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Thursday, July 1, 2010

 

Exposure to Secondhand Smoke in the Womb Has Lifelong Impact, Study Finds

 

ScienceDaily

Thursday, July 1, 2010

ScienceDaily (July 1, 2010) — Newborns of non-smoking moms exposed to secondhand smoke during pregnancy have genetic mutations that may affect long-term health, according to a University of Pittsburgh Graduate School of Public Health study published online in the Open Pediatric Medicine Journal. The abnormalities, which were indistinguishable from those found in newborns of mothers who were active smokers, may affect survival, birth weight and lifelong susceptibility to diseases like cancer.

The study confirms previous research in which study author Stephen G. Grant, Ph.D., associate professor of environmental and occupational health at Pitt's Graduate School of Public Health, discovered evidence of abnormalities in the HPRT gene located on the X chromosome in cord blood from newborns of non-smokers exposed to environmental tobacco smoke.

In the current study, Dr. Grant confirmed smoke-induced mutation in another gene called glycophorin A, or GPA, that is representative of oncogenes -- genes that transform normal cells into cancer cells and cause solid tumors. The GPA mutation was the same level and type in newborns of mothers who were active smokers and of non-smoking mothers exposed to tobacco smoke. Likewise, the mutations were discernable in newborns of women who had stopped smoking during their pregnancies, but who did not actively avoid secondhand smoke.

"These findings back up our previous conclusion that passive, or secondary, smoke causes permanent genetic damage in newborns that is very similar to the damage caused by active smoking," said Dr. Grant. "By using a different assay, we were able to pick up a completely distinct yet equally important type of genetic mutation that is likely to persist throughout a child's lifetime. Pregnant women should not only stop smoking, but be aware of their exposure to tobacco smoke from other family members, work and social situations."

The research was funded by grants from the National Institute of Child Health and Human Development and the University of Pittsburgh Competitive Medical Research Fund.

 

Cold cereal might beat a hot breakfast

 

By Rachael Myers Lowe

Reuters Health

Thursday, July 1, 2010

NEW YORK (Reuters Health) – You needn't feel guilty if you don't cook hot breakfasts for your kids. In a recent large study of children that compared breakfast-skippers, cereal eaters, and kids who had "other" breakfasts, the cereal-eaters came out on top for healthiest diets.

Regardless of whether their breakfasts were relatively high or low in sugar, the cereal eaters did not consume more than the daily recommended amount.

The breakfast skippers, on the other hand, got more of their daily energy from "added sugars" than breakfast eaters and ended up with less fiber, fewer nutrients, and the smallest percent of their daily energy provided by protein.

They also ended up with larger waists and a higher BMI (body mass index) than their breakfast-eating counterparts, on average.

Skipping breakfast not only starts the day off on the wrong foot nutritionally, but can set kids up for tough health challenges in years to come, the researchers say in the Journal of the American Dietetic Association. Larger waist size, for example, is a risk factor for diabetes, even in children and adolescents.

Ready-to-eat cereals sometimes get a bum rap because some of them have high sugar contents, study co-author Carol O'Neil of Louisiana State University told Reuters Health. But "many are high in nutrients, vitamin fortified, made with whole grains, with fiber added," she said.

Twenty-two percent of breakfast skippers were obese, compared to just under 20 percent of the "other breakfast" eaters and 15 percent of the cereal eaters.

The researchers analyzed everything the kids ate over a 24-hour period. While they didn't specifically calculate how much of total daily nutrients came from breakfast, they found that kids who ate ready-to-eat cereals had "more favorable nutrient intake profiles" and healthier weights than either the breakfast skippers or kids who ate "other breakfasts."

O'Neil and her colleagues studied nearly 10 thousand kids between the ages of 9 and 18 who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2006.

They found that 20 percent of children between the ages of nine and 13 and nearly a third of kids from 14 to 18 were skipping breakfast.

The numbers of kids who ate breakfast began to drop off as children got older, and by the time they were in high school, nearly a third were skipping breakfast.

A third of older girls skipped breakfast, the authors found. "Ironically, one of their concerns is about weight so they think they'll skip this meal and get fewer calories during the day when in reality they skip the meal, they're hungry and they start snacking on this, that, and the other, and overall they tend to eat more calories and fewer nutrient-dense foods," O'Neil said.

Kids don't realize that ready-to-eat cereals provide a quick and easy way to get a good breakfast, she added.

"One of the things that needs to be explored now is why so many children skip breakfast and why so many older children skip breakfast," O'Neil said.

She and her colleagues found that a higher percentage of children and adolescents from single-parent or low-income households skipped breakfast. They also found that ready-to-eat cereal consumption was lower in minority kids than in white kids. At least one earlier study has shown than access and availability of healthy foods, including fortified ready-to-eat cereals, are lower for blacks than for whites, the researchers say.

The research was funded by the US Department of Agriculture and Kellogg's Corporate Citizenship Fund.

Source: http://link.reuters.com/fyw35m

Journal of the American Dietetic Association, July 2010.

 Wednesday, June 30, 2010

 

PSA Test Does Cut Prostate Cancer Deaths, Study Finds

 

By Steven Reinberg
HealthDay
Reporter

Wednesday, June 30, 2010

WEDNESDAY, June 30 (HealthDay News) -- Adding to the ongoing debate on the usefulness of the prostate-specific antigen (PSA) blood test for prostate cancer, new research from Sweden finds the screen cuts lives lost to the disease by almost half.

The argument over whether PSA screening saves men's lives or merely leads to the overdiagnosis of very slow-growing cancers (with attendant worry and overtreatment) has bedeviled the medical world for years.

According to recently revised guidelines from the American Cancer Society, men at average risk for prostate cancer should discuss the PSA test with their doctor, starting at age 50. For men at high risk for the disease -- blacks and men who have a father, brother or son found to have prostate cancer at an early age (before 65) -- that discussion should start at age 45.

"Because prostate cancer grows slowly, those men without symptoms of prostate cancer who do not have a 10-year life expectancy should not be offered testing since they are not likely to benefit," the society notes on its Web site.

Ambivalence over the test hasn't been confined to the United States.

"In Europe, we have been reluctant to recommend that all men get PSA testing as we have felt that there has been a lack of knowledge," agreed lead researcher Dr. Jonas Hugosson, a professor of urology at the University of Gothenburg.

However, he believes that with the results of the new 14-year study, "it feels ethically difficult not at least to inform all men over the age of 50 about PSA and its possibilities. Personally, I would recommend my friends check their PSA," Hugosson added.

The report is published in the June 30 online edition of The Lancet Oncology.

For the still-ongoing study, Hugosson randomly assigned some 20,000 men to either PSA screening once every two years or no screening. The men were between 50 and 65 at the start of the study.

Men whose PSA levels were above normal were offered more tests, such as a digital rectal exam and prostate biopsies.

Over 14 years of follow-up, deaths from prostate cancer dropped by 44 percent among the screened men, compared with unscreened men, the researchers found. Overall, 44 of the men who had PSA testing died from prostate cancer, compared to 78 men who had not had been screened.

Among screened men, 11.4 percent were diagnosed with prostate cancer, compared with 7.2 percent of unscreened men. Of the men in the screened group diagnosed with prostate cancer, nearly 79 percent were diagnosed because they took part in the study, the researchers noted.

In addition, men in the screened group were more likely to have their cancer diagnosed while it was in an early stage. In the screened group, 46 men were diagnosed with advanced cancer, compared with 87 men in the unscreened group, Hugosson's team found.

"Our study has a longer follow-up than previous studies, but shows that in those men invited [to the study], the risk of dying is only half of that in the control group. In men younger than 60 at study entry, the effect was even more pronounced -- only one-quarter of expected deaths occurred," Hugosson said.

Moreover, the risk of over-diagnosis was less than previously thought, with just 12 men needed to be diagnosed to save one life. However, since the benefit of PSA screening requires at least 10 years to be borne out, it still seems questionable to test PSA for men over 70, the researchers noted.

Dr. David E. Neal, a professor of surgical oncology at the University of Cambridge in the U.K. and author of an accompanying editorial, believes that, "PSA testing detects prostate cancer early in its natural history when it causes no symptoms. By doing so, it can save the lives of some men who would otherwise have died of the disease."

This study adds to previous evidence that PSA testing and screening for prostate cancer saves lives, he said. Still, the PSA test remains "a blunt instrument," when it comes to determining the aggressiveness of a particular tumor, Neal said. "We need better tests that identify more accurately those men destined to develop problems in the future from this disease," he said.

In the United States, PSA testing remains a routine part of most physical exams, according to Dr. Nelson Neal Stone, a professor of urology and radiation oncology at the Mount Sinai School of Medicine in New York City.

"I would say 70 to 80 percent of physicians now order a PSA test," he said. "So it is more or less the standard to care in America to get a PSA done."

Stone noted that screening detects a lot of early cancers, which do not need to be treated. "When we see patients with low-risk disease we don't treat them, we observe them," he said.

"Younger men benefit most from screening, because they have the greatest risk of dying," Stone said. "This study clearly supports PSA screening to prevent prostate cancer deaths."

Another expert, Dr. Anthony D'Amico, chief of radiation oncology at Brigham and Women's Hospital in Boston, added that "people in good health will benefit from [PSA] screening, but people in poor health may not benefit at all." That's because if their prostate tumor is not aggressive they are more likely to die from the other, more serious conditions, he explained.

More information

For more information on prostate cancer, visit the American Cancer Society.

How Dietary Supplement May Block Cancer Cells

ScienceDaily

Wednesday, June 30, 2010

ScienceDaily (June 30, 2010) — Researchers at the Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC-James) have discovered how a substance that is produced when eating broccoli and Brussels sprouts can block the proliferation of cancer cells.

Compelling evidence indicates that the substance, indole-3-carbinol (I3C), may have anticancer effects and other health benefits, the researchers say. These findings show how I3C affects cancer cells and normal cells.

 

The laboratory and animal study discovered a connection between I3C and a molecule called Cdc25A, which is essential for cell division and proliferation. The research showed that I3C causes the destruction of that molecule and thereby blocks the growth of breast cancer cells.

