.N. Belo of Erasmus Medical Center in Rotterdam, Netherlands published an overview of 37 studies appearing up to December 2003 to determine predictive factors of the progression of knee OA. As was the case with the Felson study, they found three studies showing no strong evidence that regular exercise was related to progression of knee OA; Other studies found that sex, knee pain, quadriceps strength and knee injury were also not associated with progression of knee OA. On the other hand, the presence of generalized OA and the level of hyaluronic acid (a protein found in joints) were predictive of progression of the disease.
In an accompanying editorial in the current issue Marian A. Minor of the University of Missouri in Columbia, MO notes that the Felson study helps to clarify the understanding of the relationship between knee OA and physical activity by using precise definitions of OA, using valid methods to assess prior physical activity, and evaluating the true incidence of the disease by eliminating patients who showed evidence of it on X-rays taken when the study began. "Taken together, these methods result in a useful and valid study that supports recommending regular moderate physical activity without undue fear that such activity may increase the risk for knee OA," the author states. Since physical activity does not appear to increase the risk of knee OA, the author wonders what variables may possibly play a role in its development and progression. She suggests that many studies fail to collect data about knee OA, such as age at onset, occupational and medical history, and response to medication and physical therapy, that may shed some light on the disease. Noting that future research should identify variables relevant to knee OA that make a difference in individual response, the author concludes: "In addition to improving the usefulness of knee OA research, our ultimate aim must be to produce evidence that assists clinical decision-making and individualized recommendations regarding safety and effectiveness of interventions, including physical activity.
Wednesday, January 31, 2007
Women in polluted areas at higher risk of cardiovascular disease
Women living in areas with higher levels of air pollution have a greater risk of developing cardiovascular disease and subsequently dying from cardiovascular causes, according to a University of Washington study appearing in the Feb. 1 issue of The New England Journal of Medicine. The study is one of the largest of its kind, involving more than 65,000 Women's Health Initiative Observational Study participants, age 50 to 79, living in 36 cities across the United States.
UW researchers studied women who did not initially have cardiovascular disease, following them for up to nine years to see who went on to have a heart attack, stroke, or coronary bypass surgery, or died from cardiovascular causes. They linked this health information with the average outdoor air pollution levels near each woman's home, and found that higher pollution levels posed a significant hazard – much higher than previously thought – for development of cardiovascular disease.
The researchers studied levels of fine particulate matter, which are tiny airborne particles of soot or dust, and can come from a variety of sources, like vehicle exhaust, coal-fired power plants, industrial sources, and wood-burning fireplaces. These particles are less than 2.5 microns in diameter -- about 30 to 40 of them would equal the diameter of a human hair. Particulate matter levels are monitored and regulated by the U.S. Environmental Protection Agency (EPA). They're typically invisible to the human eye once they're in the atmosphere, though they may be visible in dense clouds as they come out of a tailpipe, smokestack or chimney, and are responsible for urban haze.
"These soot particles, which are typically created by fossil-fuel combustion in vehicles and power plants, can contain a complex mix of chemicals," explained Dr. Joel Kaufman, professor of environmental & occupational health sciences, epidemiology, and medicine at the UW, and leader of the study. "The tiny particles – and the pollutant gases that travel along with them – cause harmful effects once they are breathed in."
Fine particulate matter is measured in micrograms (or millionths of a gram) per cubic meter; cities in the study had average levels of fine particulate matter ranging from about 4 to nearly 20 micrograms per cubic meter. The researchers found that each 10-unit increase in fine particulate matter level was linked to a 76 percent increase in the risk of death from cardiovascular disease, after taking into account known risk factors such as blood pressure, cholesterol, and smoking. Higher long-term average levels of fine particulate matter also led to a higher overall risk of cardiovascular disease events, including stroke and heart attack.
They also found that local differences in particulate matter levels within a city, as well as exposure differences between cities, translate to a higher or lower risk of cardiovascular disease and related death.
"Our findings show that both what city a woman lived in, and where she lived in that city, affected her exposure level and her disease risk," said Kristin Miller, first author of the study and a doctoral student in epidemiology at the UW.
Previous studies have found apparent links between airborne particulate matter and cardiovascular disease, but this study was the first to look specifically at new cases of cardiovascular disease in previously healthy subjects and local air pollution levels within metropolitan areas. Researchers used data from the multi-site Women's Health Initiative Observational Study, which is funded by the National Heart Lung and Blood Institute of the National Institutes of Health (NIH), and coordinated through a center based at the Fred Hutchinson Cancer Research Center in Seattle. The EPA and the National Institute of Environmental Health Sciences provided funding for the study of the effects of air pollution.
Scientists don't understand exactly how fine particulate matter may be leading to cardiovascular disease, but some believe that the soot particles are accelerating atherosclerosis, or hardening of the arteries, which is the major precursor of heart disease.
"This could be a cellular and biochemical process that starts in the lung and then proceeds from there into the cardiovascular system," Kaufman explained. "Or it could be that these very small particles actually enter the blood stream through vessels in the lung, and then begin affecting blood vessels throughout the body." Kaufman is leading a major new EPA-funded study to uncover these mechanisms – an air-pollution study based on the NIH's Multi-Ethnic Study of Atherosclerosis, or MESA. The MESA Air Pollution Study tackles two key areas for understanding this problem, Kaufman said: investigating the mechanisms through which particulate matter leads to cardiovascular disease, and identifying the sources of pollution that cause the problem. "Preventing these effects requires reducing the pollution at the source," Kaufman said.
The implications of this connection could be very significant.
"More than one out of three deaths in the United States are due to cardiovascular disease – it's the leading cause of death," Miller said. "If the annual average concentration of fine particulate air pollution can be reduced, it would potentially translate on a national scale to the prevention or delay of thousands and thousands of heart attacks, strokes, and bypass surgeries, not to mention fewer early deaths."
###
An editorial from researchers at the Harvard School of Public Health and Brigham and Women's Hospital will accompany the study in the Feb. 1 issue of the journal. In that editorial, the authors suggest public health interventions to address this problem, as well as a tightening of the EPA standards regulating fine particulate matter pollution.
In addition to Kaufman and Miller, the study included researchers from the UW School of Medicine and the School of Public Health and Community Medicine, the Fred Hutchinson Cancer Research Center, and Harborview Medical Center, all in Seattle.
NOTE: To determine the average annual concentration of fine particulate matter for a particular city or county, visit the EPA's Air Trends Web site and look for "PM 2.5 Wtd AM" in the tables provided. The most recent data available from the EPA is from 2005. http://www.epa.gov/airtrends/factbook.html
UW researchers studied women who did not initially have cardiovascular disease, following them for up to nine years to see who went on to have a heart attack, stroke, or coronary bypass surgery, or died from cardiovascular causes. They linked this health information with the average outdoor air pollution levels near each woman's home, and found that higher pollution levels posed a significant hazard – much higher than previously thought – for development of cardiovascular disease.
The researchers studied levels of fine particulate matter, which are tiny airborne particles of soot or dust, and can come from a variety of sources, like vehicle exhaust, coal-fired power plants, industrial sources, and wood-burning fireplaces. These particles are less than 2.5 microns in diameter -- about 30 to 40 of them would equal the diameter of a human hair. Particulate matter levels are monitored and regulated by the U.S. Environmental Protection Agency (EPA). They're typically invisible to the human eye once they're in the atmosphere, though they may be visible in dense clouds as they come out of a tailpipe, smokestack or chimney, and are responsible for urban haze.
"These soot particles, which are typically created by fossil-fuel combustion in vehicles and power plants, can contain a complex mix of chemicals," explained Dr. Joel Kaufman, professor of environmental & occupational health sciences, epidemiology, and medicine at the UW, and leader of the study. "The tiny particles – and the pollutant gases that travel along with them – cause harmful effects once they are breathed in."
Fine particulate matter is measured in micrograms (or millionths of a gram) per cubic meter; cities in the study had average levels of fine particulate matter ranging from about 4 to nearly 20 micrograms per cubic meter. The researchers found that each 10-unit increase in fine particulate matter level was linked to a 76 percent increase in the risk of death from cardiovascular disease, after taking into account known risk factors such as blood pressure, cholesterol, and smoking. Higher long-term average levels of fine particulate matter also led to a higher overall risk of cardiovascular disease events, including stroke and heart attack.
They also found that local differences in particulate matter levels within a city, as well as exposure differences between cities, translate to a higher or lower risk of cardiovascular disease and related death.
"Our findings show that both what city a woman lived in, and where she lived in that city, affected her exposure level and her disease risk," said Kristin Miller, first author of the study and a doctoral student in epidemiology at the UW.
Previous studies have found apparent links between airborne particulate matter and cardiovascular disease, but this study was the first to look specifically at new cases of cardiovascular disease in previously healthy subjects and local air pollution levels within metropolitan areas. Researchers used data from the multi-site Women's Health Initiative Observational Study, which is funded by the National Heart Lung and Blood Institute of the National Institutes of Health (NIH), and coordinated through a center based at the Fred Hutchinson Cancer Research Center in Seattle. The EPA and the National Institute of Environmental Health Sciences provided funding for the study of the effects of air pollution.
Scientists don't understand exactly how fine particulate matter may be leading to cardiovascular disease, but some believe that the soot particles are accelerating atherosclerosis, or hardening of the arteries, which is the major precursor of heart disease.
"This could be a cellular and biochemical process that starts in the lung and then proceeds from there into the cardiovascular system," Kaufman explained. "Or it could be that these very small particles actually enter the blood stream through vessels in the lung, and then begin affecting blood vessels throughout the body." Kaufman is leading a major new EPA-funded study to uncover these mechanisms – an air-pollution study based on the NIH's Multi-Ethnic Study of Atherosclerosis, or MESA. The MESA Air Pollution Study tackles two key areas for understanding this problem, Kaufman said: investigating the mechanisms through which particulate matter leads to cardiovascular disease, and identifying the sources of pollution that cause the problem. "Preventing these effects requires reducing the pollution at the source," Kaufman said.
The implications of this connection could be very significant.
"More than one out of three deaths in the United States are due to cardiovascular disease – it's the leading cause of death," Miller said. "If the annual average concentration of fine particulate air pollution can be reduced, it would potentially translate on a national scale to the prevention or delay of thousands and thousands of heart attacks, strokes, and bypass surgeries, not to mention fewer early deaths."
###
An editorial from researchers at the Harvard School of Public Health and Brigham and Women's Hospital will accompany the study in the Feb. 1 issue of the journal. In that editorial, the authors suggest public health interventions to address this problem, as well as a tightening of the EPA standards regulating fine particulate matter pollution.
In addition to Kaufman and Miller, the study included researchers from the UW School of Medicine and the School of Public Health and Community Medicine, the Fred Hutchinson Cancer Research Center, and Harborview Medical Center, all in Seattle.
NOTE: To determine the average annual concentration of fine particulate matter for a particular city or county, visit the EPA's Air Trends Web site and look for "PM 2.5 Wtd AM" in the tables provided. The most recent data available from the EPA is from 2005. http://www.epa.gov/airtrends/factbook.html
Passive smoke in workplace increases lung cancer risk
An analysis of nearly two dozen studies confirms the association between passive smoke in the workplace and an increased risk of lung cancer, according to a report in the American Journal of Public Health.
The research, led by University of Illinois at Chicago epidemiologist Leslie Stayner, is posted online and will appear in the March print issue of the journal.
Stayner and colleagues conducted a statistical analysis combining data from 22 studies evaluating workplace smoking exposure and lung cancer risk. They also analyzed workers' level and duration of exposure to passive smoke and their risk of lung cancer.
The researchers found a 24 percent increase in lung cancer risk among people exposed to passive smoke in the workplace. Workers who were highly exposed had a 100 percent increased (or doubled) risk of lung cancer, and workers with a long history, or duration, of exposure to passive smoke had a 50 percent increased risk.
"We believe this provides the strongest evidence to date of the relationship between workplace environmental tobacco smoke and lung cancer," said Stayner, professor and director of epidemiology and biostatistics at the UIC School of Public Health, and lead author of the study.
The research, Stayner said, has important policy implications for cities and states that have not yet legislated smoking bans in bars and restaurants where there are high levels of environmental smoke.
The research, led by University of Illinois at Chicago epidemiologist Leslie Stayner, is posted online and will appear in the March print issue of the journal.
Stayner and colleagues conducted a statistical analysis combining data from 22 studies evaluating workplace smoking exposure and lung cancer risk. They also analyzed workers' level and duration of exposure to passive smoke and their risk of lung cancer.
The researchers found a 24 percent increase in lung cancer risk among people exposed to passive smoke in the workplace. Workers who were highly exposed had a 100 percent increased (or doubled) risk of lung cancer, and workers with a long history, or duration, of exposure to passive smoke had a 50 percent increased risk.
"We believe this provides the strongest evidence to date of the relationship between workplace environmental tobacco smoke and lung cancer," said Stayner, professor and director of epidemiology and biostatistics at the UIC School of Public Health, and lead author of the study.
The research, Stayner said, has important policy implications for cities and states that have not yet legislated smoking bans in bars and restaurants where there are high levels of environmental smoke.
Natural fibre may take extra pounds away
Researcher launches human trials on promising new diet product
It sounds almost too good to be true, but Dr. Raylene Reimer, a researcher at the University of Calgary, Faculty of Kinesiology, believes she may have found an important weapon in the war against obesity.
Reimer and her colleagues are launching the first human trials anywhere to assess a promising natural fibre, which has already been shown to be effective in tests involving genetically obese rats.
"It may not be the magic bullet," Reimer says, "but in all likelihood this will likely be one factor that people can change in their life to help achieve a healthy body weight. It won't cure obesity or cause people to drop half their body weight -- not even our strongest obesity drugs can do that -- but we believe it could help."
The fibre is called oligo fructose. "It's not a chemical or a drug. In fact it's a food product that is already being used in things like yogurt, cereal and baby food. We have found in a previous study with rats that the fibre increases the levels of a satiety hormone called glucagon-like peptide (GLP-1) in the body and increases a gene in the intestines that helps the body to create more GLP-1."
In a study with genetically obese rats, Reimer and U of C PhD Student Jill Parnell found that consuming the natural fibre helped the rats to significantly reduce their food intake and improved their blood lipid profile.
The new study will involve human subjects for the first time. The researchers are looking for 50 overweight, but otherwise healthy individuals living in Calgary, Canada. The subjects would be required to take a dietary supplement over a three-month period while making no other lifestyle changes. Participants' body composition will be tracked using cutting-edge technology to determine their body fat ratios.
"What we have found so far in our animal studies has been very encouraging," says Reimer. "Another short study done by some Belgian researchers also indicates that the fibre will work for people, but we really won't know until we complete this detailed, long-term study."
It sounds almost too good to be true, but Dr. Raylene Reimer, a researcher at the University of Calgary, Faculty of Kinesiology, believes she may have found an important weapon in the war against obesity.
Reimer and her colleagues are launching the first human trials anywhere to assess a promising natural fibre, which has already been shown to be effective in tests involving genetically obese rats.
"It may not be the magic bullet," Reimer says, "but in all likelihood this will likely be one factor that people can change in their life to help achieve a healthy body weight. It won't cure obesity or cause people to drop half their body weight -- not even our strongest obesity drugs can do that -- but we believe it could help."
The fibre is called oligo fructose. "It's not a chemical or a drug. In fact it's a food product that is already being used in things like yogurt, cereal and baby food. We have found in a previous study with rats that the fibre increases the levels of a satiety hormone called glucagon-like peptide (GLP-1) in the body and increases a gene in the intestines that helps the body to create more GLP-1."
In a study with genetically obese rats, Reimer and U of C PhD Student Jill Parnell found that consuming the natural fibre helped the rats to significantly reduce their food intake and improved their blood lipid profile.
The new study will involve human subjects for the first time. The researchers are looking for 50 overweight, but otherwise healthy individuals living in Calgary, Canada. The subjects would be required to take a dietary supplement over a three-month period while making no other lifestyle changes. Participants' body composition will be tracked using cutting-edge technology to determine their body fat ratios.
"What we have found so far in our animal studies has been very encouraging," says Reimer. "Another short study done by some Belgian researchers also indicates that the fibre will work for people, but we really won't know until we complete this detailed, long-term study."
Prostate cancer patients see high survival rates with seed implants
More than ninety percent of men who receive appropriate radiation dose levels with permanent radiation seed implants to treat their prostate cancer are cured of their cancer eight years after diagnosis, according to a study released in the February 1 issue of the International Journal for Radiation Oncology*Biology*Physics, the official journal of ASTRO.
Seed implants have become a widely-accepted treatment option for early stage prostate cancer because it is very effective at curing the cancer, is minimally invasive and often spares patients from side effects of other treatments, such as impotence and incontinence. The seeds, similar in size to a grain of rice, contain a radiation dose that, once implanted, delivers concentrated radiation to the prostate, sparing surrounding organs and tissue.
Doctors in this study evaluated the long-term results of permanent seed implants in men with early stage prostate cancer. Nearly 2,700 men were studied at 11 institutions in the United States over eight years. The radioactive seeds were administered with the aid of ultrasound-guided techniques to accurately place the seeds in the prostate gland. The patients received the seed implants as the sole treatment for prostate cancer with no additional chemotherapy or radiation therapy.
"This study is exciting because it shows that brachytherapy alone without additional surgery, radiation or drugs can be effective at curing early-stage prostate cancer," said Michael J. Zelefsky, M.D., lead author of the study and Chief of Brachytherapy Services at Memorial Sloan-Kettering Cancer Center in New York. "These results also confirm other findings that the quality of the seed implant is a critical ingredient for achieving a better outcome."
Seed implants have become a widely-accepted treatment option for early stage prostate cancer because it is very effective at curing the cancer, is minimally invasive and often spares patients from side effects of other treatments, such as impotence and incontinence. The seeds, similar in size to a grain of rice, contain a radiation dose that, once implanted, delivers concentrated radiation to the prostate, sparing surrounding organs and tissue.
Doctors in this study evaluated the long-term results of permanent seed implants in men with early stage prostate cancer. Nearly 2,700 men were studied at 11 institutions in the United States over eight years. The radioactive seeds were administered with the aid of ultrasound-guided techniques to accurately place the seeds in the prostate gland. The patients received the seed implants as the sole treatment for prostate cancer with no additional chemotherapy or radiation therapy.
