Thursday, March 29, 2012

Light Drinking Can Raise Breast Cancer Likelihood


The journal Alcohol and Alcoholism has published a new review of studies that have researched the association between alcohol consumption and breast cancer. The findings revealed that the risk of breast cancer rises by 5% for low level or moderate drinkers, i.e. women who have one drink per day, whilst the risk for those who consume three or more drinks daily (heavy consumption) is 40-50% higher.

In Northern Europe and North America, about 5% of breast cancers are due to alcohol consumption, whilst in Italy and France, where alcohol consumption is more common amongst women, 10% of breast cancers are due to drinking alcohol.

Breast cancer is the most common cancer amongst European and American women. Numerous population studies have demonstrated that light drinking is very common amongst women and that the risk of associated breast cancer is a major health issue in the western world.

Scientists have known about the association between alcohol and breast cancer since the 80s; they have long known that alcohol consumption is also a risk factor for the development of cancer in various organs of the body.

Helmut K. Seitz and Carlo La Vecchia and team decided to conduct a review 'Epidemiology and Pathophysiology of Alcohol and Breast Cancer: Update 2012' that analyzed epidemiological data of the link between alcohol and breast cancer and searched for potential mechanisms of alcohol-mediated breast cancer development.

They reviewed literature published prior to November 2011 by searching databases, such as MEDLINE, ISI Web of Science and EMBASE, and found a total of 3,431 research papers, of which 113 included breast cancer risk estimates for light drinkers.

They established that overall, the studies included 44,552 non-drinkers (reference group) and 77,539 participants who were light drinkers. The geographical location of the studies revealed that 51% of the studies were conducted in North America, 38% in Europe, 6% in Asia and 10% from other regions.

According to the study's meta-analysis, which was based on the findings of over 100 studies, there was a modest, yet important link between light drinking and breast cancer, with a 5% higher risk to light drinkers compared with those who were abstinent.

Seitz and La Vecchia's findings also showed that each higher level of alcohol consumption increases the risk of breast cancer. The findings revealed a highly important progressive upward trend in risk together with consistent evidence.

The largest amount of research material was based on the relationship between high-level alcohol consumption and cancer risk, with findings suggesting that women who consume three or more drinks a day have an elevated breast cancer risk of 40-50%.

Unlike other cancers, breast cancer development can be stimulated even by small doses of alcohol. Given that alcohol consumption may affect the risk of cancer through hormone related mechanisms, the researchers specifically examined the link between alcohol consumption and the risk of breast cancer through hormone-related mechanisms like estrogen receptor (ER) and progesterone receptor (PR) status.

They discovered that a substantial amount of research indicates that alcohol consumption increased the risk of all ER+ tumors by 27% and posed a 14% risk for all ER- breast cancers in women with the highest alcohol consumption compared with those consuming the lowest level. The researchers discovered during later evaluations that their findings supported those of other studies, which demonstrated that the association between heavy alcohol consumption and ER+ breast cancers was substantially higher.

With regard to ethanol-mediated breast cancer, the scientists note that few studies have been conducted and that there is only limited information available. They state that previous studies have observed a promotional effect of estrogens on breast tissue, and given that alcohol consumption causes elevated estrogen concentrations, there have been speculations that the carcinogenic effect of alcohol is partly mediated by estrogens.

The team discussed various study examples in terms of estrogen's evidential role in ethanol-mediated breast cancer and possible carcinogens for the breast, and observed that several studies support the belief that alcohol is more strongly related to ER positive than to ER negative breast tumors, which highlights the pathogenic effect of estrogens in alcohol mediated breast cancer.


Alcohol In Moderation Lowers Risk Of Second Heart Attack


The online issue of the European Heart Journal reports that a study of almost 2,000 American men has demonstrated that men who survived a first heart attack and who consume alcohol in moderation have a lower risk of dying from heart disease or any other cause than non-drinkers.

The latest results from the US Health Professionals Follow-up Study, a prospective study of 51,529 US male health professionals, demonstrates that the any-cause mortality risk for men who survived a first heart attack and who consumed about two alcoholic drinks daily over an extended period of time was 14% lower, and the risk of dying from cardiovascular disease was 42% lower than in men who did not consume alcohol.

First author, Dr. Jennifer Pai, assistant professor of medicine at Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, and a research associate at Harvard School of Public Health, declared:

"Our findings clearly demonstrate that long-term moderate alcohol consumption among men who survived a heart attack was associated with a reduced risk of total and cardiovascular mortality. We also found that among men who consumed moderate amounts of alcohol prior to a heart attack, those who continued to consume alcohol 'in moderation' afterwards also had better long term prognosis."

Scientists know that amongst the healthy population, moderate alcohol consumption is linked to a lower risk of heart disease and death; however, whether the same applies to people with established heart disease is not known. There have been no prospective studies until now that measured alcohol consumption both before and after a heart attack, with long-term follow-up.

Dr. Pai and her team assessed a subset of 1,818 men in the Health Professionals Follow-up Study who survived a first heart attack between 1986 and 2006 and followed up 20 years from the time of their heart attack. 468 men died during the study period.

Every two years, the participants completed a survey regarding their lifestyle and medical factors, including their body mass index, their smoking habits, etc. and every four years they were surveyed regarding their alcohol consumption of beer, red wine and spirits and their diet.

A standard portion was defined as a 4oz or 125 ml of wine, which contains 11g of ethanol, i.e. the alcohol in the drink, a bottle or can of beer that contains 12.8g of ethanol, or a shot of spirits, which contains 14g of ethanol.

The men were categorized into four groups based on their daily alcohol intake, for instance 0g, 0.1-9.9g, 10-29.9g, and 30g or more. Between 10 to 29.9g of alcohol per day, i.e. the equivalent of about two drinks was classed as "moderate" drinking.

After adjusting for various variables, including smoking, body mass index, age and medical history, the researchers discovered that men who consumed about two alcoholic drinks per day following their first heart attack had a lower any-cause mortality risk as compared with non-drinkers, regardless of the type of drink they consumed.

The researchers examined the participants' alcohol consumption before and after the heart attack and discovered that the majority of men had not changed their drinking habits, and those who drank alcohol before and after their heart attack were more likely to have a lower risk of death compared with those who drank no alcohol. The researchers note, however, that the results were statistically not important because of the smaller numbers in their analysis.

They also observed a "U" shape in the results that demonstrated that participants' who drank 30g or more alcohol daily had a similar any-cause mortality risk to that of non-drinkers.

Dr. Pai explains:

"The adverse health effects of heavy drinking are well known, and include high blood pressure, reduced heart function and reduced ability to break down blood clots. In addition, other studies have shown that any benefits from light drinking are entirely eliminated after episodes of binge drinking.

Our results, showing the greatest benefit among moderate drinkers and a suggestion of excess mortality among men who consumed more than two drinks a day after a heart attack, emphasize the importance of alcohol in moderation."

She continued, saying:

"The findings of our study support the European Society of Cardiology recommended guidelines for long-term management of acute coronary syndromes that moderate alcohol consumption of 10-30 grams per day in men should not be discouraged and may be beneficial for long-term prognosis after a heart attack.

If the men were already consuming moderate amounts, then it may be beneficial to continue consuming moderate amounts of alcohol after a myocardial infarction. However, because excessive alcohol intake is harmful, we recommend that patients discuss drinking alcohol in moderation with their physicians to individually assess their risks and potential benefits."

The researchers are aware of the study's limitations, for instance, the fact that surveys reporting alcohol intake may include measurement errors, as well as treatments of heart attacks having changed in the last two decades, and that the findings only relate to drinking in men, although they do not believe that these factors affect the result's validity.

Dr. Pai concluded:

"Our study was only among men, so we cannot extrapolate to women. However, in all other cases of alcohol and chronic disease, associations are similar except at lower quantities for women. Thus, an association is likely to be observed at 5-14.9g per day, or up to a drink a day for women."

Are diet sodas good or bad for you?


The jury is still out, but a new study sheds light on the impact that zero-calorie beverages may have on health, especially in the context of a person's overall dietary habits.

For the average person, the scientific evidence can seem confusing. A number of studies have implicated diet beverage consumption as a cause of cardiovascular disease. However, others have suggested such drinks may be a viable tactic for people who are trying to lose or control their weight.

Either way, most previous research has tended to focus either on people's drinking patterns and preferences, or their overall dietary habits -- in other words, most studies have failed to tease apart how those two aspects interact to affect people's health.

To address this problem, a new study from the University of North Carolina at Chapel Hill examined not only people's beverage consumption patterns but also the diets of those who consume diet and sugar-sweetened beverages. The findings appear in the April issue of the American Journal of Clinical Nutrition.

Kiyah Duffey, Ph.D., study author and research assistant professor of nutrition at the UNC Gillings School of Global Public Health, said that similar to previous studies, the new analysis found that people who consumed diet beverages tended to be less healthy than people who did not consume them.

"However, there was an important interplay between overall diet and what people drink," Duffey said. "It is important that people consider the entirety of their diet before they consider switching to or adding diet beverages, because without doing so they may not realize the health benefits they were hoping to see."

Researchers studied data collected over 20 years from more than 4,000 young adults who participated in the Coronary Artery Risk Development in Young Adults (CARDIA) study.

In terms of eating habits, participants fell into two groups: people who ate what researchers dubbed a "prudent" diet (one with more fruit, fish, whole grains, nuts and milk) and individuals who consumed a "western" diet (which had higher amounts of fast food, meat and poultry, pizza and snacks).