 

The study was published online June 29 in the journal Cancer Prevention Research.

 

"Cdc25A is present at abnormally high levels in about half of breast cancer cases, and it is associated with a poor prognosis," says study leader Xianghong Zou, assistant professor of pathology at the Ohio State University Medical Center.

 

The molecule also occurs at abnormally high levels in cancers of the breast, prostate, liver, esophagus, endometrium and colon, and in non-Hodgkin lymphoma, and in other diseases such as Alzheimer's disease, he noted.

"For this reason, a number of anti-Cdc25 agents have been identified, but they have not been successful for cancer prevention or treatment due to concerns about their safety or efficacy," says Zou, who is also a member of the OSUCCC-James Molecular Carcinogenesis and Chemoprevention program.

 

"I3C can have striking effects on cancer cells," he explains, "and a better understanding of this mechanism may lead to the use of this dietary supplement as an effective and safe strategy for treating a variety of cancers and other human diseases associated with the overexpression of Cdc25A," Zou says.

For this study, Zou and his colleagues exposed three breast cancer cell lines to I3C. These experiments revealed that the substance caused the destruction of Cdc25A. They also pinpointed a specific location on that molecule that made it susceptible to I3C, showing that if that location is altered (because of a gene mutation), I3C no longer causes the molecule's destruction.

 

Last, the investigators tested the effectiveness of I3C in breast tumors in a mouse model. When the substance was given orally to the mice, it reduced tumor size by up to 65 percent. They also showed that I3C had no affect on breast-cell tumors in which the Cdc25A molecule had a mutation in that key location.

 

Testosterone Gel Could Raise Heart Risks in Frail, Older Men

 

By Amanda Gardner
HealthDay Reporter
HealthDay News

Wednesday, June 30, 2010

WEDNESDAY, June 30 (HealthDay News) -- Older men in poor health who use testosterone gel to boost their mobility may raise their odds of high blood pressure or heart attack, new research suggests.

The problems observed were concerning enough to cause the researchers to put an early stop to the study, which is published in the July 1 issue of the New England Journal of Medicine.

However, the trial was a small one and volunteers were older men with diabetes, cardiovascular disease and other problems, so whether or not these adverse events would affect the larger population of men taking testosterone therapy is still an open question.

Furthermore, the testosterone doses used in this study were higher than often seen in doctors' offices and other trials, the authors noted.

"These results were a caution flag but not a red light about stopping treatment," said Dr. Evan Hadley, director of the division of geriatrics and clinical gerontology at the U.S. National Institute on Aging, which funded the trial. "The men in this study differed from others in testosterone trials because they were older and frailer. Many of them had chronic diseases. We cannot draw broader conclusions in many different populations of men."

Testosterone supplementation remains a controversial therapy.

"Testosterone is currently not approved for the treatment of older men with mobility problems or frailty, even though there is considerable off-label use of testosterone by older men with low testosterone levels," noted senior study author Dr. Shalender Bhasin. "Given the findings of this research study, older patients and their physicians should carefully weigh the risks of testosterone therapy in their treatment decisions."

Testosterone therapy is approved and has been shown to be effective in men with hypogonadism (low testosterone levels), which some have dubbed male menopause, or "andropause." However, a study published in the same journal earlier this month determined that the number of men actually suffering from the condition is probably much less than previously believed - only about 2 percent of men aged 40 to 80.

This study was designed to determine if testosterone could improve older men's ability to get around, given that the hormone has already been shown to boost muscle strength.

Just over 200 men aged 65 or older with low testosterone levels and mobility problems were randomly assigned to receive testosterone gel or a placebo daily for six months.

Many of the participants started out in poor health, with higher blood pressure, cholesterol and obesity levels, and higher rates of diabetes and heart disease.

The trial was discontinued at the end of 2009 when researchers found that 23 men in the testosterone group had had cardiovascular problems including heart attacks and hypertension, compared with only five in the placebo arm. Participants taking testosterone also had more respiratory and skin-related side effects.

The men in the testosterone arm of the study did see gains in muscle strength and their ability to climb stairs, said Bhasin, who is chief of the division of endocrinology, diabetes and nutrition at Boston University School of Medicine.

But, he added, "these potentially beneficial effects on muscle strength were mitigated by the serious cardiovascular adverse events in men assigned to testosterone arm of the study."

Six other NIA-funded trials on testosterone are continuing, Hadley said.

More information

There's more on low testosterone at the U.S National Library of Medicine.

Key Mechanism Links Virgin Olive Oil to Protection Against Breast Cancer

ScienceDaily

Wednesday, June 30, 2010

ScienceDaily (June 30, 2010) — Researchers at Universitat Autònoma de Barcelona, led by Dr Eduard Escrich, have discovered a key mechanism by which virgin olive oil, in contrast to other vegetable oils, protects the body against breast cancer.

The UAB researchers have decoded a complete cascade of signals within breast tumour cells activated by virgin olive oil, and have concluded that benefits include decrease in the activity of the oncogene p21Ras, changes in protein signaling pathways, stimulation of tumour cell death and prevention of DNA damage. The study has been carried out in an experimental model and researchers have already begun a new study with human cell lines.

 

Breast cancer is the most common type of cancer in Western countries. Research carried out with animal models demonstrate that a diet rich in fats is directly related to the incidence of cancer. Some types of fats however can play a protective role against the development of these tumours. Such is the case of virgin olive oil, rich in oleic acid, a mono-unsaturated fatty acid, and containing several bioactive compounds such as antioxidants. A moderate and regular intake of virgin olive oil, characteristic of the Mediterranean diet, is associated with low incidences of specific types of cancer, including breast cancer, as well as with having a protective role against coronary diseases and other health problems.

 

The study carried out by UAB researchers decoded the mechanisms operating within the tumour cell and induced by the intake of olive oil, in comparison to those activated by corn oil, rich in n-6 polyunsaturated fatty acids, which increase the aggressiveness of tumours.

 

Scientists demonstrated that virgin olive oil is associated with higher incidences of benign breast tumours and at the same time with a decrease in the activity of the p21Ras oncogene, which spurs uncontrolled cell proliferation and stimulates the growth of tumours. In addition, olive oil suppresses the activity of some proteins, such as the AKT, essential for the survival of cells since they prevent apoptosis, the cell's "suicide" programme. Between proliferation and apoptosis in tumour cells, these effects tip the balance towards cell death, thereby slowing the growth of tumours.

 

Another result obtained by researchers is the protection of DNA in the cell nucleus. Cells from animals fed a diet rich in virgin olive oil contained less DNA lesions than those fed a control diet.

 

Scientists of the UAB Breast Cancer Study Multidisciplinary Group (GMECM) have spent over twenty years working to determine the effects fats have on breast cancer, and in particular the effects of virgin olive oil. Previous studies of the group revealed the beneficial effects of this component of the human diet on the clinical conduct of mammary tumours and on their histological grade (malignancy). Scientists also described several molecular mechanisms producing these effects and in 2004 the same group was the one to identify the four genes involved in the effects dietary fats have on experimental breast cancer. The mechanism recently discovered was published in the journal Carcinogenesis.

Journal Reference:

M. Solanas, L. Grau, R. Moral, E. Vela, R. Escrich, E. Escrich. Dietary olive oil and corn oil differentially affect experimental breast cancer through distinct modulation of the p21Ras signaling and the proliferation-apoptosis balance. Carcinogenesis, 2009; 31 (5): 871 DOI:

 

With bad news, families often don't trust docs

 

By Amy Norton

Reuters Health

Wednesday, June 30, 2010

 

NEW YORK (Reuters Health) – Families of critically ill patients may often take a more optimistic view of their loved one's condition than doctors do, even when they are given a specific estimate of the chances of survival, a new study suggests.

 

A number of studies have found that doctors and family members frequently have different opinions on critically ill patients' odds of survival. This raises the question of whether doctors are effectively communicating their estimates of patients' prognosis, that is, the course their disease is likely to take.

Many experts now recommend that doctors try to give specific numeric estimates of a patient's chances of survival -- rather than "qualitative" information, such as telling families is it "very unlikely" that their loved one will survive.

So for the new study, researchers looked at whether the numeric and qualitative approaches differed in their effects on families' views.

The researchers had 169 family members of patients treated in one intensive care unit (ICU) view videos that portrayed a doctor discussing a critically ill ICU patient's prognosis with the family.

Half the family members viewed a hypothetical scenario in which the doctor told the family that their relative was "very unlikely" to survive and "very likely" to die. The doctor also said that if he did live, he would probably have to remain on a ventilator to breathe. The other half of the family members saw a video with the same scenario, with the exception that the doctor said the patient had a 10 percent chance of surviving and a 90 percent chance of dying.

In both cases, the researchers found, study participants came away with a more-positive estimate of the hypothetical patient's prognosis than the doctor on the video had given.

When asked to give their own estimates of the patient's chances of survival, study participants gave an average estimate of 26 percent after watching the video where the doctor had said survival was "very unlikely."

But even after viewing the video in which the doctor gave 10 percent survival odds, study participants still said the patient had, on average, a 22 percent chance of making it.

"The key finding is that many families don't take physicians' estimates at face value," said Dr. Douglas B. White, of the University of Pittsburgh Medical Center in Pennsylvania, who directed the study.

The findings, reported in the American Journal of Respiratory and Critical Care Medicine, also suggest that effective communication with families is not just a matter of giving numeric estimates of the chances of survival, rather than qualitative ones.

But that does not mean that the way in which doctors communicate with families is unimportant.

Instead, White said in an interview, it may be that ICU doctors need to limit the amount of the information they convey, so that family members are less likely to be overwhelmed at a time when they are distraught. They could also try explicitly asking family members if they understood the information they were just given, he said.

Trust is another key issue, the researcher noted. ICU physicians are not the patient's or family's regular doctor, which means family members are being asked to trust the judgment of a stranger.

In this study, participants who reported relatively less trust in doctors also disagreed to a greater extent with the doctor's prognosis estimate in the video.

White said that it remains unclear exactly how ICU doctors can best establish a level of trust between themselves and family members in such a short and emotionally charged time frame.