"This study is exciting because it shows that brachytherapy alone without additional surgery, radiation or drugs can be effective at curing early-stage prostate cancer," said Michael J. Zelefsky, M.D., lead author of the study and Chief of Brachytherapy Services at Memorial Sloan-Kettering Cancer Center in New York. "These results also confirm other findings that the quality of the seed implant is a critical ingredient for achieving a better outcome."
Take Fatigue Seriously
Take fatigue seriously, says University of Alberta researcher
Instead of dismissing grumblings about being tired or exhausted, people should take these complaints seriously before they lead to a worsened health state or even death, says a University of Alberta researcher investigating fatigue.
Dr. Karin Olson, a U of A professor from the Faculty of Nursing, argues that there are differences between tiredness, fatigue and exhaustion and that recognizing those distinctions will help health-care workers create better treatment plans for their patients. Her findings are published in the current issue of "Oncology Nursing Forum."
Olson has studied fatigue in six ill and non-ill populations: shift workers, recreational long distance runners, individuals with cancer in active treatment or palliative settings, and individuals diagnosed with depression or chronic fatigue syndrome. Having worked with cancer patients for many years, she saw how serious fatigue was and the impact it had on the patients' quality of life. Some patients even withdrew for a potentially curative treatment saying they were "too tired."
"The kind of fatigue experienced by individuals with cancer is different from the feeling that you or I have at the end of a busy week," said Olson. "Interestingly, when you start looking at other populations, such as people with chronic illnesses or shift workers and take a broad view, the descriptions of fatigue are the same. Thus, while the reasons for fatigue may vary, the kinds of adaptations required may not."
Olson, who is currently an Alberta Heritage Foundation for Medical Research (AHFMR) Health Scholar, has created new definitions for tiredness, fatigue and exhaustion and argues that they represent various points on an energy continuum. The amount of energy a person has influences how easily he can adapt to stress that comes his way. Individuals who are tired still have a fair bit of energy, so although they may feel forgetful, and impatient, and experience gradual heaviness or weakness in muscles following work, this is often alleviated by rest. Fatigue, on the other hand, is characterized by difficulty concentrating, anxiety, a gradual decrease in stamina, difficulty sleeping, increased sensitivity to light and the limiting of social activities once viewed as important. Individuals with exhaustion report frank confusion that resembles delirium, emotional numbness, sudden loss of energy, difficulty both in staying awake and in sleeping and complete social withdrawal.
"It is important to recognize the difference between tiredness and fatigue, because fatigue is a marker that the body is not able to keep up," says Olson. "The onset of the manifestations of fatigue, particularly if these are not normal states for you, should be taken seriously."
Failing to understand the distinctions between tiredness, fatigue and exhaustion could result in the use of inappropriate interventions that inadvertently promote fatigue and exhaustion. Olson has some evidence that while exercise appears to help those who are tired, it may decrease the ability to adapt in individuals experiencing fatigue and exhaustion. Long-term use of caffeine and other stimulants should also be avoided by people experiencing fatigue and exhaustion, as these substances "fool" the body into thinking it has more energy available than it really does.
"The important thing is to try to prevent or at least delay the progression from tiredness to fatigue and then from fatigue to exhaustion," said Olson. "We are starting to work on some interventions that we think may be helpful. In the meantime, families and friends can help by recognizing changes consistent with fatigue and exhaustion and look for ways to help minimize stress."
This work may also have applications to other population, such as students or individuals with chronic illnesses, who have not been studied to date. "Students tend to stay up late at night, studying hard," said Olson. "Some studies show that changes in sleep patterns are may compromise one's ability to remember things and to integrate new information.
"We're a long way from having all the answers but this study was a start. It has provided us with a great foundation for future research among individuals with cancer and other groups ranging from ‘burned out' workers to recreational athletes and people with chronic diseases."
Instead of dismissing grumblings about being tired or exhausted, people should take these complaints seriously before they lead to a worsened health state or even death, says a University of Alberta researcher investigating fatigue.
Dr. Karin Olson, a U of A professor from the Faculty of Nursing, argues that there are differences between tiredness, fatigue and exhaustion and that recognizing those distinctions will help health-care workers create better treatment plans for their patients. Her findings are published in the current issue of "Oncology Nursing Forum."
Olson has studied fatigue in six ill and non-ill populations: shift workers, recreational long distance runners, individuals with cancer in active treatment or palliative settings, and individuals diagnosed with depression or chronic fatigue syndrome. Having worked with cancer patients for many years, she saw how serious fatigue was and the impact it had on the patients' quality of life. Some patients even withdrew for a potentially curative treatment saying they were "too tired."
"The kind of fatigue experienced by individuals with cancer is different from the feeling that you or I have at the end of a busy week," said Olson. "Interestingly, when you start looking at other populations, such as people with chronic illnesses or shift workers and take a broad view, the descriptions of fatigue are the same. Thus, while the reasons for fatigue may vary, the kinds of adaptations required may not."
Olson, who is currently an Alberta Heritage Foundation for Medical Research (AHFMR) Health Scholar, has created new definitions for tiredness, fatigue and exhaustion and argues that they represent various points on an energy continuum. The amount of energy a person has influences how easily he can adapt to stress that comes his way. Individuals who are tired still have a fair bit of energy, so although they may feel forgetful, and impatient, and experience gradual heaviness or weakness in muscles following work, this is often alleviated by rest. Fatigue, on the other hand, is characterized by difficulty concentrating, anxiety, a gradual decrease in stamina, difficulty sleeping, increased sensitivity to light and the limiting of social activities once viewed as important. Individuals with exhaustion report frank confusion that resembles delirium, emotional numbness, sudden loss of energy, difficulty both in staying awake and in sleeping and complete social withdrawal.
"It is important to recognize the difference between tiredness and fatigue, because fatigue is a marker that the body is not able to keep up," says Olson. "The onset of the manifestations of fatigue, particularly if these are not normal states for you, should be taken seriously."
Failing to understand the distinctions between tiredness, fatigue and exhaustion could result in the use of inappropriate interventions that inadvertently promote fatigue and exhaustion. Olson has some evidence that while exercise appears to help those who are tired, it may decrease the ability to adapt in individuals experiencing fatigue and exhaustion. Long-term use of caffeine and other stimulants should also be avoided by people experiencing fatigue and exhaustion, as these substances "fool" the body into thinking it has more energy available than it really does.
"The important thing is to try to prevent or at least delay the progression from tiredness to fatigue and then from fatigue to exhaustion," said Olson. "We are starting to work on some interventions that we think may be helpful. In the meantime, families and friends can help by recognizing changes consistent with fatigue and exhaustion and look for ways to help minimize stress."
This work may also have applications to other population, such as students or individuals with chronic illnesses, who have not been studied to date. "Students tend to stay up late at night, studying hard," said Olson. "Some studies show that changes in sleep patterns are may compromise one's ability to remember things and to integrate new information.
"We're a long way from having all the answers but this study was a start. It has provided us with a great foundation for future research among individuals with cancer and other groups ranging from ‘burned out' workers to recreational athletes and people with chronic diseases."
We eat more and less-healthy comfort foods when we feel down
Mood-food connection: We eat more and less-healthy comfort foods when we feel down, study finds
People feeling sad tend to eat more of less-healthy comfort foods than when they feel happy, finds a new study co-authored by a Cornell food marketing expert. However, when nutritional information is available, those same sad people curb their hedonistic consumption. But happier people don't.
In the January issue of the Journal of Marketing, Brian Wansink, the John S. Dyson Professor of Marketing, Applied Economics and Management at Cornell, and two colleagues describe several studies they devised to test the link between mood and food. For example, they recruited 38 administrative assistants to watch either an upbeat, funny movie ("Sweet Home Alabama") or a sad, depressing one ("Love Story"). Throughout the viewings the participants were offered hot buttered, salty popcorn and seedless grapes.
"After the movies were over and the tears were wiped away, those who had watched 'Love Story' had eaten 36 percent more popcorn than those who had watched the upbeat 'Sweet Home Alabama,'" said Wansink, author of the recent book "Mindless Eating: Why We Eat More Than We Think" (Bantam Books). "Those watching 'Sweet Home Alabama' ate popcorn and popped grapes, but they spent much more time popping grapes as they laughed through the movie than they did eating popcorn."
Wansink suspects that happy people want to maintain or extend their moods in the short term, but consider the long term and so turn to comfort food with more nutritional value. People feeling sad or depressed, however, just want to "jolt themselves out of the dumps" with a quick indulgent snack that tastes good and gives them an immediate "bump of euphoria."
To see whether nutritional information influences comfort-food consumption, the researchers offered popcorn to volunteers who completed several assignments, including irrelevant mental tasks, writing descriptions of four things that made them happy (or sad) and reading short stories that were either happy or sad. One group reviewed nutritional information about popcorn, while the other did not.
The researchers found that the sad people with no nutritional information ate twice as much popcorn as those feeling happy. In the groups that reviewed nutritional labels, however, the happy people ate about the same amount, but the sad people dramatically curbed their consumption, eating even less popcorn than the happy people.
"Thus, it appears that happy people are already avoiding consumption, and the presence of nutritional information does not drive their consumption any lower," said Wansink.
"While each of us may look for a comfort food when we are either sad or happy, we are likely to eat more of it when we are sad," Wansink concluded. "Since nutritional information appears to influence how much people eat when they are in sad moods, those eating in a sad mood would serve themselves well by checking the nutritional information of the comfort foods they choose to indulge themselves with."
People feeling sad tend to eat more of less-healthy comfort foods than when they feel happy, finds a new study co-authored by a Cornell food marketing expert. However, when nutritional information is available, those same sad people curb their hedonistic consumption. But happier people don't.
In the January issue of the Journal of Marketing, Brian Wansink, the John S. Dyson Professor of Marketing, Applied Economics and Management at Cornell, and two colleagues describe several studies they devised to test the link between mood and food. For example, they recruited 38 administrative assistants to watch either an upbeat, funny movie ("Sweet Home Alabama") or a sad, depressing one ("Love Story"). Throughout the viewings the participants were offered hot buttered, salty popcorn and seedless grapes.
"After the movies were over and the tears were wiped away, those who had watched 'Love Story' had eaten 36 percent more popcorn than those who had watched the upbeat 'Sweet Home Alabama,'" said Wansink, author of the recent book "Mindless Eating: Why We Eat More Than We Think" (Bantam Books). "Those watching 'Sweet Home Alabama' ate popcorn and popped grapes, but they spent much more time popping grapes as they laughed through the movie than they did eating popcorn."
Wansink suspects that happy people want to maintain or extend their moods in the short term, but consider the long term and so turn to comfort food with more nutritional value. People feeling sad or depressed, however, just want to "jolt themselves out of the dumps" with a quick indulgent snack that tastes good and gives them an immediate "bump of euphoria."
To see whether nutritional information influences comfort-food consumption, the researchers offered popcorn to volunteers who completed several assignments, including irrelevant mental tasks, writing descriptions of four things that made them happy (or sad) and reading short stories that were either happy or sad. One group reviewed nutritional information about popcorn, while the other did not.
The researchers found that the sad people with no nutritional information ate twice as much popcorn as those feeling happy. In the groups that reviewed nutritional labels, however, the happy people ate about the same amount, but the sad people dramatically curbed their consumption, eating even less popcorn than the happy people.
"Thus, it appears that happy people are already avoiding consumption, and the presence of nutritional information does not drive their consumption any lower," said Wansink.
"While each of us may look for a comfort food when we are either sad or happy, we are likely to eat more of it when we are sad," Wansink concluded. "Since nutritional information appears to influence how much people eat when they are in sad moods, those eating in a sad mood would serve themselves well by checking the nutritional information of the comfort foods they choose to indulge themselves with."
FDA Approves Claims for Supplement Ingredient
he Food and Drug Administration approved certain claims for Phase 2 Starch Neutralizer, an ingredient found in many over-the-counter supplements, according to WPIX-CW11 in New York. Phase 2 was developed to help people lose or maintain their weight. Phase 2 is made from an extract from the raw white kidney bean that blocks amylase, an enzyme that breaks down carbohydrates so they may be absorbed in the system. One of the claims the FDA allowed was that Phase 2 may assist in weight control when used in conjunction with a sensible diet and exercise program.
What a dentist can tell by looking in your mouth
By Dr. Brad Durham
Your mouth can get you in trouble. Research is showing that dental problems can affect your health in areas seemingly unconnected to your mouth, and dentists may be the expert to relieve you of nagging problems or to help prevent and identify serious health problems. One area of dental origin can bring about pain that patients wouldn’t think to connect to their mouth, and that area is the bite. Bite problems can cause headaches, ear pain, neck and shoulder pain, dizziness, clenching and grinding of the teeth, and numbness in fingertips, hands and arms. These symptoms, many seemingly unrelated to the mouth, can lead patients in many directions as they look for relief. It’s not uncommon for patients to have been to their ENT for examinations, to radiologists and neurologists to have CAT scans and to chiropractors for adjustments, only to have the real culprit be bite problems. The dysfunction of the bite can be related to a non-coordination of the muscles, joints or teeth. Symptoms will show up in one of those categories. Headaches are linked to muscle problems with the bite. As a matter of course, patients with recurrent headaches should be examined by a dentist with experience in bite treatment. Ear pain, dizziness and popping are related to bite problems with the joints. Teeth problems include clenching, grinding and toothaches.
Patients experiencing these symptoms should see a dentist with experience in bite treatment using computerized diagnostic equipment. Children are especially sensitive to temporomandibular joint disorder and usually show early signs with ear infections, leaning their head on an arm, lip, cheek, or finger biting, sucking or chewing, headaches, snoring, grinding of their teeth at night, and excessive chewing of gum. The temporomandibular joints, or jaw joints, are the small joints in front of each ear that attach the lower jaw to the skull, and are the most complex joints in the entire body. The area of the face where the TMJ is located is an intricate network of bones, ligaments, blood vessels and nerves. Because of this, TMJ conditions affect many areas of the body, from the top of the head in migraine-like headaches to numbness or tingling in the arms and pain in the neck or shoulders. When the teeth are misaligned, they cannot provide the support the muscles in the face need for chewing and swallowing, forcing the muscles into a strained position that results in pain throughout the face, head, arms, shoulders, and back. Although a person may have had orthodontics to straighten the teeth, the muscles and joints may still not be comfortable. After a neuromuscular dentist realigns the bite, pain that resulted from the imbalance typically disappears. In addition to the relief of the pain, patients often find they look better since getting the bite fixed improves cosmetics, giving better facial structure and a younger appearance.
There are many other dental-related maladies that can affect one’s overall health. Dental infections, especially gum infections, can lead to many other health problems, and good dental health can reduce the likelihood that a patient will be stricken with illnesses as serious as cardiovascular disease. It’s also possible that dentists may note warning signals and be able to help patients by encouraging them to see their primary care physicians for evaluation.
Research is increasingly showing that gum and tooth infections can play a part in or cause a host of other health issues. Gum or tooth infections can easily enter the bloodstream, where C-reactive protein causes inflammation that can lead to so many serious health issues. After treating the infection, dentists may want to explain the possible health risks to patients and encourage them to talk about the infection with their physician. Dental problems are connected to an increased risk of cardiovascular disease, according to recent research. Surprisingly, it seems dental problems are a possible stronger indicator of that risk than the other factors such as cholesterol that we typically consider. Gum infections near molars, serious tooth decay, gingivitis, cavities or missing teeth can put patients at risk of heart disease. Some of the diseases linked to periodontal disease include stroke, osteoporosis, colon cancer, prostate cancer, kidney disease, diabetes, Alzheimer’s, and complications in pregnancy. Appropriate dental treatment can decrease the likelihood that the patient will be stricken with these diseases. Visiting the dentist can decrease pregnant women’s chance of premature delivery and low birth weight for the baby. Other dental issues can indicate serious health problems. Patients with an abscessed tooth, many infections or inflamed gums who have good oral hygiene may have diabetes or immunosuppressive problems such as AIDS. Teeth that show chemical erosion, with enamel that seems to be melting away, likely have gastric problems or bulimia. Inflamed gums can be related to kidney disease. Red, inflamed, spongy gums can indicate leukemia. Iron deficiency can cause sores or in serious cases scarring in the throat. Gums that bleed or bruise easily can be caused by vitamin C deficiency. Research is showing more and more how your overall health is connected to the health of your mouth. Good oral hygiene and visits to your dentist now seem more important than ever – and they might even change your life.
About Dr. Durham: Dr. Brad Durham has been practicing dentistry for 25 years. He received his undergraduate degree from Presbyterian College in Clinton, S.C. and dental training from the Medical University of South Carolina in Charleston. Since beginning dental practice, he has completed thousands of hours in continuing education, with an emphasis on head, neck, and facial pain treatment, dental cosmetics, and complex dental reconstruction. He has pioneered the use and integration of technology in dentistry. He is a consultant, author, and researcher. He is presently an instructor at the world renowned Las Vegas Institute of Advanced Dental Education, where he teaches courses in cosmetic, reconstructive, and TMJ related dentistry. Email him personally at brad@braddurhamdmd.com and visit him on the web at www.braddurhamdmd.com
Your mouth can get you in trouble. Research is showing that dental problems can affect your health in areas seemingly unconnected to your mouth, and dentists may be the expert to relieve you of nagging problems or to help prevent and identify serious health problems. One area of dental origin can bring about pain that patients wouldn’t think to connect to their mouth, and that area is the bite. Bite problems can cause headaches, ear pain, neck and shoulder pain, dizziness, clenching and grinding of the teeth, and numbness in fingertips, hands and arms. These symptoms, many seemingly unrelated to the mouth, can lead patients in many directions as they look for relief. It’s not uncommon for patients to have been to their ENT for examinations, to radiologists and neurologists to have CAT scans and to chiropractors for adjustments, only to have the real culprit be bite problems. The dysfunction of the bite can be related to a non-coordination of the muscles, joints or teeth. Symptoms will show up in one of those categories. Headaches are linked to muscle problems with the bite. As a matter of course, patients with recurrent headaches should be examined by a dentist with experience in bite treatment. Ear pain, dizziness and popping are related to bite problems with the joints. Teeth problems include clenching, grinding and toothaches.