People who were healthiest tended to be those who ate a prudent diet and did not consume diet beverages. They had a lower risk of high waist circumference, high triglyceride levels and metabolic syndrome (22 percent, 28 percent and 36 percent lower, respectively, than people who ate a western diet and did not drink diet beverages). But the second healthiest group was individuals with a prudent diet who also consumed diet beverages.

In contrast, individuals who consumed the western diet had increased risk of heart disease, regardless of whether or not they drank diet beverages.

The UNC researchers found that many dietary factors contributed to a person's overall health. Without taking diet beverage consumption into account, people who ate the prudent diet had significantly better cholesterol and triglyceride profiles and significantly lower risks of hypertension and metabolic syndrome than those who ate the western diet.

Duffey added: "Our study confirms the recommendations of the American Diabetes Association and many weight-loss programs, which suggest people drink these beverages as a way to cut calories and lose or control weight, but only in the context of the whole diet."


Wednesday, March 28, 2012

Jon's Health Tips - Latest Health Research

Lots of interesting stuff in the last 3 weeks:

I'm ordering this today from Amazon (really, I am!)

Scientists today reported striking new evidence that green, or unroasted, coffee beans can produce a substantial decrease in body weight in a relatively short period of time. A group of overweight or obese people who consumed a fraction of an ounce of ground green coffee beans each day lost about 10 percent of their body weight. "Based on our results, taking multiple capsules of green coffee extract a day — while eating a low-fat, healthful diet and exercising regularly — appears to be a safe, effective, inexpensive way to lose weight," The low dose consisted of 700 mg of the coffee extract, and the high dose was 1,050 mg.

I am really, really trying to fight this:

Standing up more often may reduce your chances of dying within three years, even if you are already physically active, a study of more than 200,000 people published in Archives of Internal Medicine shows. The study found that adults who sat 11 or more hours per day had a 40% increased risk of dying in the next three years compared with those who sat for fewer than four hours a day. This was after taking into account their physical activity, weight and health status.

I need to spice up my diet (and my life):

Past research suggested that spicing food with chilies can lower blood pressure in people with that condition, reduce blood cholesterol and ease the tendency for dangerous blood clots to form. The new research has reinforced and expanded knowledge about how these substances in chilies work in improving heart health. They lower cholesterol levels by reducing accumulation of cholesterol in the body and increasing its breakdown and excretion in the feces. They also block action of a gene that makes arteries contract, restricting the flow of blood to the heart and other organs. The blocking action allows more blood to flow through blood vessels.In addition to reducing total cholesterol levels in the blood, capsaicinoids reduced levels of the so-called "bad" cholesterol (which deposits into blood vessels), but did not affect levels of so-called "good" cholesterol. The team found indications that capsaicinoids may reduce the size of deposits that already have formed in blood vessels, narrowing arteries in ways that can lead to heart attacks or strokes.

Does eating chocolate make you thinner or do only thin people eat chocolate?

More frequently eating chocolate appears related to lower BMI

I started doing this as soon as I read about it:

Do you really want to avoid cavities in your teeth? Try massaging them with a high-fluoride toothpaste after lunch. Rubbing toothpaste onto your teeth increases the fluoride protection by 400.

Another reason to try the above:

Dental plaque bacteria may trigger blood clots

Not too much soy, but I'm good on tea and peanuts:

Eating foods that contain isoflavones – a key compound in soy milk, tofu, green tea and even peanuts – every day may help young adults lower their blood pressure.

I eat raisins almost every day with oatmeal for breakfast, snack on apples, blueberries, strawberries, nuts and/or dark chocolate during the day, but went out and bought 2 bags of low-fat air-popped popcorn after reading the second article below for my evening snacking. (Now you know why I need green coffee bean extract).

Snacking on raisins a heart-healthy way to lower blood pressure

Popcorn's reputation as a snack food that's actually good for health popped up a few notches as scientists reported that it contains more of the healthful antioxidant substances called "polyphenols" than fruits and vegetables.

Six out of seven isn't bad:

In a study that included a nationally representative sample of nearly 45,000 adults, participants who met more of seven recommended cardiovascular health behaviors or factors had a lower risk of death compared to participants who met fewer factors, although only a low percentage of adults met all seven factors. The metrics are not smoking; being physically active; having normal blood pressure, blood glucose and total cholesterol levels, and weight; and eating a healthy diet. Only 1.2 percent met all 7.

I'm not as careful about this as I should be:

Lyme Disease Surge Predicted for Northeastern US

I need to clear my mind to think about this:

Meditation Strengthens the Brain

I'm in good shape on these:

Another benefit of alcohol, wine, coffee and fish (I'm now 4 for 4)

Sleeping too much or too little can be bad for your heart

White Rice Increases Risk of Type 2 Diabetes

Sugar-sweetened drinks= increased risk of heart disease in men

More red meat consumption= increased risk of death

Statins may prevent pneumonia

Statin use appears associated with modest reduction in Parkinson's disease risk

High-Fat Diets Increase Colon Cancer Risk

Light-to-moderate alcohol consumption=lower stroke risk

Moderate wine consumption improves lung function

Healthy Looking Skin Tone Linked To Fruit And Veg Consumption

Eating Berries Benefits the Brain

Exercise and caffeine change your muscle DNA

Vitamin D deficiency linked to higher mortality

Vitamin D may help clear amyloid plaques found in Alzheimer's

And finally, of no use to me personally: one of the many benefits of exercise:

Study: Exercise can lead to female orgasm, sexual pleasure

Mind Games Help Healthy Older People Too


Cognitive training including puzzles, handicrafts and life skills are known to reduce the risk, and help slow down the progress, of dementia amongst the elderly. A new study published in BioMed Central's open access journal BMC Medicine showed that cognitive training was able to improve reasoning, memory, language and hand eye co-ordination of healthy, older adults.

It is estimated that by 2050 the number of people over 65 years old will have increased to 1.1 billion worldwide, and that 37 million of these will suffer from dementia. Research has already shown that mental activity can reduce a person's risk of dementia but the effect of mental training on healthy people is less well understood. To address this researchers from China have investigated the use of cognitive training as a defence against mental decline for healthy older adults who live independently.

To be recruited onto the trial participants had to be between 65 and 75 years old, and have good enough eyesight, hearing, and communication skills, to be able to complete all parts of the training. The hour long training sessions occurred twice a week, for 12 weeks, and the subjects were provided with homework. Training included a multi-approach system tackling memory, reasoning, problem solving, map reading, handicrafts, health education and exercise, or focusing on reasoning only. The effect of booster training, provided six months later, was also tested.

The results of the study were positive. Profs Chunbo Li and Wenyuan Wu who led the research explained, "Compared to the control group, who received no training, both levels of cognitive training improved mental ability, although the multifaceted training had more of a long term effect. The more detailed training also improved memory, even when measured a year later and booster training had an additional improvement on mental ability scores."

This study shows that cognitive training therapy may prevent mental decline amongst healthy older people and help them to continue independent living longer in their advancing years.


Stand Up: Your Life Could Depend On It


Standing up more often may reduce your chances of dying within three years, even if you are already physically active, a study of more than 200,000 people published in Archives of Internal Medicine shows. The study found that adults who sat 11 or more hours per day had a 40% increased risk of dying in the next three years compared with those who sat for fewer than four hours a day. This was after taking into account their physical activity, weight and health status.

"These results have important public health implications," said study lead author Dr Hidde van der Ploeg, a senior research fellow at the University of Sydney's School of Public Health. "That morning walk or trip to the gym is still necessary, but it's also important to avoid prolonged sitting. Our results suggest the time people spend sitting at home, work and in traffic should be reduced by standing or walking more."

The results are the first landmark findings to be published from the Sax Institute's 45 and Up Study, the largest ongoing study of healthy aging in the Southern Hemisphere. They showed physical activity is still beneficial: inactive people who sat the most had double the risk of dying within three years than the active people who sat least. And among the physically inactive group, those who sat the most had nearly one-third higher chance of dying than those who sat least.

The study's size and focus on total sitting time make it an important contributor to the growing evidence on the downsides of prolonged sitting. The average adult spends 90% of their leisure time sitting down and less than half of adults meet World Health Organization physical activity recommendations.

An accompanying editorial in the journal said the evidence was strong enough to support doctors prescribing "reduced daily sitting time" to their patients. The research was commissioned by the Cardiovascular Research Network and supported by the NSW Division of the National Heart Foundation Australia. It is one of more than 60 projects underway using data from the 45 and Up Study, Australia's richest information source about the health and lifestyles of people 45 and over.

Heart Foundation NSW CEO Tony Thirlwell said being inactive greatly increased a person's risk of heart disease, which is the number one killer of Australian men and women. "Watching TV, using computers and electronic games can involve sitting for long periods and have become a big part of leisure time," he said. "But we know that people who spend less time on these things have better health than those who spend too much time on them."

A major five-year follow-up of 45 and Up study participants has just begun and will ask 265,000 men and women more about their health, lifestyle, and the medications and health services they use. Such large-scale research will help governments face the challenges of an aging population.


Hot Pepper Compound Could Help Hearts


The food that inspires wariness is on course for inspiring even more wonder from a medical standpoint as scientists have reported the latest evidence that chili peppers are a heart-healthy food with potential to protect against the No. 1 cause of death in the developed world. The report was part of the 243rd National Meeting and Exposition of the American Chemical Society (ACS), being held in San Diego the week of March 26.

