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Friday, May 6, 2011

Cigarette Smoking and Arsenic Exposure: A Deadly Combination

ScienceDaily

Friday, May 6, 2011

ScienceDaily (May 6, 2011) — Arsenic exposure and smoking each elevate the risk of disease. But when combined together, the danger of dying from cardiovascular disease is magnified, a new study finds.

Exposure to high or even moderate levels of the toxin arsenic through drinking water can elevate the risk of cardiovascular disease mortality, according to a new study published in British Medical Journal. Exposed individuals who smoke were hit with a dangerous double whammy: a combined mortality risk that exceeded the influence of either factor alone.

"Cigarette smoking is pervasive all over the world, and arsenic exposure on top of it creates a major public health problem," said Habibul Ahsan, MD, MMedSc, Professor and Director of the Center for Cancer Epidemiology and Prevention at the University of Chicago Medical Center and senior author of the study. "This tells us that there are some individuals who are dying from cardiovascular disease solely because of the presence of both factors, not because of the presence of one or the other."

The epidemiological study was part of an ongoing project to measure the health consequences of arsenic exposure in Bangladesh. Millions of people in the South Asian country have been accidentally exposed to unsafe levels of arsenic via drinking water from wells installed by health organizations in the 1970's to fight water-borne infectious disease.

For the past 11 years, researchers from the University of Chicago, Columbia University, and New York University have studied the health effects of this long-term toxic exposure in nearly 12,000 recruits from the country. The new study sought to characterize the effect of prolonged arsenic exposure upon death from cardiovascular disease -- an effect less strongly established than the toxin's links with cancer, skin lesions, and respiratory disease.

Researchers collected urine samples from 11,746 men and women and water samples from the wells they used to measure arsenic exposure. Subjects were tracked for an average of 6.6 years, with causes of death noted in those who died during that time. Of the 460 deaths observed during the study period, 198 were because of cardiovascular disease.

When arsenic exposure levels were compared across the population, a significant effect on mortality was found for those exposed to levels higher than 12 parts per million -- just slightly above the World Health Organization recommended safe limit of 10 parts per million. Individuals who drank water containing higher than 12 parts per million arsenic (ranging from 13 to 864 parts per million) were nearly 50 percent more likely to die of cardiovascular disease than those drinking water below that concentration.

"We were able to show that, even at lower doses than previously reported, there seems to be a deleterious effect of arsenic regarding cardiovascular disease mortality, particularly from ischemic and other heart diseases," Ahsan said.

When the data was further compared according to smoking behavior, another interaction was observed. The risk of dying from ischemic and other heart diseases associated with moderate or high arsenic exposure was even higher in people who currently smoke or have smoked.

Non-smokers exposed to high levels of arsenic exposure (over ten times the safe limit) were 50 percent more likely to die of cardiovascular disease than those exposed to safe levels of the toxin. By comparison, current smokers were more than 300 percent more likely to die of cardiovascular disease if exposed to high levels of arsenic.

The result is relevant both for Bangladeshis exposed to unusually high concentrations of arsenic and people around the world, including in the United States, who may be exposed to moderate levels of arsenic in water and could exacerbate the harmful effects of smoking.

"This highlights the importance of eliminating smoking from a population," Ahsan said. "It's one more reason to pay attention to arsenic exposure, but yet another reason that will underscore the importance of smoking cessation."

In an accompanying editorial, Allan H. Smith of the University of California, Berkeley and Craig M. Steinmaus of the California Office of Environmental Health Hazard Assessment agreed that the study's results reinforce the worldwide dangers of even moderate arsenic exposure.

"There is enough evidence to highlight a serious public health concern because exposure to groundwater containing arsenic is widespread throughout the world," the authors write. "Arsenic poses far higher health risks than any other known environmental exposure, with about one in 10 people dying because of high concentrations of arsenic in water."

The study will be published online May 6, 2011 by BMJ. In addition to Ahsan, authors include Yu Chen and Mengling Liu of New York University School of Medicine; Joseph Graziano, Faruque Parvez, Vesna Slavkovich, Diane Levy, and Alexander van Geen of Columbia University; Tara Kalra and Maria Argos of the University of Chicago; and Tariqul Islam, Alauddin Ahmed, Muhammad Rakibuz-Zaman, Rabiul Hasan, and Golam Sarwar of the University of Chicago and Columbia University Research Project Office in Dhaka, Bangladesh.

The research was funded by the National Institutes of Health, the National Institute of Environmental Health Sciences, and the National Cancer Institute.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Y. Chen, J. H. Graziano, F. Parvez, M. Liu, V. Slavkovich, T. Kalra, M. Argos, T. Islam, A. Ahmed, M. Rakibuz-Zaman, R. Hasan, G. Sarwar, D. Levy, A. van Geen, H. Ahsan. Arsenic exposure from drinking water and mortality from cardiovascular disease in Bangladesh: prospective cohort study. BMJ, 2011; 342 (may05 2): d2431 DOI: 10.1136/bmj.d2431

Thursday, May 5, 2011

Fish oil may not prevent depression: study

By Janice M. Horowitz

Reuters Health

Thursday, May 5, 2011

NEW YORK (Reuters Health) – Eating fish rich in omega-3 fatty acids doesn't appear to stave off the blues in women, U.S. researchers have found.

Their study, published in the American Journal of Clinical Nutrition, adds to the conflicting evidence on the benefits of fish oil, which some research has hinted might help certain people with depression.

"We know that omega-3s are important in brain function," study researcher Dr. Alberto Ascherio, a nutrition expert at the Harvard School of Public Health in Boston, told Reuters Health.

"We approached this work thinking that when it comes to preventing depression, it's conceivable that you are what you eat," he said.

But the researchers' findings didn't bear out that prediction.

The team followed nearly 55,000 nurses over 10 years. All the women, between 50 and 77 years old, were free of depression when the study began in 1996.

Over the next decade, five percent of them eventually developed clinical depression. But the risk was the same regardless of how much DHA and EPA -- two omega-3 fatty acids -- women got from eating fish.

Fish rich in omega-3s include salmon, trout, sardines and herring.

The researchers did find preliminary signs that a plant-based omega-3 called alpha-linolenic acid could play a role in mood.

For every increase of half a gram in daily intake of the substance --common in walnuts and canola oil, for instance -- there was an 18-percent reduction in the risk of depression.

A study like the current one can't prove cause-and-effect, and Ascherio said the area needs further research before any recommendations can be made.

His team also examined omega-6 fatty acids, but was unable to come up with conclusive findings on its impact on depression. Omega-6s are found in refined vegetable oils and are ubiquitous in snack foods, sweets and fast foods.

Depression strikes twice as many women as men, with one in five U.S. women experiencing the problem at some point.

Dr. Teodore Postolache, who directs the mood and anxiety program at the University of Maryland School of Medicine in Baltimore, told Reuters Health he is not yet ready to give up on fish oil.

"There are inherent limitations on studies about depression, including determining with certainty what exactly depression is for patients," Postolache said.

Using data from nurses, for example, can skew results because nurses are more educated in matters of health and diet than the general population.

"If groups who may have underlying deficits in fish oil were studied, like lower socioeconomic groups, we might have seen a more powerful effect of the omega-3s in preventing depression," he said.

He also noted that the study excluded women who had previous episodes of depression, although this group is one of "the most important targets for intervention because they are at high risk for a repeat episode."

He called for more research on animals and in broader swaths of the population.

Source: http://bit.ly/kmB4rn

American Journal of Clinical Nutrition, April 2011.

Blood Pressure May Hint at Kidney Cancer Outcome

HealthDay News

Thursday, May 5, 2011

THURSDAY, May 5 (HealthDay News) -- In people with advanced kidney cancer, blood pressure appears to indicate how well their medication is working, with high blood pressure linked to longer survival, new research shows.

The finding comes from a study of 544 people being treated with the drug sunitinib (Sutent) for advanced kidney cancer. The researchers found that those whose maximum systolic blood pressure reached 140 mmHg or higher survived nearly four times longer than those who had a lower maximum systolic blood pressure -- 30.5 months vs. 7.8 months.

Systolic is the top number and diastolic the lower number in a blood pressure reading.

People who had a maximum diastolic blood pressure of 90 mmHg or greater survived twice as long as those with a lower maximum diastolic blood pressure -- 32.2 months vs. 14.9 months.

The researchers also found that progression-free survival, which refers to the amount of time when a tumor either shrinks or does not grow, was 2.5 to 5 times longer in people with high blood pressure -- 12.5 months for those with systolic hypertension vs. 2.5 months for those without, and 13.4 months for those with diastolic hypertension vs. 5.3 months for those without.

"These findings support the hypothesis that high blood pressure may act as a biomarker of a medication's anti-tumor effectiveness," study leader Dr. Brian Rini, a staff physician at the Cleveland Clinic's Taussig Cancer Institute, said in a clinic news release. "What that means is that physicians may be able to monitor a patient's blood pressure to gauge how effectively sunitinib is treating their advanced kidney cancer."

The study was published online April 28 in the Journal of the National Cancer Institute.

More information

The American Cancer Society has more about kidney cancer.

Finding ovarian cancer fast may not help survival

By Genevra Pittman

Reuters Health

Thursday, May 5, 2011

NEW YORK (Reuters Health) – Once a woman begins experiencing symptoms of ovarian cancer, getting diagnosed and treated quickly may not help her survive longer, according to a new study of Australian women.

The finding is discouraging, researchers said, especially because doctors have believed that catching more cases of ovarian cancer early may help extend how long women live after diagnosis.

Ovarian cancer kills the majority of women with the disease within 5 years.

The results, published in the Journal of Clinical Oncology, "do not mean that women who have persistent symptoms that might be due to ovarian cancer should not seek immediate medical attention," Christina Nagle, the study's lead author from the Queensland Institute of Medical Research in Australia, told Reuters Health.

"Presenting promptly will help ensure that they are appropriately referred and can then make informed choices about their treatment," she said in an email.

Nagle and her colleagues followed almost 1,500 Australian women who were diagnosed with ovarian cancer between 2002 and 2005. The researchers interviewed the women about their symptoms and when they first went to the doctor and were diagnosed with cancer, then continued to track the participants for the next 5 years.