Research also suggests that families take a number of factors into consideration, other than the doctor's judgment, when it comes to their own views of a loved one's chances of survival.

In an earlier study, White and his colleagues found that families of critically ill ICU patients only rarely relied on doctors' prognostication alone.

Instead, they often considered their perceptions of their loved one's strength and "will to live," his or her history of overcoming illness, and their own trust in optimism, intuition and faith.

The current study did not look at whether discrepancies between family members' and doctors' prognostic estimates might affect families' decisions on whether to continue life-sustaining care. But past research, White noted, suggests that they do.

As for how well doctors are able to estimate prognosis, research suggests they are "fairly accurate" when estimating the general odds of patients in a given situation surviving to hospital discharge, according to White.

They are not as good, however, at predicting whether any one patient will live or die.

There is, White said, an "inherent uncertainty in medicine," and doctors need to convey that fact to family members as well.

Source: http://ajrccm.atsjournals.org/cgi/content/abstract/201002-026 2OCv1

 American Journal of Respiratory and Critical Care Medicine, online June 10, 2010.

Mystery Unraveled: How Asbestos Causes Cancer

ScienceDaily

Wednesday, June 30, 2010

ScienceDaily (June 30, 2010) More than 20 million people in the U.S., and many more worldwide, who have been exposed to asbestos are at risk of developing mesothelioma, a malignant cancer of the membranes that cover the lungs and abdomen that is resistant to current therapies. Moreover, asbestos exposure increases the risk of lung cancer among smokers. For the past 40 years researchers have tried to understand why asbestos causes cancer.

The answer appears in a study published in the current issue of the Proceedings of the National Academy of Sciences, U.S.A., Drs. Haining Yang and Michele Carbone at the University of Hawai'i Cancer Research Center led a research team that included collaborators at New York University, University of Chicago, University of Pittsburgh, San Raffaele University of Milano, and the Imperial College in London.

 

These researchers addressed the paradox of how asbestos fibers that kill cells could cause cancer, since a dead cell should not be able to grow and form a tumor. They found that when asbestos kills cells, it does so by inducing a process called "programmed cell necrosis" that leads to the release of a molecule called high-mobility group box 1 protein (HMGB1). HMGB1 starts a particular type of inflammatory reaction that causes the release of mutagens and factors that promote tumor growth. The researchers found that patients exposed to asbestos have elevated levels of HMGB1 in their serum. Therefore, they state that it may be possible to target HMGB1 to prevent or treat mesothelioma and identify asbestos-exposed cohorts by simple HMGB1 serological testing.

 

In the article, the researchers propose that by interfering with the inflammatory reaction caused by asbestos and HMGB1, it may be possible to decrease cancer incidence among cohorts exposed to asbestos and decrease the rate of tumor growth among those already affected by mesothelioma. Drs. Yang and Carbone, the lead authors, state that to test this hypothesis, they are now planning a clinical trial in a remote area in Cappadocia, Turkey, where over 50% of the population dies of malignant mesothelioma. If the results are positive, the approach will be extended to cohorts of asbestos-exposed individuals in the U.S.

This research emphasizes the role of inflammation in causing different types of cancers and provides novel clinical tools to identify exposed individuals and prevent or decrease tumor growth. The researchers question if it will be possible to prevent mesothelioma, like colon cancer, simply by taking aspirin or similar drugs that stop inflammation. They are about to test this hypothesis.

 

The article is authored by Haining Yang, Zeyana Rivera, Sandro Jube, Masaki Nasu, Pietro Bertino and Michele Carbone at the University of Hawai'i Cancer Research Center; Harvey I. Pass and Chandra Goparaju at New York University; Thomas Krausz at the University of Chicago; Michael T. Lotze at the University of Pittsburgh; Guido Franzoso at the Imperial College of London, U.K.; and Marco E. Bianchi at the University of San Raffele Milano, Italy. It will be published online in the Proceedings of the National Academy of Sciences U.S.A. the week of June 28 2010, and later in print. The study was supported by grants from the U.S. National Cancer Institute, and by the Mesothelioma Applied Research Foundation.

Journal Reference:

Haining Yang, Zeyana Rivera, Sandro Jube, Masaki Nasu, Pietro Bertino, Chandra Goparaju, Guido Franzoso, Michael T. Lotze, Thomas Krausz, Harvey I. Pass, Marco E. Bianchi, and Michele Carbone. Programmed necrosis induced by asbestos in human mesothelial cells causes high-mobility group box 1 protein release and resultant inflammation. Proceedings of the National Academy of Sciences, 2010; DOI: 10.1073/pnas.1006542107

 

Experts Optimistic About Solving Puzzle of Alzheimer's

 

By Dennis Thompson
HealthDay
Reporter
HealthDay
News

Wednesday, June 30, 2010

WEDNESDAY, June 30 (HealthDay News

) -- Research into Alzheimer's disease has reached a point of significant potential, even as the disease's looming impact on society grows more and more dire, experts say.

Some leading scientists, in fact, worry that we may not be doing enough to press forward with key advances and new insights into Alzheimer's, the most common type of dementia among older people.

An estimated 5.3 million U.S. residents have the disease, which results from the deterioration of nerve cells in the brain and leads to memory loss, impaired judgment, wandering and, as it progresses, to the inability to perform such normal daily functions as dressing, bathing and eating.

As the population ages, the number of people with Alzheimer's is expected to spike dramatically. Today, someone in the United States develops Alzheimer's every 70 seconds, according to the Alzheimer's Association -- a number expected to rise to once every 33 seconds in a few decades.

Scientists researching early detection and treatment for the disease, though, say they are on the verge of substantial advances.

Despite some disappointments, a large slate of Alzheimer's drugs are undergoing human trials, said Dr. John C. Morris, a professor and director of the Alzheimer's Disease Research Center at the Washington University School of Medicine in St. Louis and a spokesman for the American Academy of Neurology.

"There has never been a period in which we had more potential drugs to alter the disease course of Alzheimer's," Morris said. "We have lots of highly promising drug candidates."

The drugs focus mostly on amyloid, a protein that clumps in the brains of people with Alzheimer's.

"Many scientists believe eliminating that accumulation will eliminate Alzheimer's," said William H. Thies, chief medical and science officer for the Alzheimer's Association. "We've seen amyloid accumulation as one of the key markers in the development of Alzheimer's. It's really the first step in taking the basic science of Alzheimer's and using it to develop therapeutics."

However, three of the first anti-amyloid drugs to be tested on people all failed to produce results. Treatment with AN-1792, Flurizan and tramiprosate did not significantly improve the symptoms of people with Alzheimer's.

Part of the problem could have been that the drugs were tested on people with advanced Alzheimer's, Morris said, adding that they might be more effective if given to people in earlier stages of the disease.

But that requires a means to detect Alzheimer's disease early in its development or even to flag people who are at risk for developing the disease. The only way doctors have been able to diagnose Alzheimer's is when symptoms appear, and by then the damage has already been done, Morris and Thies said.

That might be about to change. Work is being done on scans and tests that could lead to the early detection of Alzheimer's.

Researchers are identifying substances that bind with amyloid deposits and make them visible to imaging scans, such as the PET, or positron emission tomography, scan. Previously, amyloid clumps have been invisible to scanning technology, and the only way doctors have been able to detect their presence in a human brain was during an autopsy, Morris said.

Researchers also are identifying genetic and biological markers that could indicate that a person is at increased risk for developing Alzheimer's.

"The excitement in the field is, yes, new imaging technology, and studies of amyloid beta in the spinal fluid of elderly and middle-age people do seem to identify people who, if they continue to live, will develop dementia," Morris said. "This will set the stage for targeting people at high risk of developing dementia if they live long enough."

Thies sees these two areas of research -- detection and treatment -- spurring each other along as progress is made.

"There's no doubt in my mind that, as an effective therapy emerges that slows down the course of the disease, we will find the marker for it," Thies said. "The two are linked almost arm-in-arm and will develop together. Advances in one will drag the other along."

Some people, however, question the direction of research -- worrying that efforts have been too tightly focused on eliminating amyloid from the brain, particularly given the failures in early trials.

"People who work in the field raise the question, 'Should we be doing all this amyloid work?'" Thies said. "But it's the most mature of the ideas so you have to follow it through."

Questions also have arisen as to whether Alzheimer's research is getting enough attention. Money spent by the government on Alzheimer's, for instance, lags behind research funding for other major diseases. The U.S. National Institutes of Health expects to spend $527 million on Alzheimer's disease research in the current fiscal year, compared with $6.1 billion on cancer research, $3 billion on HIV/AIDS and $1.9 billion on heart disease research, according to spending data released Feb. 1.

This disparity in spending on Alzheimer's stems in part from the fact that the United States does not have a national plan aimed at tackling research and treatment, Harry Johns, chief executive of the Alzheimer's Association, told HealthDay. England, France and Australia have such plans, but the United States does not, he said.

That might be in part because many Americans see Alzheimer's as an inevitable end-of-life disease. "A lot of people still equate getting older with loss of cognitive process," Morris said. "They consider it a part of getting older. They don't see it as a disease that reduces life span."

Whatever the reason, researchers say that the aging of the U.S. population means that Alzheimer's needs to be tackled now or the United States will face a public health crisis later.

"Alzheimer's is not only an awful disease, it's also very expensive," Thies said, noting that a person aging with Alzheimer's disease will require care that costs up to three times as much as care for a person aging normally.

"With the aging of our population, we are going to have an immense increase in Alzheimer's disease over the next 40 years," he said. "If we don't deal with this, it could bankrupt our government and wreck our health-care system."

More information

The U.S. National Institute on Aging has more on Alzheimer's disease.

Treating Depression With Omega-3: Encouraging Results from Largest Clinical Study

ScienceDaily

Wednesday, June 30, 2010

ScienceDaily (June 30, 2010) — The use of Omega-3 supplements is effective among patients with major depression who do not have anxiety disorders, according to a study directed by Dr. François Lespérance of the Centre de recherche du Centre hospitalier at the Université de Montréal (CRCHUM), head of CHUM's Department of Psychiatry and a professor at the Université de Montréal.

