Wednesday, February 28, 2007

Light wine intake = longer life expectancy in men

Drinking a little alcohol every day, especially wine, may be associated with an increase in life expectancy. That’s the conclusion of Dutch researchers who reported the findings of their study today at the American Heart Association’s 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.

The researchers found that a light intake of alcohol (on average less than one glass per day) was associated with a lower rate of cardiovascular death and death from all causes. When compared to spirits and beer, consumption of small amounts of wine, about a half a glass a day, was associated with the lowest levels of all-cause and cardiovascular deaths.

"Our study showed that long-term, light alcohol intake among middle-aged men was associated not only with lower cardiovascular and all-cause death risk, but also with longer life expectancy at age 50," said Martinette T. Streppel, lead author of the study and a Ph.D. student in the Division of Human Nutrition at Wageningen University and National Institute for Public Health and the Environment (RIVM) in Bilthoven, The Netherlands. "Furthermore, long-term light wine consumption is associated with a further protective effect when compared to that of light-to-moderate alcohol intake of other types."

Previous studies have shown that light to moderate alcohol intake is associated with a lower risk of cardiovascular death. However, it remained unclear whether a specific beverage was associated with more benefit and whether the use of long-term alcohol consumption was associated with increased life expectancy. Studies such as this cannot definitively show whether the agent being studied has a causal effect on health.

The Netherlands study — called the Zutphen Study — involved a cohort of 1,373 men born between 1900 and 1920 who were surveyed in detail about alcohol consumption seven times over 40 years. The participants, all from Zutphen, an industrial town in the eastern part of the Netherlands, were followed until death or until the final survey taken among survivors in mid-2000. The surveys included drinking habits, dietary habits, body mass index, smoking habits and the prevalence of heart attack, stroke, diabetes and cancer. The statistics on alcohol consumption were adjusted to account for other risk factors.

The researchers found that long-term, light alcohol intake of less than or equal to 20 grams per day (1 glass of alcoholic beverage contains 10 grams of alcohol, 1 ounce = ~30 mL of alcoholic beverage) compared to no alcohol intake was associated with a 36 percent lower relative risk of all-cause death and a 34 lower relative risk of cardiovascular death. The average long-term daily intake of the men throughout the 40-year study was six grams based on any alcohol intake of more than zero and up to 20 grams. The long-term average intake of six grams of alcohol is equal to one four-ounce beer, one two-ounce glass of wine or one one-ounce glass of spirits, daily.

When the researchers looked independently at wine consumption, the associated risk reduction was greater. Participants who drank on average half a glass, or 1.5 ounces, of wine per day, over a long period, had a 40 percent lower rate of all-cause death and a 48 percent lower incidence of cardiovascular death, compared to the non-wine drinkers.

Researchers said life expectancy was 3.8 years higher in those men who drank wine compared to those who did not drink alcoholic beverages. Life expectancy of wine users was more than two years longer than users of other alcoholic beverages. Men with a long-term alcohol intake less than or equal to 20 grams per day had a 1.6-year-higher life expectancy, compared to those who consumed no alcohol.

Most of the previous studies assessed alcohol intake at baseline; however, in this study researchers collected detailed information seven times over 40 years. "Consumption patterns usually change during life," Streppel said. "This enabled us to study the effects of long-term alcohol intake on mortality." Researchers found that the number of alcohol users nearly doubled from 45 percent in 1960 to 85 percent in the 2000 survey. Average alcohol consumption rose and then fell at various points during the study. Users’ consumption was eight grams a day in 1960, then survivors’ consumption was 18 grams a day in 1985, dropping to 13 grams per day in 2000. The percentage of wine users increased during follow-up from 2 percent in 1960 to more than 40 percent among the survivors in 2000. "One can speculate that a protective effect of light alcohol intake could be due to an increase in high-density lipoprotein (HDL) cholesterol, or to a reduction in blood clotting, due to an inhibition of platelet aggregation," Streppel said.

Furthermore, red wine consumption may have an additional health benefit because the polyphenolic compounds contained in wine have been seen in animal to interfere with the formation, progression and rupture of atherosclerotic plaques — the build-up of fatty tissue in the arteries that can result in stroke or heart attack.

"Those people who already consume alcoholic beverages should do so lightly (1 to 2 glasses per day) and preferably drink wine," Streppel said. "The cardio-protective effects of alcohol and wine only held up for light alcohol consumption in middle-aged men. Heavy alcohol consumption may cause accidents and diseases such as cancer and cirrhosis of the liver, even though this was not observed in our study. Since alcohol consumption can be addictive, starting to drink alcohol because of its positive health benefits is not advised."

How alcohol or wine might affect cardiovascular risk merits further research, but right now the American Heart Association does not recommend beginning to drink wine or any other form of alcohol to gain these potential benefits. The association does recommend that to reduce your risk you should talk to your doctor about lowering your cholesterol and blood pressure, controlling your weight, getting enough physical activity and following a healthy diet and quit smoking, if you smoke. There is no scientific proof that drinking wine or any other alcoholic beverage can replace these conventional measures.

Tuesday, February 27, 2007

Some Antioxidants May Increase Mortality Risk

Use of some antioxidant supplements may increase mortality risk

Contradicting claims of disease prevention, an analysis of previous studies indicates that the antioxidant supplements beta carotene, vitamin A, and vitamin E may increase the risk of death, according to a meta-analysis and review article in the February 28 issue of JAMA.

Many people take antioxidant supplements, believing they improve their health and prevent diseases. Whether these supplements are beneficial or harmful is uncertain, according to background information in the article.

Goran Bjelakovic, M.D., Dr.Med.Sci., of the Center for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark, and colleagues conducted an analysis of previous studies to examine the effects of antioxidant supplements (beta carotene, vitamins A and E, vitamin C [ascorbic acid], and selenium) on all-cause death of adults included in primary and secondary prevention trials. Using electronic databases and bibliographies, the researchers identified and included 68 randomized trials with 232,606 participants in the review and meta-analysis. The authors also classified the trials according to the risk of bias based on the quality of the methods used in the study, and stratified trials as "low-bias risk" (high quality) or "high-bias risk" (low quality).

In an analysis that pooled all low-bias risk and high bias risk trials, there was no significant association between antioxidant use and mortality. In 47 low-bias trials involving 180,938 participants, the antioxidant supplements were associated with a 5 percent increased risk of mortality. Among low-bias trials, use of beta carotene, vitamin A, and vitamin E was associated with 7 percent, 16 percent and 4 percent, respectively, increased risk of mortality, whereas there was no increased mortality risk associated with vitamin C or selenium use.

"Our systematic review contains a number of findings. Beta carotene, vitamin A, and vitamin E given singly or combined with other antioxidant supplements significantly increase mortality. There is no evidence that vitamin C may increase longevity. We lack evidence to refute a potential negative effect of vitamin C on survival. Selenium tended to reduce mortality, but we need more research on this question," the authors write.

"Our findings contradict the findings of observational studies, claiming that antioxidants improve health. Considering that 10 percent to 20 percent of the adult population (80-160 million people) in North America and Europe may consume the assessed supplements, the public health consequences may be substantial. We are exposed to intense marketing with a contrary statement, which is also reflected by the high number of publications per included randomized trial found in the present review."

"There are several possible explanations for the negative effect of antioxidant supplements on mortality. Although oxidative stress has a hypothesized role in the pathogenesis of many chronic diseases, it may be the consequence of pathological conditions. By eliminating free radicals from our organism, we interfere with some essential defensive mechanisms . Antioxidant supplements are synthetic and not subjected to the same rigorous toxicity studies as other pharmaceutical agents. Better understanding of mechanisms and actions of antioxidants in relation to a potential disease is needed," the researchers conclude.


Deep red tomatoes get their rich color from lycopene, a disease-fighting antioxidant. A new study, however, suggests that a special variety of orange-colored tomatoes provide a different form of lycopene, one that our bodies may more readily use.

Researchers found that eating spaghetti covered in sauce made from these orange tomatoes, called Tangerine tomatoes, caused a noticeable boost in this form of lycopene in participants' blood

“While red tomatoes contain far more lycopene than orange tomatoes, most of it is in a form that the body doesn't absorb well,” said Steven Schwartz, the study's lead author and a professor of food science and technology at Ohio State University.

“The people in the study actually consumed less lycopene when they ate sauce made from the orange tomatoes, but they absorbed far more lycopene than they would have if it had come from red tomatoes,” he said. “That's what is so dramatic about it.”

The tomatoes used for this work were developed specifically for the study – these particular varieties aren't readily available in grocery stores. The researchers suggest that interested consumers seek out orange- and gold-colored heirloom tomatoes as an alternative to Tangerine tomatoes, but caution that they haven't tested how much or what kind of lycopene these varieties contain.

Lycopene belongs to a family of antioxidants called the carotenoids, which give certain fruits and vegetables their distinctive colors. Carotenoids are thought to have a number of health benefits, such as reducing the risk of developing cancer, cardiovascular disease and macular degeneration.

“The tomato is a wonderful biosynthetic factory for carotenoids, and scientists are working on ways to enhance the fruit's antioxidant content and composition,” Schwartz continued.

The findings appear in a recent issue of the Journal of Agricultural and Food Chemistry.

Lycopene is a carotenoid that contains a variety of related compounds called isomers. Isomers share the same chemical formula, yet differ in chemical structure. In the case of tomatoes, the different lycopene isomers play a part in determining the color of the fruit.

Several years ago, Schwartz and his colleagues discovered the abundance of several of these isomers, called cis- lycopenes, in human blood. But most of the tomatoes and tomato-based products we currently consume are rich in all-trans -lycopene.

“We don't know why our bodies seem to transform lycopene into cis-isomers, or if some isomers are more beneficial than others,” Schwartz said.

The researchers don't know if tomatoes rich in cis-lycopene would provide greater health benefits to humans, but the study's results suggest that tomatoes can be used to increase both the intake and absorption of the health-beneficial compounds.