Most of the women had symptoms before they were diagnosed - in the others, cancer was caught at a routine check-up or during surgery for a different condition.

In women with symptoms, about 40 percent went to their doctors and were examined and diagnosed with ovarian cancer within 2 months of when the symptoms started. Within 3 months, about 60 percent of women had been diagnosed, and 6 months after symptoms began, 80 percent had been diagnosed.

Women whose cancer was picked up before symptoms started survived longer than those who had symptoms. For example, in all women with late-stage cancer, those without symptoms lived an average of 4 years after their diagnosis, compared to 3 years in women with symptoms.

But among those who did have invasive, symptomatic cancer, survival did not depend on how soon they saw their doctor.

Fifty-two percent of women who were diagnosed within 1 month of their first symptoms survived for the next 5 years, compared to 53 percent of women who took more than a year to be diagnosed.

But that doesn't necessarily mean that all efforts to get women treated fast are for naught.

Women may still get symptoms -- such as daily stomach or pelvic pain, pelvic bloating or fullness, or difficulty eating -- from early-stage cancer, and for them, it's possible that a quick diagnosis could improve outcomes, said M. Robyn Andersen, who studies ovarian cancer at the University of Washington in Seattle and was not involved in the current research.

Women who have new and persistent symptoms, she said, should still see their doctors.

And even if there is no ultimate change in how long women with ovarian cancer survive, early diagnosis and treatment is still important, Andersen said.

"Getting somebody quickly and promptly to the correct treatments helps them feel better about working with their physician team, helps them start their battle with cancer in a much better place," she told Reuters Health. "It is a quality of life issue for a cancer patient to be diagnosed promptly."

According to the National Cancer Institute, about 22,000 new cases of ovarian cancer were diagnosed last year.

Tumors or abnormal growths may first be detected during a normal pelvic exam, or through ultrasound imaging. A blood test to detect a substance called CA 125, which may be a sign of certain cancers, is still being studied as a diagnostic tool, according to the National Cancer Institute.

Because the disease is relatively rare and the benefits of early detection unclear, the U.S. Preventive Services Task Force, a federal expert panel, does not recommend that women be regularly screened for ovarian cancer.

[This story was corrected in paragraph 12 to clarify a researcher statement and to remove the first word of paragraph 13.]

Source: http://bit.ly/ky2Ojr

Journal of Clinical Oncology, online May 2, 2011.

Early solid foods tied to lower peanut allergy risk

By Amy Norton

Reuters Health

Thursday, May 5, 2011

NEW YORK (Reuters Health) – Infants with a family history of allergies might be less likely to develop a peanut allergy if they start solid foods before the age of four months, a new study suggests.

Researchers found that among 2- and 3-year-olds whose parents suffered from allergies, those who were started early on solid foods or cow's milk were about five times less likely to be sensitized to peanuts.

"Sensitized" means that a child has immune-system antibodies directed at a potential allergen -- in this case, peanut proteins -- and is at increased risk of having a full-blown allergy to that substance.

Still, the findings do not prove that early introduction of "complementary" foods prevents peanut allergies, said Christine Joseph, the lead researcher on the study and an epidemiologist at the Henry Ford Health System in Detroit.

The study, she told Reuters Health, shows an association, but cannot prove cause-and-effect.

So it's too early to make any recommendations to parents on when to introduce solid foods or cow's milk, Joseph said.

And in general, she noted, there is controversy over which infant feeding tactics, if any, might cut the risk of food allergies.

At one time, the American Academy of Pediatrics recommended that parents not give children cow's milk until after their first birthday, eggs until the age of two, or peanuts until age three. But the group reversed that position in 2008, after studies showed no good evidence that the advice lowered kids' food allergy risks.

Right now, experts generally recommend that infants be breastfed exclusively for the first six months of life because it is the best form of nutrition. Whether that has any benefit on food allergy risks, though, remains unclear.

The new findings are based on 594 children whose mothers were interviewed when the children were one, six, and 12 months old. When the children were 2 to 3 years old, the researchers tested their blood samples for antibodies against peanut, egg and milk -- three common triggers of childhood food allergies.

Overall, 11 percent of the children were sensitized to peanut. Among children whose parents had allergies or asthma, the risk of peanut sensitization was lower if they'd been started on solid food or cow's milk before the age of four months.

Of those children, just under 6 percent had peanut sensitivity, versus 16 percent of those who'd had the foods introduced later in infancy. That corresponds to a five-fold difference in risk, after taking into account other things that might set the toddlers up for allergies.

There was no similar pattern among children whose parents were allergy-free.

It's too early to tell whether early solid foods are a "good thing" for infants with a family history of allergies, Joseph said.

"Intuitively, it does seem like the opposite of what you'd expect," she noted.

However, Joseph explained, for infants with a genetic susceptibility to allergies, early exposure to a broader range of foods could be the "kick start" needed for immune-system cells in the gut to mature.

And that, in turn, could make them less likely to develop food allergies later in childhood.

Joseph said that larger studies are needed to confirm the current findings. Lab research would also be helpful to see exactly why early introduction of solid foods and cow's milk might protect against peanut sensitization.

Also unclear, she added, is why this study found a lower risk of peanut sensitization only, and not egg or milk sensitization.

Peanut allergies do tend to be more severe than milk or egg allergies, Joseph pointed out, but it's not certain if that is a reason for the findings.

It's estimated that just over one percent of U.S. children are allergic to peanuts, but that rate appears to have been on the rise over the past couple decades. No one is sure why.

Source: http://bit.ly/jBbFw8

Journal of Allergy and Clinical Immunology, May 2011.

Exercise Protects the Heart Via Nitric Oxide, Researchers Discover

ScienceDaily

Thursday, May 5, 2011

ScienceDaily (May 5, 2011) — Exercise both reduces the risk of a heart attack and protects the heart from injury if a heart attack does occur. For years, doctors have been trying to dissect how this second benefit of exercise works, with the aim of finding ways to protect the heart after a heart attack.

Researchers at Emory University School of Medicine have identified the ability of the heart to produce and store nitric oxide as an important way exercise protects the heart from injury.

Nitric oxide, a short-lived gas generated within the body, turns on chemical pathways that relax blood vessels to increase blood flow and activate survival pathways. Both the chemical nitrite and nitrosothiols, where nitric oxide is attached to proteins via sulfur, appear to act as convertible reservoirs for nitric oxide in situations where the body needs it, such as a lack of blood flow or oxygen.

The Emory team's results, published online in the journal Circulation Research, strengthen the case for nitrite and nitrosothiols as possible protectants from the damage of a heart attack.

The first author is John Calvert, PhD, assistant professor of surgery at Emory University School of Medicine. The senior author is David Lefer, PhD, professor of surgery at Emory University School of Medicine and director of the Cardiothoracic Research Laboratory at Emory University Hospital Midtown. Collaborators included scientists at University of Colorado, Boulder, and Johns Hopkins University.

"Our study provides new evidence that nitric oxide generated during physical exercise is actually stored in the bloodstream and heart in the form of nitrite and nitrosothiols. These more stable nitric oxide intermediates appear to be critical for the cardioprotection against a subsequent heart attack," Lefer says.

Timing is key -- the benefits of exercise don't last In experiments with mice, the researchers showed that four weeks of being able to run on a wheel protected them from having a coronary artery was blocked; the amount of heart muscle damaged by the blockage was less after the exercise period. Importantly, the mice are still protected a week after the wheel is taken away.

The researchers found that voluntary exercise boosted levels of an enzyme that produces nitric oxide (eNOS, endothelial nitric oxide synthase). Moreover, the levels of eNOS in heart tissue, and nitrite and nitrosothiols in the blood as well as heart tissue, stayed high for a week after exercise ceased, unlike other heart enzymes stimulated by exercise. The protective effects of exercise did not extend beyond four weeks after the exercise period was over, when nitrite and nitrosothiols in the heart returned to baseline.

In mice that lack the eNOS enzyme, exercise did not protect the heart from a coronary blockage, although these mice appeared to lack the ability to exercise as much as normal mice.

Another molecule that appears to be important for the benefits of exercise is the beta-3-adrenergic receptor, which allows cells to respond to the hormones epinephrine and norepinephrine. All of the beneficial effects of voluntary exercise are lost in mice that are deficient in this receptor. One of the effects of stimulating the receptor appears to be activating eNOS. Additional animal studies are currently underway in Lefer's lab to determine the potential benefit of beta-3-adrenergic receptor activating drugs following a heart attack.

The research was supported by the American Diabetes Association, the National Institutes of Health and the Carlyle Fraser Heart Center of Emory University Hospital Midtown.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

J. W. Calvert, M. Elston, J. Pablo Aragon, C. K. Nicholson, B. F. Moody, R. L. Hood, A. Sindler, S. Gundewar, D. R. Seals, L. A. Barouch, D. J. Lefer. Exercise Protects Against Myocardial Ischemia-Reperfusion Injury via Stimulation of β3-Adrenergic Receptors and Increased Nitric Oxide Signaling: Role of Nitrite and Nitrosothiols. Circulation Research, 2011; DOI: 10.1161/CIRCRESAHA.111.241117

Wednesday, May 4, 2011

Supplements don't prevent prostate cancer: study

By Kerry Grens

Reuters Health

Wednesday, May 4, 2011

NEW YORK (Reuters Health) – A new study deflates hopes that certain nutritional supplements could stave off prostate cancer, the second most common cancer in men.

Canadian researchers found that vitamin E, selenium and soy, taken daily for three years, provided no benefit to men who were at a higher risk of developing the disease.

The findings come three years after a larger study of men, who were at no increased risk of prostate cancer, also found no benefit of selenium or vitamin E supplementation (see Reuters Health report, October 28, 2008).

Initially, there had been high hopes for these supplements, said Dr. Neil Fleshner, who worked on the new research and heads the urology department at the University Health Network in Toronto.

Surveys of people who consumed high levels of vitamin E, selenium, or soy through their diets or by supplements found a decreased risk of developing prostate cancer, and experiments in laboratory animals also showed a benefit.