The study was published June 15 in the online Journal of Clinical Psychiatry.

This was the largest study ever conducted assessing Omega-3's efficacy in treating major depression. It was carried out in conjunction with researchers from centres affiliated with the UdM's Réseau universitaire intégré de santé (RUIS), from McGill University, Université Laval in Quebec City and Queen's University in Kingston, Ontario. The study was supported by the European firm isodisnatura, the Fondation du CHUM and the CRCHUM.

 

Initial analyses failed to clearly demonstrate the effectiveness of Omega-3 for all patients taking part in the study. Other analyses, however, revealed that Omega-3 improved depression symptoms in patients diagnosed with depression unaccompanied by an anxiety disorder. Efficacy for these patients was comparable to that generally observed with conventional antidepressant treatment.

 

From October 2005 to January 2009, 432 male and female participants with major unipolar depression were recruited to take part in this randomized, double-blind study (neither patients nor researchers knew which capsules patients received). For eight weeks, half of the participants took three capsules per day of OM3 Emotional Balance, a fish oil supplement containing high concentrations of eicosapentaenoic acid (EPA). The other half took three identical capsules of a placebo consisting of sunflower oil, flavoured with a small quantity of fish oil. In contrast with typical clinical studies designed to assess the effectiveness of antidepressants, this study included a high proportion of patients with complex and difficult-to-treat conditions, including patients resistant to conventional antidepressant treatments and patients also suffering from an anxiety disorder. The aim was to assess the value of Omega-3 supplementation in a group of individuals more like those treated in outpatient clinics.

 

Need to assess the impact of Omega-3 supplements

 

Some 11% of men and 16% of women in Canada will suffer from major depression at some point in their lives, making this disorder one of our society's leading public health issues. Depression, which is now the world's fourth leading cause of morbidity and death is expected to move up to the number two position by 2020. "Despite significant progress in neuroscience over the past two decades, depression is difficult to treat," Dr. Lespérance noted. In view of the large number of patients who stop taking their medications in the first few months of treatment and those who refuse such treatment due to fear of stigmatization or side effects, it comes as no surprise that a large number of patients suffering from major depression use alternative treatments offered outside the healthcare system. "Many of these treatments have not been adequately evaluated. That is why it was important to assess the efficacy of Omega-3, one of the most popular alternative approaches," he added.

 

Epidemiological and neurobiological studies have suggested that a relative deficit in polyunsaturated fatty acids of the Omega-3 group may predispose individuals to psychological disorders such as depression. Further, several preliminary clinical studies based on small numbers of patients have suggested that Omega-3 supplements with high concentrations of EPA can help to reduce symptoms of depression among patients who fail to respond to an initial antidepressant treatment. These studies have not, however, convinced the entire scientific community. A broader study was needed to acquire further knowledge about the properties and efficacy of high-quality Omega-3 supplements among patients suffering from major depression.

 

"We are proud that OM3 Emotional Balance, with its high concentration of EPA at unexcelled levels of purity delivers the dose of EPA needed for effective treatment," said Claire Bertin, head pharmacist for isodisnatura, the laboratory producing the Omega-3 supplement used in the study.

 

It is important to note that the study assessed use of Omega-3 for eight weeks, at doses of 1050 mg of EPA and 150 mg of DHA each day. It is currently unknown whether taking higher doses or taking supplements over a longer period would yield different results.

 

These encouraging results show that use of EPA is effective among patients with unipolar depression unaccompanied by an anxiety disorder. Additional research directly comparing Omega-3 with conventional antidepressants could more clearly confirm their usefulness for patients suffering from depression.

Journal Reference:

François Lespérance, Nancy Frasure-Smith, Elise St-André, Gustavo Turecki, Paul Lespérance, Stephen R. Wisniewski. The Efficacy of Omega-3 Supplementation for Major Depression: A Randomized Controlled Trial. Journal of Clinical Psychiatry, 2010; DOI: 10.4088/JCP.10m05966blu

 

Asian study links obesity to cancer

 

Reuters

Wednesday, June 30, 2010

HONG KONG (Reuters) – Asians who are overweight or obese are more likely to die from cancer compared with people of normal weight, a large study in Asia has found.

Obesity is regarded a risk factor for certain cancers in the West, but until now it had not been clear if it poses the same risks to Asians.

Researchers monitored 401,215 people in China, Hong Kong, Taiwan, Japan, South Korea, Singapore, Thailand, Australia and New Zealand for four years.

Compared to people of normal weight, participants who were obese were 21 percent more likely to die from cancer while those who were overweight had a 6 percent higher chance, the study found.

Obese participants were particularly vulnerable to cancers of the colon, rectum, breast, ovary, cervix, prostate, and leukemia, the researchers found.

"Overweight and obese individuals in populations across the Asia-Pacific region have a significantly increased risk of mortality from cancer," the researchers wrote in a paper published in The Lancet Oncology on Wednesday.

"New strategies are urgently needed to tackle the obesity epidemic in Asia to prevent further increases in the cancer burden in this region," said the group, which was led by Christine Parr at the University of Oslo in Norway.

There has been a rapid increase in obesity in many Asian countries in the last few decades, fueled by growing affluence and people moving from the countryside to cities, where they have become sedentary and are eating fattier foods.

Source: http://link.reuters.com/fuw94m

 The Lance Oncology online June 30, 2010.

When Food Intake Stops, Enzyme Turns Off Production of Fats, Cholesterol

ScienceDaily

Wednesday, June 30, 2010

ScienceDaily (June 30, 2010) — Massachusetts General Hospital (MGH) investigators have found that an enzyme with several important roles in energy metabolism also helps to turn off the body's generation of fats and cholesterol under conditions of fasting.

The report in Genes & Development describes how SIRT1, one of a group of enzymes called sirtuins, suppresses the activity of a family of proteins called SREBPs, which control the body's synthesis and handling of fats and cholesterol. The findings could lead to new approaches to treating conditions involving elevated cholesterol and lipid levels.

 

"SIRT1 had previously been shown to act as an energy sensor, promoting the use of stored fat in response to food deprivation; however, its function in shutting down fat and cholesterol synthesis was unknown," says Amy Walker, PhD, of the MGH Cancer Center, the study's lead author. "These findings point to SIRT1 as a master regulator of physiologic energy stability that controls the synthesis and storage of fat, as well as its usage as fuel."

 

Under normal conditions, the body produces appropriate levels of fats and cholesterol, both of which are essential to life. A high-fat diet can cause abnormal elevations in fat and cholesterol levels in the blood, which may lead to cardiovascular disease, type 2 diabetes, hypertension and other serious disorders. If the body is deprived of food for a short time, it shuts down the production and storage of fat and cholesterol and shifts to using stored fats as the primary source of energy. Fasting also is known to turn off the activity of SREBP proteins, and the research team investigated whether direct suppression of SREBPs by SIRT1 was responsible for the metabolic shift.

 

A series of experiments in worms, fruitflies and mice showed that the versions of SIRT1 present in those animals suppressed SREBP activity and the associated synthesis and storage of fats. They also showed in mouse and human cells that SIRT1 acts on SREBP by removing a protective molecule, marking the protein for degradation, and that inhibiting SIRT1 activity caused levels of SREBP to rise. Treating genetically obese mice fed a high-fat diet with an agent that increases sirtuin activity suppressed the expression of SREBP-regulated fat synthesis genes and also reduced the amount of fat stored in the animals livers.

 

"This study is significant because it explains the signals that tell the body to burn fat in response to fasting or dieting," says David Sinclair, PhD, a professor of Pathology at Harvard Medical School (HMS) who helped discover the genes that code for sirtuins but was not involved with this MGH-led study. "This improved understanding could help treat and prevent metabolic diseases such as atherosclerosis and type 2 diabetes."

Sirtuins have also been associated with the increased longevity in response to reduced calorie intake observed in several species of animals. Drugs that stimulate sirtuin activity are currently being investigated for treatment of diabetes and related conditions.

 

"Sirtuin activators could strengthen SIRT1 functions that may be suppressed in individuals with cardiometabolic disorders," explains Anders Näär, PhD, of the MGH Center for Cancer Research, senior author of the current study. "Our results suggest these agents may be able to 'trick' the body into responding as though it was experiencing fasting, with beneficial metabolic consequences, but that hypothesis needs to be tested in future studies." Näär is an associate professor of Cell Biology and Walker is an instructor in Medicine at HMS.

 

The study was supported by the Paul F. Glenn Laboratories for the Biological Mechanisms of Aging at HMS and grants from the National Institutes of Health. Additional co-authors of the Genes & Development article are Fajun Yang, Karen Jiang, Jun-Yuan Ji, Toshi Shioda, Peter Mulligan, Hani Najafi-Shoushtari, Josh Black, Jitendra Thakur, Johnathan Whetstein, Raul Mostoslavsky and Nicholas Dyson, MGH Cancer Center; Jennifer Watts, Washington State University; Aparna Purushotham and Xiaoling Li, National Institute of Environmental Health Sciences; Olivier Boss, Michael Hirsch, Scott Ribich, Jesse Smith, Kristine Israelian and Christoph Westphal, Sirtris Pharmaceuticals; Joseph Rodgers and Pere Puigserver, Dana-Farber Cancer Institute, Sarah Elson and Lisa Kadyk, Exelixis, Inc., and Anne Hart, Brown University.

 

Mouse Study Suggests Caffeine Boosts Athletic Performance

 

HealthDay News

Wednesday, June 30, 2010

WEDNESDAY, June 30 (HealthDay News) -- High doses of caffeine could increase muscle power and endurance during activities ranging from walking to running a marathon, British researchers report.

The finding stemmed from testing on mice.

The researchers, from Coventry University, found that giving a caffeine dose of 70 micrometers to mice resulted in a 6 percent increase in the power output of lower leg muscles. They indicated that the effect in humans would probably be similar.

That amount "is the absolute maximum that can normally be achieved in the blood plasma of humans," Dr. Rob James, the lead researcher, said in a Society for Experimental Biology news release. "However, concentrations of 20 to 50 micrometers are not unusual in people with high caffeine intake."