The researchers made spaghetti sauce from two tomato varieties – tangerine tomatoes, which get their name from their orange skin and are high in cis-lycopene, and a tomato variety chosen for its rich beta carotene content.

The tomatoes were grown at an Ohio State-affiliated agricultural research station in northwestern Ohio. Following harvest, both tomato varieties were immediately processed into canned tomato juice and concentrated. Italian seasoning was added for taste.

The 12 adults participating in the study ate two spaghetti test meals – one included sauce made from tangerine tomatoes, while the other featured sauce made from the tomatoes high in beta carotene. The participants were asked to avoid tomato and beta carotene-rich foods for 13 days before eating each test meal.

Researchers drew blood right before each participant ate and again every hour or two up to 10 hours after the meal. They analyzed the blood samples for lycopene and beta carotene content.

Lycopene absorption from the tangerine tomatoes was 2.5 times higher than that absorbed from the beta carotene-rich tomatoes and, Schwartz said, from typical red tomato varieties. Cis-lycopene levels spiked around five hours after eating the tangerine tomato sauce, and at this point during absorption the levels were some 200 times greater than those of trans-lycopene, which were nearly non-existent. While cis-lycopene is by far the most abundant isomer in these tomatoes, they do contain trace amounts of trans-lycopene.

The participants' bodies also readily absorbed beta carotene from the beta carotene-rich tomatoes.

“Right now, only carrots and sweet potatoes are a more readily available, richer source of beta carotene,” Schwartz said. “And this carotenoid is a major source of vitamin A for a large proportion of the world's population. Its deficiency is a serious health problem in many developing countries.

“Our study showed that a tomato can also increase beta carotene levels in the blood,” Schwartz said. While these special tomatoes were grown just for this study, the researchers have pre-commercial lines of both varieties available.

Monday, February 26, 2007

Prostate cancer therapy may increase risk of death

Prostate cancer therapy may increase risk of death from heart disease in older men

-Androgen deprivation therapy - one of the most common treatments for prostate cancer - may increase the risk of death from heart disease in patients over age 65, according to a new study by researchers at Dana-Farber Cancer Institute, Brigham and Women's Hospital and other institutions.

The study results were based on data from CaPSURE, a national registry of men with prostate cancer. Although the findings need to be confirmed in clinical trials, the study authors state that oncologists should weigh the benefits of androgen deprivation therapy, or ADT, against the risk of heart problems in older prostate cancer patients.

The researchers will present their study at the Prostate Cancer Symposium in Orlando, Fla., 1:30 pm on Saturday, Feb. 24. The symposium is sponsored by the American Society of Clinical Oncology, the American Society for Therapeutic Radiology and Oncology and the Society of Urologic Oncology.

The goal of ADT is to block the level of circulating androgens (male hormones), which can fuel the growth of prostate cancers. "Androgen deprivation therapy is associated with elevated body mass index, increased body fat deposits and diabetes, all of which raise the risk of death from heart diseased," explains the study's lead author, Henry Tsai, MD, a resident physician at Dana-Farber, Brigham and Women's and the Harvard Radiation Oncology Program.

"Although our findings demonstrated that older men receiving this treatment may be at increased risk, even after taking into account other cardiovascular risk factors, a prospective clinical trial would be needed to confirm a cause-and-effect relationship."

Drawing on the CaPSURE database, Tsai and his colleagues compared the number of cardiac-related deaths among 735 men with localized prostate cancer who received ADT and among 2,901 men with the disease whose treatment did not include ADT.

After factoring in other known risks for cardiovascular disease (such as diabetes, hypertension, body mass index and smoking), researchers found that the longer patients received ADT, the sooner they were likely to die from heart disease. When the researchers analyzed the data by patients' age, the link between ADT use and death from heart disease was significant in patients over age 65, but not in those under 65. After five years, 3 percent of older men who received androgen deprivation therapy died of cardiac causes, compared with only 0.9 percent of men who did not receive the therapy.

"These findings should help oncologists determine which older patients are the best candidates for ADT," Tsai remarks. "If a patient is at high risk of cardiovascular disease, it would be advisable for an oncologist to discuss the pros and cons of ADT treatment with him before proceeding on a course of treatment."

Magic Beans -- Anti-obesity soya

A diet rich in black soya beans could help control weight, lower fat and cholesterol levels, and aid in the prevention of diabetes, reports Lisa Richards in Chemistry & Industry, the magazine of the SCI.

Yellow soya has already been hailed for its cholesterol lowering capabilities; this is one of the reasons why frozen food manufacturer Birds Eye has added the beans to its range. However, a team of Korean researchers has shown that black soya may be even more potent in rats, and also prevents weight gain (Journal of the Science of Food and Agriculture, February 2007 DOI: 10.1002/jsfa2808).

The researchers, led by Shin Joung Rho at Hanyang University, Seoul, allowed 32 rats to gorge on a fatty diet, supplemented with various levels of black soya. The results showed that, after two weeks, those getting 10% of their energy from black soya had gained half as much weight as those in the control group. Total blood cholesterol fell by 25% and LDL (so-called ‘bad’) cholesterol fell by 60% in the rats in the 10% group.

David Bender, sub-dean at the Royal Free and University College Medical School, London, thinks that the soya protein may be having an effect on fat metabolism in the liver and adipose tissue, reducing synthesis of new fatty acids and cholesterol. It is this metabolic effect that may explain the traditional Asian use of black soya in the treatment of diabetes. ‘The key problem in type II diabetes is impairment of insulin action, mainly as a result of excess abdominal adipose tissue - so loss of weight often improves glycaemic control,’ says Dr Bender.

Lynne Garton, a registered dietician and nutritionist and consultant to the Soya Protein Association, said: "Soy fits in well to a healthy balanced diet which is important in preventing diabetes – low in fat, high in fibre and a good source of complex carbohydrates."

Pain relievers associated with increased blood pressure

Use of common pain relievers associated with increased risk of blood pressure in men

Men who regularly take commonly available and widely used pain relievers may have an increased risk of high blood pressure compared with those who do not use these medications, according to a report in the Feb. 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Acetaminophen, ibuprofen and aspirin are among the most commonly used drugs in the United States, according to background information in the article. Two large studies have recently suggested that pain-relieving medications (analgesics) may be associated with an increased risk of hypertension (high blood pressure) in women. However, the association has not been extensively studied in men.

John P. Forman, M.Sc., M.D., of Brigham and Women's Hospital and Harvard Medical School, Boston, and colleagues followed a total of 16,031 male health professionals (average age 64.6 years) who did not have a history of high blood pressure. The men were asked in 2000 and again in 2002 about whether and how often they used three types of pain relievers: acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs, which include ibuprofen and naproxen) and aspirin. They were also asked to report if their physician had diagnosed them with hypertension.

Over four years of follow-up, 1,968 men developed hypertension. Compared with men who did not take analgesics, those who took acetaminophen six or seven days a week had a 34 percent higher risk of hypertension. Those who took NSAIDs six or seven days a week had a 38 percent higher risk and those who took aspirin six or seven days a week had a 26 percent higher risk. The researchers also looked at the total number of pain-relieving pills men took each week, regardless of type. Compared with men who took no pills, those who took 15 or more pills each week had a 48 percent higher risk of hypertension.

All three types of analgesics may inhibit the effects of chemicals that relax the blood vessels, decreasing blood pressure, the authors suggest. Acetaminophen also may impair cell functioning through high levels of oxygen (oxidative stress) or reduce the proper functioning of blood vessel lining.

"These data add further support to the hypothesis that non-narcotic analgesics independently elevate the risk of hypertension," the authors write. "Given their common consumption and the high prevalence of hypertension, our results may have substantial public health implications and suggest that these agents be used with greater caution. The contribution of non-narcotic analgesics to the hypertension disease burden merits further study."

Strenuous physical activity associated with lower breast cancer risk

Women who regularly engage in strenuous physical activity may have a lower risk of developing both invasive breast cancer and in situ (early-stage) breast cancer than women who do not, according to a report in the February 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

"Few established risk factors for breast cancer are easily modifiable," the authors write as background information in the article. Physical activity has been associated with breast cancer risk and may be one of the few risk factors that women can control. "Questions remain regarding the amount and intensity of physical activity and the periods when activity provides the greatest breast cancer risk reduction."

Cher M. Dallal, M.S., University of Southern California, Los Angeles, and colleagues studied 110,599 women age 20 to 79 who were part of the California Teachers Study, established in 1995 and 1996. At the beginning of the study, the women were asked about their average participation in moderate (such as brisk walking, golf or volleyball) and strenuous (including swimming laps, aerobics and running) physical activity from high school to their current age and also in the past three years. The women also provided information about other breast cancer risk factors, including race, family history and use of hormone therapy.

Through 2002, 2,649 women were diagnosed with invasive breast cancer and 593 with in situ breast cancer. Women who reported participating in strenuous activity for more than five hours per week over the long term had a 20 percent lower risk of invasive breast cancer and 31 percent lower risk of in situ breast cancer than women who participated in less than 30 minutes of strenuous activity per week. "Long-term moderate physical activity and strenuous and moderate activity in the past three years were not associated with invasive breast cancer," the authors write. Similarly, moderate activity did not appear to influence the risk of in situ breast cancer.

The researchers also examined the association between strenuous physical activity and the risk of breast cancer by hormone receptor type, or which hormones can bind to proteins on the surface of the tumor. Strenuous activity appeared to be associated with a lower risk of estrogen-receptor–negative but not estrogen-receptor–positive breast cancers.

"In summary, these results provide additional evidence supporting a protective role for long-term strenuous recreational physical activity on risk of invasive and in situ breast cancer, whereas the beneficial effects of moderate activity are less clear. For invasive breast cancer, strenuous and moderate physical activity affect risk of estrogen-receptor–negative tumors, but neither affects risk of estrogen-receptor–positive tumors."