Vitamin E and selenium are both antioxidants that are present in foods.

In this study, the researchers randomly assigned 303 men to take either a combination of the supplements or a non-nutritive powder that resembled the supplements every day for three years.

The combination included 40 g of soy (about 1/3 of a cup), 800 U of vitamin E (about 35 times the recommended dietary levels), and 0.2 g of selenium (four times the recommended dietary amount).

All the men had signs of pre-cancerous cells, which put them at a higher risk for developing prostate cancer.

When Fleshner and his colleagues compared the number of cases of cancer in each group, the results were nearly identical. Twenty-six out of every 100 men developed prostate cancer after three years, regardless of whether they took the supplement or the whey-based placebo powder.

"To our chagrin, there was no benefit," Fleshner told Reuters Health.

The current research differed from previous work in that it included soy. Fleshner said rates of prostate cancer are much lower in China and Japan, where people consume soy in large amounts, than in the United States or Canada.

The results don't rule out that soy might be beneficial to those who eat it frequently for decades, but three years of extra soy don't appear to help prevent prostate cancer.

The Canadian Cancer Society Research Institute funded the study, and the supplements were provided by a company that manufactures them.

"I think that in the absence of more compelling scientific data for vitamin E and selenium, that we should move on," Dr. Eric Klein, chair of the Glickman Urological and Kidney Institute at the Cleveland Clinic, who headed the 2008 study, told Reuters Health.

Prostate cancer is diagnosed in 156 out of every 10,000 men in the United States each year. But some of the tumors may never become deadly and there is debate over the best way to treat them.

Fleshner agreed with Klein, who was not involved in the new study, in that there are enough data now to warrant abandoning research on vitamin E, selenium and soy and their potential benefits to preventing prostate cancer.

"We need to look at new strategies and novel nutritional agents," Fleshner said.

Source: http://bit.ly/jVMG1a

Journal of Clinical Oncology, online May 2, 2011.

Obese Teens Lack Vitamin D, Study Finds

HealthDay News

Wednesday, May 4, 2011

WEDNESDAY, May 4 (HealthDay News) -- Low levels of vitamin D are common in obese adolescents, a new study finds.

Researchers screened 68 obese adolescents and found low vitamin D levels in all of the girls (72 percent were deemed deficient and 28 percent insufficient) and in 91 percent of the boys (69 percent deficient and 22 percent insufficient).

After treatment, 43 of the youths had their vitamin D levels measured again and, although levels generally increased, normal levels were achieved in just 28 percent of the participants. In the others, repeated bouts of vitamin D treatment did not bring the teens' vitamin D levels to normal, which the researchers described as "concerning."

The adolescents' lack of response to treatment may be due to the fact that vitamin D is sequestered in body fat, the researchers said.

"The prevalence of low vitamin D status among obese adolescents in this study is greater than previously reported for this age group," Dr. Zeev Harel, a pediatrician specializing in adolescent medicine at Hasbro Children's Hospital in Providence, R.I., and the study's lead author, said in a hospital news release.

The study was published in the May issue of the Journal of Adolescent Health.

Vitamin D is produced by the skin in response to exposure to sunlight. It is also found in certain foods, including eggs, fish and fortified foods such as dairy products and breakfast cereals.

"It is possible that the association between obesity and low vitamin D status is indirect, arising from obese individuals having fewer outdoor activities than lean individuals and, therefore, less exposure to sun," the researchers wrote. "Likewise, it is also possible that obese individuals do not consume enough foods that contain vitamin D."

They called for closer monitoring of vitamin D levels in obese adolescents and for more research to determine if restoring normal vitamin D levels could help reduce the health risks associated with obesity.

Obesity -- now estimated to affect 16.4 percent of kids and teens between 10 and 17 -- can increase the risk of high blood pressure, heart disease, and type 2 diabetes, as well as some types of cancer, the researchers noted.

More information

The U.S. Office of Dietary Supplements has more about vitamin D.

To Feel Better, Exercise Harder: Study

HealthDay News

Wednesday, May 4, 2011

WEDNESDAY, May 4 (HealthDay News) -- Vigorous exercise offers more of a mood boost than less strenuous exercise, a new study finds.

U.K. researchers compared 11 sedentary people who did moderate and high-intensity exercise. Their mood was assessed before, during, immediately following, and 20 minutes after they did the workouts.

The participants' moods were more negative during and immediately after high-intensity exercise, compared to when they did the less strenuous exercise or no exercise. However, their mood 20 minutes after doing the vigorous workout was much better compared to before the workout.

This type of improvement did not occur after moderate or no exercise, the investigators found.

The study was scheduled for presentation Wednesday at the annual meeting of the British Psychological Society in Glasgow, Scotland. Research presented at meetings is considered preliminary because it has not been subject to the scrutiny required for publication in a peer-reviewed journal.

"These results have implications for the recommended intensity of exercise required to produce the 'feel good factor' often experienced following exercise," author Dr. Nickolas Smith of Manchester Metropolitan University, said in a society news release.

"There are also implications regarding how people new to regular exercise should expect to feel during the exercise itself if they are to experience post-exercise mood benefits," he added.

More information

The U.S. National Heart, Lung, and Blood Institute offers a guide to physical activity.

New Evidence That Caffeine Is a Healthful Antioxidant in Coffee

ScienceDaily

Wednesday, May 4, 2011

ScienceDaily (May 4, 2011) — Scientists are reporting an in-depth analysis of how the caffeine in coffee, tea, and other foods seems to protect against conditions such as Alzheimer's disease and heart disease on the most fundamental levels.

The report, which describes the chemistry behind caffeine's antioxidant effects, appears in ACS' The Journal of Physical Chemistry B.

Annia Galano and Jorge Rafael León-Carmona describe evidence suggesting that coffee is one of the richest sources of healthful antioxidants in the average person's diet. Some of the newest research points to caffeine (also present in tea, cocoa, and other foods) as the source of powerful antioxidant effects that may help protect people from Alzheimer's and other diseases. However, scientists know little about exactly how caffeine works in scavenging the so-called free radicals that have damaging effects in the body. And those few studies sometimes have reached contradictory conclusions.

In an effort to bolster scientific knowledge about caffeine, they present detailed theoretical calculations on caffeine's interactions with free radicals. Their theoretical conclusions show "excellent" consistency with the results that other scientists have report from animal and other experiments, bolstering the likelihood that caffeine is, indeed, a source of healthful antioxidant activity in coffee.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Jorge Rafael León-Carmona, Annia Galano. Is Caffeine a Good Scavenger of Oxygenated Free Radicals? The Journal of Physical Chemistry B, 2011; 115 (15): 4538 DOI: 10.1021/jp201383y

Study: Prostate cancer surgery helps younger men

By Marilynn Marchione

AP Medical Writer

The Associated Press

Wednesday, May 4, 2011

Men under 65 with early prostate cancer had better survival odds if they had surgery right away instead of waiting for treatment only if their cancer got worse, a study in Sweden found.

That was true even for tumors thought to be low-risk because they didn't look very aggressive under a microscope.

Doctors have long debated whether and how to treat such early cases, and the study shows "there clearly is a benefit to getting the cancer out in the younger population," said Dr. Richard Greenberg, urology chief at Fox Chase Cancer Center in Philadelphia.

But there's a big caveat: The benefit may depend on how a man is diagnosed.

About 95 percent of the cancers in the Swedish study were found because they were causing symptoms. In the United States, however, most are found after a PSA blood test suggests a problem, long before symptoms appear. Most of these cancers will not prove life-threatening, but there's no sure-fire way to tell which ones will, so many men get treatment they may not need.

The study is one of the longest-running attempts to look at this issue. It was led by researchers at University Hospital in Uppsala and the Karolinska Institute in Stockholm, and paid for by the U.S. National Institutes of Health and the Swedish Cancer Society. Results appear in Thursday's New England Journal of Medicine.

Starting in 1989, nearly 700 men under 75 were assigned to have surgery right away or to be monitored and treated if their cancer got worse. Most were having symptoms — urinary problems, blood in the urine or semen, trouble getting an erection, or pain in the lower back, hips or upper thighs.

After about 13 years of follow-up, there were fewer deaths among those who had surgery — 166 versus 201 of those being monitored. Prostate cancer was the cause for 55 and 81 of the deaths, respectively.

That means surgery lowered the risk of dying of prostate cancer within 15 years by 38 percent, researchers calculated. But the benefit was significant only for men under 65. In that age group, only seven men would need to be treated to save one life.

More men in the group initially assigned to monitoring saw their cancer spread beyond the prostate, and more of them wound up taking hormone treatments as a result.

Surgery had side effects — 58 percent of men reported at least some sexual problems and 32 percent had some urinary trouble. Researchers did not report how many men in the monitoring group had these problems, which are common as men age even if they don't have prostate cancer.

Surgery techniques have improved since the study began, and nerve-sparing approaches to minimize side effects are more common now.

The study "has provided important evidence that effective treatment is both necessary and possible for many men with early-stage prostate cancer," Dr. Matthew R. Smith of Massachusetts General Hospital wrote in an editorial in the journal.

But whether surgery benefits men with early cancers detected through PSA tests rather than symptoms remains to be seen, he added.

Two studies, one in the United States and one in the United Kingdom, are looking at this now, and include other options besides surgery, he notes.

About half of the 218,000 men diagnosed in the United States each year with prostate cancer have early, low-risk disease, and most choose to treat it right away with surgery, radiation or hormones. In Europe, most choose monitoring and treatment only if it gets worse.

Online:

Prostate cancer info: http://www.cancer.gov/cancertopics/types/prostate

and http://tinyurl.com/ASCOanswers

Risk calculator: http://tinyurl.com/riskcalculator

New England Journal: http://www.nejm.org

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

To Feel Better, Exercise Harder: Study

HealthDay News

Wednesday, May 4, 2011

WEDNESDAY, May 4 (HealthDay News) -- Vigorous exercise offers more of a mood boost than less strenuous exercise, a new study finds.