Patients experiencing these symptoms should see a dentist with experience in bite treatment using computerized diagnostic equipment. Children are especially sensitive to temporomandibular joint disorder and usually show early signs with ear infections, leaning their head on an arm, lip, cheek, or finger biting, sucking or chewing, headaches, snoring, grinding of their teeth at night, and excessive chewing of gum. The temporomandibular joints, or jaw joints, are the small joints in front of each ear that attach the lower jaw to the skull, and are the most complex joints in the entire body. The area of the face where the TMJ is located is an intricate network of bones, ligaments, blood vessels and nerves. Because of this, TMJ conditions affect many areas of the body, from the top of the head in migraine-like headaches to numbness or tingling in the arms and pain in the neck or shoulders. When the teeth are misaligned, they cannot provide the support the muscles in the face need for chewing and swallowing, forcing the muscles into a strained position that results in pain throughout the face, head, arms, shoulders, and back. Although a person may have had orthodontics to straighten the teeth, the muscles and joints may still not be comfortable. After a neuromuscular dentist realigns the bite, pain that resulted from the imbalance typically disappears. In addition to the relief of the pain, patients often find they look better since getting the bite fixed improves cosmetics, giving better facial structure and a younger appearance.
There are many other dental-related maladies that can affect one’s overall health. Dental infections, especially gum infections, can lead to many other health problems, and good dental health can reduce the likelihood that a patient will be stricken with illnesses as serious as cardiovascular disease. It’s also possible that dentists may note warning signals and be able to help patients by encouraging them to see their primary care physicians for evaluation.
Research is increasingly showing that gum and tooth infections can play a part in or cause a host of other health issues. Gum or tooth infections can easily enter the bloodstream, where C-reactive protein causes inflammation that can lead to so many serious health issues. After treating the infection, dentists may want to explain the possible health risks to patients and encourage them to talk about the infection with their physician. Dental problems are connected to an increased risk of cardiovascular disease, according to recent research. Surprisingly, it seems dental problems are a possible stronger indicator of that risk than the other factors such as cholesterol that we typically consider. Gum infections near molars, serious tooth decay, gingivitis, cavities or missing teeth can put patients at risk of heart disease. Some of the diseases linked to periodontal disease include stroke, osteoporosis, colon cancer, prostate cancer, kidney disease, diabetes, Alzheimer’s, and complications in pregnancy. Appropriate dental treatment can decrease the likelihood that the patient will be stricken with these diseases. Visiting the dentist can decrease pregnant women’s chance of premature delivery and low birth weight for the baby. Other dental issues can indicate serious health problems. Patients with an abscessed tooth, many infections or inflamed gums who have good oral hygiene may have diabetes or immunosuppressive problems such as AIDS. Teeth that show chemical erosion, with enamel that seems to be melting away, likely have gastric problems or bulimia. Inflamed gums can be related to kidney disease. Red, inflamed, spongy gums can indicate leukemia. Iron deficiency can cause sores or in serious cases scarring in the throat. Gums that bleed or bruise easily can be caused by vitamin C deficiency. Research is showing more and more how your overall health is connected to the health of your mouth. Good oral hygiene and visits to your dentist now seem more important than ever – and they might even change your life.
About Dr. Durham: Dr. Brad Durham has been practicing dentistry for 25 years. He received his undergraduate degree from Presbyterian College in Clinton, S.C. and dental training from the Medical University of South Carolina in Charleston. Since beginning dental practice, he has completed thousands of hours in continuing education, with an emphasis on head, neck, and facial pain treatment, dental cosmetics, and complex dental reconstruction. He has pioneered the use and integration of technology in dentistry. He is a consultant, author, and researcher. He is presently an instructor at the world renowned Las Vegas Institute of Advanced Dental Education, where he teaches courses in cosmetic, reconstructive, and TMJ related dentistry. Email him personally at brad@braddurhamdmd.com and visit him on the web at www.braddurhamdmd.com
Tuesday, January 30, 2007
Men warned of osteoporosis problems
A McMaster University researcher is alerting men and their doctors that osteoporosis isn't just a woman's problem but that the bone-wasting disease can severely afflict them, too.
To overcome this common perception, Dr. Aliya A. Khan, a professor of clinical medicine, led a group of five Canadian experts in the development of guidelines for the diagnosis, treatment and management of osteoporosis in men. Their paper appears in the January 30 issue of the Canadian Medical Association Journal (CMAJ).
Dr. Khan said the CMAJ paper is intended to make physicians aware of the fact that they can no longer overlook diagnosing osteoporosis in their male patients. "That's the bottom line. We want to bring all the research we have to the forefront and we want to bring it to the desk of Canadian physicians."
The CMAJ paper supplements clinical practice guidelines for the diagnosis and management of osteoporosis published by Osteoporosis Canada in 2002. It provides a review and synthesis of the current literature on the diagnosis and management of osteoporosis in men.
Up until now, Dr. Khan said, doctors have underestimated even how common the condition is in men. One in eight men over 50 years of age has osteoporosis, compared to one in four women after menopause.
In their paper, the researchers describe which men are at the highest risk, how to diagnose and investigate the disease, and offer the most up-to-date information on treatment.
Dr. Khan is also director of the Calcium Disorders Clinic at St. Joseph's Healthcare in Hamilton, Ontario and director of the Oakville Bone Centre in Oakville, Ontario.
She said scientists are "just at the tip of the iceberg" in understanding the implications of osteoporosis for men, unlike women where it's well known which women are at risk, how the disease develops and how to treat it.
"The problem," she said, "is that when men sustain fractures they are more likely to die or suffer a disability."
Statistically, one in three men die following a fracture, compared to one in five women, possibly because of underlying health problems (such as heart disease) which make it difficult for them to cope with a fracture that could involve hip surgery, prolonged bed rest and rehabilitation.
To overcome this common perception, Dr. Aliya A. Khan, a professor of clinical medicine, led a group of five Canadian experts in the development of guidelines for the diagnosis, treatment and management of osteoporosis in men. Their paper appears in the January 30 issue of the Canadian Medical Association Journal (CMAJ).
Dr. Khan said the CMAJ paper is intended to make physicians aware of the fact that they can no longer overlook diagnosing osteoporosis in their male patients. "That's the bottom line. We want to bring all the research we have to the forefront and we want to bring it to the desk of Canadian physicians."
The CMAJ paper supplements clinical practice guidelines for the diagnosis and management of osteoporosis published by Osteoporosis Canada in 2002. It provides a review and synthesis of the current literature on the diagnosis and management of osteoporosis in men.
Up until now, Dr. Khan said, doctors have underestimated even how common the condition is in men. One in eight men over 50 years of age has osteoporosis, compared to one in four women after menopause.
In their paper, the researchers describe which men are at the highest risk, how to diagnose and investigate the disease, and offer the most up-to-date information on treatment.
Dr. Khan is also director of the Calcium Disorders Clinic at St. Joseph's Healthcare in Hamilton, Ontario and director of the Oakville Bone Centre in Oakville, Ontario.
She said scientists are "just at the tip of the iceberg" in understanding the implications of osteoporosis for men, unlike women where it's well known which women are at risk, how the disease develops and how to treat it.
"The problem," she said, "is that when men sustain fractures they are more likely to die or suffer a disability."
Statistically, one in three men die following a fracture, compared to one in five women, possibly because of underlying health problems (such as heart disease) which make it difficult for them to cope with a fracture that could involve hip surgery, prolonged bed rest and rehabilitation.
Monday, January 29, 2007
Juices as beneficial to health as fruits and vegetables
100 percent juices found as beneficial to health as fruits and vegetables
When it comes to some of today’s health issues, 100 percent fruit and vegetable juices do help reduce risk factors related to certain diseases.
This conclusion is the result of a European study designed to question traditional thinking that 100 percent juices play a less significant role in reducing risk for both cancer and cardiovascular disease than whole fruits and vegetables.
Juices are comparable in their ability to reduce risk compared to their whole fruit/vegetable counterparts say several researchers in the United Kingdom who conducted the literature review. The researchers analyzed a variety of studies that looked at risk reduction attributed to the effects of both fiber and antioxidants. As a result, they determined that the positive impact fruits and vegetables offer come not from just the fiber but also from antioxidants which are present in both juice and the whole fruit and vegetables.
This 2006 review of the literature states, “When considering cancer and coronary heart disease prevention, there is no evidence that pure fruit and vegetable juices are less beneficial than whole fruit and vegetables.” The researchers add that the positioning of juices as being nutritionally inferior to whole fruits and vegetables in relationship to chronic disease development is “unjustified” and that policies which suggest otherwise about fruit and vegetable juices should be re-examined.
The researchers who authored the paper “Can pure fruit and vegetable juices protect against cancer and cardiovascular disease, too? A review of the evidence” suggest that more studies in certain area are needed to bolster their findings. The study was published in the International Journal of Food Science and Nutrition (2006).
“Although this independent review of the literature is not designed to focus on any particular 100 percent juice, it does go a long way in demonstrating that fruit and vegetable juices do play an important role in reducing the risk of various diseases, especially cancer and cardiovascular heart disease,” says Sue Taylor, RD, with the Juice Products Association, a non-profit organization not associated with this research. She adds that appropriate amounts of juices should be included in the diet of both children and adults, following guidelines established by leading health authorities.
Taylor also points to a large epidemiological study, published in the September 2006 issue of the Journal of Medicine, which found that consumption of a variety of 100 percent fruit and vegetable juices was associated with a reduced risk for Alzheimer’s disease. In fact, that study found that individuals who drank three or more servings of fruit and vegetable juices per week had a 76 percent lower risk of developing Alzheimer’s disease than those who drank juice less than once per week.
When it comes to some of today’s health issues, 100 percent fruit and vegetable juices do help reduce risk factors related to certain diseases.
This conclusion is the result of a European study designed to question traditional thinking that 100 percent juices play a less significant role in reducing risk for both cancer and cardiovascular disease than whole fruits and vegetables.
Juices are comparable in their ability to reduce risk compared to their whole fruit/vegetable counterparts say several researchers in the United Kingdom who conducted the literature review. The researchers analyzed a variety of studies that looked at risk reduction attributed to the effects of both fiber and antioxidants. As a result, they determined that the positive impact fruits and vegetables offer come not from just the fiber but also from antioxidants which are present in both juice and the whole fruit and vegetables.
This 2006 review of the literature states, “When considering cancer and coronary heart disease prevention, there is no evidence that pure fruit and vegetable juices are less beneficial than whole fruit and vegetables.” The researchers add that the positioning of juices as being nutritionally inferior to whole fruits and vegetables in relationship to chronic disease development is “unjustified” and that policies which suggest otherwise about fruit and vegetable juices should be re-examined.
The researchers who authored the paper “Can pure fruit and vegetable juices protect against cancer and cardiovascular disease, too? A review of the evidence” suggest that more studies in certain area are needed to bolster their findings. The study was published in the International Journal of Food Science and Nutrition (2006).
“Although this independent review of the literature is not designed to focus on any particular 100 percent juice, it does go a long way in demonstrating that fruit and vegetable juices do play an important role in reducing the risk of various diseases, especially cancer and cardiovascular heart disease,” says Sue Taylor, RD, with the Juice Products Association, a non-profit organization not associated with this research. She adds that appropriate amounts of juices should be included in the diet of both children and adults, following guidelines established by leading health authorities.
Taylor also points to a large epidemiological study, published in the September 2006 issue of the Journal of Medicine, which found that consumption of a variety of 100 percent fruit and vegetable juices was associated with a reduced risk for Alzheimer’s disease. In fact, that study found that individuals who drank three or more servings of fruit and vegetable juices per week had a 76 percent lower risk of developing Alzheimer’s disease than those who drank juice less than once per week.
Flavonoids in U. S. Foods
Most Comprehensive-Ever Survey of Flavonoids in U. S. Foods
Journal of Agricultural and Food Chemistry
Scientists studying the health benefits of flavonoids — those disease-preventing compounds in fruits, vegetables, wine, dark chocolate and other foods — finally have comprehensive data on flavonoid levels in foods consumers buy in the United States. The U. S. Department of Agriculture’s James M. Harnly and colleagues are unveiling new flavonoid data collected from the first systematic sampling of foods designed specifically to characterize flavonoids. The report appeared in the Jan. 10 issue of the ACS’ Journal of Agricultural and Food Chemistry, a bi-weekly publication.
The report notes that interest in the flavonoid content of foods dates to the early 1980s. Since then, two databases had been compiled on levels of these compounds in common foods; the first based on a critical evaluation of flavonoid data in the literature and the second based on the analysis of proanthocyanidins found in selected foods. The reported data have been combined with the literature database.
For the latest report, researchers determined levels of 20 flavonoids in more than 60 fresh fruits, vegetables and nuts collected at two different times of the year from commercial markets in four regions of the United States. Researchers analyzed an average of five samples for each food. Complete results are included in the article. They found flavonoid levels that compared well with the literature database, but the catechins were generally lower in fruits and nuts than the figures reported in the proanthocyanidin database. The new study found a high variability in the flavonoid content of food samples.
ARTICLE #4 FOR IMMEDIATE RELEASE
"Flavonoid Content of U. S. Fruits, Vegetables, and Nuts"
DOWNLOAD PDF
http://pubs.acs.org/cgi-bin/sample.cgi/jafcau/2006/54/i26/pdf/jf061478a.pdf
Journal of Agricultural and Food Chemistry
Scientists studying the health benefits of flavonoids — those disease-preventing compounds in fruits, vegetables, wine, dark chocolate and other foods — finally have comprehensive data on flavonoid levels in foods consumers buy in the United States. The U. S. Department of Agriculture’s James M. Harnly and colleagues are unveiling new flavonoid data collected from the first systematic sampling of foods designed specifically to characterize flavonoids. The report appeared in the Jan. 10 issue of the ACS’ Journal of Agricultural and Food Chemistry, a bi-weekly publication.
The report notes that interest in the flavonoid content of foods dates to the early 1980s. Since then, two databases had been compiled on levels of these compounds in common foods; the first based on a critical evaluation of flavonoid data in the literature and the second based on the analysis of proanthocyanidins found in selected foods. The reported data have been combined with the literature database.
For the latest report, researchers determined levels of 20 flavonoids in more than 60 fresh fruits, vegetables and nuts collected at two different times of the year from commercial markets in four regions of the United States. Researchers analyzed an average of five samples for each food. Complete results are included in the article. They found flavonoid levels that compared well with the literature database, but the catechins were generally lower in fruits and nuts than the figures reported in the proanthocyanidin database. The new study found a high variability in the flavonoid content of food samples.
ARTICLE #4 FOR IMMEDIATE RELEASE
"Flavonoid Content of U. S. Fruits, Vegetables, and Nuts"
DOWNLOAD PDF
http://pubs.acs.org/cgi-bin/sample.cgi/jafcau/2006/54/i26/pdf/jf061478a.pdf
Friday, January 26, 2007
Kids at risk: Assessing diet and exercise behaviors in adolescents
Do adolescents get enough exercise and eat the right foods? Is there too much fat in their diets? In a study published in the February 2007 issue of the American Journal of Preventive Medicine, researchers analyzed the behavior of almost 900 11-to-15 year-olds and found that nearly 80% had multiple physical activity and dietary risk behaviors, almost half had at least three risk behaviors, and only 2% met all four of the health guidelines in the study.
Using both physical measurements and surveying techniques, four behaviors were assessed: physical activity, television viewing time, percent calories from fat, and daily servings of fruits and vegetables. In addition, parental health behaviors were sampled.
Fifty-five percent of adolescents did not meet the physical activity guideline, although significantly more boys (59%) than girls (33.6%) did meet the standard. About 30% exceeded 2 hours of television viewing time and the majority of the sample did not meet dietary standards. Only 32% and 11.9% of the sample met the recommendations for fat consumption and servings of fruits and vegetables, respectively.
There was some evidence that parents' health behaviors were associated with adolescents' health behaviors. For the girls, two parent health behaviors—never smoking and meeting fruit and vegetable guidelines—were associated with fewer adolescent risk behaviors. Parents' number of risk behaviors was weakly but positively associated with a higher number of risk behaviors in boys.
Writing in the article, Alvaro Sanchez, PhD, states, "These findings contribute to the body of evidence that most adolescents fail to meet multiple diet and physical activity guidelines and continue to be in need of interventions that target multiple behaviors. Although health promotion programs frequently target multiple behaviors, little is known about the best approaches to stimulating multiple behavior change…Further research is needed to investigate the feasibility and effectiveness of different strategies for promoting multiple behavior change in adolescence."
Using both physical measurements and surveying techniques, four behaviors were assessed: physical activity, television viewing time, percent calories from fat, and daily servings of fruits and vegetables. In addition, parental health behaviors were sampled.
Fifty-five percent of adolescents did not meet the physical activity guideline, although significantly more boys (59%) than girls (33.6%) did meet the standard. About 30% exceeded 2 hours of television viewing time and the majority of the sample did not meet dietary standards. Only 32% and 11.9% of the sample met the recommendations for fat consumption and servings of fruits and vegetables, respectively.
There was some evidence that parents' health behaviors were associated with adolescents' health behaviors. For the girls, two parent health behaviors—never smoking and meeting fruit and vegetable guidelines—were associated with fewer adolescent risk behaviors. Parents' number of risk behaviors was weakly but positively associated with a higher number of risk behaviors in boys.
Writing in the article, Alvaro Sanchez, PhD, states, "These findings contribute to the body of evidence that most adolescents fail to meet multiple diet and physical activity guidelines and continue to be in need of interventions that target multiple behaviors. Although health promotion programs frequently target multiple behaviors, little is known about the best approaches to stimulating multiple behavior change…Further research is needed to investigate the feasibility and effectiveness of different strategies for promoting multiple behavior change in adolescence."
Wednesday, January 24, 2007
Getting SAD is more than having the blues
University of Rochester doctor reviews seasonal affective disorder
While many people believe that Seasonal Affective Disorder (SAD) amounts to feeling gloomy in the winter, a University of Rochester research review emphasizes that SAD is actually a subtype of major depression and should be treated as such.
Lead author Stephen Lurie, M.D., Ph.D., an assistant professor of Family Medicine at the University of Rochester Medical Center, also noted that SAD is sometimes missed in the typical doctor's office setting.