The findings, to be presented Wednesday at the society's annual meeting in Prague, Czech Republic, may have implications for the use of caffeine in sports.

"A very high dosage of caffeine, most likely achieved via tablets, powder or a concentrated liquid, is feasible and might prove attractive to a number of athletes wishing to improve their athletic performance," James said. "A small increase in athletic performance via caffeine could mean the difference between a gold medal in the Olympics and an also-ran."

Currently, caffeine is not listed as a banned substance by the World Anti-Doping Agency.

More information

Iowa State University has more about caffeine for athletes.

Antioxidants no help vs rheumatoid arthritis, lupus

 

Reuters Health

Wednesday, June 30, 2010

NEW YORK (Reuters Health) – Antioxidants in food and supplements might not protect women from rheumatoid arthritis (RA) or lupus after all, a large U.S. study suggests.

RA is not the same as osteoarthritis, which develops with age or with wear-and-tear on the joints. RA occurs much less often, but is usually more severe. RA and lupus are both autoimmune disorders.

The researchers tracked nearly 185,000 women for up to 24 years. Overall, they found no clear relationship between the women's estimated intake of antioxidants -- including vitamins A, C and E and beta-carotene -- and their likelihood of being diagnosed with RA or lupus.

The findings contradict hints from earlier research that women with higher intake of antioxidants might have lower risks of developing these diseases.

One reason for checking whether antioxidants in the diet would have an effect is that people with RA and lupus have lower antioxidant levels in their blood than healthy individuals. And studies in mice have shown that giving antioxidants helps reduce the type of immune-system-triggered inflammation that's associated with these diseases.

Not only do antioxidants help control inflammation, but they also protect body tissue from potentially cell-damaging particles called reactive oxygen species.

But in the new study reported in the American Journal of Epidemiology, researchers found no link between the women's reported antioxidant intake and their risk of developing RA or lupus. The women were participating in the Nurses' Health Study and Nurses' Health Study II, two large projects that have tracked lifestyle factors and disease risk among nearly 240,000 U.S. women since 1976 and 1989, respectively.

The study had its limitations -- including the fact that it was observational. The researchers merely asked the women about their antioxidant intake and then observed what happened to them over time, so the outcomes may just be coincidental. A study in which participants are randomly assigned to take antioxidant supplements or not, then have their RA and lupus rates followed over time, would provide stronger evidence as to whether the nutrients affect the risk of developing the diseases.

Nor can the findings exclude the possibility that significant deficiency in certain antioxidants might play a role in RA or lupus risk, note the researchers, led by Dr. Karen H. Costenbader of Brigham and Women's Hospital in Boston.

Lupus -- known formally as systemic lupus erythematosus -- involves painful, swollen joints, fatigue and skin rash, but it can also damage other parts of the body, including the heart and blood vessels. RA arises when the immune system mistakenly attacks joints all over the body, leading to inflammation, pain and progressive joint damage.

Costenbader's team focused on 184,643 women who were free of RA or lupus at the outset and had completed detailed questionnaires on their diets and supplement use starting in 1980 or 1991, depending on the study.

The researchers used those reports to estimate the women's daily intakes of vitamins A, C and E, as well as alpha- and beta-carotene, lycopene, lutein, beta-cryptoxanthin and zeaxanthin.

Between 1980 and 2004, 787 women were newly diagnosed with RA, while 192 were diagnosed with lupus.

Women with higher antioxidant intakes did tend to maintain a healthier lifestyle overall, the study found. They were generally more physically active and less likely to smoke, for example. When those factors were taken into account, antioxidant consumption itself showed no strong relationship to RA or lupus risk.

This finding, of course, does not negate the importance of eating antioxidant-rich foods for one's overall health. Foods high in the antioxidants assessed in this study include citrus fruits, leafy greens like spinach and kale, cruciferous vegetables like broccoli and Brussels sprouts, and red or orange fruits and vegetables like carrots, watermelon and sweet potatoes.

Source:http://link.reuters.com/jax94m

American Journal of Epidemiology, online June 9, 2010.

Exercise May Guard Girls Against Dementia in Senior Years

 

By Randy Dotinga
HealthDay Reporter
HealthDay News

Wednesday, June 30, 2010

WEDNESDAY, June 30 (HealthDay News) -- If you want to help your young daughter avoid dementia much later on in life, a new study suggests it might be a good idea to send her outside to play.

Canadian researchers believe they've found a link between exercise in adolescence and fewer cases of senility in a woman's senior years.

The study doesn't definitively prove that exercise lowers the risk of dementia. And the research is only based on the recollections of older women, some with signs of dementia, about their childhoods.

Still, the findings suggest that "early life physical activity is important to late-life health and in particular in preventing late-life cognitive impairment. The sooner you start being physically active, the better it is," said study author Laura E. Middleton, a researcher at the Sunnybrook Health Sciences Center in Toronto.

Scientists have been trying to document a link between exercise and dementia in later life in the hopes of understanding how physical activity affects the brain. The new study was designed to examine how exercise in youth may affect women in their later years.

The researchers asked more than 9,300 women in the United States about their exercise habits before the age of 18, at 30, at 50 and in late life. All were over 65, and their average age was 72.

The findings appear in the June 30 issue of the Journal of the American Geriatrics Society.

About 15 percent to 30 percent of the women reported being inactive during each period of their lives. Exercise occurring before the age of 18 seemed to be most influential: Close to 17 percent of those who didn't report being active then had symptoms of dementia, while just 8.5 percent of the others did.

The researchers adjusted their statistics so they wouldn't be thrown off by factors such as weight and age. After they did that, those who thought they exercised as kids were still 30 percent less likely to show signs of dementia.

The researchers don't know if exercise in childhood directly leads to less dementia since other factors could be at play, such as diet. And exercising as kids -- playing outdoors, for example -- may set a pattern for physical activity later in life, Middleton said.

If there is a cause-and-effect link between early exercise and less mental decline, she said it may have something to do with the brain's ability to change and develop new circuitry. It's also possible that exercise leads to less clogging of blood vessels in the brain, she said.

It's not clear whether men might benefit in the same way. The study only looked at women, Middleton said, and previous research has suggested that women benefit more from exercise than men.

Greg Cole, a brain researcher who's familiar with the findings, said scientists are interested in the benefits of exercise when it comes to brain decline, but they're focusing on studying the elderly at risk instead of looking backward at childhood.

Cole said the study's reliance on the memory of the elderly "makes one wonder" about its reliability. But childhood habits could presumably lead to lifelong habits that might contribute to the benefits of adult exercise seen in other studies, said Cole, a professor of medicine and neurology at the University of California at Los Angeles.

More information

Kidshealth.org has details on children and exercise.

Tuesday, June 29, 2010

 

Fewer Dying From Type 1 Diabetes

 

HealthDay News

Tuesday, June 29, 2010

TUESDAY, June 29 (HealthDay News) -- The overall death rate from type 1 diabetes is decreasing in the United States, but blacks are more likely to die from the condition than whites, a new study shows.

The finding came from an analysis of data from the Allegheny County Type 1 Diabetes Registry, which includes nearly 1,100 people diagnosed between 1965 and 1979 in Allegheny County, Pa.

As of January 2008, 26 percent of all the registry participants had died, a rate seven times higher than age- and sex-matched people in the general population. However, the death rate among those diagnosed between 1975 and 1979 was a bit lower -- 5.5 times greater than the general population.

Women with type 1 diabetes were 13 times more likely to die than women without the condition, whereas men with the disease were five times more likely to die than men in the general population.

When the researchers focused on race, they found that just 52 percent of black registry participants were alive, compared with 82 percent of whites.

The findings were presented Monday at the American Diabetes Association's annual meeting in Orlando, Fla.

"The more recently a person was diagnosed with type 1 diabetes, the less likely they were to die, suggesting the positive impact of advances made during the last few decades," study author Aaron M. Secrest, a doctoral student at the University of Pittsburgh Graduate School of Public Health, said in news release from the school. "Even so, significant disparities in mortality remain and reveal a need for continuing improvements in diabetes treatment and care."

More information

The Juvenile Diabetes Research Foundation International has more about type 1 diabetes.

Get moving: Cancer survivors urged to exercise

 

By Lauran Neergaard

AP Medical Writer

The Associated Press

Tuesday, June 29, 2010

WASHINGTON – Cancer survivors, better work up a sweat.

New guidelines are urging survivors to exercise more, even — hard as it may sound — those who haven't yet finished their treatment.

There's growing evidence that physical activity improves quality of life and eases some cancer-related fatigue. More, it can help fend off a serious decline in physical function that can last long after therapy is finished.

Consider: In one year, women who needed chemotherapy for their breast cancer can see a swapping of muscle for fat that's equivalent to 10 years of normal aging, says Dr. Wendy Demark-Wahnefried of the University of Alabama at Birmingham.

In other words, a 45-year-old may find herself with the fatter, weaker body type of a 55-year-old.

Scientists have long advised that being overweight and sedentary increases the risk for various cancers. Among the nation's nearly 12 million cancer survivors, there are hints — although not yet proof — that people who are more active may lower risk of a recurrence. And like everyone who ages, the longer cancer survivors live, the higher their risk for heart disease that exercise definitely fights.

The American College of Sports Medicine convened a panel of cancer and exercise specialists to evaluate the evidence. Guidelines issued this month advise cancer survivors to aim for the same amount of exercise as recommended for the average person: about 2 1/2 hours a week.

Patients still in treatment may not feel up to that much, the guidelines acknowledge, but should avoid inactivity on their good days.

"You don't have to be Lance Armstrong," stresses Dr. Julia Rowland of the National Cancer Institute, speaking from a survivorship meeting this month that highlighted exercise research. "Walk the dog, play a little golf."

But how much exercise is needed? And what kind? Innovative new studies are under way to start answering those questions, including:

_Oregon Health and Science University is training prostate cancer survivors to exercise with their wives. The study will enroll 66 couples, comparing those given twice-a-week muscle-strengthening exercises with pairs who don't get active.

Researchers think exercising together may help both partners stick with it. They're also testing if the shared activity improves both physical functioning and eases the strain that cancer puts on the caregiver and the marriage.