U.K. researchers compared 11 sedentary people who did moderate and high-intensity exercise. Their mood was assessed before, during, immediately following, and 20 minutes after they did the workouts.

The participants' moods were more negative during and immediately after high-intensity exercise, compared to when they did the less strenuous exercise or no exercise. However, their mood 20 minutes after doing the vigorous workout was much better compared to before the workout.

This type of improvement did not occur after moderate or no exercise, the investigators found.

The study was scheduled for presentation Wednesday at the annual meeting of the British Psychological Society in Glasgow, Scotland. Research presented at meetings is considered preliminary because it has not been subject to the scrutiny required for publication in a peer-reviewed journal.

"These results have implications for the recommended intensity of exercise required to produce the 'feel good factor' often experienced following exercise," author Dr. Nickolas Smith of Manchester Metropolitan University, said in a society news release.

"There are also implications regarding how people new to regular exercise should expect to feel during the exercise itself if they are to experience post-exercise mood benefits," he added.

More information

The U.S. National Heart, Lung, and Blood Institute offers a guide to physical activity.

Tuesday, May 3, 2011

Many Consumers Don't Know What's in Over-the-Counter Painkillers: Study

HealthDay News

Tuesday, May 3, 2011

TUESDAY, May 3 (HealthDay News) -- Few Americans bother to read the labels on over-the-counter pain relievers, nor do they pay much attention to the drugs' ingredients, a new study says.

This lack of awareness could be a main reason why acetaminophen overdose is a leading cause of acute liver failure in the United States, according to the researchers at Northwestern University in Chicago.

Acetaminophen, the active ingredient in Tylenol, is in more than 600 over-the-counter (OTC) and prescription medicines.

Researchers interviewed 45 people in six focus groups and found that only 31 percent knew that Tylenol contained acetaminophen, 19 percent realized Advil contained ibuprofen and about the same number knew that Aleve contained naproxen sodium.

About 75 percent knew Bayer contained aspirin and 47 percent knew Motrin contained ibuprofen.

Fewer than half -- 41 percent -- said they read the ingredients on drug labels.

The study appears in the May 3 issue of the American Journal of Preventive Medicine.

The fact that many people don't know acetaminophen is present in OTC products is "incredibly alarming," said senior author Michael Wolf, an associate professor of medicine at Northwestern University Feinberg School of Medicine.

"People may unintentionally misuse these medicines to a point where they cause severe liver damage," Wolf said in a university news release. "It's easy to exceed the safe limit if people don't realize how much acetaminophen they are taking. Unlike prescription products, there is no gatekeeper, no one monitoring how you take it."

He and his colleagues recommend that a universal icon for acetaminophen should appear on the labels of all medicines that contain it.

The study was funded by McNeil Consumer Healthcare, which makes Tylenol. Wolf has worked as a paid consultant to McNeil.

More information

The American Academy of Family Physicians has more about OTC pain relievers.

Eating less salt doesn't cut heart risks: study

By Genevra Pittman

Reuters Health

Tuesday, May 3, 2011

NEW YORK (Reuters Health) – People who ate lots of salt were not more likely to get high blood pressure, and were less likely to die of heart disease than those with a low salt intake, in a new European study.

The findings "certainly do not support the current recommendation to lower salt intake in the general population," study author Dr. Jan Staessen, of the University of Leuven in Belgium, told Reuters Health.

Current salt guidelines, including those released by the U.S. government in January, are based on data from short-term studies of people who volunteered to be assigned to a low-salt or high-salt diet, Staessen said.

The U.S. guidelines recommend that Americans consume less than 2,300 milligrams of salt daily - 1,500 mg in certain people who are more at risk for high blood pressure or heart disease.

While previous trials suggested a blood pressure benefit with lower salt intake, research has yet to show whether that translates into better overall heart health in the wider population.

The researchers used data from two different studies, incorporating a total of about 3,700 Europeans who had their salt consumption measured through urine samples at the start of the studies. Staessen and his colleagues broke the participants up into three groups: those with highest and lowest salt intakes, and those with average intake.

None of the participants had heart disease at the outset, and two thirds had normal blood pressure. They were followed for an average of 8 years, during which researchers determined how many of them were diagnosed with heart disease, and in a smaller group, how many got high blood pressure.

The findings are published in the Journal of the American Medical Association (JAMA).

The chance of getting heart and blood vessel diseases did not differ in the three groups. However, participants with the lowest salt intake had the highest rate of death from heart disease during the follow up (4 percent), and people who ate the most salt had the lowest (less than 1 percent).

Across all three salt-intake groups, about one in four study participants who started out with normal blood pressure were diagnosed with high blood pressure during follow up.

The researchers did find that one measure of blood pressure, systolic blood pressure, increased as salt intake increased over time - but the change was very small, so it may not be important to health outcomes, Staessen said.

Reducing salt may still be a good idea for people who already have high blood pressure or who have had heart problems in the past, he added, but the study found no evidence that dietary salt causes those conditions to arise.

"It's clear that one should be very careful in advocating generalized reduction in sodium intake in the population at large," Staessen said. "There might be some benefits, but there might also be some adverse effects."

Dr. Hillel Cohen, an epidemiologist at the Albert Einstein College of Medicine in New York, told Reuters Health that when restaurants or food companies put less salt in their products, they may put in other potentially harmful products to make up for the lost taste, or as preservatives.

Consumers shouldn't change their salt-eating behavior based on the limited studies that have tried to determine the link between sodium and heart risks, added Cohen, who was not involved in the current research.

The authors caution that their analysis included only white Europeans, and so the results may not translate to people of other ethnicities.

Source: http://bit.ly/hwxtTL

 JAMA, online May 3, 2011.

Health Tip: Risk Factors for Peripheral Artery Disease

HealthDay News

Tuesday, May 3, 2011

(HealthDay News) -- Peripheral artery disease (PAD) occurs when thick plaque accumulates in the arteries (most often in the legs) and restricts blood flow to the heart, brain, other organs and limbs.

The National Heart, Lung and Blood Institute mentions these risk factors for PAD:

Being a smoker.

Being older.

Having diabetes or a common precursor, metabolic syndrome.

Having high blood pressure or high cholesterol.

Having coronary heart disease.

Having a family history of stroke.

'Apple a Day' Advice Rooted in Science

ScienceDaily

Tuesday, May 3, 2011

ScienceDaily (May 3, 2011) — Everyone has heard the old adage, "an apple a day keeps the doctor away." We all know we should eat more fruit. But why apples? Do they contain specific benefits?

According to Dr. Bahram H. Arjmandi, PhD, RD, Margaret A. Sitton Professor and Chair, Department of Nutrition, Food and Exercise Sciences at The Florida State University, apples are truly a "miracle fruit" that convey benefits beyond fiber content. Animal studies have shown that apple pectin and polyphenols in apple improve lipid metabolism and lower the production of pro-inflammatory molecules. Arjmandi's most recent research is the first to evaluate the long-term cardioprotective effects of daily consumption of apple in postmenopausal women.

The results of this USDA-funded study will be presented at Experimental Biology 2011 on April 12 in Washington, DC.

This study randomly assigned 160 women ages 45-65 to one of two dietary intervention groups: one received dried apples daily (75g/day for 1 year) and the other group ate dried prunes every day for a year. Blood samples were taken at 3, 6 and 12-months. The results surprised Dr. Arjmandi, who stated that "incredible changes in the apple-eating women happened by 6 months- they experienced a 23% decrease in LDL cholesterol," which is known as the "bad cholesterol." The daily apple consumption also led to a lowering of lipid hydroperoxide levels and C-reactive protein in those women.

"I never expected apple consumption to reduce bad cholesterol to this extent while increasing HDL cholesterol or good cholesterol by about 4%," Arjmandi said. Yet another advantage is that the extra 240 calories per day consumed from the dried apple did not lead to weight gain in the women; in fact, they lost on average 3.3 lbs. "Reducing body weight is an added benefit to daily apple intake" he said. Part of the reason for the weight loss could be the fruit's pectin, which is known to have a satiety effect. The next step in confirming the results of this study is a multi-investigator nationwide study.

There is frequently some truth behind our common expressions, and in the case of 'an apple a day,' Dr. Arjmandi has shown that nutrition science backs up the expression. "Everyone can benefit from consuming apples," he said.

This research was performed by Drs. Sheau C. Chai, Shirin Hooshmand, Raz L. Saadat, and Bahram Arjmandi, Florida State University.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Women Often Deprived of Life-Saving Heart Procedures: Study

HealthDay News

Tuesday, May 3, 2011

TUESDAY, May 3 (HealthDay News) -- Women are less likely than men to receive lifesaving surgical interventions if they have a heart attack, according to a new study that finds large disparities in the treatment and outcomes of female and male patients in U.S. hospitals.

HealthGrades researchers analyzed more than five million Medicare patient records from 2007 to 2009, and focused on 16 of the most common procedures and diagnoses among women. HealthGrades is an independent source of hospital quality ratings.

The most significant gender differences were in the area of cardiovascular care. Only 33.5 percent of female heart attack patients received lifesaving surgical interventions, compared with 45.6 percent of male patients. Women who did have heart surgery or angioplasty had a 30 percent higher death rate than men, the researchers found.

When women treated at lower-rated hospitals were compared with women treated at hospitals awarded the HealthGrades Women's Health Excellence Award, female patients at the top-rated facilities had a 40 percent lower risk of death for nine cardiac, pulmonary and vascular-based diagnoses and procedures, and a 16 percent lower risk of complications for five orthopedic procedures.

During the study period, an additional 41,025 women over age 65 might have survived their hospitalization and 8,558 might have avoided major complications if all hospitals had performed at the level of the top-rated hospitals.

The study also found that women account for a higher percentage of hospital admissions for hip fracture than men -- 74 percent vs. 26 percent. This remained unchanged from 2005 to 2009.

"Much work remains to be done to better understand the differences between men's and women's health. But many providers are successfully implementing systems of care to more accurately diagnose and treat disease in women," report co-author Dr. Rick May, vice president of clinical quality services, said in a HealthGrades news release.

National Women's Health Week in the United States is May 8 to 14.