NSAIDs (except aspirin) increase risk for heart attack and stroke

American Heart Association Scientific Statement

Many doctors should change the way they prescribe pain relievers for chronic pain in patients with or at risk for heart disease based on accumulated evidence that nonsteroidal anti-inflammatory drugs (NSAIDs), with the exception of aspirin, increase risk for heart attack and stroke, according to an American Heart Association statement published today in Circulation: Journal of the American Heart Association.

"We believe that some physicians have been prescribing the new COX-2 inhibitors as the first line of treatment. We are turning that around and saying that, for chronic pain in patients with known heart disease or who are at risk for heart disease, these drugs should be the last line of treatment," said Elliott M. Antman, M.D., FAHA, lead author of the American Heart Association scientific statement and Professor of Medicine at Harvard Medical School and Brigham and Women's Hospital.

"We advise physicians to start with non-pharmacologic treatments such as physical therapy and exercise, weight loss to reduce stress on joints, and heat or cold therapy. If the non-pharmacologic approach does not provide enough pain relief or control of symptoms, we recommend a stepped-care approach when it comes to prescribing drugs," he added.

"Take into account the patient's health history and consider acetaminophen, aspirin and even short-term use of narcotic analgesics as the first step. If further relief is needed, physicians should suggest the least selective COX-2 inhibitors first, moving progressively toward more selective COX-2 inhibitors, which are at the bottom of the list, only if needed. All drugs should be used at the lowest dose necessary to control symptoms and prescribed for the shortest time possible."

Drugs in the NSAIDs class work by inhibiting cyclooxygenase (COX), an enzyme system that comes in two major forms: COX-1, which the body produces constantly in most tissues, and COX-2, produced during the body's inflammatory response. Because COX-1 is also protective of the gastrointestinal (GI) tract, long-term use of drugs that suppress COX-1, such as aspirin, have been associated with gastrointestinal complications, including ulcers. "Selective" COX-2 inhibitors were developed to avoid the GI complications of traditional NSAIDs, not because they had advantages in terms of pain relief,

Antman explained. However, multiple studies have indicated an increased risk of cardiovascular disease (CVD) complications from COX-2 selective NSAIDS, particularly in patients with prior CVD or risk factors for CVD.

"Recent studies indicate that the cells lining the blood vessels have more of the COX-2 enzyme than initially thought. So it's possible that inhibiting the COX-2 pathway can make a person's blood more likely to clot. There is also an increase in sodium and water retention, which in turn could worsen heart failure and produce high blood pressure," Antman explained. "The more you inhibit COX-1, the greater the increase in GI risk; the more you inhibit COX-2 the greater the cardiovascular risk."

The scientific statement comes two years after the association released the last one on the issue. It was prompted, in part, by new analyses indicating that the increased cardiovascular risk associated with COX-2 selective NSAIDs may also extend to less selective traditional NSAIDs.

The statement includes details from a meta-analysis indicating that, compared with placebo, COX-2 selective drugs seem to increase the risk of a heart attack by about 86 percent. The statement also points out that two common NSAIDs traditionally thought of an non-selective – diclofenac and ibuprofen – appear to increase the relative risk of cardiovascular disease. In the last two years, the U.S. Food and Drug Administration (FDA) added warning statements to NSAIDs, other than aspirin, pointing out the increased risk for cardiovascular events.

One non-selective NSAID, naproxen, did not seem to increase CVD risk in these analyses. However, Antman pointed out that although naproxen appeared safer than the other NSAIDs, relatively few studies have been done with naproxen and doctors should continue to be cautious about prescribing it as well, pending more information.

"This is a fast-moving field with new information available from multiple sources. We feel the most important thing the American Heart Association can do is to give practical advice to clinicians who treat cardiac patients with pain every day," said Antman.

Because there are so many drugs in the NSAID class and because they can affect either COX-1 or COX-2 or both, it is very important to know where a given drug falls in the range of selectivity, particularly when evaluating the results of head-to-head comparisons of different drugs, Antman said. The statement contains guidance that helps doctors see where individual drugs lie on the continuum of COX-1 versus COX-2 selectivity.

Selective COX-2 inhibitors have been in the news since the FDA removed the selective COX-2 inhibitor, rofecoxib, from the market in 2004. Since then, other COX-2 selective drugs have been removed from the market in the United States and other countries. One selective COX-2 inhibitor, celecoxib, remains on the market, but warnings on it were strengthened and the FDA advised that patients with a history of CVD or risk factors for CVD should be informed of the possibility of increased risks from long-term use, Antman said.


New research at Ohio State University answers an infectious question about eating at restaurants: How clean are manually washed dishes?

Jaesung Lee and Melvin Pascall found that even when they washed dishes in cooler-than-recommended water, numbers of bacteria on the dishware dropped to levels accepted in the Food and Drug Administration's Food Code. They also found that certain foods—especially cheese and milk—can be safe havens for bacteria when dried onto dishware. Lipstick, however, proved to be dangerous to bacteria.
“After washing, there were lipstick stains still left on a few glasses, but it was the least hospitable substance for bacteria,” Pascall said. “It seems to have antimicrobial properties, which was a big surprise to us.”

Lee, a doctoral candidate of food, agricultural and biological engineering, and Pascall, assistant professor of food science and technology, published their findings in the Journal of Food Engineering.

When restaurants manually wash dishes, they follow a three-step process: Dishes are washed and scrubbed in soapy water, rinsed with clean water, and finally soaked in water containing germ-killing sanitizers. But employees often use water that is cooler than 110 degrees Fahrenheit—the minimum washing temperature recommended by the FDA—because it is uncomfortably hot. The FDA also requires that washing cause a 100,000-fold drop in amounts of bacteria on those dishes.

To investigate effective lower-temperature dishwashing tactics, the researchers coated dishes individually with cheese, eggs, jelly, lipstick, and milk, and then added Escherichia coli and Listeria innocua bacteria. Contaminants like E. coli and L. innocua can survive for long periods of time if they make their way into food dried onto dishes. If those dishes aren't thoroughly washed, they can sometimes cause food-borne disease outbreaks.

After letting the food dry on to the dishes for an hour—a plausible wait in a busy restaurant dish room—they gave each utensil a few scrubs per side and measured the amount of microscopic organisms still clinging to the dishes.

Lee and Pascall discovered that washing dishes in hot dish water, followed by soaking in extra sanitizers, eliminated almost all of the bacteria on them, even when coated with dried-on cheese. But dishes washed in soapy room-temperature water, rinsed, and then weakly sanitized with ammonium-based chemicals also achieved FDA-acceptable results.

The find is important because acceptable sanitization can be achieved with cooler dish-washing water, as dishes washed in room-temperature water and then rinsed in more-concentrated sanitizers achieved results comparable to higher-temperature alternatives.

“We wanted to show that employees could use a more comfortable washing technique and still get clean dishes,” Pascall said. “We were able to do that, and we did it by using different combinations of washing, rinsing, and sanitizing.”

But all dishes are not created equal. Compared to ceramic plates, steel knives, spoons, and plastic trays, steel forks seemed to be the best home for bacterial contaminants.

“The prongs of forks actually shield food from the action of scrubbing,” Pascall said. “Taking extra time to wash forks is a good idea, especially those covered with sticky foods like cheese.”

Although cheesy forks were the most problematic utensil, milk dried onto glasses protected bacteria more than any other food. Pascall explained that milk is a good growth medium in the laboratory, but why it adheres to glass so well isn't clearly understood.

“Milk is an area of research we'd like to explore further,” Pascall said. “We want to find ways to safely and quickly remove milk dried on glasses.”

The research aimed to explore restaurant dishwashing conditions, but Pascall explained that homeowners can benefit from the findings, too.

“Leaving food on eating utensils and dishes could easily cause bacteria to grow on them, especially if it's moist,” Pascall said. “The best thing you can do is wash your dishes off right away, before the food dries. It saves washing time and gets rid of places where bacteria can survive drying and washing.”

Claims That Garlic Lowers Cholesterol Levels Debunked

Stanford Study Drives Stake Through Claims That Garlic Lowers Cholesterol Levels

When it comes to lowering cholesterol levels, garlic stinks, according to a new study from the Stanford University School of Medicine.

Despite decades of conflicting studies about the pungent herb’s ability to improve heart health, the researchers say their study provides the most rigorous evidence to date that consuming garlic on a daily basis — in the form of either raw garlic or two of the most popular garlic supplements — does not lower LDL cholesterol levels among adults with moderately high cholesterol levels.

“It just doesn’t work,” said senior author Christopher Gardner, PhD, assistant professor of medicine at the Stanford Prevention Research Center. “There’s no shortcut. You achieve good health through eating healthy food. There isn’t a pill or an herb you can take to counteract an unhealthy diet.”

Gardner said the study, which will be published in the Feb. 26 issue of the Archives of Internal Medicine, is the first independent, long-term, head-to-head assessment of raw garlic and garlic supplements. The study also drew on the expertise of two of the nation’s foremost garlic experts — Larry Lawson, PhD, of the Plant Bioactives Research Institute in Utah, and Eric Block, PhD, professor of chemistry at the University at Albany, State University of New York — who have devoted much of their careers to understanding the biochemical properties of the herb and who ensured the quality and stability of the garlic consumed in the study.

“If garlic was going to work, in one form or another, then it would have worked in our study,” Gardner said. “The lack of effect was compelling and clear. We took cholesterol measurements every month for six months and the numbers just didn’t move. There was no effect with any of the three products, even though fairly high doses were used.”

Most of the medicinal claims about garlic revolve around the sulfur-containing substance allicin, which is produced when raw garlic is chopped or crushed. Allicin has been shown to inhibit the synthesis of cholesterol in test tubes and in animal models, but there is conflicting clinical evidence about its ability to react inside the human body the same way it does in a lab dish.

“In lab tests, you can apply the garlic compounds directly to cells,” Gardner said. “But in real people you don’t know whether allicin would actually get directly to cells if someone ate garlic. You still have to do the human clinical trial to see if it really works, and the previous clinical trials left people confused.”