"It has the potential to have not just physical benefits but emotional benefits, too," says lead researcher Dr. Kerri Winters-Stone.

·        Demark-Wahnefried led a recent study of 641 overweight breast cancer survivors that found at-home exercises with some muscle-strengthening, plus a better diet, could slow physical decline.

·        Duke University is recruiting 160 lung cancer patients to test if three-times-a-week aerobic exercise, strength training or both could improve their fitness after surgery. Lung cancer has long been thought beyond the reach of exercise benefits because it's so often diagnosed at late stages. But Duke's Dr. Lee Jones notes that thousands who are caught in time to remove the lung tumor do survive about five years, and he suspects that fitness — measured by how well their bodies use oxygen — plays a role.

People with cancer usually get less active as symptoms or treatments make them feel lousy. Plus, certain therapies can weaken muscles, bones, even the heart. Not that long ago, doctors advised taking it easy.

Not anymore: Be as active as you're able, says Dr. Kathryn Schmitz of the University of Pennsylvania, lead author of the new guidelines.

"Absolutely it's as simple as getting up off the couch and walking," she says.

Exercise programs are beginning to target cancer survivors, like Livestrong at the YMCA, a partnership with cycling great and cancer survivor Lance Armstrong's foundation. The American College of Sports Medicine now certifies fitness trainers who specialize in cancer survivors.

But anyone starting more vigorous activity for the first time or who has particular risks — like the painful arm swelling called lymphedema that some breast cancer survivors experience — may need more specialized exercise advice, Schmitz says. They should discuss physical therapy with their oncologist, she advises.

For example, Schmitz led a major study that found careful weight training can protect against lymphedema, reversing years of advice to coddle the at-risk arm. But the average fitness trainer doesn't know how to safely offer that special training, she cautions.

Mary Lou Galantino of Wilmington, Del., is a physical therapist who specializes in cancer care — and kept exercising when her own breast cancer was diagnosed at Penn in 2003. Then 42, she says she was on the treadmill within 24 hours of each chemo session, to stay fit enough to care for her two preschoolers.

"You can feel more energy" with the right exercise, says Galantino, a physical therapy professor at the Richard Stockton College of New Jersey. "I was giving my body up to the surgeons and chemo, but I could take my body back through yoga and aerobic exercise."

Editor’s Note: Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

Key-Hole Surgery for Knee Injury Doesn't Lower Arthritis Risk

 

HealthDay News

Tuesday, June 29, 2010

TUESDAY, June 29 (HealthDay News) -- Arthroscopic surgery to repair a torn anterior cruciate ligament (ACL) or meniscal cartilage injury in the knee does not reduce the risk of developing osteoarthritis later, a new study finds.

Researchers analyzed data from 326 patients who were examined and treated for knee injuries in 1996 and 1997. A decade after the injuries were diagnosed, localized knee osteoarthritis (OA) was evident in the patients, regardless of whether or not they'd had surgery to repair their injuries.

The findings appear online June 29 and in the August print issue of the journal Radiology.

"This study proves that meniscal and cruciate ligament lesions increase the risk of developing specific types of knee osteoarthritis. Surgical therapy does not decrease that risk," study author Dr. Kasper Huetink, a resident radiologist at Leiden University Medical Center in the Netherlands, said in a journal news release.

Further research is needed to investigate the short- and long-term effects of different types of surgical repair of ACL or meniscal cartilage injuries, Huetink noted.

More than 9 million Americans have knee OA, which typically develops over several years. Symptoms include pain, stiffness, swelling and decreased knee mobility.

More information

The American Academy of Orthopaedic Surgeons has more about knee OA.

Statins Associated With Lower Cancer Recurrence Following Prostatectomy

ScienceDaily

Tuesday, June 29, 2010

ScienceDaily (June 29, 2010) — Men who use statins to lower their cholesterol are 30 percent less likely to see their prostate cancer come back after surgery compared to men who do not use the drugs, according to researchers at Duke University Medical Center. Researchers also found that higher doses of the drugs were associated with lower risk of recurrence.

The findings are published in the journal Cancer.

 

"The findings add another layer of evidence suggesting that statins may have an important role in slowing the growth and progression of prostate cancer," says Stephen Freedland, M.D., a member of the Duke Prostate Center and the Urology Section at the Durham Veterans Affairs Medical Center, and the senior author of the study. "Previous studies have shown that statins have anti-cancer properties, but it's not entirely clear when it's best to use them -- or even how they work."

 

Researchers examined the records of 1319 men who underwent radical prostatectomy included in the Shared Equal Access Regional Cancer Hospital (SEARCH) database. They found that 18 percent of the men -- 236 -- were taking statins at the time of surgery.

 

Researchers followed the patients after surgery to evaluate recurrence rates, measured by slight rises in the PSA levels after surgery, a development known as "biochemical recurrence." Time to biochemical recurrence is viewed as an important clinical factor because it is correlated with the risk of disease progression and death.

 

The authors found that 304 men had a rising PSA, including 37 (16 percent) of the statin users and 267 (25 percent) of the non-users. Taking into account various clinical and pathological features that differed between the two groups, the data showed that overall, statin use reduced the risk of biochemical recurrence by 30 percent.

 

Among men taking statins equivalent to 20 mg of simvastatin a day, the risk of recurrence was reduced 43 percent and among the men taking the equivalent of more than 20 mg of simvastatin a day, the risk of recurrence was reduced 50 percent. Men who took a statin dose the equivalent of less than 20 mg of simvastatin daily saw no benefit.

 

There were significant differences between those who took the drugs and those who did not. Statin users tended to be white, older and heavier than non-users. They also had lower clinical stages at diagnosis, but higher Gleason scores, a measure of tumor aggressiveness.

 

"These findings are intriguing, but we do need to approach them with some caution," says Robert Hamilton, M.D., a urologist at the University of Toronto and the lead author of the study. "For example, we don't know the diet, exercise or smoking habits of these men. So it's not entirely clear if the lower risk we detected is related to the statins alone -- it could be due to other factors we were not able to measure. We do feel, however, that based on these findings and those from other studies, the time is ripe to perform a well-controlled randomized trial to test whether statins do indeed slow prostate cancer progression."

 

The study was funded by the Department of Defense, Prostate Cancer Research Program; the Department of Veterans Affairs, the National Institute of Health, the Georgia Cancer Coalition and the American Urological Association Foundation/Astellas Rising Star in Urology Award.

 

Colleagues who contributed to the study include Lionel Banez of Duke; William Aronson, from UCLA and the Veterans Affairs Greater Los Angeles Healthcare System; Martha Terris, from UCLA and the Medical College of Georgia; Elizabeth Platz, from John Hopkins; Christopher Kane, from UC San Diego; Joseph Presti Jr., from Stanford and the Palo Alto Veterans Affairs Medical Center; and Christopher Amling, from the University of Alabama in Birmingham.

 

Tight Blood Sugar Control in Older Diabetics May Not Reduce Heart Risk

 

 

By Kathleen Doheny
HealthDay Reporter
HealthDay News

Tuesday, June 29, 2010

TUESDAY, June 29 (HealthDay News) -- Intensive control of blood glucose levels does not reduce the odds of cardiovascular disease for those with long-term type 2 diabetes who are at risk of heart problems, as researchers have known. But it may have some other benefits, a new analysis suggests.

Strict control of blood sugar in a certain group of patients may slow progression of eye disease and help kidney and peripheral nerve health, the researchers found.

The new study is the latest analysis from the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial.

The study results, like the previous research, apply only to a certain group of people with diabetes, said study lead author Dr. Faramarz Ismail-Beigi, professor of medicine at Case Western Reserve University and University Hospitals of Cleveland.

"The trial fundamentally is on older adults, average age 60, who had diabetes 10 years on average," he said. "All are type 2." Because they have had the disease for 10 years, typically the disease has progressed, he said. The 10,251 participants had either a history of heart disease or two or more risk factors for it.

The study compared intense blood sugar control -- A1C values of less than 6 percent -- with standard, 7 to 7.9 percent, control. A1C levels reflect blood sugar levels over the preceding three months. Under 6 percent is viewed as normal; diabetics are often advised to keep it at around 7.

The study results, published online June 29 in The Lancet, were to be presented Tuesday at the American Diabetes Association annual meeting, in Orlando, Fla.

Study participants were assigned to either intensive glucose-control therapy or standard therapy. When it was found that those in the intensive group had an increase in deaths, the study was stopped in February 2008, and all participants were switched to the standard group for the remainder of the five-year follow-up, which ended in June 2009.

In this new analysis, the researchers looked at kidney, eye and nerve problems. The intensive therapy did not reduce the risk of problems such as advanced kidney or eye complications. But it did delay the onset of albuminuria, protein in the urine, which is associated with renal failure, and some eye complications and nerve problems.

But those on tight control also gained more weight and were at risk for very low blood sugar, the study found.

The researchers concluded that: "The observed benefits associated with intense glycaemia management should be weighed against higher total and cardiovascular-related mortality, weight gain, and severe hypoglycaemia in patients at high risk of cardiovascular disease."

"A target of 6 percent or less with present strategies seems imprudent," the researchers wrote.

In a commentary accompanying the study in The Lancet, Dr. Ronald Klein of the University of Wisconsin School of Medicine and Public Health, Madison, noted the three-fold increase in severely low blood sugar found in those on intensive therapy. Technological improvements are needed, he said, to normalize blood sugar without causing it to drop dangerously low.

It's not surprising that no benefits were found for all complications, Klein said. "The study didn't really go long enough," he said, to observe the protective effect of intensive therapy on some complications.

Even so, he added, it's still crucial to control blood sugar -- perhaps just not as intensively as researchers previously thought necessary.

Other researchers in a subgroup of the ACCORD study reported online June 29 in the New England Journal of Medicine that tight glucose control helped reduce the progression of retinopathy, a common complication of diabetes that can cause blindness.

Looking at 2,856 study participants, the subgroup researchers found that the rates of progression of diabetic retinopathy were 7.3 percent with intensive therapy but 10.4 percent with standard therapy. Retinopathy was also less likely to progress in those who got intensive cholesterol-lowering treatment, but intensive blood pressure control had little effect on the eye disease, the researchers said.