More information

WomensHealth.gov has more about National Women's Health Week.

Following Cancer Prevention Guidelines Lowers Risk of Death from Cancer, Heart Disease, All Causes

ScienceDaily

Tuesday, May 3, 2011

ScienceDaily (May 3, 2011) — A study of more than 100,000 men and women over 14 years finds nonsmokers who followed recommendations for cancer prevention had a lower risk of death from cancer, cardiovascular disease, and all-causes. The study appears early online in Cancer Biomarkers, Epidemiology, and Prevention, and was led by American Cancer Society epidemiologists.

Few studies have evaluated the combined impact of following recommended lifestyle behaviors on cancer, cardiovascular disease, and all-cause mortality, and most of those included tobacco avoidance as one of the recommendations. Because eight in ten Americans are never or former smokers, researchers wanted to more clearly understand the impact of other recommended behaviors.

For their study, researchers led by Marji McCullough at the American Cancer Society used diet and lifestyle questionnaires filled out in 1992 and 1993 by 111,966 non-smoking men and women in the Cancer Prevention Study (CPS)-II Nutrition Cohort. The participants were scored on a range from 0 to 8 points to reflect adherence to the American Cancer Society (ACS) cancer prevention guidelines regarding body mass index, physical activity, diet, and alcohol consumption, with 8 points representing adherence to all of the recommendations simultaneously.

After 14 years, men and women with high compliance scores (7, 8) had a 42% lower risk of death compared to those with low scores (0-2). Risk of cardiovascular disease death were 48% lower among men and 58% lower among women, while the risk of cancer death was 30% lower in men and 24% lower in women. Similar associations, albeit not all statistically significant, were observed for never and former smokers.

The researchers conclude that adhering to cancer prevention guidelines for obesity, diet, physical activity, and alcohol consumption is associated with lower risk of death from cancer, cardiovascular disease, and all-causes in non-smokers. They say beyond tobacco avoidance, following other cancer prevention guidelines may substantially lower risk of premature mortality in older adults.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Marjorie L McCullough, Alpa V Patel, Lawrence H Kushi, Roshni Patel, Walter C Willett, Colleen Doyle, Michael J Thun, and Susan Gapstur. Following cancer prevention guidelines reduces risk of cancer, cardiovascular disease and all-cause mortality. Cancer Epidemiol Biomarkers Prev, April 5, 2011 DOI: 10.1158/1055-9965.EPI-10-1173

Structured Exercise Programs Help Lower Blood Sugar, Study Finds

By Serena Gordon
HealthDay Reporter

HealthDay News

Tuesday, May 3, 2011

TUESDAY, May 3 (HealthDay News) -- A structured exercise program helped people with type 2 diabetes lower their blood sugar level more effectively than just receiving advice about getting more physical activity, according to a new review of data.

After analyzing the results of 47 randomized clinical trials, the researchers also found that exercising for longer periods of time was better at bringing blood sugar levels down than exercising more intensively.

"People with type 2 diabetes should engage in regular exercise training, preferentially supervised exercise training," said the study's senior author, Dr. Beatriz Schaan, a medical school professor at the Hospital de Clinicas de Porto Alegre in Brazil. "If these patients can perform training for more than 150 minutes per week, this would be more beneficial concerning their glucose control. However, if they cannot reach this amount of weekly exercise, lower exercise amounts are also beneficial."

Results of the study are published in the May 4 issue of the Journal of the American Medical Association.

The clinical trials included in the current analysis included more than 8,500 participants. The studies used a measure known as hemoglobin A1C (HbA1C) to assess a particular treatment's effectiveness. HbA1C, sometimes just called A1C, is a measure of long-term blood sugar control. It provides an average of blood sugar levels over a two- to three- month time period. The results of this test are expressed in terms of a percentage. Generally, less than 6 percent is considered normal. People with diabetes usually have levels higher than this. The American Diabetes Association recommends that people with diabetes strive to lower their HbA1C levels to less than 7 percent.

Currently, exercise guidelines recommend that people with type 2 diabetes perform at least 150 minutes a week of moderate-intensity aerobic exercise, and resistance training, such as weight lifting, three times a week, according to the study.

"We always tell patients, even those without diabetes, that it's important to exercise, but we don't tell them how. We don't provide a good structure on what to do," said Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City. "It would be good if we were able to prescribe an exercise program for our patients to follow."

The current analysis compared a group of people with type 2 diabetes who participated in a structured exercise program with a control group that received advice about exercise. A structured exercise program was one that engaged people in planned, individualized exercise. All of the structured programs were supervised.

People in the exercise advice-only groups were told that they needed to exercise and were given advice on how to do so, but they were not engaged in a supervised program, or they were involved in a partially supervised program, according to the study.

People in structured training classes that included both aerobic and strength training lowered their HbA1C by 0.67 percent more than control participants. And structured exercise programs that lasted more than 150 minutes per week resulted in an average drop of 0.89 percent over control participants.

Physical activity advice programs, on the other hand, had an average HbA1C reduction of 0.43 percent versus controls. When combined with dietary advice, physical activity advice lowered HbA1C levels by 0.58 percent over the controls.

"Exercise improves insulin sensitivity; it makes insulin work better," explained Zonszein.

In an accompanying editorial, Dr. Marco Pahor from the University of Florida, Gainesville, suggested that insurance companies should consider paying for the costs of structured exercise programs or fitness center memberships. He notes that in one study, when older adults went to a gym two times or more a week for two years, they incurred $1,252 less in health-care costs than their less-active counterparts.

"Given the health benefits of physical exercise on diabetes prevention, managing type 2 diabetes in patients, and on improving the health of the general adult and older population, it may be time to consider insurance reimbursements for structured physical exercise programs," wrote Pahor.

Zonszein agreed that insurance reimbursement for structured physical activity is a good idea. "It's important, but it's not something that our current system pays much attention to. We pay for diabetes-related dialysis and heart surgeries, but not for exercise to prevent the complications," he said.

More information

Learn more about exercise and diabetes from the American Diabetes Association.

Insomnia Linked to High Insulin Resistance in Diabetics

ScienceDaily

Tuesday, May 3, 2011

ScienceDaily (May 3, 2011) — In the largest study of it kind to establish a link between sleep and diabetes, researchers found that people with diabetes who sleep poorly have higher insulin resistance, and a harder time controlling the disease

The findings, published in the June issue of Diabetes Care, suggest that poor sleep may contribute to worse outcomes in people with diabetes.

"Poor sleep quality in people with diabetes was associated with worse control of their blood glucose levels," said Kristen Knutson, PhD, assistant professor of medicine and lead author of the study. "People who have a hard time controlling their blood glucose levels have a greater risk of complications. They have a reduced quality of life. And, they have a reduced life expectancy."

People with diabetes generally have poorer sleep than the general population, and poor sleep has been proposed as a risk factor for developing the disease. Sleep disorders, such as obstructive sleep apnea, are more prevalent in people with type 2 diabetes, Knutson said.

For the study, researchers monitored the sleep of 40 people with diabetes for six nights. The subjects also reported if they generally suffered from symptoms of sleep disturbances like insomnia, snoring or sleep apnea. At clinical examinations, they gave blood samples to allow researchers to measure insulin and glucose levels.

The subjects wore activity monitors on their wrists at night, which measure their wrist movements throughout the night. Poor sleep, or insomnia, was determined by both poor sleep quality based on the activity monitors and the subject telling the researchers that they often had a hard time falling asleep or woke up during the night.

Among the diabetics, poor sleepers had 23% higher blood glucose levels in the morning, and 48% higher blood insulin levels. Using these numbers to estimate a person's insulin resistance, the researchers found that poor sleepers with diabetes had 82% higher insulin resistance than normal sleepers with diabetes.

Knutson said the next step for researchers is to see if treating poor sleep can improve long-term outcomes and quality of life for diabetics. "For someone who already has diabetes, adding a sleep treatment intervention, whether it's treating sleep apnea or treating insomnia, may be an additional help for them to control their disease," Knutson said.

In fact, restoring a healthy amount of sleep may be as powerful an intervention as the drugs currently used to treat type 2 diabetes. "This suggests that improving sleep quality in diabetics would have a similar beneficial effect as the most commonly used anti-diabetes drugs," said Eve Van Cauter, PhD, professor of medicine and co-author of the study.

Further investigation into which leads to the other -- the chronic poor sleep or chronic insulin resistance -- could improve the quality of life for people with type 2 diabetes. "Anything that we can do to help people improve their ability to control their glucose will help their lives in the long run," Knutson said.

The data was collected as part of the CARDIA study, an ongoing longitudinal study of the heart health. It has tracked thousands of people for over 20 years.

The study, "Cross-sectional associations between measure of sleep and markers of glucose metabolism among persons with and without diabetes" was published online March 16, 2011, in the journal Diabetes Care. In addition to Drs. Knutson and Van Cauter, authors include Phyllis Zee and Kiang Liu at Northwestern University, and Diane Lauderdale at the University of Chicago Department of Health Studies.

The research was funded by a grant from the National Institute on Aging at the U.S. National Institutes of Health. The CARDIA study is supported by the National Heart, Lung, and Blood Institute.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

K. L. Knutson, E. Van Cauter, P. Zee, K. Liu, D. S. Lauderdale. Cross-Sectional Associations Between Measures of Sleep and Markers of Glucose Metabolism Among Subjects With and Without Diabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) Sleep Study. Diabetes Care, 2011; 34 (5): 1171 DOI: 10.2337/dc10-1962

Tumors Spotted Between Mammograms Often More Aggressive: Study

By Amanda Gardner
HealthDay Reporter

HealthDay News

Tuesday, May 3, 2011

TUESDAY, May 3 (HealthDay News) -- Breast tumors that are detected in between regular screening mammograms tend to be more aggressive and fast-moving than those found during scheduled screenings, indicating that better screening methods are needed, researchers say.

"We may have to look at other imaging techniques or newer technologies to find these types of cancers," said Anna M. Chiarelli, co-author of a study published online May 3 in the Journal of the National Cancer Institute.