Indeed, the fact that allicin had positive results in some lab tests and animal studies made it possible for supplement makers to tout garlic as a natural remedy for high LDL cholesterol levels. LDL cholesterol is known as the “bad cholesterol” because when too much of the substance circulates in the blood, it can build up and clog arteries, increasing the risk of heart attack or stroke. LDL levels of less than 130 mg/dl are considered optimal, while levels greater than that are considered high.

For the study, the researchers recruited 192 patients with moderately elevated LDL cholesterol levels, with an average level of about 140 mg/dl. “These are the people who are the most likely to use supplements,” Gardner said. “If their cholesterol were higher, then their doctors would be putting them on statins or some other prescription medication.”

The study participants were then randomly assigned to ingest either raw garlic, an aged garlic supplement, a powdered garlic supplement or a placebo six days a week for six months. For those assigned to take either raw or supplemental forms of garlic, each participant consumed the equivalent of a 4-gram clove of garlic per day (which the researchers determined was the average size of a clove of garlic). For those assigned to the supplements, this meant taking somewhat more than the dosage recommended on the packaging instructions for both supplements.

The garlic supplements used in the study are two of the top sellers, but are manufactured in very different ways. Gardner said that the manufacturer of the aged garlic extract calls it “the ‘sociable’ garlic because they say the aging process takes away the bad-breath aspect. Extensive chemical analyses of the three garlic products confirmed that the daily doses represented similar amounts of the original starting material and that all three remained stable over the course of the study.

All of the study participants were given tablets as well as sandwiches prepared by Gardner’s team. For those assigned to consume raw garlic, the garlic was mixed into the sandwich condiments, and the pills were placebos. For those assigned to take supplements, the condiments were garlic-free. In all, the research team made more than 30,000 heart-healthy gourmet sandwiches for the six-month study.

Participants were closely monitored throughout the study to ensure that they didn’t gain or lose weight, which might have affected their cholesterol readings. Additionally, blood samples were taken monthly from the study participants.

When the researchers tested the blood samples, they found that the LDL cholesterol readings remained nearly identical from start to finish.

“Our study had the statistical power to see any small differences that would have shown up, and we had the duration to see whether it might take a while for the effect of the garlic to creep in. We even looked separately at the participants with the highest vs. the lowest LDL cholesterol levels at the start of the study, and the results were identical,” Gardner said. “Garlic just didn’t work.”

One potential reason for the confusion surrounding garlic’s reputed health benefits is that the supplement makers themselves funded many of the previous studies claiming that garlic lowered cholesterol. Gardner’s funding came from the National Institutes of Health.

Gardner said garlic may still have an effect on other health and disease processes that were not addressed in this study, such as inflammation, immune function or cancer. But, he added, those potential benefits also need to be studied in rigorously controlled trials.

He also said that garlic can still be a valuable part of the diet if it’s used to increase the consumption of healthy dishes, such as a stir fry or a Mediterranean salad. “But if you choose garlic fries as a cholesterol-lowering food, then you blew it. The garlic doesn’t counteract the fries,” Gardner said.

Friday, February 23, 2007

Study to Look at Aspirin as Aid to Conception, Healthy Pregnancy

Researchers at the University at Buffalo and the University of Utah are beginning a clinical trial to test whether aspirin can improve a woman's chances of becoming pregnant and of maintaining a pregnancy to term.

UB's portion of the study is funded by a $2.8 million grant from the National Institute of Child Health and Development.

The trial is aimed at women who have miscarried a pregnancy in the past year.

"In women who have had their first miscarriage, the reasons for losing that pregnancy are in many instances unknown," said Jean Wactawski-Wende, Ph.D., UB associate professor of social and preventive medicine and principal investigator of the UB clinical center.

"These women generally are advised to try to get pregnant again, but health-care providers can offer limited assistance on any specific actions to take to improve their next pregnancy outcome," she noted. "If aspirin can help some women become pregnant or maintain a health pregnancy, it will be a critically important finding.

"Aspirin is available, inexpensive and has very few side effects," she added. "We're hopeful that this trial could produce an important finding."

Statistics show that in the United States, 10-15 percent of couples trying to become pregnant are not able to conceive, 15-31 percent of pregnancies that do occur end in miscarriage, and 8-15 percent of pregnancies that continue beyond 20 weeks end in premature birth, putting these infants at risk for increased health problems.

Aspirin has been shown to have beneficial effects in humans, said Wactawski-Wende. "It is an anticoagulant and an anti-inflammatory agent. It may aid in implantation of the egg in the uterine wall, and has potential for producing a positive effect on blood flow to the placenta. It may aid in reducing preeclampsia. This clinical trial provides an opportunity to determine the impact of low-dose aspirin on many pregnancy outcomes."

The Effects of Aspirin in Gestation & Reproduction trial, or EAGeR, will begin this spring and will continue for five years. The UB center will enroll 535 women. Another 1,070 will be recruited by investigators at the University of Utah, for a total enrollment of 1,600 women.

Participants must be between the ages of 18 and 40, have had one miscarriage in the year prior to entering the study, wish to become pregnant and are not already pregnant when they start the study. All will take 400 micrograms of folic acid (a B vitamin shown to reduce the chance of certain birth defects if started early) plus either an 80 milligram aspirin pill or a placebo pill daily.

The women will come to the UB study clinic twice a month for two months and will be followed for an additional four months in the clinic or by telephone. If they become pregnant they will be followed throughout the pregnancy. Participants will take their study pills daily, maintain daily records and provide both urine and blood samples.

Caffeine may prevent heart disease death in elderly

Habitual intake of caffeinated beverages provides protection against heart disease mortality in the elderly, say researchers at SUNY Downstate Medical Center and Brooklyn College.

Using data from the first federal National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, the researchers found that survey participants 65 or more years old with higher caffeinated beverage intake exhibited lower relative risk of coronary vascular disease and heart mortality than did participants with lower caffeinated beverage intake.

John Kassotis, MD, associate professor of medicine at SUNY Downstate, said, "The protection against death from heart disease in the elderly afforded by caffeine is likely due to caffeine's enhancement of blood pressure."

The protective effect also was found to be dose-responsive: the higher the caffeine intake the stronger the protection. The protective effect was found only in participants who were not severely hypertensive. No significant protective effect was in patients below the age of 65.

No protective effect was found against cerebrovascular disease mortality – death from stroke – regardless of age.

Thursday, February 22, 2007

How to Identify and Combat Serious Dental Problems

To help fight an epidemic of cavities and oral disease among the state's young children, the
California Dental Hygienists' Association (CDHA) is offering information
about how to effectively spot and prevent tooth decay, which plagues
millions of California schoolchildren.
During February's National Children's Oral Health Month, as well as
throughout the entire year, California dental hygienists play a vital role
in raising awareness about a serious and often misunderstood problem in
oral health. The profession also devotes significant volunteer time to
helping protect the state's children from a preventable disease.
"Dental caries -- also known as cavities -- is the most common
childhood disease and can lead to a wide range of other health and other
problems," said Susan McLearan, president of CDHA. "Yet, there are some
very simple ways we as a society can better prevent and attack this
A Serious Problem
The first step, according to CDHA, is to understand the serious nature
of the disease and then take steps to eliminate the risk factors that can
lead to cavities, especially in small children.
-- Parents should realize how important baby teeth are to speech,
nutrition and self esteem
-- Early childhood caries is a very serious form of cavities that can
destroy the teeth of preschool children and toddlers
-- The first signs of caries are white chalky or brown spots on the teeth,
usually starting at the gum line
-- This problem may be overlooked by parents until the pain becomes so
severe and the teeth so decayed that the only options for these kids is
to have their teeth taken out

Prevention Tips
Prevention must begin early. CDHA recommends that a child's first
dental evaluation should be within six months after the first primary tooth
appears or by the time a child is one year old.
Additionally, parents should:
-- Try to eliminate starchy and sugary foods
-- Reduce or avoid nighttime bottle-feeding for infants. Putting a child
to bed with a bottle or the prolonged use of a "sippy" cup can cause
-- Prevent contact with a parent or care taker with untreated caries,
which can easily spread to a child through the sharing of a spoon, cup,
-- Ensure that fluoride varnish or sealants are given to children who have
already had one or more cavities because they are considered a high
risk for developing more
-- Promote brushing of teeth on a regular basis. When a tooth first
appears or erupts, it should be wiped gently with a damp cloth or soft
brush; beginning around ages two or three, children can use fluoride
toothpaste with a brush
-- Seek the advice of a dental hygienist, who can work with parents to
make recommendations on how to avoid this serious disease
-- Use products containing xylitol, a natural sugar substitute that helps
fight bacteria that causes tooth decay
"California dental hygienists are unsung heroes in the fight against
cavities," said CDHA's McLearan, who noted that her members are a wealth of
information for the public and generously volunteer their time to offer
nutritional counseling, oral health education in the schools, fluoride
treatments, cleanings and student dental screenings.
"For California dental hygienists, protecting our children from oral
disease is a 12-month effort," said McLearan. "This month is just a good
time to emphasize the problem and solutions to parents about better
protecting their children."
The California Dental Hygienists' Association (CDHA) is the
authoritative voice of the state's dental hygiene profession. While
registered dental hygienists have worked in the state for nearly a century,
CDHA was established 20 years ago when two regional associations merged to
form a unified professional group. CDHA represents thousands of dental
hygienists throughout the state and is dedicated to expanding opportunities
for the profession and access to care for all Californians.

Wednesday, February 21, 2007

Boosting brain power — with chocolate

Eating chocolate could help to sharpen up the mind and give a short-term boost to cognitive skills, a University of Nottingham expert has found.

A study led by Professor Ian Macdonald found that consumption of a cocoa drink rich in flavanols — a key ingredient of dark chocolate — boosts blood flow to key areas of the brain for two to three hours.

Increased blood flow to these areas of the brain may help to increase performance in specific tasks and boost general alertness over a short period.