In an editorial accompanying the study in the journal, Dr. Barbara Klein, also of the University of Wisconsin, Madison, said the subgroup study adds valuable information about the effect of blood sugar on retinopathy and points to the need for further study of the value of cholesterol-lowering drugs.

More information

To learn more about eye complications of diabetes, visit the American Diabetes Association.

 

Monday, June 28, 2010 

High Sugar Content in Packaged Toddler and Baby Food Products

ScienceDaily

Monday, June 28, 2010

ScienceDaily (June 28, 2010) — Fifty three percent of food products specifically targeted to babies and toddlers in Canadian grocery stores have an excessive proportion -- more than 20 per cent -- of calories coming from sugar, according to a new study by University of Calgary professor Charlene Elliott.

The study, funded by the Centre for Science in the Public Interest Canada, examined sugar and sodium levels in 186 food products specifically marketed for babies and toddlers. Published in the advanced online version of the Journal of Public Health, the study also analysed four categories of baby/toddler foods against their adult counterparts to reveal whether a 'halo effect' attributed to baby/toddler food is warranted.

 

"There is a presumed halo effect around baby and toddler foods because people expect these foods to be held to a higher standard," says Elliott, an associate professor in the Communications & Culture department. "Yet this is not necessarily the case."

 

The study sought to draw attention to the new, and expanding category of "toddler" foods available in the supermarket -- which include fruit snacks, cereal bars, desserts, and cookies -- as well as baby food products outside of simple purees of fruits and vegetables (which could be classified as pure foods).

 

Products in the study included pureed dinners and desserts, toddler entrees and dinners, snacks (biscuits, cookies, fruit snacks, snack bars and yogurts) and some cereals. Excluded were simple purees of fruits and vegetables, juices and beverages, and also infant formulas and infant cereals designed to be mixed with breast milk or water. The study also made specific comparisons between four types of toddler food products -- toddler cereal bars, cookies/biscuits, fruit snacks and yogurt -- and their adult equivalents. It found that these baby/toddler foods were not nutritionally superior to the adult equivalents when it comes to sugar and in some cases fared worse.

 

"Assessing sugar levels in baby and toddler foods is challenging because there is currently no universally accepted standard," explained Elliott. "While the American Heart Association (AHA) recommends that adults should limit their consumption of added sugars to six teaspoons a day for women and nine teaspoons a day for men, these recommendations do not extend to children or toddlers. In fact, the AHA has not published specific 'added sugar' recommendations for children or toddlers -- even though high sugar foods are deliberately created for them. Health Canada, similarly, offers no direct recommendations -- or cautions -- regarding sugar intake or upper limits on the intake of added sugar for very young children, or for toddlers, per se."

 

Given this, the study used established guidelines that suggest foods are of poor nutritional quality if more than 20 per cent of their calories derive from sugar.

 

Over half (53 per cent) of the products examined met these criteria. Forty percent of products listed sugar -- or some variant like corn syrup, cane syrup, brown sugar, or dextrose) -- in the first four ingredients on the label. Nineteen percent listed sugar (or some variant) as either the first or second ingredient.

 

"This draws attention to the, perhaps obvious, need to carefully examine the ingredient list," says Elliott. "While some products derive their sugar content from naturally occurring fruit sugars, many products also contain added sugars. It remains fair to ask why it is necessary to add sugar to these baby or toddler products in the first place."

 

Elliott also observes that much of the packaging, labeling and framing of such foods play to adult conceptions and classifications of treats and of what it means to eat a meal. "The study contained baby food desserts and 'premium organic cookies' for toddlers -- products that would be target adult tastes, as there is no nutritional reason that babies should complete their meals with Banana Coconut Cream Dessert puree or cookies, organic or otherwise. Equally significant is the way such products steer our youngest consumers down the wrong path in terms of reinforcing tastes for sweet foods."

Journal Reference:

Elliott et al. Sweet and salty: nutritional content and analysis of baby and toddler foods. Journal of Public Health, 2010; DOI: 10.1093/pubmed/fdq037


Exercise OK for Rheumatoid Arthritis Patients: Review

 

HealthDay News

Monday, June 28, 2010

MONDAY, June 28 (HealthDay News) -- Aerobic cardio exercise is safe for patients coping with rheumatoid arthritis (RA), a new French review of prior research suggests.

The study, published in the July issue of Arthritis Care & Research, also found that regular exercise can lead to less joint pain, higher functioning and an improved quality of life overall for these patients.

"While past studies have indicated that RA patients are quite physically inactive, our study shows aerobic exercise to be a safe and beneficial intervention for this group. Further trials are needed to clearly determine the clinical impact of cardio-respiratory conditioning in the management of RA," lead author Dr. Athan Baillet, from the University of Grenoble Medical School in France, said in a news release from the journal's publisher.

Relative to healthy people, RA patients are two times more likely to have health-driven limitations on the kinds of activities they can engage in, according to the U.S. Centers for Disease Control and Prevention.

The 1 percent of the global population that is struck by the disease, which is characterized by swollen joints, pain, stiffness, fatigue and a general sense of being unwell, are also 40 percent more likely to say they are in fair or poor general health, the World Health Organization has noted.

In the new report, researchers looked at 14 previous studies that focused on RA patients and aerobic exercise.

Collectively, the studies included more than 1,000 patients, evenly divided between those with RA and healthy participants, aged 44 to 68.

Those with RA had coped with the disease for up to 16 years, the study authors noted.

"Our results show that patients with stable RA would benefit from regular aerobic exercise," Baillet said in a news release from the journal's publisher. "Cardio-respiratory conditioning appears safe and its effects, while small, help to reduce joint pain and improve function," Baillet added.

According to the American College of Rheumatology, people with rheumatoid arthritis can benefit from exercise. In fact, the organization recommends 150 minutes per week of moderate intensity aerobics, including walking, aerobic dance and water exercise.

More information

For more on rheumatoid arthritis, visit the Arthritis Foundation.

Nitrate in Beetroot Juice Lowers Blood Pressure, Study Finds

ScienceDaily

Monday, June 28, 2010

ScienceDaily (June 28, 2010) — The nitrate content of beetroot juice is the underlying cause of its blood pressure lowering benefits, research from Queen Mary University of London reveals.

The study, published online in the American Heart Association journal Hypertension, found that blood pressure was lowered within 24 hours in people who took nitrate tablets, and people who drank beetroot juice.

 

The research will be welcome news to people with high blood pressure who might now be able to use a new 'natural' approach to reduce their risk of cardiovascular disease (including stroke and heart attacks) -- the world's biggest killer.

 

Study author Amrita Ahluwalia, Professor of Vascular Biology at Queen Mary's William Harvey Research Institute, said the investigation was able to demonstrate that the nitrate found in beetroot juice was the cause of its beneficial effects upon cardiovascular health by increasing the levels of the gas nitric oxide in the circulation.

 

Professor Ahluwalia said. "We gave inorganic nitrate capsules or beetroot juice to healthy volunteers and compared their blood pressure responses and the biochemical changes occurring in the circulation.

 

"We showed that beetroot and nitrate capsules are equally effective in lowering blood pressure indicating that it is the nitrate content of beetroot juice that underlies its potential to reduce blood pressure. We also found that only a small amount of juice is needed -- just 250ml -- to have this effect, and that the higher the blood pressure at the start of the study the greater the decrease caused by the nitrate.

 

"Our previous study two years ago found that drinking beetroot juice lowered blood pressure; now we know how it works."

 

The results of the study could pave the way for a natural approach to lowering blood pressure that ultimately may help reduce the currently massive burden of cardiovascular disease on the NHS.

Journal Reference:

Vikas Kapil, Alexandra B. Milsom, Michael Okorie, Sheiva Maleki-Toyserkani, Farihah Akram, Farkhanda Rehman, Shah Arghandawi, Vanessa Pearl, Nigel Benjamin, Stavros Loukogeorgakis, Raymond MacAllister, Adrian J. Hobbs, Andrew J. Webb, and Amrita Ahluwalia. Inorganic Nitrate Supplementation Lowers Blood Pressure in Humans. Role for Nitrite-Derived NO. Hypertension, 2010; DOI: 10.1161/HYPERTENSIONAHA.110.153536


Study raises questions over wider use of statins

 

By Kate Kelland

Reuters

Monday, June 28, 2010

LONDON (Reuters) – There is no evidence that prescribing cholesterol-lowering drugs known as statins to patients at risk of heart disease reduces their chances of premature death in the short term, scientists said on Monday.

The results of a study by British researchers call into question the expanded use of statins such as Pfizer's Lipitor and AstraZeneca's Crestor in patients who do not have heart disease but may develop it.

Statins are one of the most widely used drugs for the treatment and prevention of heart disease, both among people who already have it and among high-risk but healthy people. They are among the most successful drugs of all time and have been credited with preventing millions of heart attacks and strokes.

But in a meta-analysis -- a study which reviews all previous published scientific evidence on a specific area -- Professor Kausik Ray and colleagues from the University of Cambridge and Addenbrooke's Hospital found scant evidence that statins saved lives in the short term in groups without heart disease.

"There is little evidence that statins reduce the risk of dying from any cause in individuals without heart disease," they wrote in the study in Archives of Internal Medicine journal.

"This, along with harms caused by statins in some subgroups, have called into question the benefit of statins in primary prevention (prevention of the development of heart disease)."

Heart disease is the biggest killer of men and women in the rich world and is also a growing problem in developing nations.

Side Effects

Although statins are widely seen as safe and effective drugs, a study published last month found that people taking them may have higher risks of liver dysfunction, kidney failure, muscle weakness and cataracts. Scientists have warned such side effects should be closely monitored.

In their analysis, the Cambridge team combined data from 11 studies involving 65,229 people. A total of 32,623 individuals were assigned to take statins and 32,606 individuals were assigned to take placebo.

Over an average of 3.7 years of follow-up, 2,793 participants died, including 1,447 on placebo and 1,346 on statins. The scientists said the small reduction in the statin group was not statistically significant.