The study focused on capsaicin and its fiery-hot relatives, a piquant family of substances termed "capsaicinoids." The stuff that gives cayennes, jalapenos, habaneros and other chili peppers their heat, capsaicin already has an established role in medicine in rub-on-the-skin creams to treat arthritis and certain forms of pain. Past research suggested that spicing food with chilies can lower blood pressure in people with that condition, reduce blood cholesterol and ease the tendency for dangerous blood clots to form.

"Our research has reinforced and expanded knowledge about how these substances in chilies work in improving heart health," said Zhen-Yu Chen, Ph.D., who presented the study. "We now have a clearer and more detailed portrait of their innermost effects on genes and other mechanisms that influence cholesterol and the health of blood vessels. It is among the first research to provide that information."

The team found, for instance, that capsaicin and a close chemical relative boost heart health in two ways. They lower cholesterol levels by reducing accumulation of cholesterol in the body and increasing its breakdown and excretion in the feces. They also block action of a gene that makes arteries contract, restricting the flow of blood to the heart and other organs. The blocking action allows more blood to flow through blood vessels.

"We concluded that capsaicinoids were beneficial in improving a range of factors related to heart and blood vessel health," said Chen, a professor of food and nutritional science at the Chinese University of Hong Kong. "But we certainly do not recommend that people start consuming chilies to an excess. A good diet is a matter of balance. And remember, chilies are no substitute for the prescription medications proven to be beneficial. They may be a nice supplement, however, for people who find the hot flavor pleasant."

Chen and his colleagues turned to hamsters for the study, animals that serve as stand-ins for humans in research that cannot be done in people. They gave the hamsters high-cholesterol diets, divided them into groups, and supplemented each group's food with either no capsaicinoids (the control group) or various amounts of capsaicinoids. The scientists then analyzed the effects.

In addition to reducing total cholesterol levels in the blood, capsaicinoids reduced levels of the so-called "bad" cholesterol (which deposits into blood vessels), but did not affect levels of so-called "good" cholesterol. The team found indications that capsaicinoids may reduce the size of deposits that already have formed in blood vessels, narrowing arteries in ways that can lead to heart attacks or strokes.

Capsaicinoids also blocked the activity of a gene that produces cyclooxygenase-2, a substance that makes the muscles around blood vessels constrict. By blocking it, muscles can relax and widen, allowing more blood to flow.


Tuesday, March 27, 2012

New evidence on effects of green coffee beans in weight loss


Scientists today reported striking new evidence that green, or unroasted, coffee beans can produce a substantial decrease in body weight in a relatively short period of time.

In a study presented at the 243rd National Meeting & Exposition of the American Chemical Society (ACS), the world's largest scientific society, Joe Vinson, Ph.D., and colleagues described how a group of overweight or obese people who consumed a fraction of an ounce of ground green coffee beans each day lost about 10 percent of their body weight.

"Based on our results, taking multiple capsules of green coffee extract a day — while eating a low-fat, healthful diet and exercising regularly — appears to be a safe, effective, inexpensive way to lose weight," Vinson said at the ACS meeting, being held here this week. He is with the University of Scranton in Pennsylvania.

The study involved 16 overweight or obese people aged 22-26 years who took capsules of the extract or capsules containing a placebo, an inactive powder, for a total of 22 weeks. The subjects alternated between a low dose and a higher dose of the extract. The low dose consisted of 700 mg of the coffee extract, and the high dose was 1,050 mg. It was a so-called "cross-over" study in which people cycled through the two doses and the placebo, each for six weeks. Such studies have advantages because each person serves as his or her own "control," improving the chances of getting an accurate result.

All of the participants were monitored for their overall diet (calories, food eaten, etc.) and exercise over the study period. "Their calories, carbohydrates, fats and protein intake did not change during the study, nor did their exercise regimen change," Vinson said.

Participants lost an average of 17 pounds during the 22 weeks of the study. It included an average of a 10.5 percent decrease in overall body weight and a 16 percent decrease in body fat. Vinson noted that weight loss might have been significantly faster, except that participants received the placebo and the lower dose of green coffee extract for part of the study period.

Vinson pointed out that previous studies have shown weight loss with green coffee. But this was the first to use higher amounts of the coffee extract and the first to measure the response to various doses. Based on those studies, Vinson believes that green coffee beans' effects likely are due to a substance called chlorogenic acid that is present in unroasted coffee beans. Chlorogenic acid breaks down when coffee beans are roasted (usually at a temperature of 464-482 degrees Fahrenheit). Roasting gives coffee beans their distinctive color, aroma and flavor. Green coffee beans, in contrast, have little aroma and a slightly bitter taste.


More frequently eating chocolate appears related to lower BMI


More frequently eating chocolate was linked to lower body mass index (BMI), according to a research letter in the March 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Consumption of certain types of chocolate has been linked to some favorable metabolic associations with blood pressure, insulin sensitivity and cholesterol level. However, because chocolate can be a calorie-laden sweet there are concerns about eating it.

Beatrice A. Golomb, M.D., Ph.D., and colleagues with the University of California, San Diego, studied 1,018 men and woman without known cardiovascular disease, diabetes or extremes of low-density lipoprotein cholesterol (LDL-C) levels who were screened for participation in a clinical study examining noncardiac effects of statins. To measure chocolate consumption, 1,017 of the participants answered a question about how many times per week they ate chocolate. BMI was calculated for 972 of them. Of the participants, 975 completed a food frequency questionnaire.

“Adults who consumed chocolate more frequently had a lower BMI than those who consumed chocolate less often,” the authors note.

Participants had a mean (average) age of 57 years, 68 percent were men and the mean BMI was 28. They ate chocolate a mean (average) of two times a week and exercised 3.6 times a week.

“In conclusion, our findings – that more frequent chocolate intake is linked to lower BMI – are intriguing,” the authors conclude. “A randomized trial of chocolate for metabolic benefits in humans may be merited.”


Monday, March 26, 2012

New 'massage method' quadruples protection against tooth decay


Do you really want to avoid cavities in your teeth? Try massaging them with a high-fluoride toothpaste after lunch. "Rubbing toothpaste onto your teeth increases the fluoride protection by 400%," says Anna Nordström, dentist, PhD and researcher at the Sahlgrenska Academy at the University of Gothenburg, Sweden.

Eight years ago a new brand of toothpaste was launched in Sweden with more than three times as much fluoride as standard toothpaste. Available without prescription, it is aimed primarily at those with high caries risk.

First scientific evaluation

Researchers at the University of Gothenburg's Sahlgrenska Academy have now performed the first scientific evaluation of the effect of this so called "high-fluoride toothpaste". The study has resulted in a new method that quadruples the level of protection from fluoride.

Four times better protection

In the study, 16 volunteers tested a variety of brushing techniques, using either high-fluoride or standard toothpaste, and brushing either two or three times a day. "The study revealed that those who used a high-fluoride toothpaste three times a day had four times better fluoride protection in the mouth than those who used standard toothpaste twice a day," says researcher Anna Nordström from the Institute of Odontology at the Sahlgrenska Academy.

Rub your teeth after lunch

Also tested was a new method developed in collaboration with professor Dowen Birkhed, which involves rubbing toothpaste onto your teeth with a finger. "This 'massage' method proved to be at least as effective as a third brushing in increasing the amount of fluoride in the mouth," Anna Nordström explains. "Rubbing the front of your teeth with toothpaste can be an easy way of giving your teeth a third "shot" of fluoride during the day, after lunch for example. But this should not replace brushing with a fluoride toothpaste morning and evening – it's an extra."

Daily use is essential

Brushing with fluoride toothpaste has played – and continues to play – a major role in combating tooth decay, and there is strong scientific evidence that daily use of fluoride toothpaste has a pronounced preventive effect.


Dental plaque bacteria may trigger blood clots


Oral bacteria that escape into the bloodstream are able to cause blood clots and trigger life-threatening endocarditis. Further research could lead to new drugs to tackle infective heart disease, say scientists presenting their work at the Society for General Microbiology's Spring Conference in Dublin this week.

Streptococcus gordonii is a normal inhabitant of the mouth and contributes to plaque that forms on the surface of teeth. If these bacteria enter into the blood stream through bleeding gums they can start to wreak havoc by masquerading as human proteins.

Researchers from the Royal College of Surgeons in Ireland (RCSI) and the University of Bristol have discovered that S. gordonii is able to produce a molecule on its surface that lets it mimic the human protein fibrinogen – a blood-clotting factor. This activates the platelets, causing them to clump inside blood vessels. These unwanted blood clots encase the bacteria, protecting them from the immune system and from antibiotics that might be used to treat infection. Platelet clumping can lead to growths on the heart valves (endocarditis), or inflammation of blood vessels that can block the blood supply to the heart or brain.

Dr Helen Petersen who is presenting the work said that better understanding of the relationship between bacteria and platelets could ultimately lead to new treatments for infective endocarditis. "In the development of infective endocarditis, a crucial step is the bacteria sticking to the heart valve and then activating platelets to form a clot. We are now looking at the mechanism behind this sequence of events in the hope that we can develop new drugs which are needed to prevent blood clots and also infective endocarditis," she said.