"Like major depression, Seasonal Affective Disorder probably is under-diagnosed in primary care offices," Lurie said. "But with personalized and detailed attention to symptoms, most patients can be helped a great deal."
New, preliminary studies link SAD to alcoholism or Attention Deficit Hyperactivity Disorder (ADHD). However, not all people with SAD will have ADHD, according to the review article for the American Academy of Family Physicians.
"The important message here is that if you are a patient who has been diagnosed with a mental illness of any kind, don't just assume that any new mental or emotional problem is due to that illness," Lurie said. "Specifically, if you have ADHD and you feel worse in the winter, don't just assume it's your ADHD getting worse. It could actually be SAD – and you should see your doctor because ADHD and SAD are treated entirely differently."
Although SAD has only been studied in adults, parents of children with ADHD should be sensitive to seasonal patterns of behavior and report any changes to a doctor, Lurie said.
Emerging evidence also shows that a pattern of seasonal alcohol use or abuse is associated with SAD. Patients might be self-medicating to cope with an underlying depression, researchers said.
Treatment for SAD includes light therapy, medications such as antidepressants, and cognitive behavior therapy. Each option seems to be effective, Lurie said, but none has been proven superior.
For some patients, SAD is precipitated by darker days causing a shift in 24-hour hormonal rhythms. The loss of natural light outdoors can be replaced with treatment by indoor light-therapy units designed for SAD. Light therapy is best delivered in the morning, when it can regulate the daily pattern of melatonin secretion, the review said.
Treatment with cognitive therapy has been shown to improve a person's dysfunctional thoughts and attitudes and other symptoms in patients with major depression, but no large studies have established whether this type of treatment is effective for SAD.
Doctors often prescribe antidepressants such as Zoloft for SAD. But most of the clinical studies have compared the drug therapy to a placebo pill rather than to light therapy, making it difficult to determine if one treatment is better, the review said.
While many people believe that Seasonal Affective Disorder (SAD) amounts to feeling gloomy in the winter, a University of Rochester research review emphasizes that SAD is actually a subtype of major depression and should be treated as such.
Lead author Stephen Lurie, M.D., Ph.D., an assistant professor of Family Medicine at the University of Rochester Medical Center, also noted that SAD is sometimes missed in the typical doctor's office setting.
"Like major depression, Seasonal Affective Disorder probably is under-diagnosed in primary care offices," Lurie said. "But with personalized and detailed attention to symptoms, most patients can be helped a great deal."
New, preliminary studies link SAD to alcoholism or Attention Deficit Hyperactivity Disorder (ADHD). However, not all people with SAD will have ADHD, according to the review article for the American Academy of Family Physicians.
"The important message here is that if you are a patient who has been diagnosed with a mental illness of any kind, don't just assume that any new mental or emotional problem is due to that illness," Lurie said. "Specifically, if you have ADHD and you feel worse in the winter, don't just assume it's your ADHD getting worse. It could actually be SAD – and you should see your doctor because ADHD and SAD are treated entirely differently."
Although SAD has only been studied in adults, parents of children with ADHD should be sensitive to seasonal patterns of behavior and report any changes to a doctor, Lurie said.
Emerging evidence also shows that a pattern of seasonal alcohol use or abuse is associated with SAD. Patients might be self-medicating to cope with an underlying depression, researchers said.
Treatment for SAD includes light therapy, medications such as antidepressants, and cognitive behavior therapy. Each option seems to be effective, Lurie said, but none has been proven superior.
For some patients, SAD is precipitated by darker days causing a shift in 24-hour hormonal rhythms. The loss of natural light outdoors can be replaced with treatment by indoor light-therapy units designed for SAD. Light therapy is best delivered in the morning, when it can regulate the daily pattern of melatonin secretion, the review said.
Treatment with cognitive therapy has been shown to improve a person's dysfunctional thoughts and attitudes and other symptoms in patients with major depression, but no large studies have established whether this type of treatment is effective for SAD.
Doctors often prescribe antidepressants such as Zoloft for SAD. But most of the clinical studies have compared the drug therapy to a placebo pill rather than to light therapy, making it difficult to determine if one treatment is better, the review said.
HOW TO RECOGNIZE & TREAT EXERTIONAL HEAT ILLNESSES
The National Athletic Trainers’ Association (NATA) has tips to treat exertional heat illnesses should they occur.
Treatment Strategies for Exertional Heat Illnesses:
DEHYDRATION
When athletes do not replenish lost fluids, they become dehydrated.
Signs and Symptoms:
Dry mouth
Thirst
Being irritable or cranky
Headache
Seeming bored or disinterested
Dizziness
Cramps
Excessive fatigue
Not able to run as fast or play as well as usual
Treatment:
Move athlete to a cool environment and rehydrate.
Maintain normal hydration (as indicated by baseline body weight).
Begin exercise sessions properly hydrated. Any fluid deficits should be replaced within 1 to 2 hours after exercise is complete.
Hydrate with a sports drink like Gatorade, which contains carbohydrates and electrolytes (sodium and potassium) before and during exercise is optimal to replace losses and provide energy.
Hydrate throughout sports practice to minimize dehydration and maximize performance.
Seek medical attention to replace fluids via an intravenous line if athlete is nauseated or vomiting.
Return-to-Play Considerations:
If degree of dehydration is minor and the athlete is symptom free, continued participation is acceptable
EXERTIONAL HEAT STROKE
A severe illness characterized by central nervous system (CNS) abnormalities and potentially tissue damage resulting from elevated body temperatures induced by strenuous physical exercise and increased environmental heat stress.
Signs and Symptoms:
Increase in core body temperature, usually above 104°F/40°C (rectal temperature) when athlete falls ill
Central nervous system dysfunction, such as altered consciousness, seizures, confusion, emotional instability, irrational behavior or decreased mental acuity
Nausea, vomiting or diarrhea
Headache, dizziness or weakness
Hot and wet or dry skin
Increased heart rate, decreased blood pressure or fast breathing
Dehydration
Combativeness
Treatment
Aggressive and immediate whole-body cooling is the key to optimizing treatment. The duration and degree of hyperthermia may determine adverse outcomes. If untreated, hyperthermia-induced physiological changes resulting in fatal consequences may occur within vital organ systems (muscle, heart, brain, etc.). Due to superior cooling rates, immediate whole-body cooling (cold water immersion), is the best treatment for EHS and should be initiated within minutes post-incident. It is recommended to cool first and transport second if onsite rapid cooling and adequate medical supervision are available.
Return-to-Play Considerations:
The athlete’s physician should devise a careful return-to-play strategy that can be implemented with the assistance of a qualified health care professional.
HEAT EXHAUSTION
Heat exhaustion is a moderate illness characterized by the inability to sustain adequate cardiac output, resulting from strenuous physical exercise and environmental heat stress.
Signs and Symptoms:
Athlete finds it hard or impossible to keep playing
Loss of coordination, dizziness or fainting
Dehydration
Profuse sweating or pale skin
Headache, nausea, vomiting or diarrhea
Stomach/intestinal cramps or persistent muscle cramps
Treatment:
Remove athlete from play and immediately move to shaded or air-conditioned area.
Remove excess clothing and equipment.
Cool athlete until rectal temperature is approximately 101°F (38.3°C)
Have athlete lie comfortably with legs propped above heart level.
If athlete is not nauseated, vomiting or experiencing any CNS dysfunction, rehydrate orally with chilled water or sports drink. If athlete is unable to take oral fluids, implement intravenous infusion of normal saline.
Monitor heart rate, blood pressure, respiratory rate, core temperature and CNS status.
Transport to an emergency facility if rapid improvement is not noted with prescribed treatment.
Return-to-Play Considerations:
Athlete should be symptom free and fully hydrated; recommend physician clearance; rule out underlying condition that predisposed him/her for continue problems; and avoid intense practice in heat until at least the next day.
HEAT CRAMPS
Muscle cramps are not well understood. Heat cramps are often present in athletes who perform strenuous exercise in the heat. Conversely, cramps also occur in the absence of warm or hot conditions, which is common in ice hockey players.
Signs and Symptoms:
Intense pain (not associated with pulling or straining a muscle)
Persistent muscle contractions that continue during and after exercise
Treatment:
Reestablish normal hydration status and replace some sodium losses with a sports drink or water
Some additional sodium may be needed (especially in those with a history of heat cramps) earlier in the activity.
Light stretching, relaxation and massage of the involved muscle may help acute pain of a muscle cramp.
Return-to-Play Considerations:
Athletes should be assessed to determine if they can perform at the level needed for successful participation.
EXERTIONAL HYPONATREMIA
When an athlete’s blood sodium levels decrease, either due to overhydration or inadequate sodium intake, or both, medical complications can result in cerebral and/or pulmonary edema. This tends to occur during warm/hot weather activities. Hyponatremia may be completely avoided if fluid consumption during activity does not exceed fluid losses.
Signs and Symptoms:
Excessive fluid consumption before, during and after exercising (weight gain during activity)
Increasing headache
Nausea, vomiting (often repetitive)
Swelling of extremities (hands and feet)
Treatment:
If blood sodium levels cannot be determined onsite, hold off on rehydrating athlete (may worsen condition) and transport immediately to a medical facility.
The delivery of sodium, certain diuretics or intravenous solutions may be necessary. All will be monitored in the emergency department to ensure no complications develop.
Treatment Strategies for Exertional Heat Illnesses:
DEHYDRATION
When athletes do not replenish lost fluids, they become dehydrated.
Signs and Symptoms:
Dry mouth
Thirst
Being irritable or cranky
Headache
Seeming bored or disinterested
Dizziness
Cramps
Excessive fatigue
Not able to run as fast or play as well as usual
Treatment:
Move athlete to a cool environment and rehydrate.
Maintain normal hydration (as indicated by baseline body weight).
Begin exercise sessions properly hydrated. Any fluid deficits should be replaced within 1 to 2 hours after exercise is complete.
Hydrate with a sports drink like Gatorade, which contains carbohydrates and electrolytes (sodium and potassium) before and during exercise is optimal to replace losses and provide energy.
Hydrate throughout sports practice to minimize dehydration and maximize performance.
Seek medical attention to replace fluids via an intravenous line if athlete is nauseated or vomiting.
Return-to-Play Considerations:
If degree of dehydration is minor and the athlete is symptom free, continued participation is acceptable
EXERTIONAL HEAT STROKE
A severe illness characterized by central nervous system (CNS) abnormalities and potentially tissue damage resulting from elevated body temperatures induced by strenuous physical exercise and increased environmental heat stress.
Signs and Symptoms:
Increase in core body temperature, usually above 104°F/40°C (rectal temperature) when athlete falls ill
Central nervous system dysfunction, such as altered consciousness, seizures, confusion, emotional instability, irrational behavior or decreased mental acuity
Nausea, vomiting or diarrhea
Headache, dizziness or weakness
Hot and wet or dry skin
Increased heart rate, decreased blood pressure or fast breathing
Dehydration
Combativeness
Treatment
Aggressive and immediate whole-body cooling is the key to optimizing treatment. The duration and degree of hyperthermia may determine adverse outcomes. If untreated, hyperthermia-induced physiological changes resulting in fatal consequences may occur within vital organ systems (muscle, heart, brain, etc.). Due to superior cooling rates, immediate whole-body cooling (cold water immersion), is the best treatment for EHS and should be initiated within minutes post-incident. It is recommended to cool first and transport second if onsite rapid cooling and adequate medical supervision are available.
Return-to-Play Considerations:
The athlete’s physician should devise a careful return-to-play strategy that can be implemented with the assistance of a qualified health care professional.
HEAT EXHAUSTION
Heat exhaustion is a moderate illness characterized by the inability to sustain adequate cardiac output, resulting from strenuous physical exercise and environmental heat stress.
Signs and Symptoms:
Athlete finds it hard or impossible to keep playing
Loss of coordination, dizziness or fainting
Dehydration
Profuse sweating or pale skin
Headache, nausea, vomiting or diarrhea
Stomach/intestinal cramps or persistent muscle cramps
Treatment:
Remove athlete from play and immediately move to shaded or air-conditioned area.
Remove excess clothing and equipment.
Cool athlete until rectal temperature is approximately 101°F (38.3°C)
Have athlete lie comfortably with legs propped above heart level.
If athlete is not nauseated, vomiting or experiencing any CNS dysfunction, rehydrate orally with chilled water or sports drink. If athlete is unable to take oral fluids, implement intravenous infusion of normal saline.
Monitor heart rate, blood pressure, respiratory rate, core temperature and CNS status.
Transport to an emergency facility if rapid improvement is not noted with prescribed treatment.
Return-to-Play Considerations:
Athlete should be symptom free and fully hydrated; recommend physician clearance; rule out underlying condition that predisposed him/her for continue problems; and avoid intense practice in heat until at least the next day.
HEAT CRAMPS
Muscle cramps are not well understood. Heat cramps are often present in athletes who perform strenuous exercise in the heat. Conversely, cramps also occur in the absence of warm or hot conditions, which is common in ice hockey players.
Signs and Symptoms:
Intense pain (not associated with pulling or straining a muscle)
Persistent muscle contractions that continue during and after exercise
Treatment:
Reestablish normal hydration status and replace some sodium losses with a sports drink or water
Some additional sodium may be needed (especially in those with a history of heat cramps) earlier in the activity.
Light stretching, relaxation and massage of the involved muscle may help acute pain of a muscle cramp.
Return-to-Play Considerations:
Athletes should be assessed to determine if they can perform at the level needed for successful participation.
EXERTIONAL HYPONATREMIA
When an athlete’s blood sodium levels decrease, either due to overhydration or inadequate sodium intake, or both, medical complications can result in cerebral and/or pulmonary edema. This tends to occur during warm/hot weather activities. Hyponatremia may be completely avoided if fluid consumption during activity does not exceed fluid losses.
Signs and Symptoms:
Excessive fluid consumption before, during and after exercising (weight gain during activity)
Increasing headache
Nausea, vomiting (often repetitive)
Swelling of extremities (hands and feet)
Treatment:
If blood sodium levels cannot be determined onsite, hold off on rehydrating athlete (may worsen condition) and transport immediately to a medical facility.
The delivery of sodium, certain diuretics or intravenous solutions may be necessary. All will be monitored in the emergency department to ensure no complications develop.
10 STEPS TO COMBAT LOW BACK PAIN
The National Athletic Trainers’ Association (NATA) has prepared a 10-step guide that people of all ages can use to reduce body stress, prevent back pain and thereby improve quality of life. NATA represents certified athletic trainers.
“The human body is an incredible machine that adapts to the stresses we give it every day,” said certified athletic trainer Darrell Barnes, LAT, ATC, CSCS, performance center coordinator, St. Vincent Sports Performance Center in Indianapolis, Ind. “Stresses such as poor posture and a sedentary lifestyle lead to break down and pain. Disability from back pain is second only to the common cold as a cause of lost work time.”
According to the Arthritis Foundation, back pain affects 80 percent of the adult population at some point in their lives. In fact, back pain, limited mobility and stiffness end up costing American consumers $24 billion in treatment costs annually.
Following are recommendations to prevent and reduce back pain:
Identify negative stresses – Everybody has physical limitations that can lead to body imbalances, so it’s important to identifying problematic areas and correct these imbalances. Look at your sitting/standing posture. Do you complain that your muscles “feel tight” or weak? Do you use poor mechanics when lifting heavy items?
Make yourself mobile – Poor posture and muscle stiffness decrease the body’s ability to move freely, which can lead to injury or pain. There are many ways to increase mobility including daily stretches or activities that increase flexibility and get the body moving in different directions. Try yoga, tai chi, swimming or pilates to keep you limber.
Increase strength – It’s important to get strong to improve overall balance and flexibility to reduce stress on the back. Exercises should involve the whole body, especially the core muscles of the stomach, back, hips and pelvis. At the same time, strengthening of the legs and shoulders can help you more easily squat, lift and carry even heavy items without overworking or injuring your back.
Add aerobic exercise – Physical activities like walking, swimming and running for at least 20 minutes three times a week increases muscular endurance and cardiovascular fitness. Aerobic activities also improve blood flow to the spine and help decrease daily stress.
Pay attention to posture – Try not to sit or drive for long periods of time. Get up every 15 to 30 minutes and move around or stretch to increase your mobility. When seated always remember to keep your hips and knees at right angles to one another and find a chair with adequate lumbar (lower back) support.
Stand up straight – When engaged in activities while standing, be sure to stand with your head up, shoulders straight, chest forward and stomach tight. Avoid standing in the same position for too long, though, and use your legs – rather than your back – when pushing or pulling heavy doors and other items.
Use proper lifting mechanics – When lifting objects from a position below your waist, stand with a wide stance and a slight bend at your hips and knees. Tighten your stomach as you lift and keep your back as flat as possible – do not arch or bend. When carrying heavy objects, keep them as close to your body as you can. Avoid carrying objects on only one side of your body.
Get a good night’s sleep – Select a firm mattress and box spring that does not sag. Try to sleep in a position that allows you to maintain the natural curve in your back.
Warm-up before physical activity – Engage in a low impact activity, prior to playing sports or exercising. Increasing muscle temperature and mobility will decrease the chance of injury.
Improve your healthy lifestyle – Obesity and smoking have been found to increase the incidence of back pain. Taking steps to improve your health will decrease the chance of back pain and improve your overall quality of life.
“The human body is an incredible machine that adapts to the stresses we give it every day,” said certified athletic trainer Darrell Barnes, LAT, ATC, CSCS, performance center coordinator, St. Vincent Sports Performance Center in Indianapolis, Ind. “Stresses such as poor posture and a sedentary lifestyle lead to break down and pain. Disability from back pain is second only to the common cold as a cause of lost work time.”
According to the Arthritis Foundation, back pain affects 80 percent of the adult population at some point in their lives. In fact, back pain, limited mobility and stiffness end up costing American consumers $24 billion in treatment costs annually.
Following are recommendations to prevent and reduce back pain:
Identify negative stresses – Everybody has physical limitations that can lead to body imbalances, so it’s important to identifying problematic areas and correct these imbalances. Look at your sitting/standing posture. Do you complain that your muscles “feel tight” or weak? Do you use poor mechanics when lifting heavy items?