While low-density lipoprotein (LDL), or "bad" cholesterol levels, were higher among those taking placebo than those taking statins (134 milligrams per deciliter versus 94 milligrams per deciliter), this had no effect on the risk of premature death.

The scientists said their results showed "the need for caution when extending the potential benefits of statins to a wider population."

Professor Peter Weissberg of the British Heart Foundation noted the findings but said they were only short-term.

"The people in these studies were followed for less than four years on average. Since heart and circulatory disease develops over many decades, it's reasonable to assume that we would see a significant improvement in mortality after a longer period of follow-up," he said in a statement.

He also said premature death was not the only consideration when seeking to prevent heart disease.

"Many studies have shown that statins prevent non-fatal heart attacks and strokes," he said. "Preventing serious ill health, such as heart failure resulting from a heart attack, or disability due to a stroke, is every bit as important as lengthening lives."

(Editing by David Holmes)

FDA Urges Limiting Antibiotics in Meat

 

By Steven Reinberg
HealthDay Reporter
HealthDay News

Monday, June 28, 2010

MONDAY, June 28 (HealthDay News) -- The continued use of antimicrobial drugs to promote growth in chickens, cattle and other livestock is tied to antibiotic resistance and should be phased out for that purpose, the U.S. Food and Drug Administration said Monday.

The drugs in question include penicillin, tetracycline, macrolides and erythromycin, which are also commonly prescribed to people to fight serious illnesses. Growing microbial resistance to these and other antibiotics is rendering them less effective against a range of infections, agency experts said.

"FDA believes the overall evidence supports the conclusion that using medically important antimicrobial drugs for production purposes is not in the interest of protecting and promoting the public health," Dr. Joshua Sharfstein, principal deputy commissioner of food and drugs at the Food and Drug Administration, said during a late morning teleconference.

"Antimicrobial agents have been used in human and veterinarian medicine for more than 50 years, with tremendous benefits to both humans and animals," Sharfstein said. "But, because bacteria are so good at becoming resistant to antimicrobial drugs, it is essential that such drugs be used judiciously to delay the development of resistance."

Misuse and overuse of these drugs result in a rapid development of resistance, which has been growing, Sharfstein said. "Developing strategies to reduce antimicrobial resistance is critically important to protect the public health," he said.

The FDA is issuing draft guidelines for limiting the use of these drugs in food-producing animals to situations involving the animal's health. In addition, to reduce antibiotic resistance, these drugs should only be used under the supervision of a veterinarian, the agency said.

Although there have been attempts by the food industry and veterinary groups to limit the use of antibiotics, they have fallen short, said Dr. Bernadette Dunham, director of the FDA's Center for Veterinary Medicine. "We believe additional steps are needed to have an impact on this problem," she said at the press conference.

The public and industry will have 60 days to comment on the proposed guidelines, the agency said. Sharfstein said he hopes to see progress soon.

One food industry group, the National Pork Producers Council, believes that FDA regulations already in place are sufficient.

The FDA approves antibiotics for four purposes: treatment of illness, prevention of disease, control of disease and the nutritional efficiency of animals, the council said.

"According to the Animal Health Institute, approximately 13 percent of animal antibiotics are used for nutritional efficiency," the council said in a note on its Web site. "Existing FDA regulations provide adequate safeguards against antibiotic resistance. Any regulatory decisions or legislative action on antibiotic use in animals must be transparent and made based on scientific risk analysis."

More information

For more information on antibiotic resistance, visit the U.S. Centers for Disease Control and Prevention.

Dark Chocolate Lowers Blood Pressure, Research Finds

ScienceDaily

Monday, June 28, 2010

ScienceDaily (June 28, 2010) — For people with hypertension, eating dark chocolate can significantly reduce blood pressure. Researchers writing in the open access journal BMC Medicine combined the results of 15 studies into the effects of flavanols, the compounds in chocolate which cause dilation of blood vessels, on blood pressure.

Dr Karin Ried worked with a team of researchers from the University of Adelaide, Australia, to conduct the analysis. She said, "Flavanols have been shown to increase the formation of endothelial nitric oxide, which promotes vasodilation and consequently may lower blood pressure. There have, however, been conflicting results as to the real-life effects of eating chocolate. We've found that consumption can significantly, albeit modestly, reduce blood pressure for people with high blood pressure but not for people with normal blood pressure."

 

The pressure reduction seen in the combined results for people with hypertension, 5mm Hg systolic, may be clinically relevant -- it is comparable to the known effects of 30 daily minutes of physical activity (4-9mm Hg) and could theoretically reduce the risk of a cardiovascular event by about 20% over five years.

 

The researchers are cautious, however, "The practicability of chocolate or cocoa drinks as long-term treatment is questionable," said Dr Ried.

Journal Reference:

Karin Ried, Thomas Sullivan, Peter Fakler, Oliver R Frank and Nigel P Stocks. Does chocolate reduce blood pressure? A meta-analysis. BMC Medicine, 2010; DOI: 10.1186/1741-7015-8-39

Agent Orange Exposure Linked to Graves' Disease in Vietnam Veterans, Study Finds

ScienceDaily

Monday, June 28, 2010

ScienceDaily (June 28, 2010) — Vietnam War-era veterans exposed to Agent Orange appear to have significantly more Graves' disease, a thyroid disorder, than veterans with no exposure, a new study by endocrinologists at the University at Buffalo has shown.

Ajay Varanasi, MD, an endocrinology fellow in the UB Department of Medicine and first author on the study, garnered first prize in the oral presentation category for this research at the American Association of Clinical Endocrinologists annual meeting held in Boston in April.

 

"Our findings show that Vietnam veterans who came in contact with Agent Orange are more likely to develop Graves' disease than those who avoided exposure," says Varanasi.

 

"The autoimmune disorder was three times more prevalent among veterans who encountered the dioxin-containing chemical. We also looked at other thyroid diagnoses, but we didn't find any significant differences in thyroid cancer or nodules."

 

Agent Orange is a defoliant that was used in Vietnam to destroy crops and reduce jungle foliage that could shelter enemy combatants. The herbicide contains dioxin, which has chemical properties similar to the thyroid hormones.

Graves' disease is an autoimmune disease associated with overactivity of the thyroid gland. This gland releases the hormones thyroxine (T4) and triiodothyronine (T3), which control body metabolism and are critical for regulating mood, weight, and mental and physical energy levels.

 

Varanasi and colleagues assessed the prevalence of major thyroid diagnoses in the Veterans Administration electronic medical record database for upstate New York veterans born between 1925 and 1953, the age group that would have been eligible for military service during the Vietnam era. They conducted the research at the Buffalo VA Medical Center.

 

They compared the frequency of diagnoses of thyroid cancer, nodules, hypothyroidism and Graves' disease in veterans who identified themselves as being exposed to Agent Orange (23,939) or not exposed to Agent Orange (200,109).

 

"Analyzing data on thyroid conditions, we found no difference in the prevalence of thyroid nodules or cancers between the exposed and non-exposed groups," says Varanasi. "Graves' disease, however, was three times more prevalent in the exposed group.

 

"Interestingly, hypothyroidism [lower than normal thyroid] was less common in the exposed group."

 

Varanasi says that in view of the known effects of dioxin on the immune system, further research should be conducted on the increased prevalence of Graves' disease in Vietnam veterans. His research group is planning to continue this investigation either in vitro or in animal models.

 

Additional authors on the study are Toufic Abdo, MD, David Kasinski, Amy O'Donnell, MD, and Stephen Spaulding, MD, all associated with UB.

 

Sunday, June 27, 2010

 

More Genes Implicated in Type 2 Diabetes

 

By Amanda Gardner
HealthDay Reporter
HealthDay News

Sunday, June 27, 2010

SUNDAY, June 27 (HealthDay News) -- Scientists have located 12 new genes that seem to be linked with a predisposition for type 2 diabetes, bringing the total number of genetic locations implicated in the condition to 38.

At this point, the findings don't mean much for patients or doctors, although one day they may lead to better treatments.

"From here, to apply this clinically is going to be many more years," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

"It is tough to pull clinical relevance out of [these types of studies], but this is laying the groundwork for what can come later," added Jacob L. McCauley, an assistant professor at the John P. Hussman Institute for Human Genomics at the University of Miami's Miller School of Medicine. "The size of this study is what's impressive. This provides a lot of power that in time these results will have medical relevance."

Also, Zonszein pointed out, these genes only relate to a predisposition for developing diabetes, not actually having or getting diabetes.

"Environmental factors are the other 50 percent of the story," he said.

And those environmental factors are well known. The most important is being overweight or obese.

According to the study authors, who publish their report in the June 27 online edition of Nature Genetics, the genes related to type 2 diabetes that are already known represent less than 10 percent of the total genetic picture of this disease.

"The majority of people with type 2 diabetes don't have a monogenetic [traceable to one gene] disease. These are only 4 to 5 percent," Zonszein said. "Most have a very complex polygenic disease."

And each of the genomic regions identified in this study lend only a small increase to the risk of diabetes.

These researchers, from Europe and North America, revisited data from previously conducted genome-wide association studies involving more than 8,000 individuals with type 2 diabetes and almost 40,000 healthy controls. All participants were of European descent.

They then added genetic data from another 34,000 people with diabetes and close to 60,000 controls.

The genes they found were associated with well-known biological processes of diabetes, namely beta-cell function (these are the pancreatic cells that produce insulin) and insulin performance, as well as cell-cycle regulation.

An unexpected finding was that one of the genes resides on the X chromosome. "That's important because it may indicate maternal inheritance," Zonszein explained.

"X chromosome association has been rare in most complex diseases, and this is the first one identified for type 2 diabetes," McCauley explained.

Also interesting is the fact that seven of the regions are known to be involved in other diseases or human characteristics including height, certain cardiovascular risk factors, and skin and prostate cancer.

"There are independent associated signals in what we would consider to be unrelated diseases or unrelated phenotypes," McCauley stated. "This further points out that biology is complex. Genes do a lot of things. They're involved with a lot of networks."

More information

The American Diabetes Association has more on type 2 diabetes.