Infective endocarditis is treated with surgery or by strong antibiotics – which is becoming more difficult with growing antibiotic resistance. "About 30% of people with infective endocarditis die and most will require surgery for replacement of the infected heart valve with a metal or animal valve," said Dr Petersen. "Our team has now identified the critical components of the S. gordonii molecule that mimics fibrinogen, so we are getting closer to being able to design new compounds to inhibit it. This would prevent the stimulation of unwanted blood clots," said Dr Steve Kerrigan from the RCSI.

The team are also looking more widely at other dental plaque bacteria that may have similar effects to S. gordonii. "We are also trying to determine how widespread this phenomenon is by studying other bacteria related to S. gordonii. What our work clearly shows is how important it is to keep your mouth healthy through regular brushing and flossing, to keep these bacteria in check," stressed Dr Petersen.


Low LDL cholesterol is related to cancer risk


Research finds low LDL cholesterol levels present in cancer patients many years prior to diagnosis

Low LDL cholesterol in patients with no history of taking cholesterol-lowering drugs predates cancer risk by decades, suggesting there may be some underlying mechanism affecting both cancer and low LDL cholesterol that requires further examination, according to research presented today at the American College of Cardiology's 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field.

While scientific evidence supports the benefits of lowering low-density lipoprotein cholesterol (LDL-C) to help prevent heart disease, previous studies of cholesterol-lowering drugs have suggested a strong association between low levels of LDL-C and cancer risk. This is the first study to examine the relationship of low LDL-C and cancer risk over an extended period of time only in patients with no history of taking cholesterol-lowering drugs.

"There has been some debate as to whether or not medications used to lower cholesterol may contribute to cancer, but the evidence so far tells us that the drugs themselves do not increase the risk of cancer. We wanted to take those medications out of the equation and just look at the link between cancer and low LDL-cholesterol itself in people who had never taken statins or other cholesterol-lowering drugs," said Paul Michael Lavigne, MD, resident, Tufts Medical Center and the study's lead investigator.

In a matched case control study, researchers used data from the Framingham Heart Study Offspring Cohort to assess the trend of low LDL-C for an extended period of time prior to cancer diagnosis. They compared 201 cancer cases and 402 control cases that were cancer-free. Cases were matched on factors including age, gender, diabetes, tobacco use, blood pressure and body mass index. All subjects had no history of using cholesterol-lowering drugs.

Researchers reviewed data at four points in time prior to cancer diagnosis and found that LDL cholesterol values were lower in cancer subjects than matched controls at each point of assessment throughout an average of 18.7 years prior to diagnosis (p = .038). The trend for lower LDL-C in cancer patients compared with those who were cancer-free was consistent throughout the duration of the study (p = .968 for differences between time points). These findings did not change when controlling for high-density lipoprotein (HDL) cholesterol levels.

Dr. Lavigne cautions the current study does not suggest that having low LDL-C somehow leads to the development of cancer. He recommended that patients diagnosed with high LDL-C should adhere to cholesterol-lowering guidelines, including the use of medications, to prevent heart disease.

"There is no evidence to indicate that lowering your cholesterol with a medication in any way predisposes to a risk for cancer. We suspect there may be some underlying mechanism affecting both cancer and low LDL-C, but we can only say definitively that the relationship between the two exists for many years prior to cancer diagnosis, and therefore underscores the need for further examination," Dr. Lavigne said.


Compound in soy products may help lower blood pressure


Soy-based food products have taken grocery store shelves by storm, and the benefits of soy are steadily beginning to emerge. Eating foods that contain isoflavones – a key compound in soy milk, tofu, green tea and even peanuts – every day may help young adults lower their blood pressure. Moreover, and for the first time, there appears to be a particular benefit for African Americans, who have hypertension prevalence rates near 42 percent, according to research presented today at the American College of Cardiology's 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field.

"What's unique about this study is that the results are very applicable to the general population. Our results strongly suggest a blood pressure benefit for moderate amounts of dietary isoflavone intake in young black and white adults," said Safiya Richardson, a graduating medical student at Columbia University's College of Physicians and Surgeons and the study's lead investigator. "Our study is the first to show a benefit in African Americans, who have a higher incidence of high blood pressure, with an earlier onset and more severe end-organ damage."

Compared to those consuming less than 0.33 mg of isoflavones per day, those reporting the most isoflavone intake (more than 2.5 mg per day) had a significantly lower systolic blood pressure (𔃃.5 mmHg lower on average). To help put this into context, an 8 ounce glass of soy milk has about 22 mg of isoflavones, and 100 g of roasted soybeans have as much as 130 mg.

"This could mean that consuming soy protein, for example, in combination with a DASH diet – one that is high in fruits and vegetables, low-fat dairy and whole grains – could lead to as much as a 10 mmHg drop in systolic blood pressure for pre-hypertensives, greatly improving their chances of not progressing to hypertension," said Richardson. "Any dietary or lifestyle modification people can easily make that doesn't require a daily medication is exciting, especially considering recent figures estimating that only about one third of American hypertensives have their blood pressure under control."

Isoflavones are thought to work by increasing the production of enzymes that create nitric oxide (NO), a substance that helps to dilate or widen blood vessels, thereby reducing the pressure created by blood against the vessel walls. Richardson said this mechanism may partially explain why the study was able to find an association with smaller amounts of isoflavone intake than examined previously. The relatively pronounced results in the overall biracial cohort may be driven by a more intense effect of isoflavones in African Americans, Richardson said. This is because endothelial dysfunction, a condition in which the blood vessels have a hard time either producing or using NO, plays a bigger role in hypertension in African Americans than it does in whites.

"It's possible that these foods may help compensate for this," she said. "Based on our results and those of previous studies, we would encourage the average adult to consider including moderate amounts of soy products in a healthy, well-balanced diet to reduce the chances of developing high blood pressure. For people with hypertension, it's important that they talk with their doctor about isoflavones as a possible addition to a low sodium DASH diet that could reduce the need for medication."

Richardson added that different soy products have different concentrations of isoflavones, so it is important for consumers to do their homework.

Researchers analyzed data from year-20 of the Coronary Artery Risk Development in Young Adults (CARDIA) study, which is an NIH-funded study created to examine the development and determinants of cardiovascular disease. This study began in 1985 with 5,115 African American and white Americans aged 18-30 years old who have been followed and reexamined at various intervals. Year-20 was the first year that participants completed an extensive dietary survey. Multivariable linear regression models evaluated the relation between daily isoflavone intake and systolic BP (SBP) after dividing patients across quartiles according to self-reported isoflavone intake. Even after controlling for age, sex, BMI, smoking, alcohol, physical activity and total caloric intake, the relationship between daily isoflavones and lower systolic blood pressure remained.


Sleeping too much or too little can be bad for your heart

Large population survey reveals strong association between sleep duration and cardiovascular outcomes; Researchers urge doctors and patients to talk about sleep

Getting too little sleep – or even too much – appears to spell trouble for the heart. New data reveal that adults who get less than six hours of sleep a night are at significantly greater risk of stroke, heart attack and congestive heart failure. Even those who reportedly sleep more than eight hours a night have a higher prevalence of heart problems, namely chest pain (angina) and coronary artery disease, a narrowing of the blood vessels that supply blood and oxygen to the heart, according to research presented today at the American College of Cardiology's 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field.

While these findings echo those from previous, smaller studies, investigators say this is the first nationally representative sample to find an association between sleep duration and heart health, and the first to look at five different conditions at one time. Researchers retrospectively studied approximately 3,019 patients over the age of 45 years who participated in the National Health and Nutrition Examination Survey (NHANES), a survey of U.S. households that assessed a broad range of health issues. Analyses showed that people getting too little sleep were two times more likely to have a stroke or heart attack and 1.6 times more likely to have congestive heart failure. Those reporting more than eight hours of sleep a night were two times more likely to have angina and 1.1 times more likely to have coronary artery disease.

"We now have an indication that sleep can impact heart health, and it should be a priority," said Rohit R. Arora, MD, FACC, chairman of cardiology and professor of medicine, the Chicago Medical School, and the study's principal investigator. "Based on these findings, it seems getting six to eight hours of sleep everyday probably confers the least risk for cardiovascular disease over the long term."

Insufficient sleep has previously been linked to the hyper-activation of the sympathetic nervous system, glucose intolerance, diabetes and an increase in cortisone levels, blood pressure, resting heart rate and inflammatory markers – all of which are associated with cardiovascular disease. However, researchers are still unclear as to why longer sleep duration might be linked to heart problems.

Dr. Arora speculates that the people sleeping more than eight hours, who report chest pains to their doctor, may have been given a greater clinical workup than people getting less than six hours of sleep, who are not presenting chest pains, which may explain why there are more significant cardiovascular events in this group; however, this needs to be evaluated in future long-term studies. In addition, unknown factors not yet elucidated and other co-morbid conditions like diabetes mellitus, obesity or hypertension may cause higher risk in those sleeping under six hours.

What is clear, according to Dr. Arora, is the need for clinicians and patients to talk about sleep patterns.

"Clinicians need to start asking patients about sleep, especially with those who are already at greater risk for heart disease," he said. "It's a really simple thing to assess as part of a physical exam, it doesn't cost anything and it may help encourage patients to adopt better sleep habits."