Make yourself mobile – Poor posture and muscle stiffness decrease the body’s ability to move freely, which can lead to injury or pain. There are many ways to increase mobility including daily stretches or activities that increase flexibility and get the body moving in different directions. Try yoga, tai chi, swimming or pilates to keep you limber.
Increase strength – It’s important to get strong to improve overall balance and flexibility to reduce stress on the back. Exercises should involve the whole body, especially the core muscles of the stomach, back, hips and pelvis. At the same time, strengthening of the legs and shoulders can help you more easily squat, lift and carry even heavy items without overworking or injuring your back.
Add aerobic exercise – Physical activities like walking, swimming and running for at least 20 minutes three times a week increases muscular endurance and cardiovascular fitness. Aerobic activities also improve blood flow to the spine and help decrease daily stress.
Pay attention to posture – Try not to sit or drive for long periods of time. Get up every 15 to 30 minutes and move around or stretch to increase your mobility. When seated always remember to keep your hips and knees at right angles to one another and find a chair with adequate lumbar (lower back) support.
Stand up straight – When engaged in activities while standing, be sure to stand with your head up, shoulders straight, chest forward and stomach tight. Avoid standing in the same position for too long, though, and use your legs – rather than your back – when pushing or pulling heavy doors and other items.
Use proper lifting mechanics – When lifting objects from a position below your waist, stand with a wide stance and a slight bend at your hips and knees. Tighten your stomach as you lift and keep your back as flat as possible – do not arch or bend. When carrying heavy objects, keep them as close to your body as you can. Avoid carrying objects on only one side of your body.
Get a good night’s sleep – Select a firm mattress and box spring that does not sag. Try to sleep in a position that allows you to maintain the natural curve in your back.
Warm-up before physical activity – Engage in a low impact activity, prior to playing sports or exercising. Increasing muscle temperature and mobility will decrease the chance of injury.
Improve your healthy lifestyle – Obesity and smoking have been found to increase the incidence of back pain. Taking steps to improve your health will decrease the chance of back pain and improve your overall quality of life.
Study Demonstrates New Mattress Can Relieve Chronic Back Pain
Subjects with high back pain report 63 per cent improvement in back discomfort after switching to new mattress
A new study published in the current issue of the Journal of Chiropractic Medicine has demonstrated that switching to a new mattress can significantly reduce back pain and stiffness. The study by Oklahoma State University found that subjects who suffered from persistent back pain found immediate and significant relief by switching to a new mattress and that the improvements persisted past the initial switch to the new mattress. It also found that subjects who were sleeping on mattresses five years or older were significantly more likely to suffer from back pain and stiffness.
The research is the first study of its kind to attempt to quantify the link between back pain relief and bedding systems. The team at Oklahoma State University studied a control group of 59 healthy participants (30 women and 29 men) who slept on their own five-plus year-old mattresses for four weeks and then slept on a new bedding system for the same time period. The study analyzed the difference in lower back discomfort, spine stiffness, sleep quality, comfort and efficiency.
Subjects reported immediate and sustained benefits in all areas of measurement following their transition to a new mattress, regardless of their age or weight. This was especially true of participants who entered the study with high back pain complaints; they reported a 63 per cent improvement in back discomfort.
"More than 80 per cent of Canadians suffer from back pain at some time in their life(*), said Dr. Stacy Irvine, chiropractor and fitness expert, on behalf of the Better Sleep Council Canada. "There are many ways to treat back pain, but people may not realize that an answer might be right under their noses, literally, in the age and state of their mattress."
"Back pain should be taken seriously - left untreated it will negatively impact people's quality of life and productivity at home and at work," adds Dr. Irvine. "This research shows that a new mattress could hold a key to unlocking some of that pain and discomfort."
According to the article in The Journal of Chiropractic Medicine, while health care professionals are often asked to recommend a bedding system that can reduce sleep disturbances and improve sleep quality, there has been little or no consistent information or benchmark for doctors to reference. According to the study's authors "health professionals may safely recommend a medium-firm sleep surface with a certain degree of confidence for patients experiencing minor musculoskeletal sleep disturbance."
48 Million Lost Hours of Productivity Every Week Due to Poor Sleep
The study also notes that sleep deficiency interferes with daytime activity, social interactions, mood, and even loss of work production further making the case that a new mattress can improve sleep quality and therefore overall quality-of-life for consumers.
Past Better Sleep Council Canada research has found that 30 per cent of adult Canadians admit poor sleep compromises between 3 and 10 hours of productivity at work each week(
) which translates into about 48 million hours of lost productivity every week.
"We've always known intuitively that a new mattress can help with back pain and quality of sleep but now we have been able to measure that impact," said Gary Baskerville of the Better Sleep Council Canada. "On average, Canadians spend more than 2,000 hours each year sleeping. The mattress is one of the hardest working pieces of furniture in our home. And now we have further proof of its very real contribution to our personal health and comfort."
The Better Sleep Council Canada recommends that you perform a bi-annual bed check to evaluate the state of their mattress and foundation. Look for these simple ABC'S:
A - Age: has your mattress had more than eight to 10 years of nightly use?
B - Beauty: would you be embarrassed to show your uncovered mattress in public? Does it have stains, soils or tears? Does it sag?
C - Comfort: over time you become desensitized to the dwindling comfort and support of your mattress - just like you would to an old pair of sneakers. When you lie down and concentrate on the comfort of your mattress, does it feel the same as it did when you first tried it at the store?
S - Support check - when you lie flat on your back, and place your hand under the small of your back, how much space is there? You should be able to move your hand around.
About the Study
"Subjective Rating of Perceived Back Pain, Stiffness and Sleep Quality Following Introduction of Medium-Firm Bedding Systems" is authored by Bert Jacobson, EdD, Tia Wallace, MS, and Hugh Gemmell, DC, EdD of Oklahoma State University and published in the Winter 2006 issue of the Journal of Chiropractic Medicine.
The study was commissioned by the International Sleep Products Association and The Better Sleep Council Canada in order to determine if a scientific link existed between sleep products' age and quality and people's back pain, discomfort and sleep quantity.
A new study published in the current issue of the Journal of Chiropractic Medicine has demonstrated that switching to a new mattress can significantly reduce back pain and stiffness. The study by Oklahoma State University found that subjects who suffered from persistent back pain found immediate and significant relief by switching to a new mattress and that the improvements persisted past the initial switch to the new mattress. It also found that subjects who were sleeping on mattresses five years or older were significantly more likely to suffer from back pain and stiffness.
The research is the first study of its kind to attempt to quantify the link between back pain relief and bedding systems. The team at Oklahoma State University studied a control group of 59 healthy participants (30 women and 29 men) who slept on their own five-plus year-old mattresses for four weeks and then slept on a new bedding system for the same time period. The study analyzed the difference in lower back discomfort, spine stiffness, sleep quality, comfort and efficiency.
Subjects reported immediate and sustained benefits in all areas of measurement following their transition to a new mattress, regardless of their age or weight. This was especially true of participants who entered the study with high back pain complaints; they reported a 63 per cent improvement in back discomfort.
"More than 80 per cent of Canadians suffer from back pain at some time in their life(*), said Dr. Stacy Irvine, chiropractor and fitness expert, on behalf of the Better Sleep Council Canada. "There are many ways to treat back pain, but people may not realize that an answer might be right under their noses, literally, in the age and state of their mattress."
"Back pain should be taken seriously - left untreated it will negatively impact people's quality of life and productivity at home and at work," adds Dr. Irvine. "This research shows that a new mattress could hold a key to unlocking some of that pain and discomfort."
According to the article in The Journal of Chiropractic Medicine, while health care professionals are often asked to recommend a bedding system that can reduce sleep disturbances and improve sleep quality, there has been little or no consistent information or benchmark for doctors to reference. According to the study's authors "health professionals may safely recommend a medium-firm sleep surface with a certain degree of confidence for patients experiencing minor musculoskeletal sleep disturbance."
48 Million Lost Hours of Productivity Every Week Due to Poor Sleep
The study also notes that sleep deficiency interferes with daytime activity, social interactions, mood, and even loss of work production further making the case that a new mattress can improve sleep quality and therefore overall quality-of-life for consumers.
Past Better Sleep Council Canada research has found that 30 per cent of adult Canadians admit poor sleep compromises between 3 and 10 hours of productivity at work each week(
) which translates into about 48 million hours of lost productivity every week.
"We've always known intuitively that a new mattress can help with back pain and quality of sleep but now we have been able to measure that impact," said Gary Baskerville of the Better Sleep Council Canada. "On average, Canadians spend more than 2,000 hours each year sleeping. The mattress is one of the hardest working pieces of furniture in our home. And now we have further proof of its very real contribution to our personal health and comfort."
The Better Sleep Council Canada recommends that you perform a bi-annual bed check to evaluate the state of their mattress and foundation. Look for these simple ABC'S:
A - Age: has your mattress had more than eight to 10 years of nightly use?
B - Beauty: would you be embarrassed to show your uncovered mattress in public? Does it have stains, soils or tears? Does it sag?
C - Comfort: over time you become desensitized to the dwindling comfort and support of your mattress - just like you would to an old pair of sneakers. When you lie down and concentrate on the comfort of your mattress, does it feel the same as it did when you first tried it at the store?
S - Support check - when you lie flat on your back, and place your hand under the small of your back, how much space is there? You should be able to move your hand around.
About the Study
"Subjective Rating of Perceived Back Pain, Stiffness and Sleep Quality Following Introduction of Medium-Firm Bedding Systems" is authored by Bert Jacobson, EdD, Tia Wallace, MS, and Hugh Gemmell, DC, EdD of Oklahoma State University and published in the Winter 2006 issue of the Journal of Chiropractic Medicine.
The study was commissioned by the International Sleep Products Association and The Better Sleep Council Canada in order to determine if a scientific link existed between sleep products' age and quality and people's back pain, discomfort and sleep quantity.
Tuesday, January 23, 2007
Mercury present in all western fish
A new survey by researchers at Oregon State University and the U.S. Environmental Protection Agency of more than 600 rivers and streams in the western United States found widespread mercury concentrations in fish.
Though few of the more than 2,700 fish analyzed in the study contained alarmingly high levels of mercury, the prevalence of the element throughout 12 western states caught the researchers somewhat by surprise.
"Mercury is everywhere," said Alan Herlihy, a research associate professor with OSU's Department of Fisheries and Wildlife and one of the authors of the study. "It was literally in every fish we sampled, which suggests an atmospheric source. There also tended to be a noticeable difference between 'piscivores,' or fish-eating fish, and non-piscivores such as salmonids."
The researchers found that mercury levels were much higher in the larger fish-eating species, including bass, walleye, northern pike and pikeminnow. These piscivores are not as widespread throughout western river systems as salmonids, such as rainbow and cutthroat trout, which had lower levels of mercury.
Results of the study were published earlier this month in the journal Environmental Science and Technology.
The researchers say the risk for humans who may occasionally eat fish from the streams is fairly low and they compare the mercury levels in most of the larger piscivorous fish they analyzed to that found in cans of store-bought tuna. Consumption of those products in moderation is considered safe, though infants, young children, pregnant women and persons who eat a lot of fish have higher risk levels than the general population.
Less clear is the impact of that mercury on fish-eating birds and mammals, said Robert Hughes, also an author on the paper and an OSU fisheries and wildlife research associate professor.
"If I were a mink or an otter," Hughes said, "I'd be concerned. Those guys are loading up on fish containing mercury and we don't really know at what levels they may be affected. In birds, the effects of mercury contamination are neurological or behavioral – and often subtle. They may not clean their young, or they may leave eggs unattended in their nests.
"We simply haven't done enough studies to know all of the impacts, especially on fish-eating animals," Hughes added.
The study, based on data collected from EPA's Environmental Monitoring and Assessment Program, encompassed nearly 188,000 miles of perennial streams and rivers in the western United States. The selection of the more than 600 creek and river sample sites was done randomly to address regional questions about the prevalence of mercury contamination among fish in western rivers; not to do a stream-by-stream analysis of the impact.
The EPA's "tissue-based water quality criterion" is set at 0.3 micrograms of mercury per gram of fish tissue. In the survey, only 2.3 percent of the stream network that contained large (5 inches or longer) salmonids had mercury levels at or exceeding that 0.3 mg level. Salmonids were the most prevalent group of species, found in 41 percent of the network sampled.
On the other hand, large bass, walleye and other piscivores were found in only 10 percent of the streams and rivers, yet 57 percent of them met or exceeded the 0.3 microgram level.
"The difference in mercury levels between salmonids and piscivores is likely a function of their diet," Hughes said.
"Most of the salmonids we sampled were insect-eaters. Older, very large salmon may respond more like piscivores, but we didn't sample salmonids of that size."
In looking at mercury levels in fish across the West, the most important factors "were where the fish were in the food web, and their ages," Herlihy said. "The older a fish is, the larger it is, and the more fish that it eats, the more likely it is to bioaccumulate mercury."
Mercury levels of 0.1 micrograms per gram of tissue are considered a threshold of concern for fish-eating mammals, though little research has been done on how different levels of mercury affect mink, otter and related animals. Nevertheless, the survey found that 93 percent of the streams and rivers with large piscivores exceeded that level of mercury deemed "protective" for fish-eating mammals.
Conducting the study with Herlihy and Hughes were Spencer Peterson and John Van Sickle of the EPA National Health and Ecological Effects Research Laboratory, located on the OSU campus.
Mercury entering the water via the atmosphere has a variety of natural and manmade sources, the researchers say, including coal power plants from as far away as China, the burning of heavy oils and other fossil fuels, and even forest fires.
In the survey, the researchers did find 13 fish from eight different sites that had very high mercury concentrations – levels of 1.0 microgram or higher – likely indicating a point source. These high levels could be caused by nearby mines, dump sites or gravel pits, they added.
"There are mercury 'hotspots' out there," Hughes said, "but they are not common in the West. What we found, though, is that mercury is in fish throughout the western United States, and at higher levels in piscivores than in salmonids."
Though few of the more than 2,700 fish analyzed in the study contained alarmingly high levels of mercury, the prevalence of the element throughout 12 western states caught the researchers somewhat by surprise.
"Mercury is everywhere," said Alan Herlihy, a research associate professor with OSU's Department of Fisheries and Wildlife and one of the authors of the study. "It was literally in every fish we sampled, which suggests an atmospheric source. There also tended to be a noticeable difference between 'piscivores,' or fish-eating fish, and non-piscivores such as salmonids."
The researchers found that mercury levels were much higher in the larger fish-eating species, including bass, walleye, northern pike and pikeminnow. These piscivores are not as widespread throughout western river systems as salmonids, such as rainbow and cutthroat trout, which had lower levels of mercury.
Results of the study were published earlier this month in the journal Environmental Science and Technology.
The researchers say the risk for humans who may occasionally eat fish from the streams is fairly low and they compare the mercury levels in most of the larger piscivorous fish they analyzed to that found in cans of store-bought tuna. Consumption of those products in moderation is considered safe, though infants, young children, pregnant women and persons who eat a lot of fish have higher risk levels than the general population.
Less clear is the impact of that mercury on fish-eating birds and mammals, said Robert Hughes, also an author on the paper and an OSU fisheries and wildlife research associate professor.
"If I were a mink or an otter," Hughes said, "I'd be concerned. Those guys are loading up on fish containing mercury and we don't really know at what levels they may be affected. In birds, the effects of mercury contamination are neurological or behavioral – and often subtle. They may not clean their young, or they may leave eggs unattended in their nests.
"We simply haven't done enough studies to know all of the impacts, especially on fish-eating animals," Hughes added.
The study, based on data collected from EPA's Environmental Monitoring and Assessment Program, encompassed nearly 188,000 miles of perennial streams and rivers in the western United States. The selection of the more than 600 creek and river sample sites was done randomly to address regional questions about the prevalence of mercury contamination among fish in western rivers; not to do a stream-by-stream analysis of the impact.
The EPA's "tissue-based water quality criterion" is set at 0.3 micrograms of mercury per gram of fish tissue. In the survey, only 2.3 percent of the stream network that contained large (5 inches or longer) salmonids had mercury levels at or exceeding that 0.3 mg level. Salmonids were the most prevalent group of species, found in 41 percent of the network sampled.
On the other hand, large bass, walleye and other piscivores were found in only 10 percent of the streams and rivers, yet 57 percent of them met or exceeded the 0.3 microgram level.
"The difference in mercury levels between salmonids and piscivores is likely a function of their diet," Hughes said.
"Most of the salmonids we sampled were insect-eaters. Older, very large salmon may respond more like piscivores, but we didn't sample salmonids of that size."
In looking at mercury levels in fish across the West, the most important factors "were where the fish were in the food web, and their ages," Herlihy said. "The older a fish is, the larger it is, and the more fish that it eats, the more likely it is to bioaccumulate mercury."
Mercury levels of 0.1 micrograms per gram of tissue are considered a threshold of concern for fish-eating mammals, though little research has been done on how different levels of mercury affect mink, otter and related animals. Nevertheless, the survey found that 93 percent of the streams and rivers with large piscivores exceeded that level of mercury deemed "protective" for fish-eating mammals.
Conducting the study with Herlihy and Hughes were Spencer Peterson and John Van Sickle of the EPA National Health and Ecological Effects Research Laboratory, located on the OSU campus.
Mercury entering the water via the atmosphere has a variety of natural and manmade sources, the researchers say, including coal power plants from as far away as China, the burning of heavy oils and other fossil fuels, and even forest fires.
In the survey, the researchers did find 13 fish from eight different sites that had very high mercury concentrations – levels of 1.0 microgram or higher – likely indicating a point source. These high levels could be caused by nearby mines, dump sites or gravel pits, they added.
"There are mercury 'hotspots' out there," Hughes said, "but they are not common in the West. What we found, though, is that mercury is in fish throughout the western United States, and at higher levels in piscivores than in salmonids."
Inhaled steroids best treatment for children with asthma
Although several medications are available to help children maintain asthma control, clinical trials directly comparing them have not been conducted. In fact, current recommendations in national and international asthma guidelines are based either on studies of single treatments compared to a placebo in children or on comparison studies in adults.