The findings, unveiled at one of the biggest scientific conferences in America, also raise the prospect of ingredients in chocolate being used to treat vascular impairment, including dementia and strokes, and thus for maintaining cardiovascular health.

The study also suggests that the cocoa flavanols found in chocolate could be useful in enhancing brain function for people fighting fatigue, sleep deprivation, and even the effects of ageing.

Ian Macdonald, professor of metabolic physiology at The University of Nottingham, used magnetic resonance imaging (MRI) to detect increased activity in specific areas of the brain in individuals who had consumed a single drink of flavanol-rich cocoa. The effect is linked to dilation of cerebral blood vessels, allowing more blood — and therefore more oxygen — to reach key areas of the brain.

Flavanols are not only found in chocolate with a high cocoa content — they are also present in other substances such as red wine, green tea and blueberries.

He presented his research at the annual meeting of the American Association for the Advancement of Science (AAAS), one of the biggest annual gatherings of scientists from all over the world. This year's meeting takes place in San Francisco from February 15–19.

Professor Macdonald said: “Acute consumption of this particular flavanol-rich cocoa beverage was associated with increased grey matter flow for two to three hours.

“The demonstration of an effect of consuming this particular beverage on cerebral blood flow raises the possibility that certain food ingredients may be beneficial in increasing brain blood flow and enhancing brain function, in situations where individuals are cognitively impaired such as fatigue, sleep deprivation, or possibly ageing.”

He emphasised that the level of cocoa flavanol used in the study is not available commercially. The cocoa-rich flavanol beverage was specially formulated for the purpose of the study.

Monday, February 19, 2007

Plant-derived omega-3s may aid in bone health

Plant-based omega-3 polyunsaturated fatty acids (PUFA) may have a protective effect on bone health, according to a team of Penn State researchers who carried out the first controlled diet study of these fatty acids contained in such foods as flaxseed and walnuts.

Normally, most of the omega-3 fatty acids in the diet are plant-derived and come mainly from soybean and canola oil. Other sources are flaxseed, flaxseed oil, walnuts and walnut oil. Smaller amounts also come from marine sources, mainly fish, but also algae. Omega-3s are thought to have an anti-inflammatory effect and may play an important part in heart and bone health.

"The unique thing about this study is that we know exactly what the participants ate because we closely controlled their food," says Dr. Rebecca Corwin, associate professor of nutrition. "These people are really dedicated to spend a total of 24 weeks in the study with 18 weeks eating only what was supplied to them."

Previous studies of omega-3s on bone health used oil supplements rather than whole food sources. The researchers note in a recent issue of Nutrition Journal, that "supplement studies typically do not involve control of the background diet, and it is possible that differences across studies could be explained by failure to control for other nutrients that affect bones."

The researchers developed three diets that they fed sequentially to the 23 participants. Twenty of the subjects were men and three were postmenopausal women not on hormone replacement therapy for six months. This study was part of a larger one investigating the effects of omega-3 fatty acids on cardiovascular health. For six weeks the subjects ate either the control diet, dubbed average American diet or two other diets high in PUFA. After six weeks the group had three weeks off to resume their typical eating pattern and then for the next six weeks they ate one of the other diets. This continued for 24 weeks until all participants consumed six weeks of all the diets.

Monday through Friday the participants ate either breakfast or dinner in the diet center and packed the remaining meals, including weekend meals and snacks home. The researchers designed the diets so that individual body weight remained unchanged; participants carried out their normal activities and exercise levels. Blood tests showed that all subjects ate their supplied food and did not cheat on their regimens.

The two high PUFA diets had different amounts of linoleic acid (LA), an omega-6 fatty acid and alpha linolenic acid (ALA), an omega-3 fatty acid. Walnuts, which are high in omega-6 and omega-3 fatty acids, supplied half the total fat in both diets. They appeared in walnut granola, honey walnut butter, walnut pesto and as snacks. The ALA diet also contained flaxseed oil to increase the ALA content of the diet. Other sources of ALA, such as canola oil, were not used in this study.

Blood tests screened for two biological markers of bone health, one that indicates bone formation and one that indicates bone resorption or breakdown. Throughout life, two different types of cells – osteoblasts and osteoclasts – constantly build and break down bone. In this process they produce chemicals that researchers can measure in the blood. This process allows broken bones to heal, and bones to remain strong, but if more bone is lost than is rebuilt, osteoporosis occurs.

The biomarker for bone resorption, N-telopeptides, decreased significantly during the ALA diet and marginally during the LA diet compared to the average American diet. Levels of bone-specific alkaline phosphatases, a measure of bone building, were unaffected by the diets.

"If less bone is being resorbed and the same amount of bone is being created, then there is a positive balance for bone health," says Corwin.

Some scientists believe that the ratio of omega-6 and omega-3 fatty acids is the important factor. The ratio of these fatty acids in the average American diet was about 9.5, while in the LA and ALA diets it was 3.5 and 1.6 respectively.

The researchers caution that it is unknown if the observed effects are due to increased ALA or conversion of ALA to eicosapentaenoic acid, EPA. Fish oils in fish, are the main source of EPA in the American diet.

The researchers note that "recent epidemiologic data suggest that the effects of dietary fats on bone health may be particularly strong in men." So, while middle-aged men are often overlooked in studies of bone health, incorporating plant sources of omega-3 PUFA into the diet may not only improve cardiovascular health, but also enhance bone health.

How A Wrinkle-Filler Works: New Collagen

The science behind a wrinkle-filler: Researchers discover for the first time how product works

University of Michigan study on dermal filler Restylane shows that it causes the skin to create more collagen.

The study is the first to discover that one of the fillers – known by the brand-name Restylane – works by stretching fibroblasts, the cells in the skin that make collagen, in a way that causes the skin to create new collagen. This new, natural collagen then would contribute to the reduction of the appearance of creases and wrinkles. The study also shows that the product seems to inhibit the breakdown of existing collagen.

“Prior to our research, it has been thought that Restylane’s physical volume caused the improvement in the appearance of one’s skin,” says senior author John J. Voorhees, M.D., the Duncan and Ella Poth Distinguished Professor and chair of the Department of Dermatology at the U-M Medical School.

“It is true that the physical presence of the product increases volume in the skin. Our research makes clear that injection of the product leads to creation of new collagen, which contributes to reduction in creases and wrinkles in a person’s aging skin,” Voorhees says.

The paper appears in the new issue of the journal Archives of Dermatology. Funding was provided by the U-M Department of Dermatology Cosmetic Research Fund, the Babcock Research Endowment at U-M and grants from the National Institutes of Health.

While Medicis Aesthetics provided the Restylane syringes used in the study, the company (which makes Restylane) had no involvement in the collection, management, analysis and interpretation of the data. The company also was not involved in the preparation or review of the manuscript.

Restylane has been in the news frequently in recent months, in part because of a competition between Medicis and Allergan Inc., the maker of the dermal filler Juvederm. More than one observer has compared the rivalry to the height of the “cola wars” between Coke and Pepsi. These fillers are used to reduce the appearance of creases and wrinkles on the lower part of the face.

The findings of the study are based on injections in 11 volunteers, ages 64 to 84 years, and the subsequent analyses of the skin biopsies (including immunostaining and gene expression).

Some of the key findings relate to fibroblasts, which are in the dermis, the layer of the skin below the epidermis (outer layer). In young people, fibroblasts are stretched, and this produces enough collagen to make the skin appear relatively smooth. As people age, the fibroblasts become relaxed and do not stretch as easily, and therefore do not release as much collagen, causing creases and wrinkles to appear.

With the injection of Restylane in this study, the relaxed fibroblasts were re-stretched, says lead author Frank Wang, M.D., research fellow with the U-M Department of Dermatology. In a sense, this stretching encourages the fibroblasts to behave in the way they do in younger skin and to release collagen.

Another factor is that in older skin, an enzyme called collagenase breaks down the collagen in the skin. The research found that injection of this dermal filler inhibits the breakdown of collagen by collagenase, which also helps with the appearance of one’s skin, Wang says.

The study notes that procedures involving dermal fillers are increasingly common. Of the 12 million cosmetic procedures performed annually in the United States, about 1 million currently involve the class of injectable fillers that includes Restylane, according to the researchers.

Friday, February 16, 2007

Shedding Pounds from Diet or Exercise—Take Your Pick

People looking to lose those extra pounds have been told for decades that dieting together with exercise will bring about the best results. Not so, says new research published in the Journal of Clinical Endocrinology & Metabolism, which reveals that dieting alone is as effective as dieting plus exercise. The key is in the calories and the study shows that calories can be lost effectively by either dietary restrictions or exercise.

Newswise — People looking to lose those extra pounds have been told for decades that dieting together with exercise will bring about the best results. Not so, says new research published in the Journal of Clinical Endocrinology & Metabolism, which reveals that dieting alone is as effective as dieting plus exercise. The key is in the calories and the study shows that calories can be lost effectively by either dietary restrictions or exercise.

“For weight loss to occur, an individual needs to maintain a difference between the number of calories they consume everyday and the number of calories they burn through metabolism and physical activity,” says Leanne Redman, Ph.D., first author of the study and clinical research fellow at the Pennington Biomedical Research Center in Baton Rouge, La. “What we found was that it did not matter whether a reduction in calories was achieved through diet or burned everyday through exercise.”

The researchers conducted a randomized, controlled trial to examine the effects of diet alone or diet plus exercise in overweight but otherwise healthy study participants. The participants were divided into three groups. One group only reduced caloric intake. A second group reduced caloric intake by a smaller amount, but included exercise as part of their program, and a third set of participants served as a control group. They were all followed for a six-month period.

At the end of the study, the reduced caloric intake group and the group that combined a smaller amount of reduced calories with exercise had similar results. Members of both groups lost roughly 10 percent of their body weight, 24 percent of their fat mass and 27 percent of their abdominal visceral fat, which is fat buried deep in the abdomen and linked to heart disease risk.