Respondents were asked about sleep duration and subsequently stratified into one of three categories: 1) less than six hours of sleep a night, 2) between six and eight hours of sleep a night, 3) over eight hours of sleep a night. Each patient was also asked if they were ever told they had congestive heart failure, heart attack, coronary artery disease, angina or stroke. Analyses adjusted for covariates such as age, gender, total cholesterol, high-density lipoprotein, systolic blood pressure, smoking status, diabetes mellitus and body mass index. Investigators also controlled for sleep apnea and other sleep disturbances that have previously been linked to heart problems.

Dr. Arora says larger prospective studies are needed to confirm these findings and, if proven, to determine whether asking about sleep patterns presents a cost-effective way to further screen and identify patients who may be at high risk for heart disease.


Snacking on raisins a heart-healthy way to lower blood pressure


Small randomized controlled trial is first to put this potassium-rich fruit to the test

If you have slightly higher than normal blood pressure – known as prehypertension – consider eating a handful of raisins. New data suggest that, among individuals with mild increases in blood pressure, the routine consumption of raisins (three times a day) may significantly lower blood pressure, especially when compared to eating other common snacks, according to research presented today at the American College of Cardiology's 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field.

Even though raisins are popularly cited to lower blood pressure on various websites and are known to have intrinsic properties that could benefit heart and vascular health, researchers believe this is the first controlled study to scientifically support raisins' blood pressure-lowering effects compared to alternative snacks.

"It is often stated as a known fact that raisins lower blood pressure. But we could not find much objective evidence in the medical literature to support such a claim," said Harold Bays, MD, medical director and president of Louisville Metabolic and Atherosclerosis Research Center (L-MARC) and the study's lead investigator. "However, our study suggests if you have a choice between eating raisins or other snacks like crackers and chocolate chip cookies, you may be better off snacking on raisins at least with respect to blood pressure."

In this investigation, Dr. Bays and his team conducted a randomized controlled clinical trial to compare the blood pressure effect of eating raisins versus other snacks in 46 men and women with prehypertension. Participants were randomly assigned to snack on raisins or prepackaged commercial snacks that did not contain raisins, other fruits or vegetables but had the same number of calories per serving three times a day for 12 weeks. The study controlled for individual differences in nutrition and physical activity.

Data analyses found that compared to other snacks, raisins significantly reduced systolic blood pressure at weeks 4, 8, and 12, ranging from -4.8 to -7.2% or -6.0 to -10.2 mmHg (p values <0.05). Within group analysis demonstrated that raisins significantly reduced mean diastolic blood pressure at all study visits, with changes ranging from -2.4 to - 5.2 mmHg (p values < 0.05). Pre-packaged snacks (including crackers and cookies) did not significantly reduce systolic or diastolic blood pressure at any study visit.

"Overall, these findings support what many people intrinsically believe: that natural foods often have greater health benefits than processed foods," Dr. Bays said.

The study did not identify how raisins lower blood pressure. However, raisins are high in potassium, and have fiber, polyphenols, phenolic acid, tannins and antioxidants.

"Raisins are packed with potassium, which is known to lower blood pressure," Dr. Bays said. "They are also a good source of antioxidant dietary fiber that may favorably alter the biochemistry of blood vessels, causing them to be less stiff, which in turn, may reduce blood pressure."

Although this study was not designed or powered to evaluate for outcomes benefits, other studies support that in patients with prehypertension, mild lowering of blood pressure with medications may have clinical benefits in reducing cardiovascular events.

According to the Centers for Disease Control and Prevention, nearly one in three (28 percent) American adults have prehypertension – defined as a systolic pressure from 120 to 139 millimeters of mercury (mm Hg) or a diastolic pressure from 80 to 89 mm Hg. This study's findings help validate some current nutritional recommendations. For example, 60 raisins – about a handful – contain 1 gram of fiber and 212 milligrams of potassium, which are both recommended in the Dietary Approaches to Stop Hypertension (DASH) diet.

Dr. Bays cautions that this was a single site study; larger trials are needed to confirm the blood pressure-regulating effect of raisins. Nonetheless, he says work in this area is particularly exciting because applying similar scientific methods to natural products, as required for drug development, provides consumers with objective data about which foods may or may not benefit heart health.


Aspirin: High or Low Dose? No significant difference.


Researchers report no significant difference in high versus low dose aspirin in preventing recurring cardiovascular events.

Each year, more than one million Americans suffer a heart attack and nearly all patients are prescribed a daily aspirin and an antiplatelet medication during recovery. However, the optimal aspirin dose has been unclear. Now, new research from Brigham and Women's Hospital (BWH) reports that there is no significant difference between high versus low dose aspirin in the prevention of recurring cardiovascular events in patients who suffer from acute coronary syndromes (ACS), which are characterized by symptoms related to obstruction in coronary arteries, which supply blood to the heart. These findings are presented at the American College of Cardiology Scientific Sessions on March 24, 2012.

"We observed no difference between patients taking a high dose versus a low of aspirin as it relates to cardiovascular death, heart attack, stroke or stent thrombosis," said Payal Kohli, MD,cardiology fellow at BWH and researcher in the TIMI Study Group, who is the lead author on this study. "Interestingly, we did find a dramatic difference in practice patterns of physicians in North America compared to those in the rest of the world," Kohli said. "North American physicians prescribed a high dose of aspirin for two-thirds of all their patients, while the exact reverse was true of the rest of the world. International physicians prescribed a low dose of aspirin to more than two-thirds of their patients." Dr. Stephen D. Wiviott, a cardiologist at BWH and researcher in the TIMI Study Group, is the senior author on the study.

Researchers analyzed data from more than 11000 patients from around the world that were enrolled in the TRITON-TIMI 38 trial, which randomized ACS patients to receive either clopidigrel or prasugrel, two different antiplatelet medications. Some patients were prescribed high doses of aspirin following a heart attack, while others, low doses. The aspirin dose was prescribed at the clinician investigator's discretion and the analysis included 7,106 patients who received low dose aspirin, defined as 150 mg or less, and 4,610 patients who received high dose aspirin, defined as 150 mg or more. Researchers reported that there was no significant difference observed in the prevention of the combination of heart attack, stroke, cardiovascular death or the prevention of stent thrombosis between the groups that received high or low dose aspirin. Prasugrel was more effective at preventing major adverse cardiovascular events than clopidogrel, regardless of whether patients received low or high dose aspirin.

Researchers also present that patients who received high dose aspirin were more likely to have more cardiac risk factors and have higher cholesterol. Patients who received low dose aspirin were more likely to be white and have no prior history of high blood pressure.

The authors caution that because this is not a randomized study, there may be other treatment differences that could have affected the results and a randomized controlled trial would be needed to definitively establish that no difference existed in outcomes between aspirin dose regimens. These data are, however, consistent with previous reports.


Lowering LDL, the earlier the better


New research shows 3-fold reduction in the risk of coronary heart disease through earlier intervention

Coronary atherosclerosis – a hardening of the arteries due to a build-up of fat and cholesterol – can lead to heart attacks and other forms of coronary heart disease (CHD). Lowering low-density lipoprotein (LDL), or "bad" cholesterol, reduces the risk of CHD, and researchers found that lowering LDL beginning early in life resulted in a three-fold greater reduction in the risk of CHD than treatment with a statin started later in life, according to research presented today at the American College of Cardiology's 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field.

By the time most people begin treatment to lower LDL, CHD has often been quietly developing for decades. Because coronary atherosclerosis begins early in life, lowering LDL at a younger age may produce even greater reductions in the risk of CHD. Researchers sought to test this hypothesis by using genetic data to conduct a series of "natural" randomized controlled trials involving over one million study participants.

"Our study shows that the benefit of lowering LDL cholesterol depends on both the timing and the magnitude of LDL reduction," said Brian A. Ference, MD, MPhil, MSc, FACC, director of the cardiovascular genomic research center at Wayne State University School of Medicine and the study's principal investigator. "The increased benefit of lowering LDL beginning early in life appeared to be independent of how LDL was lowered. This means that diet and exercise are probably as effective as statins or other medications at reducing the risk of CHD when started early in life."

Lowering LDL cholesterol at an early age, before the development of atherosclerosis, would understandably be more effective at reducing heart attacks, but testing this hypothesis has proven difficult. A conventional randomized trial would have to follow a very large number of young, asymptomatic people for several decades to test this hypothesis. As an alternative, researchers used a novel study design called a Mendelian randomized controlled trial (mRCT) to study the effect of nine single-nucleotide polymorphisms (SNPs), or single-letter changes in DNA sequence, each of which is associated with lower levels of LDL cholesterol. Because each of these SNPs is allocated randomly at the time of conception, inheriting one of these SNPs is like being randomly allocated to a treatment that lowers LDL cholesterol beginning at birth. The researchers found that all nine SNPs were associated with a consistent 50-60 percent reduction in the risk of CHD for each 1 mmol/L (38.67 mg/dl) lower lifetime exposure to LDL cholesterol. Lowering LDL by 2 mmol/L (77.34 mg/dl) could reduce the risk of CHD by almost 80 percent.

"The results of our study demonstrate that the clinical benefit of lowering LDL can be substantially improved by initiating therapies to lower LDL cholesterol beginning early in life," Dr. Ference said.

Coronary heart disease is the most common cause of death and disability throughout the world. Treatment of CHD and its risk factors is costly and consumes a large proportion of health care expenditures. Dr. Ference believes that the results of this study suggest that focusing on prolonged and sustained reductions in LDL cholesterol beginning early in life has the potential to substantially reduce the global burden of CHD.