For the first time, researchers compared the effectiveness and safety of three different asthma medicines for initial daily therapy for school-aged children with mild to moderate persistent asthma: a low dose inhaled corticosteroid (200 mcg fluticasone a day); a combination of a lower dose inhaled corticosteroid and an inhaled long acting beta2 agonist (100 mcg fluticasone each morning plus 50mcg salmeterol twice daily), and a leukotriene receptor antagonist (montelukast). Studying 285 children ages 6 – 14 years, researchers in the Childhood Asthma Research and Education Network of the National Heart, Lung, and Blood Institute (NHLBI) found that after 48 weeks, inhaled corticosteroids are the most effective initial daily therapy for children with mild to moderate persistent asthma. They also found no significant adverse growth effects among any of the medicines studied.
"Long-term comparison of 3 controller regimens for mild-moderate persistent childhood asthma: The Pediatric Asthma Controller Trial," is published in this month's issue of the Journal of Allergy and Clinical Immunology (JACI). These results support the current asthma clinical guidelines, which recommend inhaled corticosteroids as the preferred initial therapy for children with mild to moderate asthma.
For the first time, researchers compared the effectiveness and safety of three different asthma medicines for initial daily therapy for school-aged children with mild to moderate persistent asthma: a low dose inhaled corticosteroid (200 mcg fluticasone a day); a combination of a lower dose inhaled corticosteroid and an inhaled long acting beta2 agonist (100 mcg fluticasone each morning plus 50mcg salmeterol twice daily), and a leukotriene receptor antagonist (montelukast). Studying 285 children ages 6 – 14 years, researchers in the Childhood Asthma Research and Education Network of the National Heart, Lung, and Blood Institute (NHLBI) found that after 48 weeks, inhaled corticosteroids are the most effective initial daily therapy for children with mild to moderate persistent asthma. They also found no significant adverse growth effects among any of the medicines studied.
"Long-term comparison of 3 controller regimens for mild-moderate persistent childhood asthma: The Pediatric Asthma Controller Trial," is published in this month's issue of the Journal of Allergy and Clinical Immunology (JACI). These results support the current asthma clinical guidelines, which recommend inhaled corticosteroids as the preferred initial therapy for children with mild to moderate asthma.
Monday, January 22, 2007
Microwave oven can sterilize sponges, scrub pads
Microwave ovens may be good for more than just zapping the leftovers; they may also help protect your family.
University of Florida engineering researchers have found that microwaving kitchen sponges and plastic scrubbers — known to be common carriers of the bacteria and viruses that cause food-borne illnesses – sterilizes them rapidly and effectively.
That means that the estimated 90-plus percent of Americans with microwaves in their kitchens have a powerful weapon against E. coli, salmonella and other bugs at the root of increasing incidents of potentially deadly food poisoning and other illnesses.
“Basically what we find is that we could knock out most bacteria in two minutes,” said Gabriel Bitton, a UF professor of environmental engineering. “People often put their sponges and scrubbers in the dishwasher, but if they really want to decontaminate them and not just clean them, they should use the microwave.”
Bitton, an expert on wastewater microbiology, co-authored a paper about the research that appears in the December issue of the Journal of Environmental Health, the most recent issue. The other authors are Richard Melker, a UF professor of anesthesiology, and Dong Kyoo Park, a UF biomedical engineering doctoral student.
Food-borne illnesses afflict at least 6 million Americans annually, causing at least 9,000 deaths and $4 billion to $6 billion in medical costs and other expenses. Home kitchens are a common source of contamination, as pathogens from uncooked eggs, meat and vegetables find their way onto countertops, utensils and cleaning tools. Previous studies have shown that sponges and dishcloths are common carriers of the pathogens, in part because they often remain damp, which helps the bugs survive, according to the UF paper.
Bitton said the UF researchers soaked sponges and scrubbing pads in raw wastewater containing a witch’s brew of fecal bacteria, viruses, protozoan parasites and bacterial spores, including Bacillus cereus spores.
Like many other bacterial spores, Bacillus cereus spores are quite resistant to radiation, heat and toxic chemicals, and they are notoriously difficult to kill. The UF researchers used the spores as surrogates for cysts and oocysts of disease-causing parasitic protozoa such as Giardia, the infectious stage of the protozoa. The researchers used bacterial viruses as a substitute for disease-causing food-borne viruses, such as noroviruses and hepatitis A virus.
The researchers used an off-the-shelf microwave oven to zap the sponges and scrub pads for varying lengths of time, wringing them out and determining the microbial load of the water for each test. They compared their findings with water from control sponges and pads not placed in the microwave.
The results were unambiguous: Two minutes of microwaving on full power mode killed or inactivated more than 99 percent of all the living pathogens in the sponges and pads, although the Bacillus cereus spores required four minutes for total inactivation.
Bitton said the heat, rather than the microwave radiation, likely is what proves fatal to the pathogens. Because the microwave works by exciting water molecules, it is better to microwave wet rather than dry sponges or scrub pads, he said.
“The microwave is a very powerful and an inexpensive tool for sterilization,” Bitton said, adding that people should microwave their sponges according to how often they cook, with every other day being a good rule of thumb.
Spurred by the trend toward home health care, the researchers also examined the effects of microwaving contaminated syringes. Bitton said the goal in this research was to come up with a way to sterilize syringes and other equipment that, at home, often gets tossed in the household trash, winding up in standard rather than hazardous waste landfills.
The researchers also found that microwaves were effective in decontaminating syringes, but that it generally took far longer, up to 12 minutes for Bacillus cereus spores. The researchers also discovered they could shorten the time required for sterilization by placing the syringes in heat-trapping ceramic bowls.
Bitton said preliminary research also shows that microwaves might be effective against bioterrorism pathogens such as anthrax, used in the deadly, still-unsolved 2001 postal attacks.
Using a dose of Bacillus cereus dried on an envelope as a substitute for mail contaminated by anthrax spores, Bitton said he found he could kill 98 percent of the spores in 10 minutes by microwaving the paper – suggesting, he said, one possible course of action for people who fear mail might be contaminated. However, more research is needed to confirm that this approach works against actual anthrax spores, he said.
University of Florida engineering researchers have found that microwaving kitchen sponges and plastic scrubbers — known to be common carriers of the bacteria and viruses that cause food-borne illnesses – sterilizes them rapidly and effectively.
That means that the estimated 90-plus percent of Americans with microwaves in their kitchens have a powerful weapon against E. coli, salmonella and other bugs at the root of increasing incidents of potentially deadly food poisoning and other illnesses.
“Basically what we find is that we could knock out most bacteria in two minutes,” said Gabriel Bitton, a UF professor of environmental engineering. “People often put their sponges and scrubbers in the dishwasher, but if they really want to decontaminate them and not just clean them, they should use the microwave.”
Bitton, an expert on wastewater microbiology, co-authored a paper about the research that appears in the December issue of the Journal of Environmental Health, the most recent issue. The other authors are Richard Melker, a UF professor of anesthesiology, and Dong Kyoo Park, a UF biomedical engineering doctoral student.
Food-borne illnesses afflict at least 6 million Americans annually, causing at least 9,000 deaths and $4 billion to $6 billion in medical costs and other expenses. Home kitchens are a common source of contamination, as pathogens from uncooked eggs, meat and vegetables find their way onto countertops, utensils and cleaning tools. Previous studies have shown that sponges and dishcloths are common carriers of the pathogens, in part because they often remain damp, which helps the bugs survive, according to the UF paper.
Bitton said the UF researchers soaked sponges and scrubbing pads in raw wastewater containing a witch’s brew of fecal bacteria, viruses, protozoan parasites and bacterial spores, including Bacillus cereus spores.
Like many other bacterial spores, Bacillus cereus spores are quite resistant to radiation, heat and toxic chemicals, and they are notoriously difficult to kill. The UF researchers used the spores as surrogates for cysts and oocysts of disease-causing parasitic protozoa such as Giardia, the infectious stage of the protozoa. The researchers used bacterial viruses as a substitute for disease-causing food-borne viruses, such as noroviruses and hepatitis A virus.
The researchers used an off-the-shelf microwave oven to zap the sponges and scrub pads for varying lengths of time, wringing them out and determining the microbial load of the water for each test. They compared their findings with water from control sponges and pads not placed in the microwave.
The results were unambiguous: Two minutes of microwaving on full power mode killed or inactivated more than 99 percent of all the living pathogens in the sponges and pads, although the Bacillus cereus spores required four minutes for total inactivation.
Bitton said the heat, rather than the microwave radiation, likely is what proves fatal to the pathogens. Because the microwave works by exciting water molecules, it is better to microwave wet rather than dry sponges or scrub pads, he said.
“The microwave is a very powerful and an inexpensive tool for sterilization,” Bitton said, adding that people should microwave their sponges according to how often they cook, with every other day being a good rule of thumb.
Spurred by the trend toward home health care, the researchers also examined the effects of microwaving contaminated syringes. Bitton said the goal in this research was to come up with a way to sterilize syringes and other equipment that, at home, often gets tossed in the household trash, winding up in standard rather than hazardous waste landfills.
The researchers also found that microwaves were effective in decontaminating syringes, but that it generally took far longer, up to 12 minutes for Bacillus cereus spores. The researchers also discovered they could shorten the time required for sterilization by placing the syringes in heat-trapping ceramic bowls.
Bitton said preliminary research also shows that microwaves might be effective against bioterrorism pathogens such as anthrax, used in the deadly, still-unsolved 2001 postal attacks.
Using a dose of Bacillus cereus dried on an envelope as a substitute for mail contaminated by anthrax spores, Bitton said he found he could kill 98 percent of the spores in 10 minutes by microwaving the paper – suggesting, he said, one possible course of action for people who fear mail might be contaminated. However, more research is needed to confirm that this approach works against actual anthrax spores, he said.
Friday, January 19, 2007
Aspirin saves lives of cancer patients suffering heart attacks, despite fears of bleeding
Many cancer patients who have heart attacks often are not treated with life saving aspirin given the belief in the medical community that they could experience lethal bleeding. Researchers at The University of Texas M. D. Anderson Cancer Center, however, say that notion is now proven wrong and that without aspirin, the majority of these patients will die.
Researchers say that their study, to be published in the February 1, 2007 issue of the journal Cancer and now available online, turns common medical assumptions upside down and will likely change medical practice for cancer patients. Because aspirin can thin blood and cancer patients experience low platelet counts and abnormal clotting, physicians view aspirin as a relative contraindication. Given that blood platelets are responsible for the clotting process, physicians do not eagerly prescribe aspirin as a standard treatment.
In this study, however, the investigators found that 9 of 10 cancer patients with thrombocytopenia (low platelet count) who were experiencing a heart attack and who did not receive aspirin died, whereas only one patient died in a group of 17 similar cancer patients who received aspirin. They also found aspirin helps cancer patients with normal platelet count survive heart attacks, just as it does for people without cancer.
"The notion that heart attacks in patients with low platelets should be treated with clot-dissolving aspirin defies logic, that is unless you suspect that the cancer is interfering with platelet function," says the study's senior investigator and author, Jean-Bernard Durand, M.D., assistant professor in the Department of Cardiology at M. D. Anderson Cancer Center.
"We believe tumors may be releasing chemicals that allow the cancer to form new blood supplies which makes blood more susceptible to forming clots." Durand, a heart failure specialist, says. "There appears to be a platelet paradox suggesting that cancer may affect the mechanism of the way that blood clots, and from this analysis, we have found that the single most important predictor of survival in these patients is whether or not they received aspirin." Durand says more research is needed to better understand this contraindication.
According to the World Health Organization there are approximately 10 million cancer patients worldwide, of which 1.5 million may develop blood clots during their cancer treatment and, as such, are at a much higher risk of dying from heart disease if not treated properly. "Now that we have this study, it would be a travesty if you survive treatment for cancer only to die of a heart attack soon thereafter," Durand says.
According to Durand, no guidelines currently exist for treatment of heart attacks in patients with cancer. He says that physicians are especially perplexed about what to do for cancer patients with thrombosis (blood clots), a condition that affects about 15 percent of all cancer patients and can be due to the use of chemotherapy or the presence of cancer.
Durand came to M. D. Anderson in 2000 to start the Cardiomyopathy Services, which is believed to be the only program in the world specifically designed to look at cardiovascular complications caused by chemotherapy treatment. He is also the co-founder of CONQUER (Cardiology Oncology International Quest to Educate and Research Heart Failure in Cancer), a newly created organization with goals of increasing the success of chemotherapy by reducing cardiovascular disease as a barrier and long term risk.
He and anesthesiologist Mona Sarkiss, M.D., Ph.D., made the observation that patients with thrombocytopenia who suffered a heart attack and were being treated in the intensive care unit at M. D. Anderson tended to die more often when they were not given aspirin. However, they noted that some of the patients given aspirin and/or beta-blockers had "great" clinical outcomes. "Because no practice guidelines exist, physicians were treating their patients with great variability and the disparity was obvious," Durand says.
Sarkiss, who is the study's lead author, Durand, and a team of researchers which included investigators from Baylor College of Medicine and Duke University Medical Center, conducted a retrospective analysis of cancer patients treated for heart attacks at M. D. Anderson Cancer Center in 2001. These 70 patients were divided into two groups based on their platelet counts, and data was collected on the use of aspirin, bleeding complications, and survival.
They found that heart attack patients with low platelets who did not receive aspirin had a seven-day survival rate of 6 percent, compared with 90 percent survival in those who received aspirin. Dr. Durand notes that there were no severe bleeding complications in patients who used aspirin. Conversely, patients with low platelet counts who formed a blood clot and were not exposed to aspirin died.
The beneficial effect of aspirin also was seen in patients with normal platelet counts. Seven-day survival was 88 percent in aspirin-treated patients as compared to 45 percent in patients who did not receive aspirin, the researchers found.
Durand observed that these deaths rates are abnormally high. "In the non-cancer patient with acute coronary syndrome anywhere in the United States, an expected seven-day mortality is less than 1 percent," he says.
There were parallel findings for those patients in either group who were treated with beta-blockers, which block the heart's use of adrenalin. The protective effect was not as strong as seen with aspirin, but was still life saving.
In those patients with a normal platelet count, 91 percent survived seven days when treated with beta-blockers, whereas 36 percent survived if they were not treated with the agent. In the thrombocytopenic group, 73 percent survived seven days when treated with beta-blockers, whereas only 13 percent survived if they were not treated.
Researchers say that their study, to be published in the February 1, 2007 issue of the journal Cancer and now available online, turns common medical assumptions upside down and will likely change medical practice for cancer patients. Because aspirin can thin blood and cancer patients experience low platelet counts and abnormal clotting, physicians view aspirin as a relative contraindication. Given that blood platelets are responsible for the clotting process, physicians do not eagerly prescribe aspirin as a standard treatment.
In this study, however, the investigators found that 9 of 10 cancer patients with thrombocytopenia (low platelet count) who were experiencing a heart attack and who did not receive aspirin died, whereas only one patient died in a group of 17 similar cancer patients who received aspirin. They also found aspirin helps cancer patients with normal platelet count survive heart attacks, just as it does for people without cancer.
"The notion that heart attacks in patients with low platelets should be treated with clot-dissolving aspirin defies logic, that is unless you suspect that the cancer is interfering with platelet function," says the study's senior investigator and author, Jean-Bernard Durand, M.D., assistant professor in the Department of Cardiology at M. D. Anderson Cancer Center.
"We believe tumors may be releasing chemicals that allow the cancer to form new blood supplies which makes blood more susceptible to forming clots." Durand, a heart failure specialist, says. "There appears to be a platelet paradox suggesting that cancer may affect the mechanism of the way that blood clots, and from this analysis, we have found that the single most important predictor of survival in these patients is whether or not they received aspirin." Durand says more research is needed to better understand this contraindication.
According to the World Health Organization there are approximately 10 million cancer patients worldwide, of which 1.5 million may develop blood clots during their cancer treatment and, as such, are at a much higher risk of dying from heart disease if not treated properly. "Now that we have this study, it would be a travesty if you survive treatment for cancer only to die of a heart attack soon thereafter," Durand says.
According to Durand, no guidelines currently exist for treatment of heart attacks in patients with cancer. He says that physicians are especially perplexed about what to do for cancer patients with thrombosis (blood clots), a condition that affects about 15 percent of all cancer patients and can be due to the use of chemotherapy or the presence of cancer.
Durand came to M. D. Anderson in 2000 to start the Cardiomyopathy Services, which is believed to be the only program in the world specifically designed to look at cardiovascular complications caused by chemotherapy treatment. He is also the co-founder of CONQUER (Cardiology Oncology International Quest to Educate and Research Heart Failure in Cancer), a newly created organization with goals of increasing the success of chemotherapy by reducing cardiovascular disease as a barrier and long term risk.
He and anesthesiologist Mona Sarkiss, M.D., Ph.D., made the observation that patients with thrombocytopenia who suffered a heart attack and were being treated in the intensive care unit at M. D. Anderson tended to die more often when they were not given aspirin. However, they noted that some of the patients given aspirin and/or beta-blockers had "great" clinical outcomes. "Because no practice guidelines exist, physicians were treating their patients with great variability and the disparity was obvious," Durand says.
Sarkiss, who is the study's lead author, Durand, and a team of researchers which included investigators from Baylor College of Medicine and Duke University Medical Center, conducted a retrospective analysis of cancer patients treated for heart attacks at M. D. Anderson Cancer Center in 2001. These 70 patients were divided into two groups based on their platelet counts, and data was collected on the use of aspirin, bleeding complications, and survival.
They found that heart attack patients with low platelets who did not receive aspirin had a seven-day survival rate of 6 percent, compared with 90 percent survival in those who received aspirin. Dr. Durand notes that there were no severe bleeding complications in patients who used aspirin. Conversely, patients with low platelet counts who formed a blood clot and were not exposed to aspirin died.
The beneficial effect of aspirin also was seen in patients with normal platelet counts. Seven-day survival was 88 percent in aspirin-treated patients as compared to 45 percent in patients who did not receive aspirin, the researchers found.
Durand observed that these deaths rates are abnormally high. "In the non-cancer patient with acute coronary syndrome anywhere in the United States, an expected seven-day mortality is less than 1 percent," he says.
There were parallel findings for those patients in either group who were treated with beta-blockers, which block the heart's use of adrenalin. The protective effect was not as strong as seen with aspirin, but was still life saving.