Other studies have come up with similar results but they didn't make a distinction between what these authors call "true" interval cancers, meaning those that weren't detectable by a radiologist on a regular screening mammogram but showed up in retrospect, as opposed to "missed" interval cancers, which did show on the previous mammogram but were missed.

"Interval cancers are a heterogeneous group," said Chiarelli, a senior scientist in prevention and cancer control at Cancer Care Ontario in Toronto, Canada. "We wanted to see the different pathologies [and] prognostic factors."

In this study, an interval cancer was one that was diagnosed within two years after the last negative mammogram.

The authors identified "true" interval cancers and "missed" interval cancers in a group of almost 431,500 Ontario women aged 50 or older who were screened from 1994 through 2002.

They then compared those tumors with a control group of mammography-detected cancers.

Both the true and missed interval cancers were more aggressive than the cancers picked up by screening in that they were a higher stage and grade.

But the true interval cancers had even more worrying characteristics -- they were three times more likely to have a high "mitotic index," which is a measure of how fast the cells are dividing. They were also more than twice as likely to be both estrogen-receptor and progesterone-receptor negative, which means that they cannot be fought with hormonal therapies and so are usually harder to treat.

True interval cancers were also more likely to belong to the minority of breast cancers that do not originate in the milk ducts.

"The true interval cancers were even worse than the missed intervals," Chiarelli said.

It's possible the missed cancers had worse characteristics than the true intervals simply because they were caught later, she added.

One expert said the phenomenon might not be so common in the United States, however.

"In Canada they only do mammograms every two years, so the number of interval cancers in the U.S. is going to be smaller because we're doing mammograms every year," said Dr. Paul Tartter, a senior breast surgeon with St. Luke's-Roosevelt Hospital's Comprehensive Breast Center in New York City. "Also, all of these mammograms were done before digital mammography, so hopefully digital mammography will reduce the number of missed cancers," he said.

Ultrasound detection is one other option that women might have available to them to spot cancers, said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City. But, she added, "it's hard to prove a large benefit to ultrasound."

Still, when interpreted by the right person, "it's definitely useful in women with dense breast tissue," Bernik added.

But although women with denser breast tissue might benefit from this additional screening, it's often not covered by insurance, she noted.

"The good news is that interval cancers are a small percentage of cancers," Chiarelli said. "Most cancers are found from [mammographic] screening but it's important to look at these and to have to find a technique to detect them."

In contrast to a recent guideline change, Bernik advised that women should start getting mammograms when they're 40 years old.

More information

The U.S. National Cancer Institute has more on breast cancer screening.

Antioxidant May Prevent Alcohol-Induced Liver Disease, Study Suggests

ScienceDaily

Tuesday, May 3, 2011

ScienceDaily (May 3, 2011) — An antioxidant may prevent damage to the liver caused by excessive alcohol, according to new research from the University of Alabama at Birmingham. The findings, published online April 21, 2011, in the journal Hepatology, may point the way to treatments to reverse steatosis, or fatty deposits in the liver that can lead to cirrhosis and cancer.

The research team, led by Victor Darley-Usmar, Ph.D., professor of pathology at UAB, introduced an antioxidant called mitochondria-targeted ubiquinone, or MitoQ, to the mitochondria of rats that were given alcohol every day for five to six weeks in an amount sufficient to mirror excessive intake in a human.

Chronic alcoholics, those who drink to excess every day, experience a buildup of fat in the liver cells. When alcohol is metabolized in the liver, it creates free radicals that damage mitochondria in the liver cells and prevent them from using sufficient amounts of oxygen to produce energy. Moreover, the low-oxygen condition called hypoxia worsens mitochondrial damage and promotes the formation of the fatty deposits that can progress to cirrhosis.

Darley-Usmar and his collaborators say that the antioxidant MitoQ is able to intercept and neutralize free radicals before they can damage the mitochondria, preventing the cascade of effects that ultimately leads to steatosis.

"There has not been a promising pharmaceutical approach to preventing or reversing the long-term damage associated with fatty deposits in the liver that result from excessive consumption of alcohol," said Darley-Usmar. "Our findings suggest that MitoQ might be a useful agent for treating the liver damage caused by prolonged, habitual alcohol use."

"Previous studies have shown that MitoQ can be safely administered long-term to humans," said Balu Chacko, Ph.D., a research associate and co-author of the study. "As it has been shown to decrease liver damage in hepatitis C patients, it may have potential to ameliorate the initial stages of fatty liver disease in patients with alcoholic and non-alcoholic liver disease."

The Annals of Hepatology estimate that alcohol abuse costs $185 billion annually in the United States, and that 2 million people have some form of alcoholic liver disease. It links as much as 90 percent of cirrhosis of the liver is related to alcohol abuse and up to 30 percent of liver cancer.

Darley-Usmar, who is also the director of the Center for Free Radical Biology at UAB, says his team is in discussions with the National Institutes of Health to develop a whole family of drugs based around interactions with mitochondria. He suggests such drugs might be effective in treating cardiovascular disease, kidney disease and neurodegenerative disorders.

"We know that free radicals play a role in human disease, and we have developed antioxidants that can eliminate free radicals in the laboratory," he said. "Unfortunately, previous trials using antioxidants in humans have not been as successful as anticipated. The difference with our current findings is that we targeted a specific part of the cell, the mitochondria. This is a unique approach, and this is one of the few pre-clinical trials that shows effectiveness."

Darley-Usmar says the findings also may have significance for the treatment of metabolic syndrome, a rapidly growing condition that affects some 50 million Americans, according to the American Heart Association.

"Metabolic syndrome describes a complex interaction of factors caused by obesity which includes damage to the liver due to an increase in free radicals, hypoxia and deposition of fat," said Darley-Usmar. "It's quite similar to alcohol-dependent hepatotoxicity. It would be interesting to see if an antioxidant such as MitoQ had any therapeutic effect in preventing liver damage in those with metabolic syndrome."

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Balu K Chacko, Anup Srivastava, Michelle Johnson, Gloria A. Benavides, Mi Jung Chang, Yaozu Ye, Nirag Jhala, Michael P Murphy, Balaraman Kalyanaraman, Victor-Darley Usmar. The mitochondria-targeted ubiquinone MitoQ decreases ethanol-dependent micro and macro hepatosteatosis. Hepatology, 2011; DOI: 10.1002/hep.24377

Heart Bypass Surgery Rates Drop Dramatically, Study Finds

By Jenifer Goodwin
HealthDay Reporter

HealthDay News

Tuesday, May 3, 2011

TUESDAY, May 3 (HealthDay News) -- The number of heart patients getting bypass surgery fell by nearly 40 percent between 2001 and 2008, new U.S. research finds.

The drop likely reflects several factors, including a decline in smoking rates, which has led to less coronary artery disease, said senior study author Dr. Peter Groeneveld, an assistant professor of medicine at the University of Pennsylvania School of Medicine.

Also, better and more aggressive treatment of coronary artery disease risk factors, such as high blood pressure, high cholesterol and diabetes, means fewer patients progress to needing surgery.

Another factor is that many patients with blocked arteries instead undergo percutaneous coronary intervention (PCI), also called balloon angioplasty, in which a doctor threads a catheter into the artery and inflates a balloon at the tip. Usually, a wire mesh structure called a stent is left behind to prevent the artery from narrowing again.

Though PCI is an excellent option for many patients, researchers stressed that bypass surgery -- officially called coronary artery bypass graft, or CABG -- may be the best option for some patients with certain severe blockages, including those with triple blockages or left main coronary artery stenosis, Groeneveld said.

"Patients need to be aware that CABG can be a good treatment option, and it's gotten better," Groeneveld said. "There have been several innovations that have made the recovery time much less than it used to be." In CABG, a new artery or vein is grafted, or connected, to the blocked artery to restore blood flow.

The study is published in the May 4 issue of the Journal of the American Medical Association.

Groeneveld and his colleagues analyzed data on a national sample of patients who underwent procedures to clear blockages at U.S. hospitals between 2001 and 2008. Most of the procedures were scheduled, though some were for emergency situations such as heart attacks.

During that period, there was a 15 percent overall decrease in procedures to clear coronary blockages, the investigators found.

Most of that reduction was because of a decline in annual CABG surgeries, which dropped by 38 percent. PCI, in contrast, held mostly steady with a 4 percent dip.

When the figures were projected to the entire U.S. population, there were an estimated 130,000 fewer CABG surgeries in 2008 compared with 2001, according to the study.

Dr. Debabrata Mukherjee, chief of cardiology at Texas Tech University Health Sciences Center, said even though PCI popularity has risen (the number of hospitals offering PCI increased by 26 percent during the study period, compared to about 12 percent for CABG), technological advances have made fewer PCI surgeries necessary.

In 2003, the U.S. Food and Drug Administration approved drug-eluting stents, which come with an immunosuppressant coating that helps prevent scarring and inflammation around the stent. The improved stents, which were in widespread use by 2005, reduced the need for redoing procedures because of scarring, Mukherjee said.

Prior to the innovation, about one-third of PCI patients needed a re-do within six months, he said. "Now, 5 percent, maybe 10 percent at most, need to come back," he said. "There has been a marked decrease in repeat procedures. So even as cardiologists are taking on more complex, multi-vessel cases, the overall volume of PCI hasn't gone up."

Groeneveld raised another possibility for the decline in CABG: Interventional cardiologists can do PCI, while only cardiac surgeons do bypass surgery.

Since most people see a cardiologist who would refer them to a cardiac surgeon if necessary, it's possible some patients who might be better off getting bypass surgery are being offered PCI instead, Groeneveld said.

"My hunch is cardiologists are referring fewer [patients] onto surgeons and treating more with interventional cardiology," he said. "The worry is there are patients who really who should be getting CABG that aren't getting it."

While bypass procedures used to involve cutting through the chest, technological advances now allow surgeons to do the procedure much less invasively. Innovations include doing the surgery through a small incision and using fiber-optic cameras, or even robotic surgery.

Despite the improvements, it's possible old perceptions die hard. Given the choice between doing PCI on the spot or waiting to see a surgeon and getting bypass surgery that comes with a longer recovery time, many patients may opt for the PCI, Groeneveld said.