Popcorn: Higher Antioxidant Levels Than Fruits And Vegetables


Popcorn's reputation as a snack food that's actually good for health popped up a few notches as scientists reported that it contains more of the healthful antioxidant substances called "polyphenols" than fruits and vegetables. They spoke at the 243rd National Meeting & Exposition of the American Chemical Society (ACS), the world's largest scientific society.

Joe Vinson, Ph.D., a pioneer in analyzing healthful components in chocolate, nuts and other common foods, explained that the polyphenols are more concentrated in popcorn, which averages only about 4 percent water, while polyphenols are diluted in the 90 percent water that makes up many fruits and vegetables.

In another surprising finding, the researchers discovered that the hulls of the popcorn - the part that everyone hates for its tendency to get caught in the teeth - actually has the highest concentration of polyphenols and fiber.

"Those hulls deserve more respect," said Vinson, who is with the University of Scranton in Pennsylvania. "They are nutritional gold nuggets."

The overall findings led Vinson to declare, "Popcorn may be the perfect snack food. It's the only snack that is 100 percent unprocessed whole grain. All other grains are processed and diluted with other ingredients, and although cereals are called "whole grain," this simply means that over 51 percent of the weight of the product is whole grain. One serving of popcorn will provide more than 70 percent of the daily intake of whole grain. The average person only gets about half a serving of whole grains a day, and popcorn could fill that gap in a very pleasant way."

Vinson cautioned, however, that the way people prepare and serve popcorn can quickly put a dent in its healthful image. Cook it in a potful of oil, slather on butter or the fake butter used in many movie theaters, pour on the salt; eat it as "kettle corn" cooked in oil and sugar - and popcorn can become a nutritional nightmare loaded with fat and calories.

"Air-popped popcorn has the lowest number of calories, of course," Vinson said. "Microwave popcorn has twice as many calories as air-popped, and if you pop your own with oil, this has twice as many calories as air-popped popcorn. About 43 percent of microwave popcorn is fat, compared to 28 percent if you pop the corn in oil yourself."

Likewise, Vinson pointed out that popcorn cannot replace fresh fruits and vegetables in a healthy diet. Fruits and vegetables contain vitamins and other nutrients that are critical for good health, but are missing from popcorn.

Vinson explained that the same concentration principle applies to dried fruit versus regular fruit, giving dried fruit a polyphenol edge. Previous studies found low concentrations of free polyphenols in popcorn, but Vinson's team did the first study to calculate total polyphenols in popcorn. The amounts of these antioxidants were much higher than previously believed, he said. The levels of polyphenols rivaled those in nuts and were up to 15 times greater than whole-grain tortilla chips.

The new study found that the amount of polyphenols found in popcorn was up to 300 mg a serving compared to 114 mg for a serving of sweet corn and 160 mg for all fruits per serving. In addition, one serving of popcorn would provide 13 percent of an average intake of polyphenols a day per person in the U.S. Fruits provide 255 mg per day of polyphenols and vegetables provide 218 mg per day to the average U.S. diet.


Tuesday, March 20, 2012

Taking vitamin E does not impact women's heart failure risk


Taking vitamin E supplements does not increase or decrease heart failure risk among women, according to a study in Circulation: Heart Failure, an American Heart Association journal.

The study is the first to investigate the effectiveness of vitamin E to prevent the development of heart failure. Researchers studied nearly 40,000 women in the Women's Health Study who took 600 International Units of vitamin E or placebo every other day. The women were age 45 or older and healthy at the study's start. Researchers followed them for an average 10.2 years to determine if taking the supplement affected heart failure risk. Investigators recorded 220 heart failure cases.

Overall, researchers found no impact from vitamin E supplementation.

They did, however, observe a 41 percent decrease in the risk of developing a type of heart failure in which the heart retains its normal pumping function. This sub finding is only an observation and topic for future research, said Claudia U. Chae, M.D., M.P.H, lead researcher in the cardiology division at Massachusetts General Hospital in Boston.

They conclude: vitamin E does not prevent heart failure. Prevention strategies should instead focus on what has been shown in research to reduce heart failure risk, such as controlling blood pressure and preventing heart disease.

More than six million American adults suffer from heart failure, a chronic, progressive condition in which the heart muscle is unable to pump enough blood to meet the body's blood and oxygen needs.


Ibuprofen decreases likelihood of altitude sickness


"A really nasty hangover" is how Grant Lipman, MD, describes the feeling of acute mountain sickness, and for good reason: Symptoms can include headache, fatigue, dizziness, nausea, vomiting and poor appetite.

More than 25 percent of the millions of Americans who travel to high elevations each year, often to hike, camp or ski, will suffer from this condition, also known as altitude illness. But a new study led by Lipman, an emergency medicine physician at Stanford Hospital & Clinics and a clinical assistant professor at the Stanford University School of Medicine, has found that a widely available, over-the-counter drug may help.

Ibuprofen, an anti-inflammatory medication often used as a painkiller, was found to significantly reduce the incidence of altitude sickness in a double-blind, placebo-controlled trial of 86 men and women, according to the study, which will be published online March 20 in Annals of Emergency Medicine.

The findings could prove especially useful for recreationists who have weeklong vacations planned at high altitudes. "You don't want to feel horrible for 15 to 20 percent of your vacation," Lipman said. "Ibuprofen could be a way to prevent AMS in a significant number of the tens of millions of people who travel to high altitudes each year."

Acute mountain sickness can do more than just make life miserable: If left unrecognized or untreated, it can lead to high-altitude cerebral edema, an often-fatal swelling of the brain.

For the study, 58 men and 28 women traveled to an area of the White Mountains northeast of Bishop, Calif. They spent the night at 4,100 feet and were given either 600 milligrams of ibuprofen or a placebo at 8 a.m., before heading up the mountain to a staging area at 11,700 feet. There, they were given a second dose at 2 p.m. Then they hiked about 3 miles up to 12,570 feet, where they received a third dose at 8 p.m. before spending the night on the mountain.

Of the 44 participants who received ibuprofen, 19 (43 percent) suffered symptoms of altitude sickness, whereas 29 of the 42 participants (69 percent) receiving placebo had symptoms, according to the study. In other words, ibuprofen reduced the incidence of the illness by 26 percent.

The researchers also observed less severe symptoms overall in those who took the drug compared with those in the placebo group, but the reduction in severity was not statistically significant, based on the self-reporting questionnaire that was used.

At high altitudes, decreased atmospheric pressure means that each breath you take contains fewer oxygen molecules. However, the exact physiological mechanisms that lead to acute mountain sickness are not clearly understood. Some researchers think the condition occurs because a lack of oxygen to the brain causes it to swell with fluids. Ibuprofen may help to reduce that swelling.

Other medications are available to prevent mountain sickness — specifically, acetazolamide and dexamethasone — but they have downsides. "The safety profile of ibuprofen makes it more attractive then dexamethasone, which has been associated with hyperglycemia, adrenal suppression, delirium, depression, insomnia and mania," the authors note. "Acetazolamide's adverse effects of nausea, dizziness and fatigue are usually well-tolerated but can be as debilitating as acute mountain sickness."

They add: "We suggest that availability alone makes ibuprofen an appealing drug for individuals who travel to high altitudes. In addition, ibuprofen was effective when taken six hours before ascent, in contrast to acetazolamide, whose recommendations include that it be started the day before travel to high altitude."

The authors say that taking more than 600 mg of ibuprofen might "provide more robust prevention" but that the theoretical benefits of such a move would have to weighed against a possibly increased risk of gastrointestinal and kidney problems in people who may be dehydrated.


Pain Relievers Could be Spiking Your Blood Pressure

According to Prof. Ehud Grossman of Tel Aviv University's Sackler Faculty of Medicine and the Sheba Medical Center, many common over-the-counter and prescription medications are underlying causes of hypertension, which is a major risk factor for stroke, heart attack, and aneurisms. The chemical components of the drugs can raise blood pressure or interfere with anti-hypertensive medications, he explains. And while many medications can cause this drug-induced hypertension, both patients and doctors remain dangerously uninformed.

His recent research was published in the American Journal of Medicine.

Weighing the treatment options

"In diagnosing the causes of hypertension, over-the-counter drugs like ibuprofen are often overlooked," says Prof. Grossman. Patients often assume that because a medication can be obtained without a prescription, it's relatively harmless. But that's not always the case.

Many of the medications that are linked with a rise in blood pressure are quite widely used, says Prof. Grossman, whose research provides an overview of which medications are related to high blood pressure. Examples include contraceptive pills, various anti-depressants, anti-inflammatory pills to control pain. and bacterial antibiotics.

Though high blood pressure is a known side effect of many of these medications, doctors do not always account for them in their treatment plans, and they don't inform patients of the potential risks associated with these medications. It's ultimately the doctor's responsibility to weigh treatment options and present the best course for their patient should issues of hypertension arise, Prof. Grossman says.

Doctors may be advised to decrease the dosage of the drug, or add an anti-hypertensive drug to the treatment regime, he says. In any case, awareness on the part of both doctors and patients needs to be raised. "Many physicians don't account for this, and some don't even know about it. It's their responsibility to be informed and make sure that their patients are aware that this is a possibility."

Cost and benefit

Though much of the time a course of treatment can be altered to account for the dangers of hypertension, that isn't always the case. For example, new anti-vascular endothelial growth factor drugs, which may increase blood pressure, block the formation of new blood vessels and arteries to solid tumors. Because the drugs are so effective in treating these malignancies, the benefit outweighs the cost, he believes.