In those patients with a normal platelet count, 91 percent survived seven days when treated with beta-blockers, whereas 36 percent survived if they were not treated with the agent. In the thrombocytopenic group, 73 percent survived seven days when treated with beta-blockers, whereas only 13 percent survived if they were not treated.
Thursday, January 18, 2007
Active ingredient in common Chinese herb shown to reduce hypertension
Some 50 million Americans have hypertension, that is, blood pressure measuring above the normal range (less than 120/80 mmHg). If untreated, it can lead to heart attacks, strokes, or kidney disease. Lifestyle changes are the first-stage treatment for the disease, but if they fail, medications are prescribed.
Many patients with high blood pressure have sought relief from complementary and alternative medicine (CAM). In so doing, many have consumed danshen, a Chinese herb used in Oriental medicine that promotes blood flow and treats cardiovascular disease.
Tanshinone IIA is an active ingredient of danshen. Since tanshinone IIA is widely available, a team of researchers has used it to investigate if this active ingredient can reduce blood pressure. In a soon-to-be-released study, using an animal model, the scientists have found that tanshinone IIA does reduce blood pressure.
Summary of Methodology
To assess the effect of tanshinone IIA, the protocol consisted of several parts. The researchers applied the 2-kidney-1-clip protocol to induce renal hypertension in male golden Syrian hamsters. The animals were anesthetized and a retroperitoneal approach was used to place a silver clip to constrict the right renal artery. Sham-operated hamsters and mice underwent the same procedure, except for the placement of a clip.
Both sets of hamsters received 50 ¦Ìg of tanshinone IIA/100g of body weight once a day for two weeks. After the two-week treatment period, mean arterial blood pressure was measured in the right carotid artery. To examine the microvascular actions of tanshinone IIA researchers applied it topically to the hamsters¡¯ cheek pouch or mice cremaster muscles to achieve the final concentration of one ¦Ìg/ml or five ¦Ìg/ml. After the application of tanshinone IIA, the experiment was continued for an additional 60-minute period in order to measure arteriolar diameter and peri-arteriolar nitric oxide concentration.
Results
Tanshinone IIA was found to have significantly reduced blood pressure in the hamsters. The experimental constriction of the renal artery increased mean arterial pressure to 161.2¡À6.9 mmHg relative to 114.3¡À9.2 mmHg in age-matched hamsters. Treatment with 50 ¦Ìg tanshinone IIA/100g body for two weeks reduced the mean arterial pressure from 161.2¡À6.9 to 130.0¡À7.8 mmHg.
The research team also discovered that tanshinone IIA caused widening of the arterioles in the hamster cheek pouch microcirculation via enhanced expression of endothelial nitric oxide synthase. The topical application of tanshinone IIA at one ¦Ìg/ml and five ¦Ìg/ml caused significant dose-related vasodilation, indicated by the increased agent/control ratio of arteriolar diameters from 1.0 to 1.25¡À0.08 and 1.57¡À0.11, respectively, in the hamster cheek pouch. The increase in arteriolar diameter ratio was significant relative to the vehicle for each concentration as well as for comparison between the two concentrations of tanshinone IIA.
Conclusions
As a result of the findings the researchers concluded that tanshinone IIA: (1) significantly reduced blood pressure in hamsters, (2) enhanced the expression of endothelial nitric oxide synthase, (3) increased the production of nitric oxide and (4) induced blood pressure changes through vasodilation in hamster blood microvessels. While the mechanisms of how tanshinone IIA or danshen work in hypertension are not yet fully understood, these results contribute to the effort to bring complementary and alternative medicine and allopathic care closer together in the treatment of hypertensive patients.
Many patients with high blood pressure have sought relief from complementary and alternative medicine (CAM). In so doing, many have consumed danshen, a Chinese herb used in Oriental medicine that promotes blood flow and treats cardiovascular disease.
Tanshinone IIA is an active ingredient of danshen. Since tanshinone IIA is widely available, a team of researchers has used it to investigate if this active ingredient can reduce blood pressure. In a soon-to-be-released study, using an animal model, the scientists have found that tanshinone IIA does reduce blood pressure.
Summary of Methodology
To assess the effect of tanshinone IIA, the protocol consisted of several parts. The researchers applied the 2-kidney-1-clip protocol to induce renal hypertension in male golden Syrian hamsters. The animals were anesthetized and a retroperitoneal approach was used to place a silver clip to constrict the right renal artery. Sham-operated hamsters and mice underwent the same procedure, except for the placement of a clip.
Both sets of hamsters received 50 ¦Ìg of tanshinone IIA/100g of body weight once a day for two weeks. After the two-week treatment period, mean arterial blood pressure was measured in the right carotid artery. To examine the microvascular actions of tanshinone IIA researchers applied it topically to the hamsters¡¯ cheek pouch or mice cremaster muscles to achieve the final concentration of one ¦Ìg/ml or five ¦Ìg/ml. After the application of tanshinone IIA, the experiment was continued for an additional 60-minute period in order to measure arteriolar diameter and peri-arteriolar nitric oxide concentration.
Results
Tanshinone IIA was found to have significantly reduced blood pressure in the hamsters. The experimental constriction of the renal artery increased mean arterial pressure to 161.2¡À6.9 mmHg relative to 114.3¡À9.2 mmHg in age-matched hamsters. Treatment with 50 ¦Ìg tanshinone IIA/100g body for two weeks reduced the mean arterial pressure from 161.2¡À6.9 to 130.0¡À7.8 mmHg.
The research team also discovered that tanshinone IIA caused widening of the arterioles in the hamster cheek pouch microcirculation via enhanced expression of endothelial nitric oxide synthase. The topical application of tanshinone IIA at one ¦Ìg/ml and five ¦Ìg/ml caused significant dose-related vasodilation, indicated by the increased agent/control ratio of arteriolar diameters from 1.0 to 1.25¡À0.08 and 1.57¡À0.11, respectively, in the hamster cheek pouch. The increase in arteriolar diameter ratio was significant relative to the vehicle for each concentration as well as for comparison between the two concentrations of tanshinone IIA.
Conclusions
As a result of the findings the researchers concluded that tanshinone IIA: (1) significantly reduced blood pressure in hamsters, (2) enhanced the expression of endothelial nitric oxide synthase, (3) increased the production of nitric oxide and (4) induced blood pressure changes through vasodilation in hamster blood microvessels. While the mechanisms of how tanshinone IIA or danshen work in hypertension are not yet fully understood, these results contribute to the effort to bring complementary and alternative medicine and allopathic care closer together in the treatment of hypertensive patients.
Monday, January 15, 2007
Low-dose aspirin offers lower chance of asthma
In a large, randomized, placebo-controlled study of 22,071 healthy male physicians, taking a low-dose of aspirin every other day lowered the risk of receiving an initial asthma diagnosis by 22 percent.
These findings, based on data from the double-blind Physicians' Health Study, appear in the second issue for January 2007 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
Tobias Kurth, M.D., Sc.D., of the Division of Aging at Brigham and Women's Hospital in Massachusetts, and five associates studied physicians, ages 40 to 84, over a period of 4.9 years. Among the 11,037 individuals who took aspirin, 113 new cases of asthma were diagnosed, as contrasted to 145 in the placebo group.
Asthma is a chronic inflammatory disease that causes potentially reversible obstructive lung problems. Breathing difficulties from asthma usually occur during "attacks," which involve narrowing of the airways, swelling of the lining, tightening of respiratory muscles and an increased secretion of mucus. In 2004, more than 20 million Americans were estimated to have asthma.
"Aspirin reduced the risk by 22 percent of newly-diagnosed adult-onset asthma," said Dr. Kurth. "These results suggest that aspirin may reduce the development of asthma in adults. They do not imply that aspirin improves symptoms in patients with asthma."
"Indeed, asthma can cause severe bronchospasm in some patients who have asthma," he continued. "Because asthma was not the primary endpoint of the U. S. Public Health Service study, additional randomized trials would be helpful to confirm the apparent reduction in asthma incidence caused by aspirin."
The Physicians Health Study, which began in 1982, was terminated after 4.9 years when results showed a 44-percent reduction in the risk of a first heart attack among those randomly assigned to aspirin.
"Physicians could self-report an asthma diagnosis on questionnaires at baseline, at six months and annually thereafter," said Dr. Kurth. "Asthma was not the original deductive endpoint of the trial."
According to the authors, the 22-percent lower risk of newly-diagnosed asthma among those assigned to the low-dose aspirin group was not affected by participant characteristics like smoking, body mass index or age.
They noted that aspirin-intolerant asthma, a problem in which aspirin exacerbates the disease, affects only a small minority of asthma patients. In three large population-based studies, that difficulty affected only four to 11 percent of the groups. In children, however, the proportion affected by aspirin intolerant asthma was significantly smaller.
These findings, based on data from the double-blind Physicians' Health Study, appear in the second issue for January 2007 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
Tobias Kurth, M.D., Sc.D., of the Division of Aging at Brigham and Women's Hospital in Massachusetts, and five associates studied physicians, ages 40 to 84, over a period of 4.9 years. Among the 11,037 individuals who took aspirin, 113 new cases of asthma were diagnosed, as contrasted to 145 in the placebo group.
Asthma is a chronic inflammatory disease that causes potentially reversible obstructive lung problems. Breathing difficulties from asthma usually occur during "attacks," which involve narrowing of the airways, swelling of the lining, tightening of respiratory muscles and an increased secretion of mucus. In 2004, more than 20 million Americans were estimated to have asthma.
"Aspirin reduced the risk by 22 percent of newly-diagnosed adult-onset asthma," said Dr. Kurth. "These results suggest that aspirin may reduce the development of asthma in adults. They do not imply that aspirin improves symptoms in patients with asthma."
"Indeed, asthma can cause severe bronchospasm in some patients who have asthma," he continued. "Because asthma was not the primary endpoint of the U. S. Public Health Service study, additional randomized trials would be helpful to confirm the apparent reduction in asthma incidence caused by aspirin."
The Physicians Health Study, which began in 1982, was terminated after 4.9 years when results showed a 44-percent reduction in the risk of a first heart attack among those randomly assigned to aspirin.
"Physicians could self-report an asthma diagnosis on questionnaires at baseline, at six months and annually thereafter," said Dr. Kurth. "Asthma was not the original deductive endpoint of the trial."
According to the authors, the 22-percent lower risk of newly-diagnosed asthma among those assigned to the low-dose aspirin group was not affected by participant characteristics like smoking, body mass index or age.
They noted that aspirin-intolerant asthma, a problem in which aspirin exacerbates the disease, affects only a small minority of asthma patients. In three large population-based studies, that difficulty affected only four to 11 percent of the groups. In children, however, the proportion affected by aspirin intolerant asthma was significantly smaller.
Worried about prostate cancer? Tomato-broccoli combo shown to be effective
A new University of Illinois study shows that tomatoes and broccoli--two vegetables known for their cancer-fighting qualities--are better at shrinking prostate tumors when both are part of the daily diet than when they're eaten alone.
"When tomatoes and broccoli are eaten together, we see an additive effect. We think it's because different bioactive compounds in each food work on different anti-cancer pathways," said University of Illinois food science and human nutrition professor John Erdman.
In a study published in the January 15 issue of Cancer Research, Erdman and doctoral candidate Kirstie Canene-Adams fed a diet containing 10 percent tomato powder and 10 percent broccoli powder to laboratory rats that had been implanted with prostate cancer cells. The powders were made from whole foods so the effects of eating the entire vegetable could be compared with consuming individual parts of them as a nutritional supplement.
Other rats in the study received either tomato or broccoli powder alone; or a supplemental dose of lycopene, the red pigment in tomatoes thought to be the effective cancer-preventive agent in tomatoes; or finasteride, a drug prescribed for men with enlarged prostates. Another group of rats was castrated.
After 22 weeks, the tumors were weighed. The tomato/broccoli combo outperformed all other diets in shrinking prostate tumors. Biopsies of tumors were evaluated at The Ohio State University, confirming that tumor cells in the tomato/broccoli-fed rats were not proliferating as rapidly. The only treatment that approached the tomato/broccoli diet's level of effectiveness was castration, said Erdman.
"As nutritionists, it was very exciting to compare this drastic surgery to diet and see that tumor reduction was similar. Older men with slow-growing prostate cancer who have chosen watchful waiting over chemotherapy and radiation should seriously consider altering their diets to include more tomatoes and broccoli," said Canene-Adams.
How much tomato and broccoli should a 55-year-old man concerned about prostate health eat in order to receive these benefits? The scientists did some conversions.
"To get these effects, men should consume daily 1.4 cups of raw broccoli and 2.5 cups of fresh tomato, or 1 cup of tomato sauce, or ½ cup of tomato paste. I think it's very doable for a man to eat a cup and a half of broccoli per day or put broccoli on a pizza with ½ cup of tomato paste," said Canene-Adams.
Erdman said the study showed that eating whole foods is better than consuming their components. "It's better to eat tomatoes than to take a lycopene supplement," he said. "And cooked tomatoes may be better than raw tomatoes. Chopping and heating make the cancer-fighting constituents of tomatoes and broccoli more bioavailable."
"When tomatoes are cooked, for example, the water is removed and the healthful parts become more concentrated. That doesn't mean you should stay away from fresh produce. The lesson here, I think, is to eat a variety of fruits and vegetables prepared in a variety of ways," Canene-Adams added.
Another recent Erdman study shows that rats fed the tomato carotenoids phytofluene, lycopene, or a diet containing 10 percent tomato powder for four days had significantly reduced testosterone levels. "Most prostate cancer is hormone-sensitive, and reducing testosterone levels may be another way that eating tomatoes reduces prostate cancer growth," Erdman said.
Erdman said the tomato/broccoli study was a natural to be carried out at Illinois because of the pioneering work his colleague Elizabeth Jeffery has done on the cancer-fighting agents found in broccoli and other cruciferous vegetables. Jeffery has discovered sulfur compounds in broccoli that enhance certain enzymes in the human body, which then act to degrade carcinogens.
"For ten years, I've been learning how the phytochemicals in tomatoes affect the progression of prostate cancer. Meanwhile Dr. Jeffery has been investigating the ways in which the healthful effects of broccoli are produced. Teaming up to see how these vegetables worked together just made sense and certainly contributes to our knowledge about dietary treatments for prostate cancer," said Erdman.
"When tomatoes and broccoli are eaten together, we see an additive effect. We think it's because different bioactive compounds in each food work on different anti-cancer pathways," said University of Illinois food science and human nutrition professor John Erdman.
In a study published in the January 15 issue of Cancer Research, Erdman and doctoral candidate Kirstie Canene-Adams fed a diet containing 10 percent tomato powder and 10 percent broccoli powder to laboratory rats that had been implanted with prostate cancer cells. The powders were made from whole foods so the effects of eating the entire vegetable could be compared with consuming individual parts of them as a nutritional supplement.
Other rats in the study received either tomato or broccoli powder alone; or a supplemental dose of lycopene, the red pigment in tomatoes thought to be the effective cancer-preventive agent in tomatoes; or finasteride, a drug prescribed for men with enlarged prostates. Another group of rats was castrated.
After 22 weeks, the tumors were weighed. The tomato/broccoli combo outperformed all other diets in shrinking prostate tumors. Biopsies of tumors were evaluated at The Ohio State University, confirming that tumor cells in the tomato/broccoli-fed rats were not proliferating as rapidly. The only treatment that approached the tomato/broccoli diet's level of effectiveness was castration, said Erdman.
"As nutritionists, it was very exciting to compare this drastic surgery to diet and see that tumor reduction was similar. Older men with slow-growing prostate cancer who have chosen watchful waiting over chemotherapy and radiation should seriously consider altering their diets to include more tomatoes and broccoli," said Canene-Adams.
How much tomato and broccoli should a 55-year-old man concerned about prostate health eat in order to receive these benefits? The scientists did some conversions.
"To get these effects, men should consume daily 1.4 cups of raw broccoli and 2.5 cups of fresh tomato, or 1 cup of tomato sauce, or ½ cup of tomato paste. I think it's very doable for a man to eat a cup and a half of broccoli per day or put broccoli on a pizza with ½ cup of tomato paste," said Canene-Adams.
Erdman said the study showed that eating whole foods is better than consuming their components. "It's better to eat tomatoes than to take a lycopene supplement," he said. "And cooked tomatoes may be better than raw tomatoes. Chopping and heating make the cancer-fighting constituents of tomatoes and broccoli more bioavailable."
"When tomatoes are cooked, for example, the water is removed and the healthful parts become more concentrated. That doesn't mean you should stay away from fresh produce. The lesson here, I think, is to eat a variety of fruits and vegetables prepared in a variety of ways," Canene-Adams added.
Another recent Erdman study shows that rats fed the tomato carotenoids phytofluene, lycopene, or a diet containing 10 percent tomato powder for four days had significantly reduced testosterone levels. "Most prostate cancer is hormone-sensitive, and reducing testosterone levels may be another way that eating tomatoes reduces prostate cancer growth," Erdman said.
Erdman said the tomato/broccoli study was a natural to be carried out at Illinois because of the pioneering work his colleague Elizabeth Jeffery has done on the cancer-fighting agents found in broccoli and other cruciferous vegetables. Jeffery has discovered sulfur compounds in broccoli that enhance certain enzymes in the human body, which then act to degrade carcinogens.
"For ten years, I've been learning how the phytochemicals in tomatoes affect the progression of prostate cancer. Meanwhile Dr. Jeffery has been investigating the ways in which the healthful effects of broccoli are produced. Teaming up to see how these vegetables worked together just made sense and certainly contributes to our knowledge about dietary treatments for prostate cancer," said Erdman.
No proof that growth hormone therapy makes you live longer, Stanford study finds
Surveyors of anti-aging elixirs tout human growth hormone as a remedy for all things sagging-from skin to libidos - and claim it can even prevent or reverse aging. But researchers at the Stanford University School of Medicine say there's no evidence to suggest that this purported fountain of youth has any more effect than a trickle of tap water when it comes to fending off Father Time.
"There is certainly no data out there to suggest that giving growth hormone to an otherwise healthy person will make him or her live longer," said Hau Liu, MD, a research fellow in the division of endocrinology and in the Center for Primary Care and Outcomes Research, and first author of a review study to be published in the Jan. 16 issue of Annals of Internal Medicine. "We did find, however, that there was substantial potential for adverse side effects."