The shape of a person’s body, as well as their body weight can be indicators of their risk for cardiovascular disease. Some studies have shown that people with “apple shaped” bodies, or more fat distributed at the waistline may have a higher risk of heart disease than people with “pear shaped” bodies, or more fat at the thigh or hips.

“Researchers are working to understand how abdominal fat and subcutaneous fat, which is fat located closer to the surface just beneath the skin, differ in response to the body’s need to use fat for energy,” says Sherry Marts, Ph.D., vice president of scientific affairs for the Society for Women’s Health Research in Washington, D.C. “It is known that, on the whole, pre-menopausal women who gain fat add it to the subcutaneous fat, mostly on the hips and thighs. Men and women after menopause, tend to add fat to the deeper reserves in the abdominal area.”

Increased levels of fat in the abdomen are linked to a higher risk of cardiovascular disease, but the precise influence of this visceral fat is not yet understood.

Despite the fact that weight loss can be achieved equally through diet or fitness, according to the study, both are important for a person’s overall health. Weight loss isn’t the only reason to diet and exercise. Regular exercise has been shown to lower your risk for many diseases including: heart disease, type 2 diabetes and certain types of cancer. In addition, many experts recommend that permanent weight loss should be achieved with consistent dietary restrictions, low-caloric and low-fat foods, and regular exercise.

But if you’re looking to tone certain areas of your body with exercise, think again! The researchers also discovered that fat distribution was not affected by either approach. The exercise group was not able to eliminate fat in certain parts of the body: so much for sit ups!

“We found that fat is reduced consistently across the whole body and not more in any one part,” says Redman. “We found some evidence in other studies that suggested the way in which we store fat is linked to our genetics and our study then would indicate that weight loss cannot override the way in which any individual stores fat. Perhaps an apple will always be an apple, and a pear, a pear!”

Researchers are now trying to determine how sex hormones and being a man or a woman affect fat distribution. “The roles of hormones,” Marts said, “such as estrogen, progesterone and testosterone in fat deposition and loss are not yet understood, but research in this field is advancing rapidly.” The answers to those questions may hold the keys to a healthier life for everyone.

Wednesday, February 14, 2007

Over One-Third of Americans Now Using Alternative Medicine

More than 37 percent of U.S. households regularly turn to alternative treatments for everything from headaches to diabetes, according to a survey conducted by Thomson Medstat.

Thomson Medstat's 2006 consumer healthcare survey asked 23,000 adults about their use of alternative medicine and found that:

-- 37.2 percent of U.S. households use some form of alternative medicine. The most common reason was to improve general wellness.

-- Alternative medicine use is most prevalent among those with annual incomes exceeding $100,000 and those with post-graduate college degrees.

-- Nearly two-thirds of respondents said their physicians were aware of their use of alternative medicine.

-- 41.9 percent said at least some of the costs of their alternative treatments were covered by insurance.

-- Herbal supplements and massage/chiropractic care were the most commonly used alternative care, followed by mind/body practices, energy therapies and naturopathy.

Alternative medicines are broadly defined as therapeutic or preventive healthcare practices such as homeopathy, naturopathy, chiropractic, and herbal medicine.

Despite the potential for dangerous interactions between alternative and prescription medicines, the study found that affluent, highly educated Americans are driving the growth of the alternative market. Nearly half (49.9 percent) of households earning more than $100,000 per year sought alternative treatments in the past 12 months. Likewise, 49.6 percent of those with post- graduate degrees used alternative medicine. At the lower end of the income/education scale, utilization dropped to 30 percent in households earning $15,000-$24,999 per year and to 18.1 percent among those without a high school diploma.

"Alternative medicine use has become so widespread that it is now critical for traditional, Western physicians to factor a whole new set of potential interactions into treatment decisions," said Dr. David Schutt, associate medical director at Thomson Medstat. "Knowing the statistics behind alternative medicine use is a good start, but further study of this area is necessary."

The study suggests that doctors are increasingly making it a habit to ask patients about their alternative medicine use and history. In total, 64.1 percent of respondents said their physicians were aware of their use of alternative medicine.

For more detailed report on the survey findings, visit d=7 00. (Due to the length of the URL, you may need to copy and paste this address into your browser.)

Tuesday, February 13, 2007

Midday napping (siesta) associated with reduced risk of heart-related death

Among Greek adults, taking regular midday naps is associated with reduced risk of death from heart disease over a six-year period, especially among working men, according to a report in the February 12 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Some evidence suggests that in countries where siestas are common, rates of death from heart disease tend to be lower. However, the few studies that have assessed the potential relationship have not controlled for other factors that may influence heart disease risk, such as physical activity and age, according to background information in the article.

Androniki Naska, Ph.D., University of Athens Medical School, Greece, and colleagues studied 23,681 Greek men and women ages 20 to 86 who did not have a history of heart disease or any other severe condition when they enrolled in the study between 1994 and 1999. At the beginning of the study, participants were asked if they took midday naps, and if so, how often and for how long at a time. They also reported their level of physical activity and dietary habits over the previous year.

Over an average of 6.32 years of follow-up, 792 participants died, including 133 who died from heart disease. After the researchers factored in other cardiovascular risk factors, individuals who took naps of any frequency and duration had a 34 percent lower risk of dying from heart disease than those who did not take midday naps. Systematic nappers, those who took a siesta for 30 minutes or more at least three times per week, had a 37 percent lower risk of heart-related death.

Among working men, those who took midday naps either occasionally or systematically had a 64 percent lower risk of death from heart disease during the study than those who did not nap, while non-working men who napped had a 36 percent reduction in risk. "We were unable to undertake a similar analysis among women because there were only six deaths among working women," the authors write.

"We interpret our findings as indicating that among healthy adults, siesta, possibly on account of stress-releasing consequences, may reduce coronary mortality," they continue. The fact that the association was stronger in working men, who likely face job-related stress, than non-working men is compatible with this hypothesis, they write.

"This is an important finding because the siesta habit is common in many parts of the world, including the Mediterranean region and Central America," the authors conclude.

Monday, February 12, 2007

Protein's power to preserve lean body mass during weight loss

New study with lean pork reveals protein's power to preserve lean body mass during weight loss

Purdue University research also finds higher protein diet

Reducing daily caloric intake is typically the first approach that dieters take to shed those unwanted pounds. However, a new study released today in the journal Obesity found that including protein from lean sources of pork in your diet could help you retain more lean body mass, which includes muscle, while losing weight.1

The new research, conducted by Dr. Wayne Campbell, lead researcher at Purdue University's Laboratory for Integrative Research in Nutrition, Fitness and Aging, and his colleagues evaluated the weight loss of 46 overweight or obese women who followed one of two reduced-calorie diets. One group ate a diet that included about 18 percent of their calories from protein. The other group ate a higher protein diet – about 30 percent of total calories from protein, including 6 ounces of lean pork on average per day.

"After 12 weeks, our study found that the group of women who followed a reduced-calorie eating plan while consuming a higher level of protein was more effective in maintaining lean body mass during weight loss compared to those who consumed the same amount of calories with less protein," said Dr. Wayne Campbell. In fact, the higher protein group retained nearly double the amount of lean body mass (losing just 3.3 pounds of lean mass) compared to the women on the normal protein diet (who lost 6.2 pounds of lean mass). Because muscle burns more calories, the finding is important in long-term weight control.

Lean Pork Helps Women Preserve Lean Body Mass With Weight Loss

"In addition to helping preserve lean body mass during weight loss, consuming a higher-protein diet helped retain the women's sense of satiety or fullness after meals. The women on the higher protein diet rated themselves more positively in terms of overall mood and feelings of pleasure during dieting," said Campbell, "which could help dieters stay true to their weight loss plans longer."

The researchers tracked the participants' food intake, body weight and composition, and feelings of fullness throughout the study to compare the effect of the two different diets on these outcomes.

"While previous studies have evaluated the impact higher-protein diets have on a weight-loss program, this is the first study to use pork as the only source of meat," said Ceci Snyder, MS, RD, assistant vice president of consumer marketing for the National Pork Board. "We know consumers may be surprised to learn that pork is a lean protein choice that can help you achieve your weight loss goals. In fact, there are six cuts of pork that meet the U.S. Department of Agriculture's guidelines for 'lean,' with less than 10 grams of fat, 4.5 grams of saturated fat and 95 milligrams of cholesterol per 3-ounce serving."

The study also concluded that a person's weight before dieting might play a role in the amount of lean body tissue lost on higher- versus normal-protein diets. The preservation of lean body mass was more pronounced in the pre-obese women compared with the obese women. The pre-obese group lost 2.6 pounds of lean body mass compared to 6.4 pounds of lean body mass lost by the obese women.

Choosing Lean Sources of Protein

"One of the biggest struggles I hear about with respect to dieting is the need for meal satisfaction. When individuals lack satiety or the feeling of fullness, more often then not they'll feel deprived and overeat," said Kathleen Zelman, MPH, RD. "Eating a variety of lean protein foods can help dieters stay on track."

Pork also packs a significant amount of nutrients in every lean portion. A 3-ounce serving of pork tenderloin is an "excellent" source of protein, thiamin, vitamin B6, phosphorus and niacin, and a "good" source of riboflavin, potassium and zinc, yet contributes only 6 percent of the calories in a 2,000 calorie diet.

Lean Pork Helps Women Preserve Lean Body Mass With Weight Loss

"When increasing the amount of protein you eat, it's important to make lean choices, such as pork tenderloin. According to the U.S. Department of Agriculture, pork tenderloin contains the same amount of fat and slightly less calories than the same size serving of skinless chicken breast2, often a welcomed surprise for many dieters," says Zelman.

"To find the leaner cuts of pork, I encourage my clients to look for the word 'loin' on the label, such as 'loin chop' or 'tenderloin'," added Zelman.

Vasectomy may put men at risk for type of dementia

Northwestern University researchers have discovered men with an unusual form of dementia have a higher rate of vasectomy than men the same age who are cognitively normal.