But that doesn't mean that patients shouldn't be watched closely for signs of hypertension. "Once a patient has won a longer life with the use of these drugs, you don't want to expose them to problems associated with blood pressure, such as stroke," says Prof. Grossman. There are simple ways to counteract drug-induced hypertension, such as the thoughtful addition of anti-hypertensive medications to a treatment plan, he says.


Monday, March 19, 2012

Health Factors Linked with Lower Risk of Death


In a study that included a nationally representative sample of nearly 45,000 adults, participants who met more of seven recommended cardiovascular health behaviors or factors (such as not smoking, having normal cholesterol levels, eating a healthy diet), had a lower risk of death compared to participants who met fewer factors, although only a low percentage of adults met all seven factors, according to a study appearing in JAMA. The study is being published early online to coincide with its presentation at a specialty meeting of the American Heart Association.

"Cardiovascular disease (CVD) is the leading cause of deaths in the United States [greater than 800,000, or about 1 in 3 overall deaths/year], with estimated annual direct and overall costs of $273 billion and $444 billion, respectively," according to background information in the article. The American Heart Association (AHA) recently published recommendations aimed at improving cardiovascular health and reducing deaths from CVD in the United States by encouraging the general population to meet seven defined ideal cardiovascular health behaviors or factors (for this study, called cardiovascular health metrics). The metrics are not smoking; being physically active; having normal blood pressure, blood glucose and total cholesterol levels, and weight; and eating a healthy diet.

Quanhe Yang, Ph.D., of the Centers for Disease Control and Prevention, Atlanta, and colleagues conducted a study to examine the trends of these health metrics and estimated their associations with risk of all-cause and CVD mortality. The study included 44,959 U.S. adults (age 20 years or older), using data from the National Health and Nutrition Examination Survey (NHANES) 1988-1994,1999-2004, and 2005-2010 and the NHANES III Linked Mortality File (through 2006).

The researchers found that regarding trends over the study period, the prevalence of current smoking continued to decline since 1988. However, the desirable level of untreated blood pressure and total cholesterol level remained unchanged, and the prevalence of desirable levels of body mass index (BMI) (less than 25) and fasting glucose continued to decline for the study period.

Few participants met all 7 cardiovascular health metrics (2.0 percent in 1988-1994, 1.2 percent in 2005-2010). Younger participants, women, non-Hispanic whites, and those with higher education levels tended to meet a greater number of cardiovascular health metrics.

The authors found that meeting a greater number of cardiovascular health metrics was associated with a significantly lower risk of all-cause, CVD, and ischemic heart disease (IHD) mortality. "During a median [midpoint] of 14.5 years of follow-up in the NHANES III Linked Mortality File cohort, participants who met 6 or more vs. 1 or fewer cardiovascular health metrics had a 51 percent lower risk of all-cause mortality, a 76 percent lower risk of CVD mortality, and a 70 percent lower risk of IHD mortality. In addition, meeting a greater number of cardiovascular health metrics also appeared to be associated with lower risk for all-cancer mortality."

The researchers add that a significant interaction between cardiovascular health metrics and age group (less than 60 vs. 60 years or older) on CVD mortality suggested that meeting cardiovascular health metrics might offer greater protection against premature CVD deaths among younger participants.


Statins may prevent pneumonia


Statins may prevent pneumonia, according to a new study in CMAJ (Canadian Medical Association Journal). Researchers from Israel and the United States analyzed data from the JUPITER trial, a randomized, double-blind trial with placebo control groups conducted at 1315 sites in 26 countries to look at the use of the statin rosuvastatin in disease prevention. The trial involved 17 802 men aged 50 years or older and women aged 60 years or older without a history of heart disease or diabetes.

Patients were randomized to receive either a placebo or rosuvastatin, a statin used to treat high cholesterol levels and prevent heart disease. During a median follow-up period of almost two years, the researchers found that 214 people in the statin group compared with 257 people in the placebo group contracted pneumonia.

"Participants randomly assigned to receive rosuvastatin had a modest reduction in the incidence of pneumonia compared with participants assigned to the placebo group," writes Dr. Victor Novack, Soroka University Medical Center, Israel and coauthors.

"Although a number of observational studies have suggested a protective effect of statin use on the incidence of pneumonia and other infections, we are not aware of any evidence from prior randomized trials that specifically evaluated this question," state the authors.

The authors conclude that the "absolute risk reduction observed in this primary prevention setting was small, and the effects on infection may be greater in other settings."


Study: Exercise can lead to female orgasm, sexual pleasure


Findings from a first-of-its-kind study by Indiana University researchers confirm anecdotal evidence that exercise -- absent sex or fantasies -- can lead to female orgasm.

While the findings are new, reports of this phenomenon, sometimes called "coregasm" because of its association with exercises for core abdominal muscles, have circulated in the media for years, said Debby Herbenick, co-director of the Center for Sexual Health Promotion in IU's School of Health, Physical Education and Recreation. In addition to being a researcher, Herbenick is a widely read advice columnist and book author.

"The most common exercises associated with exercise-induced orgasm were abdominal exercises, climbing poles or ropes, biking/spinning and weight lifting," Herbenick said. "These data are interesting because they suggest that orgasm is not necessarily a sexual event, and they may also teach us more about the bodily processes underlying women's experiences of orgasm."

The findings are published in a special issue of Sexual and Relationship Therapy, a leading peer-reviewed journal in the area of sex therapy and sexual health. Co-author is J. Dennis Fortenberry, M.D., professor at the IU School of Medicine and Center for Sexual Health Promotion affiliate.

The results are based on surveys administered online to 124 women who reported experiencing exercise-induced orgasms (EIO) and 246 women who experienced exercise-induced sexual pleasure (EISP). The women ranged in age from 18 to 63. Most were in a relationship or married, and about 69 percent identified themselves as heterosexual.

Here are some key findings:

About 40 percent of women who had experienced EIO and EISP had done so on more than 10 occasions.
Most of the women in the EIO group reported feeling some degree of self-consciousness when exercising in public places, with about 20 percent reporting they could not control their experience.
Most women reporting EIO said they were not fantasizing sexually or thinking about anyone they were attracted to during their experiences.
Diverse types of physical exercise were associated with EIO and EISP. Of the EIO group, 51.4 percent reported experiencing an orgasm in connection with abdominal exercises within the previous 90 days. Others reported experiencing orgasm in connection to such exercises as weight lifting (26.5 percent), yoga (20 percent), bicycling (15.8), running (13.2 percent) and walking/hiking (9.6 percent).
In open-ended responses, ab exercises were particularly associated with the "captain's chair," which consists of a rack with padded arm rests and back support that allows the legs to hang free. The goal is to repeatedly lift the knees toward the chest or toward a 90-degree angle with the body.
Herbenick said that the mechanisms behind exercise-induced orgasm and exercise-induced sexual pleasure remain unclear and, in future research, they hope to learn more about triggers for both. She also said that study findings may help women who experience EIO/EISP feel more normal about their experiences or put them into context.

Herbenick cautioned that it is not yet known whether such exercises can improve women's sexual experiences.

"It may be that exercise -- which is already known to have significant benefits to health and well-being -- has the potential to enhance women's sexual lives as well."

The study did not determine how common it is for women to experience exercise-induced orgasm or exercise-induced sexual pleasure. But the authors note that it took only five weeks to recruit the 370 women who experienced the phenomenon, suggesting it is not rare.

"Magazines and blogs have long highlighted cases of what they sometimes call 'coregasms,'" Herbenick said. "But aside from early reports by Kinsey and colleagues, this is an area of women's sexual health research that has been largely ignored over the past six decades."


Benefits of alcohol, wine, coffee and fish


Patients with relapsing onset Multiple Sclerosis (MS) who consumed alcohol, wine, coffee and fish on a regular basis took four to seven years longer to reach the point where they needed a walking aid than people who never consumed them. However the study, published in the April issue of the European Journal of Neurology, did not observe the same patterns in patients with progressive onset MS.

The authors say that the findings suggest that different mechanisms might be involved in how disability progresses in relapsing and progressive onset MS.

Researchers asked patients registered with the Flemish MS Society to take part in a survey, which included questions on themselves, their MS and their current consumption of alcohol, wine, coffee, tea, fish and cigarettes.

The 1,372 patients who agreed to take part were also asked to indicate whether they had reached stage six on the zero to ten stage Expanded Disability Status Scale (EDSS) and, if so, when this had happened.

"MS is a chronic, often disabling disease that attacks the central nervous system" explains lead author Dr Marie D'hooghe from the National MS Center at Melsbroek, Belgium. "The clinical symptoms, progression of disability and severity of MS are unpredictable and vary from one person to another.

"Two major MS onset types can be distinguished. Progressive onset MS is characterised by a gradual worsening of neurological function from the beginning, whereas patients with relapsing onset MS patients experience clearly defined attacks of worsening neurologic function with partial or full remission.

"EDSS 6 is an important milestone in the development of MS as it is the point at which patients need support to walk a reasonable distance."