Those negative side effects included joint swelling and pain, carpal tunnel syndrome and a trend toward increased new diagnoses of diabetes or pre-diabetes. "You're paying a lot of money for a therapy that may have minimal or no benefit and yet has a potential for some serious side effects," Liu said. "You've got to really think about what this drug is doing for you."
Growth hormone is widely promoted on the Internet and its use as a purported anti-aging drug has caught the attention of the popular media, ranging from the "Today Show" to Business Week.
Between 20,000 and 30,000 people in the United States used growth hormone as an anti-aging therapy in 2004, a tenfold increase since the mid-1990s, according to the authors of an unrelated study published in the Journal of the American Medical Association in 2005. This increase comes despite both the high cost of such therapy - often more than $1,000 a month - and the illegality of distributing growth hormone for anti-aging therapy in this country. Those numbers prompted Liu and some colleagues to see if the medical literature provided any support for such therapy.
Growth hormone is naturally produced by the pituitary gland, a pea-sized organ at the base of the brain. Production is highest during childhood and the hormone-drenched adolescent years, then typically starts tapering off around age 30, continuing to decline into old age. Growth hormone is critical to proper development in children, particularly their height, and injections of growth hormone are considered a legitimate treatment for short children and for adults whose pituitary glands don't produce enough growth hormone to maintain normal metabolism. But most promoters of growth hormone as an anti-aging therapy target the healthy elderly.
Liu's team undertook a systematic review and analysis of published studies, excluding any that looked at diseases for which growth hormone is an accepted therapy. They focused solely on studies using growth hormone to treat the elderly, specifically those whose main maladies were nothing worse than age and being mildly to moderately overweight. They also included only studies that evaluated the use of the hormone in randomized, controlled clinical trials.
Of all the papers contained in two of the largest databases of medical literature in the world, only 31 met the team's criteria. The 31 studies had a combined total of slightly more than 500 participants, and the average duration of therapy was about a half-year, said Liu, adding that he was surprised at the limited amount of data in the literature.
"These studies were designed to look at what happens when you give growth hormone to a healthy elderly person," said Liu. "For example, what happens to their bone density, to their exercise levels and to their exercise capacity."
The researchers found that growth hormone had a modest effect on body composition, increasing lean body mass, or muscle, by slightly more than 2 kilograms and decreasing body fat by roughly the same amount.
But, Liu said, "It did not change other clinically important outcomes, such as bone density measurements, cholesterol and lipid measurements, and maximal oxygen consumption." In short, the studies provided no real evidence that the therapy resulted in increased fitness.
"From our review, there's no data to suggest that growth hormone prolongs life, and none of the studies makes that claim," said Liu.
That finding, according to Liu, highlights one of the fundamental problems in the whole debate over the use of growth hormone to combat the effects of aging-misinterpretation of the data.
The promotion of growth hormone as an anti-aging treatment took off in 1990 when a paper published in the New England Journal of Medicine presented results of a small study in which 12 men over the age of 60 were injected with growth hormone three times a week for six months. At the end of treatment, they had statistically significant increases in lean body mass and bone mineral, unlike a group of nine men who had received no treatment.
The authors of that study made no claims that the treatment had reversed the aging process and stated that many questions remained unanswered, but they did note that the increase in muscle and decrease in fat were "equivalent in magnitude to the changes incurred during 10 to 20 years of aging."
That statement triggered a wave of misinterpretation-inadvertent or otherwise-that persists to this day, despite repeated efforts by the journal to play down the sensational claims now made for growth hormone or growth hormone "releasing agents" widely sold on the Internet. The original study was accompanied by an editorial warning against the general use of growth hormone as a therapy in adults.
In 2003 another NEJM editorial specifically addressed the issue again, as the 1990 paper was receiving as many online "hits" in a week as other 1990 articles got in a year, owing largely to promoters of growth hormone citing it as supporting evidence.
Growth hormone is not the anti-aging bullet for healthy adults.
Further, people who took GH had increased rates of unhealthy side effects such as soft tissue swelling, joint pain, carpal tunnel syndrome, and, in men, abnormal breast development. They were also somewhat more likely to develop diabetes.
The review, "The Safety and Efficacy of Growth Hormone in the Healthy Elderly," was published in the Jan. 16, 2007, issue of Annals of Internal Medicine and is available on the Web at www.annals.org on that day.
"Growth hormone has been widely promoted as an anti-aging therapy," said Hau Liu, MD, a research fellow in endocrinology and health policy at Stanford University and an author of the review.
"But the scant clinical experience of GH in the healthy elderly suggests that although GH may minimally alter body composition, it does not improve other clinically relevant outcomes such as bone density, cholesterol levels, stamina, and longevity in this population.
"And it's associated with high rates of adverse events.
"So, on the basis of available evidence, we cannot recommend growth hormone use for anti-aging in the healthy elderly."
Human growth hormone, a protein produced by the pituitary gland, helps regulate growth during childhood and metabolism in adults.
In the United States, the FDA has approved the drug, now produced synthetically, to treat children with short stature and some other growth problems caused by childhood diseases.
The FDA has approved GH to treat adults with growth hormone deficiency syndrome. Its use for anti-aging falls into a grey area. The FDA prohibits drug companies from marketing GH for off-label uses such as anti-aging.
Yet thousands of adults use GH as an anti-aging drug. One estimate is that 20,000 to 30,000 adults used it for anti-aging purposes in the United States in 2004.
The Web is replete with ads for all kinds of products said to contain GH, from pills, sprays, injections, secretagogues, homeopathic formations, and GH releasers and enhancers. GH, often in conjunction with vitamins, testosterone and other hormones, is said to increase muscle strength and mass, decrease body fat, improve mood and motivation, increase exercise capacity, increase bone density and (wink, wink) make wives and girlfriends happy.
Despite these enticing claims, careful review of existing evidence does not support the prescription of GH for anti-aging purposes.
Growth hormone is among the most expensive of all hormones used for replacement therapy. One physician estimated that a year's supply for an adult with GH-deficiency caused by pituitary disease would cost between $7,500 and $10,000 per year. Estimates of the cost of GH for anti-aging purposes range from $1,000 per month to $2,000 per month.
"Everyone is looking for the fountain of youth," Liu said. "We wanted to see if there is any validity behind some of the claims made about growth hormone's anti-aging properties.
"Our biggest surprise was the general lack of research that had been done in this area. When we reviewed the scientific evidence, we found that there were really only about 500 patients involved in rigorous controlled trials. And only a few more than 200 actually received growth hormone.
"Think about all the scientific claims made on anti-aging Web sites based on this small population of patients. The FDA typically doesn't approve a drug until it's been tested in thousands of patients.
"In our review, we found that growth hormone increased lean body mass or muscle mass by slightly more than two kilograms (that's a little over four pounds) and decreased fat mass by about two kilograms. But it had no other beneficial effects that we could see.
"If you went to a gym pretty regularly, you might get that change without breaking into too much of a sweat, and you wouldn't spend $1,000 to $2,000 a month on something that appears to have modest or minimal benefit and the probability of bad side effects," said Liu.
"There is certainly no data out there to suggest that giving growth hormone to an otherwise healthy person will make him or her live longer," said Hau Liu, MD, a research fellow in the division of endocrinology and in the Center for Primary Care and Outcomes Research, and first author of a review study to be published in the Jan. 16 issue of Annals of Internal Medicine. "We did find, however, that there was substantial potential for adverse side effects."
Those negative side effects included joint swelling and pain, carpal tunnel syndrome and a trend toward increased new diagnoses of diabetes or pre-diabetes. "You're paying a lot of money for a therapy that may have minimal or no benefit and yet has a potential for some serious side effects," Liu said. "You've got to really think about what this drug is doing for you."
Growth hormone is widely promoted on the Internet and its use as a purported anti-aging drug has caught the attention of the popular media, ranging from the "Today Show" to Business Week.
Between 20,000 and 30,000 people in the United States used growth hormone as an anti-aging therapy in 2004, a tenfold increase since the mid-1990s, according to the authors of an unrelated study published in the Journal of the American Medical Association in 2005. This increase comes despite both the high cost of such therapy - often more than $1,000 a month - and the illegality of distributing growth hormone for anti-aging therapy in this country. Those numbers prompted Liu and some colleagues to see if the medical literature provided any support for such therapy.
Growth hormone is naturally produced by the pituitary gland, a pea-sized organ at the base of the brain. Production is highest during childhood and the hormone-drenched adolescent years, then typically starts tapering off around age 30, continuing to decline into old age. Growth hormone is critical to proper development in children, particularly their height, and injections of growth hormone are considered a legitimate treatment for short children and for adults whose pituitary glands don't produce enough growth hormone to maintain normal metabolism. But most promoters of growth hormone as an anti-aging therapy target the healthy elderly.
Liu's team undertook a systematic review and analysis of published studies, excluding any that looked at diseases for which growth hormone is an accepted therapy. They focused solely on studies using growth hormone to treat the elderly, specifically those whose main maladies were nothing worse than age and being mildly to moderately overweight. They also included only studies that evaluated the use of the hormone in randomized, controlled clinical trials.
Of all the papers contained in two of the largest databases of medical literature in the world, only 31 met the team's criteria. The 31 studies had a combined total of slightly more than 500 participants, and the average duration of therapy was about a half-year, said Liu, adding that he was surprised at the limited amount of data in the literature.
"These studies were designed to look at what happens when you give growth hormone to a healthy elderly person," said Liu. "For example, what happens to their bone density, to their exercise levels and to their exercise capacity."
The researchers found that growth hormone had a modest effect on body composition, increasing lean body mass, or muscle, by slightly more than 2 kilograms and decreasing body fat by roughly the same amount.
But, Liu said, "It did not change other clinically important outcomes, such as bone density measurements, cholesterol and lipid measurements, and maximal oxygen consumption." In short, the studies provided no real evidence that the therapy resulted in increased fitness.
"From our review, there's no data to suggest that growth hormone prolongs life, and none of the studies makes that claim," said Liu.
That finding, according to Liu, highlights one of the fundamental problems in the whole debate over the use of growth hormone to combat the effects of aging-misinterpretation of the data.
The promotion of growth hormone as an anti-aging treatment took off in 1990 when a paper published in the New England Journal of Medicine presented results of a small study in which 12 men over the age of 60 were injected with growth hormone three times a week for six months. At the end of treatment, they had statistically significant increases in lean body mass and bone mineral, unlike a group of nine men who had received no treatment.
The authors of that study made no claims that the treatment had reversed the aging process and stated that many questions remained unanswered, but they did note that the increase in muscle and decrease in fat were "equivalent in magnitude to the changes incurred during 10 to 20 years of aging."
That statement triggered a wave of misinterpretation-inadvertent or otherwise-that persists to this day, despite repeated efforts by the journal to play down the sensational claims now made for growth hormone or growth hormone "releasing agents" widely sold on the Internet. The original study was accompanied by an editorial warning against the general use of growth hormone as a therapy in adults.
In 2003 another NEJM editorial specifically addressed the issue again, as the 1990 paper was receiving as many online "hits" in a week as other 1990 articles got in a year, owing largely to promoters of growth hormone citing it as supporting evidence.
Growth hormone is not the anti-aging bullet for healthy adults.
Further, people who took GH had increased rates of unhealthy side effects such as soft tissue swelling, joint pain, carpal tunnel syndrome, and, in men, abnormal breast development. They were also somewhat more likely to develop diabetes.
The review, "The Safety and Efficacy of Growth Hormone in the Healthy Elderly," was published in the Jan. 16, 2007, issue of Annals of Internal Medicine and is available on the Web at www.annals.org on that day.
"Growth hormone has been widely promoted as an anti-aging therapy," said Hau Liu, MD, a research fellow in endocrinology and health policy at Stanford University and an author of the review.
"But the scant clinical experience of GH in the healthy elderly suggests that although GH may minimally alter body composition, it does not improve other clinically relevant outcomes such as bone density, cholesterol levels, stamina, and longevity in this population.
"And it's associated with high rates of adverse events.
"So, on the basis of available evidence, we cannot recommend growth hormone use for anti-aging in the healthy elderly."
Human growth hormone, a protein produced by the pituitary gland, helps regulate growth during childhood and metabolism in adults.
In the United States, the FDA has approved the drug, now produced synthetically, to treat children with short stature and some other growth problems caused by childhood diseases.
The FDA has approved GH to treat adults with growth hormone deficiency syndrome. Its use for anti-aging falls into a grey area. The FDA prohibits drug companies from marketing GH for off-label uses such as anti-aging.
Yet thousands of adults use GH as an anti-aging drug. One estimate is that 20,000 to 30,000 adults used it for anti-aging purposes in the United States in 2004.
The Web is replete with ads for all kinds of products said to contain GH, from pills, sprays, injections, secretagogues, homeopathic formations, and GH releasers and enhancers. GH, often in conjunction with vitamins, testosterone and other hormones, is said to increase muscle strength and mass, decrease body fat, improve mood and motivation, increase exercise capacity, increase bone density and (wink, wink) make wives and girlfriends happy.
Despite these enticing claims, careful review of existing evidence does not support the prescription of GH for anti-aging purposes.
Growth hormone is among the most expensive of all hormones used for replacement therapy. One physician estimated that a year's supply for an adult with GH-deficiency caused by pituitary disease would cost between $7,500 and $10,000 per year. Estimates of the cost of GH for anti-aging purposes range from $1,000 per month to $2,000 per month.
"Everyone is looking for the fountain of youth," Liu said. "We wanted to see if there is any validity behind some of the claims made about growth hormone's anti-aging properties.
"Our biggest surprise was the general lack of research that had been done in this area. When we reviewed the scientific evidence, we found that there were really only about 500 patients involved in rigorous controlled trials. And only a few more than 200 actually received growth hormone.
"Think about all the scientific claims made on anti-aging Web sites based on this small population of patients. The FDA typically doesn't approve a drug until it's been tested in thousands of patients.
"In our review, we found that growth hormone increased lean body mass or muscle mass by slightly more than two kilograms (that's a little over four pounds) and decreased fat mass by about two kilograms. But it had no other beneficial effects that we could see.
"If you went to a gym pretty regularly, you might get that change without breaking into too much of a sweat, and you wouldn't spend $1,000 to $2,000 a month on something that appears to have modest or minimal benefit and the probability of bad side effects," said Liu.
Thursday, January 11, 2007
Journal Explores how lifestyle affects heart disease
New journal starts publication by looking at controlling the No. 1 cause of death
Cardiovascular disease is the most common cause of death in the United States. Although some risk factors, such as age and heredity, cannot be controlled, many factors, including smoking, cholesterol, blood pressure, obesity, and inactivity can be modified, thus, lowering the risk.
This lifestyle concern is thoroughly explored in the headline article of the debut issue of the new American Journal of Lifestyle Medicine (AJLM) published by SAGE. The article, co-written by journal editor-in-chief James M. Rippe, MD, along with Theodore J. Angelopoulos, PhD, MPH, and Linda Zukley, MA, RN, exposes the truth about coronary heart disease (CHD) and its causes.
"In many ways," write the authors, "coronary heart disease represents the quintessential lifestyle disease of developed countries. Six of the major risk factors for developing CHD involve lifestyle practices, including the decision of whether or not to smoke, the control of blood pressure and lipids, diabetes, level of physical activity, and obesity."
Encouraging heart patients to control modifiable risk factors fits perfectly with the mission of the new American Journal of Lifestyle Medicine of looking at both the medical and the lifestyle aspects of disease management. The article concludes that intervention from health care providers makes good sense, to help heart patients reduce the controllable CHD risk factors through proper lifestyle choices.
The article, "The Rationale for Intervention to Reduce the Risk of Coronary Heart Disease," published in the January/February 2007 issue of AJLM, can be accessed free for a limited time at http://ajl.sagepub.com/cgi/reprint/1/1/10. Specific techniques for incorporating lifestyle changes into clinical practice to lower the risk of CHD will be published in the second issue of AJLM.
The American Journal of Lifestyle Medicine (AJLM), a bimonthly, peer-reviewed journal which began publishing in January 2007, focuses on recognizing and addressing the impact that lifestyle decisions have on health, emphasizing the interaction between traditional therapies and lifestyle modalities to achieve superior outcomes in disease treatment. It also provides information about therapies that minimize the extent to which illness impacts lifestyle. For more information, visit http://ajlm.sagepub.com
Cardiovascular disease is the most common cause of death in the United States. Although some risk factors, such as age and heredity, cannot be controlled, many factors, including smoking, cholesterol, blood pressure, obesity, and inactivity can be modified, thus, lowering the risk.
This lifestyle concern is thoroughly explored in the headline article of the debut issue of the new American Journal of Lifestyle Medicine (AJLM) published by SAGE. The article, co-written by journal editor-in-chief James M. Rippe, MD, along with Theodore J. Angelopoulos, PhD, MPH, and Linda Zukley, MA, RN, exposes the truth about coronary heart disease (CHD) and its causes.
"In many ways," write the authors, "coronary heart disease represents the quintessential lifestyle disease of developed countries. Six of the major risk factors for developing CHD involve lifestyle practices, including the decision of whether or not to smoke, the control of blood pressure and lipids, diabetes, level of physical activity, and obesity."
Encouraging heart patients to control modifiable risk factors fits perfectly with the mission of the new American Journal of Lifestyle Medicine of looking at both the medical and the lifestyle aspects of disease management. The article concludes that intervention from health care providers makes good sense, to help heart patients reduce the controllable CHD risk factors through proper lifestyle choices.
The article, "The Rationale for Intervention to Reduce the Risk of Coronary Heart Disease," published in the January/February 2007 issue of AJLM, can be accessed free for a limited time at http://ajl.sagepub.com/cgi/reprint/1/1/10. Specific techniques for incorporating lifestyle changes into clinical practice to lower the risk of CHD will be published in the second issue of AJLM.
The American Journal of Lifestyle Medicine (AJLM), a bimonthly, peer-reviewed journal which began publishing in January 2007, focuses on recognizing and addressing the impact that lifestyle decisions have on health, emphasizing the interaction between traditional therapies and lifestyle modalities to achieve superior outcomes in disease treatment. It also provides information about therapies that minimize the extent to which illness impacts lifestyle. For more information, visit http://ajlm.sagepub.com
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