"Patients are sometimes put in positions to make decisions while lying on a cath lab table with a cardiologist leaning over them," Groeneveld said, referring to the catheterization lab, where cardiologists perform PCIs.

"Patients should be made aware that there are alternatives to PCI, and those conversations about whether PCI is the right thing should be happening before the patient goes into the cath lab," he added.

More information

The American Heart Association has more on heart attack risk factors.

Care for Irregular Heartbeat Costs U.S. Billions: Study

HealthDay News

Tuesday, May 3, 2011

TUESDAY, May 3 (HealthDay News) -- It costs $26 billion a year to treat U.S. patients with the heart rhythm disorder known as atrial fibrillation, according to a new study.

That total includes $6 billion for atrial fibrillation care, $9.9 billion for other cardiovascular risk factors or disease and $10.1 billion for non-cardiovascular medical problems, the researchers said.

"Atrial fibrillation places a huge economic burden on health care payers, patients and our country," lead study author Dr. Michael H. Kim, an associate professor of medicine at Northwestern University in Chicago, said in a news release from the American Heart Association. "It is not clear that the country realizes that atrial fibrillation patients are much more likely to have cardiovascular hospitalizations specifically, and more hospitalizations in general."

The study is published in the current issue of the journal Circulation: Cardiovascular Quality and Outcomes.

About 3 million American adults have atrial fibrillation, a number expected to double over the next 25 years, according to background information in the news release. Atrial fibrillation increases the risk of stroke and heart attack.

In the study, researchers analyzed 12 months of data collected from about 89,000 atrial fibrillation patients between 2004 and 2006. Of those patients, nearly 20 percent were newly diagnosed while 81 percent had existing atrial fibrillation.

Along with the $26 billion annual cost, the researchers also found that:

Atrial fibrillation patients were hospitalized for any reason twice as often as people without atrial fibrillation (37.5 percent versus 17.5 percent) and were three times more likely to have multiple hospitalizations (11.1 percent versus 3.3 percent).

Atrial fibrillation patients were hospitalized for cardiovascular problems four times more often than those without atrial fibrillation (21.3 percent versus 5.4 percent), and had multiple cardiovascular-related hospitalizations eight times more often (4.1 percent versus 0.5 percent).

Atrial fibrillation patients were more likely than non-atrial fibrillation patients to die in the hospital (2.1 percent versus 0.1 percent).

The average direct health care cost for an atrial fibrillation patient was $20,670, compared with $11,965 for a non-atrial fibrillation patient.

"We're not going to impact health care costs or cardiovascular outcomes by just addressing atrial fibrillation itself," Kim said. "The large amount of cardiovascular disease among atrial fibrillation patients appears to worsen outcomes and increase costs. This is a sicker population."

More information

The American Academy of Family Physicians has more about atrial fibrillation.

Expert Suggests Skipping Pelvis When Scanning for Clots

HealthDay News

Tuesday, May 3, 2011

TUESDAY, May 3 (HealthDay News) -- A new study suggests that eliminating the pelvis from areas of the lower body that are scanned when looking for blood clots would not lessen the effectiveness of the test but would significantly reduce the exposure to radiation.

The imaging test, called CT venography, checks for a venous thromboembolism, or a blood clot in the veins. Such clots usually form in the legs. It's critical to locate and treat any clots before they can migrate to the lungs, where they can be life-threatening.

But it does not truly aid the diagnosis to include the pelvis in the scanning, according to the researchers, who were to present their findings Tuesday in Chicago at the annual meeting of the American Roentgen Ray Society.

The study involved an analysis of data on 1,527 people who were examined for venous thromboembolism at the Nassau University Medical Center in East Meadow, N.Y., during a three-year period. In those exams, just five people -- 0.3 percent -- were found to have isolated pelvic VTE, according to the study.

Dr. Charbel Ishak, the study's lead author, said that the finding should help radiologists implement new protocols for pelvic examinations that would reduce patients' exposure to radiation.

"Radiologists and technologists can eliminate pelvic imaging while acquiring only images of the lower extremities with CT venography, starting from groin to below the knee," he said in a news release from the society. "We believe that by stopping the imaging of the pelvis, we can decrease patient radiation dose without significantly affecting the diagnosis of VTE."

Experts note that research presented at a meeting should be considered preliminary because it has not been subjected to the rigorous scrutiny given to research published in medical journals.

More information

The Coalition to Prevent VTE has more about venous thromboembolism.

MRIs Can Tell Endometrial, Cervical Cancer Apart: Study

HealthDay News

Tuesday, May 3, 2011

TUESDAY, May 3 (HealthDay News) -- Magnetic resonance imaging (MRI) can distinguish between endometrial and cervical cancer in most cases where a biopsy fails to do so, a new study says.

It found that radiologists using MRI were able to correctly identify the type of cancer in 38 of 48 patients, or 79 percent, who had inconclusive biopsy results.

More than 43,000 women were newly diagnosed with endometrial cancer, which starts in the lining of the uterus, in the United States last year, according to the U.S. National Cancer Institute.

There were about 12,200 newly diagnosed cases of cervical cancer, which starts in the cervix, or the lower part of the uterus that opens into the vagina, according to the NCI.

"In about 3 percent of the cases, there is difficulty determining the primary cancer site," said study author Dr. Heather He, of the M.D. Anderson Cancer Center in Houston, in an American Roentgen Ray Society news release. "Knowing the primary cancer site means that we can give the patients the most appropriate therapy and save some patients from unnecessary surgery."

The MRI images used in the study were examined by two radiologists, one with five years' experience and the other with 18 years' experience. Their diagnoses matched most of the time, which shows that extensive experience isn't crucial, according to He.

The study was presented Tuesday at the society's annual meeting in Chicago.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The American Cancer Society has more about endometrial cancer.

Monday, May 2, 2011 

A Little Belly Fat Can Double the Risk of Death in Coronary Artery Disease Patients

ScienceDaily

Monday, May 2, 2011

ScienceDaily (May 2, 2011) — One of the largest studies of its kind has found that people with coronary artery disease who have even a modest beer belly or muffin top are at higher risk for death than people whose fat collects elsewhere. The effect was observed even in patients with a normal Body Mass Index (BMI). The findings of this Mayo Clinic analysis are published in the May 10 issue of the Journal of the American College of Cardiology.

Researchers analyzed data from 15,923 people with coronary artery disease involved in five studies from around the world. They found that those with coronary artery disease and central obesity, measured by waist circumference and waist-to-hip ratio, have up to twice the risk of dying. That is equivalent to the risk of smoking a pack of cigarettes per day or having very high cholesterol, particularly for men.

The findings refute the obesity paradox, a puzzling finding in many studies that shows that patients with a higher BMI and chronic diseases such as coronary artery disease have better survival odds than normal-weight individuals.

"We suspected that the obesity paradox was happening because BMI is not a good measure of body fatness and gives no insight into the distribution of fat," says Thais Coutinho, M.D., the study's lead author and a cardiology fellow at Mayo Clinic. "BMI is just a measure of weight in proportion to height. What seems to be more important is how the fat is distributed on the body,'' she says.

Francisco Lopez-Jimenez, M.D., the project's lead investigator and director of the Cardiometabolic Program at Mayo Clinic, explains why this type of fat may be more harmful: "Visceral fat has been found to be more metabolically active. It produces more changes in cholesterol, blood pressure and blood sugar. However, people who have fat mostly in other locations in the body, specifically, the legs and buttocks, don't show this increased risk."

The researchers say physicians should counsel coronary artery disease patients who have normal BMIs to lose weight if they have a large waist circumference or a high waist-to-hip ratio. The measure is very easy to use, Dr. Coutinho says: "All it takes is a tape measure and one minute of a physician's time to measure the perimeter of a patient's waist and hip."

The research subjects were diverse, coming from studies in the U.S. (Rochester, Minn. and San Francisco, Calif.), Denmark, France and Korea. The inclusion of different ethnic groups makes the study more applicable to the real world, Dr. Coutinho says.

Other members of the research team are Kashish Goel, M.D.; Daniel Correa de Sa, M.D.; Randal Thomas, M.D.; Veronique Roger, M.D., MPH; and Virend Somers, M.D., Ph.D., of Mayo Clinic; Charlotte Kragelund, M.D., Ph.D.; Lars Kober, M.D., Ph.D.; and Christian Torp-Pedersen, M.D., Ph.D., from Rigshaspitalet, Copenhagen, Denmark; Alka Kanaya, M.D. of the University of California, San Francisco, California; Jong-Seon Park, M.D.; Sang-Hee Lee, M.D.; and Young-Jo Kim, M.D., of Yeungnam University Hospital, Daegu, Korea; and Yves Cottin, M.D., Ph.D.; and Luc Lorgis, M.D., from CHU Bocage, Dijon, France.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Mom's Exposure to Plastics Chemical Tied to Baby's Wheeze

HealthDay News

Monday, May 2, 2011

MONDAY, May 2 (HealthDay News) -- Children born to women exposed to bisphenol A (BPA) during the early part of pregnancy may be more likely to experience wheezing early in life, according to a new study.

BPA is widely used in consumer products, including many hard plastic food containers, water bottles and the lining of metal food and beverage cans. The chemical is present in more than 90 percent of the U.S. population, the researchers note.

This study included 367 pairs of mothers and infants. BPA levels were measured in the mothers' urine at 16 and 26 weeks' gestation and when they gave birth. The parents reported on signs of wheezing in their babies every six months for three years.

The tests showed that 99 percent of the children were born to mothers who had detectable BPA in their urine at some time during pregnancy. A link between BPA levels and wheezing was found only in the youngest children.

Among infants 6 months of age, those whose mothers had high levels of BPA during pregnancy were twice as likely to wheeze as those whose mothers had low BPA levels. There were no differences in wheezing rates by the time the children were 3 years old.

The study found a link between wheezing in children and high BPA levels early in pregnancy -- 16 weeks' gestation -- but not at 26 weeks' gestation or birth.