The dementia is Primary Progressive Aphasia (PPA), a neurological disease in which people have trouble recalling and understanding words. In PPA, people lose the ability to express themselves and understand speech. It differs from typical Alzheimer's disease in which a person's memory becomes impaired.

Sandra Weintraub, principal investigator and professor of psychiatry and behavioral sciences and of neurology at Northwestern's Feinberg School of Medicine, began investigating a possible link between the surgery and PPA when one of her male patients connected the onset of his language problem at age 43 to the period after his vasectomy.

At a twice-yearly Chicago support group for PPA patients Weintraub sees from around the country, the male patient rushed into the room and asked the men sitting there, "OK, guys, how many of you have PPA?" Nine hands went up.

"How many of you had a vasectomy?" he demanded next. Eight hands shot up.

Weintraub and her team of researchers surveyed 47 men with PPA who were being treated at Northwestern's Cognitive Neurology and Alzheimer's Disease Center and 57 men with no cognitive impairment who were community volunteers. They ranged from 55 to 80 years old.

Of the non-impaired men, 16 percent had undergone a vasectomy. In contrast, 40 percent of the men with PPA had had the surgery.

"That's a huge difference," said Weintraub, director of neuropsychology in the Cognitive Neurology and Alzheimer's Disease Center. "It doesn't mean having a vasectomy will give you this disease, but it may be a risk factor to increase your chance of getting it."

In addition, the men who had undergone a vasectomy developed PPA at a younger age (58 years) than men with PPA who hadn't had one (62 years.)

While PPA robs people of their ability to speak and understand language, an unusual twist of the disease is patients are still able to maintain their hobbies and perform other complicated tasks for a number of years before other symptoms develop. Some people garden, build cabinets and even navigate a city subway system. By contrast, Alzheimer's patients lose interest in their hobbies, family life and may become idle. As PPA progresses over a number of years, however, patients eventually lose their ability to function independently.

Preliminary evidence from the study also seemed to connect another form of dementia to a vasectomy. In a smaller group of 30 men with a dementia called frontotemporal dementia (FTD,) 37 percent had undergone a vasectomy. The earliest symptoms of FTD are personality changes, lack of judgment and bizarre behavior. As in PPA, FTD usually starts at an earlier age, in the 40s and 50s.

One of Weintraub's patients with FTD was eating lunch in a restaurant with his family and excused himself to go to the bathroom. When he hadn't returned after 10 minutes, his sons went to investigate. They found him doing pushups on the bathroom floor. Other FTD patients begin shoplifting, compulsively gambling, misspending large amounts of money or become sexually demanding.

The most common form of dementia caused by brain deterioration in individuals over age 65 is Alzheimer's disease. Weintraub did not find an increased rate of vasectomy in patients with Alzheimer's.

Many patients with FTD and PPA share a common brain disease that is completely different from Alzheimer's. Whether a patient will get the behavioral or language problems depends on where the disease causes the most destruction in the brain. In FTD, most of the damage is in the frontal lobes; in PPA, it's in the language centers of the left hemisphere of the brain.

Weintraub theorizes a vasectomy may raise the risk of PPA (and possibly FTD) because the surgery breeches the protective barrier between the blood and the testes, called the blood-testis barrier.

Certain organs – including the testes and the brain – exist in what is the equivalent of a gated community in the body. Tiny tubes within the testes (in which sperm are produced) are protected by a physical barrier of Sertoli cells. The tight connections between these cells prevent blood-borne infections and poisonous molecules from entering the semen.

After a vasectomy, however, the protective barrier is broken and semen mixes into the blood. The immune system recognizes the sperm as invading foreign agents and produces anti-sperm antibodies in 60 to 70 percent of men.

Weintraub said these antibodies might cross the blood-brain-barrier and cause damage resulting in dementia. "There are other neurological models of disease which you can use as a parallel," Weintraub said. Certain malignant tumors produce antibodies that reach the brain and cause an illness similar to encephalitis, she noted.

The next step in Weintraub's research will be to launch a national study to see if her results will be confirmed in a larger population.

"I don't want to scare anyone away from getting a vasectomy," Weintraub stressed. "It's obviously a major birth control alternative. This is just a correlational observation," she said of the dementia connection. "We need to do more research to find out."

Friday, February 9, 2007

Folate and B12 may influence cognition in seniors

Folate and vitamin B12, two important nutrients for the development of healthy nerves and blood cells, may work together to protect cognitive function among seniors, reports a new epidemiological study from the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University (USDA HNRCA). According to Martha Savaria Morris, PhD, epidemiologist at the USDA HNRCA, "we found a strong relationship between high folate status and good cognitive function among people 60 and older who also had adequate levels of vitamin B12." The study, published in the January 2007 issue of the American Journal of Clinical Nutrition, also determined that low vitamin B12 status was associated with increased cognitive impairment.

Using data collected from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2002, Morris and colleagues found that people with normal vitamin B12 status and high serum folate, which is a measure of folate in the blood, had higher scores on a test of cognitive function. Blood tests were used to determine folate and vitamin B12 levels, and the cognitive function test assessed aptitudes such as response speed, sustained attention, visual spatial skills, associative learning, and memory. Cognitive impairment was identified when a subject fell into the bottom 20th percentile of the distribution on the test.

"People with normal vitamin B12 status performed better if their serum folate was high," explains Morris, corresponding author of the study. "But for people with low vitamin B12 status, high serum folate was associated with poor performance on the cognitive test." Seniors with low vitamin B12 status and high serum folate were also significantly more likely than seniors in other categories to have anemia, a condition caused by reduced amounts of hemoglobin in oxygen-carrying red blood cells, or by a deficiency in the number or volume of such cells.

"For seniors, low vitamin B12 status and high serum folate was the worst combination," says Morris. "Specifically, anemia and cognitive impairment were observed nearly five times as often for people with this combination than among people with normal vitamin B12 and normal folate." Vitamin B12 deficiency, which affects many seniors due to age-related decreases in absorption, can impact the production of DNA needed for new cells, as well as neurological function.

Vitamin B12 is normally consumed in meat, fish, poultry, eggs, and dairy products, and folate is found in leafy green vegetables, citrus fruits, and beans. Although folate occurs naturally in many foods, the U.S. Food and Drug Administration in 1998 required that all enriched cereal-grain products be fortified with folic acid, the synthetic form of folate, in order to help prevent birth defects in infants.

Morris notes that the study's results are inconsistent with the idea that high folate status delays detection of vitamin B12 by masking one of its key signs: anemia. "When folate fortification was considered, opponents raised the possibility that because more folate might mask anemia, many cases of vitamin B12 deficiency would go undetected, causing people with the condition to suffer neuropsychiatric consequences. But in our study, the people with low vitamin B12 who also had high serum folate were more likely to exhibit anemia and cognitive impairment than subjects with low vitamin B12 status and normal serum folate. So although having high serum folate had an impact on cognitive function in our study, it did not cure anemia, as opponents of food fortification have suggested."

Senior author Jacob Selhub, PhD, director of the Vitamin Metabolism Laboratory at the USDA HNRCA and professor at the Friedman School, says, "Our findings support the often-expressed idea that many seniors would benefit from more folate, but the research shows that we must look at the effects this would have on seniors with age-related vitamin B12 deficiency, who may be more numerous than once realized. There are also indications that too much folic acid and too little B12 is a general phenomenon that affects other systems in the body, and might be a factor in some other diseases."

As with any epidemiological study, Morris cautions that the results show association and not causation. She also notes that because the study only measured levels of total folate in the blood, it is uncertain whether the results were due to unmetabolized folic acid in the body. "We encourage further studies of these relationships and their underlying mechanisms," write Morris and her colleagues at Tufts. "We hope our findings both inform the continuing debate about folic acid fortification and influence future efforts to detect and treat low vitamin B12 status among seniors."

Vitamin K Research

In a recent article in Current Opinion in Clinical Nutrition and Metabolic Care, Sarah Booth, PhD, lab director of the Vitamin K Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University (USDA HNRCA), reviewed studies regarding vitamin K status among the elderly. Although older adults seem to consume more vitamin K than younger adults, many seniors are still not meeting the recommended intake of vitamin K.

"Research has shown poor vitamin K intake may be associated with conditions such as bone fractures, bone loss, hardening of the arteries, and osteoarthritis," says Booth, who is also a professor at the Friedman School of Nutrition Science and Policy at Tufts.

Although it may be important for the elderly to increase dietary vitamin K, Booth notes that it is also essential for researchers to examine factors other than diet that may affect vitamin K status in the body. "One promising area of research is the interrelationship between estrogen and vitamin K," says Booth, "as studies indicate that low estrogen levels in menopause may change the way vitamin K is metabolized. More research is also needed to determine vitamin K status of elderly men, as well as to determine what populations, if any, might benefit from vitamin K supplements."

In a study published in Nutrition, Metabolism & Cardiovascular Diseases, Booth and colleagues examined dietary patterns of more than 40,000 men to determine if phylloquinone, the form of vitamin K found in plant sources like leafy green vegetables, could serve as a marker for reduced risk of developing cardiovascular disease.

Booth and colleagues, including corresponding author Arja Erkkila, PhD, of both the USDA HNRCA and the University of Kuopio in Finland, determined that high phylloquinone intake did not appear to be an independent risk factor for cardiovascular disease. However, men consuming high amounts of phylloquinone generally had better dietary habits, such as eating more fruits and vegetables and less saturated fat. Men consuming high amounts of phylloquinone were also less likely to smoke and more likely to exercise or take dietary supplements.

The association between high phylloquinone intake and a healthy diet and lifestyle led Booth and colleagues to conclude that phylloquinone intake could indeed play an important role in cardiovascular research studies. "...In large population groups, phylloquinone may provide a more robust assessment of overall cardiovascular risk status than assessing multiple individual diet and lifestyle habits," write the authors.