The patients who took part were aged between 17 and 89 years-of-age:

65% (893) had relapsing onset MS. 76% were female, with an average age of 50 years. Age at MS onset averaged 31.5 years and disease duration averaged 19 years.
35% (479) had progressive onset MS. 62% were female, with an average age of 59 years. Age at MS onset averaged 37 years and disease duration averaged 21 years.
The researchers analysed how long it had taken people to reach EDSS 6 and compared those who reported moderate consumption of fish, alcoholic and non-alcoholic drinks and cigarettes with those who reported occasional or no consumption. This showed that:

Just over half (51%) had reached EDSS 6 after an average disease duration of 20 years. The percentage was much higher for people with progressive onset MS (80%) than relapsing onset (36%).
Patients with relapsing onset MS who consumed moderate amounts of alcohol (one drink a week or more) reached EDSS 6 seven years later than people who did not drink at all and wine drinkers reached it four years later than those who did not drink wine. The time differences were insignificant in people with progressive onset MS.
Daily coffee consumption delayed reaching EDSS 6 by five years in people with relapsing onset MS, but there were no significant differences in people with progressive onset MS. Drinking tea daily produced insignificant results in both groups.
People with relapsing onset MS who ate fish two or more times a week reached EDSS 6 seven years later than those who ate it less than once a month. It made no difference whether the fish was lean or fatty.
The time differences quoted above did not take into account gender, age at onset and treatment, which are known to affect disability progression in MS. But even after adjusting for these factors, the hazard risk analysis for time to sustained EDSS 6 (where 1.0 was the reference number for zero consumption) showed that:

The hazard risks for relapsing onset MS were significantly lower for a number of factors: moderate alcohol (0.61), moderate wine (0.67), daily coffee (0.60), occasional coffee (0.60), fish at least twice a week (0.60) and fish at least once a month (0.63).
Daily cigarette smoking raised the risk to 1.35 in relapsing onset MS.
The only hazard risk of any statistical significance for progressive onset MS was 1.56 for patients who preferred fatty fish, compared with those who preferred lean fish.
The paper contains full details of the suggested mechanisms that may be involved in the links between consumption and disease progression.

"Although our findings show a number of associations between consumption and disease progression, it is important that patients recognise that this does not imply that certain food and drinks provide a protective effect as other factors may be involved" stresses Dr D'hooghe.

"Our study does, however, provide valuable pointers for future research as it reinforces the theory that different mechanisms may be involved in the progression of disability in relapsing and progressive onset MS."


Lyme Disease Surge Predicted for Northeastern US


Lyme Disease Surge Predicted for Northeastern US: Due to Acorns and Mice, Not Mild Winter

ScienceDaily (Mar. 16, 2012) — The northeastern U.S. should prepare for a surge in Lyme disease this spring. And we can blame fluctuations in acorns and mouse populations, not the mild winter. So reports Dr. Richard S. Ostfeld, a disease ecologist at the Cary Institute of Ecosystem Studies in Millbrook, NY.

What do acorns have to do with illness? Acorn crops vary from year-to-year, with boom-and-bust cycles influencing the winter survival and breeding success of white-footed mice. These small mammals pack a one-two punch: they are preferred hosts for black-legged ticks and they are very effective at transmitting Borrelia burgdorferi, the bacterium that causes Lyme disease.

"We had a boom in acorns, followed by a boom in mice. And now, on the heels of one of the smallest acorn crops we've ever seen, the mouse population is crashing," Ostfeld explains. Adding, "This spring, there will be a lot of Borrelia burgdorferi-infected black-legged ticks in our forests looking for a blood meal. And instead of finding a white-footed mouse, they are going to find other mammals -- like us."

For more than two decades, Ostfeld, Cary Institute forest ecologist Dr. Charles D. Canham, and their research team have been investigating connections among acorn abundance, white-footed mice, black-legged ticks, and Lyme disease. In 2010, acorn crops were the heaviest recorded at their Millbrook-based research site. And in 2011, mouse populations followed suit, peaking in the summer months. The scarcity of acorns in the fall of 2011 set up a perfect storm for human Lyme disease risk.

Black-legged ticks take three bloodmeals -- as larvae, as nymphs, and as adults. Larval ticks that fed on 2011's booming mouse population will soon be in need of a nymphal meal. These tiny ticks -- as small as poppy seeds -- are very effective at transmitting Lyme to people. The last time Ostfeld's research site experienced a heavy acorn crop (2006) followed by a sparse acorn crop (2007), nymphal black-legged ticks reached a 20-year high.

The May-July nymph season will be dangerous, and Ostfeld urges people to be aware when outdoors. Unlike white-footed mice, who can be infected with Lyme with minimal cost, the disease is debilitating to humans. Left undiagnosed, it can cause chronic fatigue, joint pain, and neurological problems. It is the most prevalent vector-borne illness in the U.S., with the majority of cases occurring in the Northeast.

Ostfeld says that mild winter weather does not cause a rise in tick populations, although it can change tick behavior. Adult ticks, which are slightly larger than a sesame seed, are normally dormant in winter but can seek a host whenever temperatures rise several degrees above freezing. The warm winter of 2011-2012 induced earlier than normal activity. While adult ticks can transmit Lyme, they are responsible for a small fraction of tick-borne disease, with spring-summer nymphs posing more of a human health threat.

Past research by Ostfeld and colleagues has highlighted the role that intact forest habitat and animal diversity play in buffering Lyme disease risks. He is currently working with health departments in impacted areas to educate citizens and physicians about the impending surge in Lyme disease.


White Rice Increases Risk of Type 2 Diabetes


The risk of type 2 diabetes is significantly increased if white rice is eaten regularly, claims a study published today on

The authors from the Harvard School of Public Health look at previous studies and evidence of the association between eating white rice and the risk of type 2 diabetes. Their study seeks to determine whether this risk is dependent on the amount of rice consumed and if the association is stronger for the Asian population, who tend to eat more white rice than the Western world.

The authors analysed the results of four studies: two in Asian countries (China and Japan) and two in Western countries (USA and Australia). All participants were diabetes free at study baseline.

White rice is the predominant type of rice eaten worldwide and has high GI values. High GI diets are associated with an increased risk of developing type 2 diabetes. The average amount of rice eaten varies widely between Western and Asian countries, with the Chinese population eating an average of four portions a day while those in the Western world eat less than five portions a week.

A significant trend was found in both Asian and Western countries with a stronger association found amongst women than men. The results also show that the more white rice eaten, the higher the risk of type 2 diabetes: the authors estimate that the risk of type 2 diabetes is increased by 10% with each increased serving of white rice (assuming 158g per serving).

White rice has a lower content of nutrients than brown rice including fibre, magnesium and vitamins, some of which are associated with a lower risk of type 2 diabetes. The authors report, therefore, that a high consumption of white rice may lead to increased risk because of the low intake of these nutrients.

In conclusion, the authors state that "higher white rice intake is associated with a significantly elevated risk of type 2 diabetes." This applies for both Asian and Western cultures, although due to findings suggesting that the more rice eaten the higher the risk, it is thought that Asian countries are at a higher risk. The authors recommend eating whole grains instead of refined carbohydrates such as white rice, which they hope will help slow down the global diabetes epidemic.


Friday, March 16, 2012

Meditation Strengthens the Brain


Earlier evidence out of UCLA suggested that meditating for years thickens the brain (in a good way) and strengthens the connections between brain cells. Now a further report by UCLA researchers suggests yet another benefit.

Eileen Luders, an assistant professor at the UCLA Laboratory of Neuro Imaging, and colleagues, have found that long-term meditators have larger amounts of gyrification ("folding" of the cortex, which may allow the brain to process information faster) than people who do not meditate. Further, a direct correlation was found between the amount of gyrification and the number of meditation years, possibly providing further proof of the brain's neuroplasticity, or ability to adapt to environmental changes.

The article appears in the online edition of the journal Frontiers in Human Neuroscience.

The cerebral cortex is the outermost layer of neural tissue. Among other functions, it plays a key role in memory, attention, thought and consciousness. Gyrification or cortical folding is the process by which the surface of the brain undergoes changes to create narrow furrows and folds called sulci and gyri. Their formation may promote and enhance neural processing. Presumably then, the more folding that occurs, the better the brain is at processing information, making decisions, forming memories and so forth.

"Rather than just comparing meditators and non-meditators, we wanted to see if there is a link between the amount of meditation practice and the extent of brain alteration," said Luders. "That is, correlating the number of years of meditation with the degree of folding."

Of the 49 recruited subjects, the researchers took MRI scans of 23 meditators and compared them to 16 control subjects matched for age, handedness and sex. (Ten participants dropped out.) The scans for the controls were obtained from an existing MRI database, while the meditators were recruited from various meditation venues. The meditators had practiced their craft on average for 20 years using a variety of meditation types -- Samatha, Vipassana, Zen and more. The researchers applied a well-established and automated whole-brain approach to measure cortical gyrification at thousands of points across the surface of the brain.

They found pronounced group differences (heightened levels of gyrification in active meditation practitioners) across a wide swatch of the cortex, including the left precentral gyrus, the left and right anterior dorsal insula, the right fusiform gyrus and the right cuneus.

Perhaps most interesting, though, was the positive correlation between the number of meditation years and the amount of insular gyrification.

"The insula has been suggested to function as a hub for autonomic, affective and cognitive integration," said Luders. "Meditators are known to be masters in introspection and awareness as well as emotional control and self-regulation, so the findings make sense that the longer someone has meditated, the higher the degree of folding in the insula."

While Luders cautions that genetic and other environmental factors could have contributed to the effects the researchers observed, still, "The positive correlation between gyrification and the number of practice years supports the idea that meditation enhances regional gyrification."