The Vitamin K Laboratory, as part of the Agricultural Research Service (ARS) National Food and Nutrient Analysis Program, has been contributing vitamin K food content data to the National Nutrient Databank for nearly a decade. For more information on vitamin K research at the USDA HNRCA, refer to "Tufts Researchers are Keeping Track of Vitamin K" in the May/June 2006 issue of Friedman Nutrition Notes []. The ARS is the chief scientific research agency of the USDA.

Suicide Among Youth

More people die by suicide than by homicide in the United States. Suicide rates among youth have been increasing steadily for the past four decades; suicide is the third leading cause of death among children and youth between the ages of 10 and 24. In the United States, nearly 60% of suicides are committed with a firearm.

Who's at Risk?

Suicide among teens and young adults has nearly tripled since the 1940's. Possible risk factors include: unauthorized access to firearms; alcohol use at home; exposure to previous suicides; and residential mobility that might lessen opportunities for developing social networks.

In 1998, males accounted for 80% of all suicides in the U.S. Between 1979 and 1992, suicide rates for Native Americans (a category that includes American Indians and Alaska Natives) were about 1.5 greater than the national rate. Suicides among young Native American males age 15-24 accounted for 64% of all Native American suicides during this period. Suicide among black youths has also increased sharply in recent years: From 1980 to 1992, the rate for black teens age 15-19 more than doubled, from 3.6 per 100,000 to 8.1 per 100,000. Although white teens still have higher suicide rates, the gap is narrowing.

Can It Be Prevented?

A number of prevention efforts are aimed at detecting suicide warning signs. Signals that a young person may be contemplating suicide include: 1) attempted suicide at least once; 2) making plans to take his/her own life, drafting a will, or giving away cherished valuables; and 3) personality or behavior changes, or indications of clinical depression (changes in appetite and sleeping patterns, feelings of worthlessness, self-reproach, and thoughts of death or suicide).

Prevention efforts cover a wide range: school gatekeeper programs, community gatekeeper programs, general suicide education, screening programs, peer support programs, crisis centers and hotlines, restriction of access to lethal means, and interventions (with peers) after a suicide. Adults who supervise a young person can possibly deter suicide through recognition of the warning signs. They can also urge a potentially suicidal young person to talk things over with a counselor or a professional before considering any actions.

Psoriasis May be Under-Treated

The National Psoriasis Foundation and Amgen (NASDAQ: AMGN), today announced survey findings which show that nearly 40 percent of 1,142 patients surveyed with chronic moderate or severe psoriasis are not currently receiving any treatment. These results were presented at the American Academy of Dermatology (AAD) Scientific Meeting in Washington, D.C.

According to AAD therapy guidelines, patients diagnosed with chronic moderate to severe plaque psoriasis are candidates for phototherapy or systemic therapy, including biologic agents. Despite the increased number of psoriasis treatment options, the findings show no significant change in treatment patterns across three survey years.

According to further data presented at AAD, based on National Psoriasis Foundation surveys from 2003 to 2005, more than half of moderate to severe patients on treatment are not being treated as recommended by AAD guidelines. Of those treated, 57 percent of patients with severe psoriasis (n=459) and 73 percent of patients with moderate psoriasis (n=683) are receiving topical treatment alone.

“Psoriasis is not a cosmetic disease, but rather a chronic inflammatory condition that can have a profound negative impact on a person’s ability to function,” said Mark Lebwohl, M.D., Chairman of the National Psoriasis Foundation Medical Board. “It’s important for patients to openly discuss with their dermatologist how the condition may be impacting them, so that together they can determine the most appropriate treatment option.”

According to additional survey findings, severe psoriasis is associated with lower income. Data presented at AAD show that 21 percent of patients with severe psoriasis (n=179) had a low household income (<$30,000), compared to 13 percent for patients with mild psoriasis (n=180).

“These are the first data to show a relationship between psoriasis severity and household income,” said Liz Horn, Ph.D., director of research, National Psoriasis Foundation. “Psoriasis is a serious disease that can significantly impact a patient’s life by interfering with everyday activities, including work. Further research will be valuable in supporting these data and will hopefully lead to the improved treatment of psoriasis.”

Data from semi-annual patient surveys conducted by the National Psoriasis Foundation from 2003 to 2005 were combined and analyzed to study treatment patterns for psoriasis patients. Psoriasis severity was assessed using patient-reported affected body surface area (BSA) and was defined as mild (<3% BSA), moderate (3—10% BSA), or severe (>10% BSA). A separate analysis was conducted in patients greater than 30 years of age to study the relationship between psoriasis severity and household income. The research was funded by the National Psoriasis Foundation, Amgen Inc. and Wyeth Pharmaceuticals.

About Psoriasis
Psoriasis is a non-contagious, chronic disease, in which the immune system causes the skin to grow at an accelerated rate. According to the National Institutes of Health, up to 7.5 million people in the United States suffer from psoriasis. The disease occurs among people of all ages, although it is most commonly diagnosed in early adulthood. Types of psoriasis include plaque, guttate, pustular, inverse, and erythrodermic. Due to genetic factors, certain people are more likely to develop psoriasis, but a “trigger” is usually necessary to make psoriasis appear. These triggers may include emotional stress, injury to the skin, some types of infection, or reaction to certain drugs.

About the National Psoriasis Foundation
The National Psoriasis Foundation is the leading patient-driven, nonprofit organization dedicated to improving the quality of life millions of Americans with psoriasis and/or psoriatic arthritis, and their families. The Psoriasis Foundation focuses on education, advocacy and research toward better treatments and a cure. For more information, please call the National Psoriasis Foundation, headquartered in Portland, Ore., at 800-723-9166, or visit

Food Best

Try looking to food instead of a pill for that overall balanced nutrition, says Sara Blackburn D.Sc., R.D., clinical associate professor of the Nutrition and Dietetics Program at the Indiana University School of Health and Rehabilitation Sciences. Under the scrutiny of research, complementary medicines involving supplements are proving less effective than hoped. Blackburn said supplements are a reasonable option when a person has a nutrient deficiency or when a particular nutrient is limited in his or her diet. She said this deficiency may manifest itself in a medical problem, thus she encourages people to work with their family physician or a dietitian to determine the best course of treatment. A real gift to ourselves, said Blackburn, is daily "body wellness care," which involves putting care of yourself first.

"In a land of plenty, we don't think we have problems with malnutrition but we do," Blackburn said. "Folks limit themselves all the time, and as a result do not make wise food choices, thinking they will correct it later."

Blackburn offers the following suggestions:

* Look to food. The emphasis should be on foods, particularly fruits and vegetables. The goal for fruits and veggies, Blackburn said, is five servings a day, which is about 2.5 cups of each. A 10-ounce, bottle of orange juice, for example, is about 2.5 servings.

* Oldies but goodies. Sleeping eight hours per day, eating a nutritionally balanced diet and exercising regularly is the triad for good overall health promotion and disease prevention.

* Federal guidelines. The Dietary Guidelines for Americans 2005, which is the most recent set of guidelines from the Department of Health and Human Services and the USDA, supports the use of B12 for people older than 50; iron and folic acid for women of child bearing years and vitamin D for older folks, especially those with dark skin. The guidelines can be found at

* Too much of a good thing. Large doses of some supplements, such as vitamin A, can be toxic. Blackburn recommends that vitamin and/or mineral preparations have the minimal levels as recommended by the recommended daily allowance.

* Cost and quality. The cost of a vitamin or supplement does not indicate its quality. Information about potency is included on supplements' UPS label, which follows recognized processing standards.

* Expert help. This Web site,, can help viewers find registered dietitians near them


Sticking with a workout regimen takes strategy. Diving into the gym without annoying the gym veterans takes some consideration and know-how. Bryan Stednitz, assistant director of Fitness and Wellness for Indiana University's Division of Campus Recreational Sports, and Chris Arvin, program director for Fitness and Wellness at the division, offer both -- tips for how to stay in the weight room and look good doing it.

Pet peeves to avoid:

* In your own little world. Especially when the gym is crowded, be aware of your surroundings. "One of the worst things you can do is take up space or equipment by being on your cell phone or just standing around talking," Arvin says. Chances are good that somebody is waiting to use the equipment you are using. If you are going to the gym to work out, then work out.

* Leaving puddles of sweat. Nobody wants to sit or lay down in a pool of your sweat. Many facilities, such as IU Bloomington's facilities, provide towels and squirt bottles to wipe down the equipment when you're moving on in the workout. Also, put weights back when the workout is complete.

* Excessive noise. "Nobody likes someone who screams during their sets," says Stednitz. If you're really pushing yourself, some grunts on the last couple reps are to be expected. But don't let out a Tarzan-like scream every time you push the weight. And try not to drop the weights. Not only is it obnoxious, you can damage them and yourself.

* Bad form is well, bad form. It happens all the time; someone puts on way too much weight, can't do the exercise correctly, and looks foolish. Not only is this dangerous, it is counter-productive. Using the correct form, getting the full range of motion on your exercise, while using less weight will give you a much better workout.

* Cutting in line for the machines. Many facilities have sign-up sheets for elliptical machines, treadmills and other exercise equipment. Once signed up, don't be late.

Five tips for making the most of your workout:

* Slow but steady wins the race. "Lots of people either hurt themselves or burn themselves out by exercising too much," Stednitz says. "But it is important to be consistent. Work out more than once a week. Make it a priority by putting it on your calendar.

* Find a partner. Partners are great for holding you responsible and making sure you get to the gym, Stednitz says. They make the time pass quicker and can give you a spot if you need one. If you can't find one, consider hiring a personal trainer, especially if you need help learning the correct techniques.

* Make it fun. "Do something you enjoy," advises Stednitz. "If you make it fun, you're more likely to stick with it.

* Be persistent. If you miss a couple of days, don't fret, it happens. "Don't let a couple missed sessions deter you," says Arvin. "All is not lost." It takes a long time to get in shape, and it also take a long time to lose what you've gained.

* Ask questions. Find out what resources are available to you, such as assistance with spots, finding a workout or getting tips from trained staff. Some facilities offer special programs and workout areas for specific needs, such as private spaces where smaller groups can meet - less people and less mirrors.