"Consumers need more information about the chemicals in the products they purchase so they can make informed decisions," lead author Dr. Adam J. Spanier, assistant professor of pediatrics and public health sciences at Penn State College of Medicine, said in an American Academy of Pediatrics news release.

"Additional research is needed in this area to determine if changes should be made in public policy to reduce exposure to this chemical," Spanier said.

He suggested women of childbearing age consider avoiding products made with BPA until more information is available.

The study was to be presented Sunday at the annual meeting of the Pediatric Academic Societies in Denver. Research presented at meetings is considered preliminary because it has not been subject to the scrutiny required for publication in a peer-reviewed journal.

More information

The U.S. National Library of Medicine has more about BPA.

Washing With Contaminated Soap Increases Bacteria on Hands, Research Finds

ScienceDaily

Monday, May 2, 2011

ScienceDaily (May 2, 2011) — People who wash their hands with contaminated soap from bulk-soap-refillable dispensers can increase the number of disease-causing microbes on their hands and may play a role in transmission of bacteria in public settings according to research published in the May issue of the journal Applied and Environmental Microbiology.

"Hand washing with soap and water is a universally accepted practice for reducing the transmission of potentially pathogenic microorganisms. However, liquid soap can become contaminated with bacteria and poses a recognized health risk in health care settings," says Carrie Zapka from GOJO Industries in Akron Ohio, the lead researcher on the study that also included scientists from BioScience Laboratories in Bozeman, Montana and the University of Arizona, Tucson.

Bulk-soap-refillable dispensers, in which new soap is poured into a dispenser, are the predominant soap dispenser type in community settings, such as public restrooms. In contrast to sealed-soap dispensers, which are refilled by inserting a new bag or cartridge of soap, they are prone to bacterial contamination and several outbreaks linked to the use of contaminated soap have already been reported in healthcare settings.

In this study Zapka and her colleagues investigated the health risk associated with the use of bulk-soap-refillable dispensers in a community setting. They found an elementary school where all 14 of the soap dispensers were already contaminated and asked students and staff to wash their hands, measuring bacteria levels before and after handwashing. They found that Gram-negative bacteria on the hands of students and staff increased 26-fold after washing with the contaminated soap.

"This is the first study to quantitatively demonstrate that washing hands with contaminated liquid soap actually increases the number of Gram-negative bacteria on hands. Furthermore, the results directly demonstrate that bacteria from contaminated hands can be transferred to secondary surfaces," says Zapka.

Zapka notes that all the participants' hands were decontaminated after testing by washing with uncontaminated soap followed by hand sanitizer. At the conclusion of the study, all the contaminated soap dispensers were replaced with dispensers using sealed-soap refills. After one year of use, not one of them was found to be contaminated.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

C. A. Zapka, E. J. Campbell, S. L. Maxwell, C. P. Gerba, M. J. Dolan, J. W. Arbogast, D. R. Macinga. Bacterial Hand Contamination and Transfer after Use of Contaminated Bulk-Soap-Refillable Dispensers. Applied and Environmental Microbiology, 2011; 77 (9): 2898 DOI: 10.1128/AEM.02632-10

Extra weight linked to dementia risk: study

By Genevra Pittman

Reuters Health

Monday, May 2, 2011

NEW YORK (Reuters Health) – Carrying around extra pounds during middle age was associated with a higher risk of dementia later in life in a new study that followed twins in Sweden for 30 years.

The research was not set up to prove that dementia was caused by the added weight, but Dr. Weili Xu, the study's lead author from the Karolinksa Institutet in Stockholm, said that the evidence is pointing in that direction.

The findings, published in the journal Neurology, suggest that "control of body fat as early as middle life is important to prevent dementia later in life," she told Reuters Health.

Xu and her colleagues analyzed data from close to 9,000 Swedish twins.

When the participants were an average age of 43, they gave researchers information about their height and weight.

Thirty years later, the researchers examined the same individuals for signs of declining thinking and memory skills, then diagnosed some of them with Alzheimer's disease and other types of dementia.

Close to one in three of the participants were overweight or obese in middle age. And those that were had about an 80 percent higher chance of getting any kind of dementia than people of normal weight.

The more participants weighed in mid-life, the higher their chance of getting dementia or "questionable dementia" - meaning they had signs of thinking and reasoning problems, but not enough to be diagnosed with dementia.

In total, about 4 percent of everyone in the study was diagnosed with dementia, and another 1 to 2 percent with questionable dementia.

Despite the link between excess pounds in midlife and later dementia, when the researchers looked specifically at 137 twin pairs who were "discordant" - one twin had dementia and the other didn't - the tie to midlife overweight shrank considerably.

While Xu said that finding suggests that "there are some common genes that predispose (people) to both diseases (overweight and dementia)," it could also be that it was just more difficult to establish a solid link in such a small sample.

Whether genes predispose a person to being overweight in adulthood, or it's just bad eating habits, the likely explanation for the link to dementia, researchers say, is that fat tissue in the body releases hormones and other signaling cells that may affect the brain's functioning.

In addition, Xu said, extra weight has been shown to increase a person's risk for diabetes and heart and blood vessel diseases - and those conditions are related to a higher dementia risk. However, the link between weight and dementia remained even after the researchers took other diseases into account.

The findings are the latest evidence that preventing Alzheimer's disease and dementia starts long before their signs and symptoms typically show up, said Rachel Whitmer, an epidemiologist at Kaiser Permanente Division of Research in Oakland who was not involved in the study.

"People need to understand that what they do today could have an effect on them 30 or 40 years from now," Whitmer told Reuters Health.

When it comes to maintaining a healthy weight, she said, "what's good for the heart is good for the brain."

Source: http://bit.ly/csS3ol

Neurology, online May 2, 2011.

Drinking Energy Beverages Mixed With Alcohol May Be Riskier Than Drinking Alcohol Alone

ScienceDaily

Monday, May 2, 2011

ScienceDaily (May 2, 2011) — Energy drinks mixed with alcohol, such as Red Bull™ and vodka, have become trendy. While this consumption has been implicated in risky drinking practices and associated accidents and injuries, there is little laboratory research on how the effects of this combination differ from those of drinking alcohol alone. A recent laboratory study, comparing measures of intoxication due to alcohol alone versus alcohol/energy drink, has found that the combination of the energy drink enhanced feelings of stimulation in participants. However, the energy drink did not change the level of impairment for impulsive behavior. These findings suggest that energy drinks combined with alcohol may increase the risks associated with drinking.

Results will be published in the July 2011 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Young people are now drinking alcohol in different ways than they have in the past," said Cecile A. Marczinski, assistant professor of psychology at Northern Kentucky University and first author of the study. "Classic mixed drinks such as rum and coke have been replaced with mixed drinks that use energy drinks instead, such as yagerbombs and Red Bull™ and vodka."

"We have sales data showing that energy drinks have gained in popularity, and we know anecdotally that this practice is popular, but we have little data on objective and subjective responses that support growing concern about the safety of mixing energy drinks with alcohol," said Amelia M. Arria, director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health.

Marczinski concurred. "While consuming energy drinks with alcohol is thought of as a risky drinking practice, the laboratory evidence demonstrating this is quite limited," she said. "In fact, most of the evidence that consuming alcohol/energy drinks is risky comes from epidemiological studies that have reported an increased risk of accidents and injuries associated with their use. However, those studies do not address the key confound that risky drinkers, who are prone to drinking heavily anyways, are just attracted to these drinks since they are trendy. Our study was designed to demonstrate that alcohol/energy drinks are pharmacologically distinct from alcohol alone and are adding to the risks of drinking."

Marczinski and her colleagues randomly assigned 56 college student participants (28 men, 28 women), between the ages of 21 and 33, to one of four groups that received four different doses: 0.65 g/kg alcohol, 3.57 ml/kg energy drink, energy drink/alcohol, or a placebo beverage. The participants' behavior was measured on a task that measures how quickly one can execute and suppress actions following the dose. Participants also rated how they felt, including feelings of stimulation, sedation, impairment, and levels of intoxication.

"We found that an energy drink alters the reaction to alcohol that a drinker experiences when compared to a drinker that consumed alcohol alone," said Marczinski. "A consumer of alcohol, with or without the energy drink, acts impulsively compared to when they had not consumed alcohol. However, the consumer of the alcohol/energy drink felt more stimulated compared to an alcohol-alone consumer. Therefore, consumption of an energy drink combined with alcohol sets up a risky scenario for the drinker due to this enhanced feeling of stimulation and high impulsivity levels."

"To reiterate," said Arria, "the investigators found that the presence of an energy drink did not change the level of impairment associated with alcohol consumption." It did, however, change the perception of impairment.

"The findings from this study provide concrete laboratory evidence that the mixture of energy drinks with alcohol is riskier than alcohol alone," said Marczinski. "College students need to be aware of the risks of these beverages. Moreover, clinicians who are working with risky drinkers will need to try and steer their clients away from these beverages."

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Journal Reference:

Cecile A. Marczinski, Mark T. Fillmore, Mark E. Bardgett, Meagan A. Howard. Effects of Energy Drinks Mixed with Alcohol on Behavioral Control: Risks for College Students Consuming Trendy Cocktails. Alcoholism: Clinical and Experimental Research, 2011; DOI: 10.1111/j.1530-0277.2011.01464.x

Exercising While Learning Boosts Test Scores, Study Finds

HealthDay News

Monday, May 2, 2011

MONDAY, May 2 (HealthDay News) -- Exercising while learning might improve kids' test scores, a new study finds.

The researchers looked at students in grades 1 through 6 at an academically low-scoring school in Charleston, S.C., who took part in a program that incorporated physical activity and classroom lessons for 40 minutes a day, five days a week. Before the study, the students had 40 minutes of physical education classes a week.

As part of the program, students in grades 1 and 2 learned movement skills while basic academic skills were reinforced. For example, they hopped through ladders while naming colors on each rung.

Students in grades 3 to 6 used exercise equipment with TV monitors. For example, a monitor on a treadmill would feature geography lessons while a student "ran" through the scene, the study authors explained.

The researchers compared results from standardized tests taken by the students before and after the program, and found that the percentage of students who reached their goal on the state tests increased from 55 percent to 68.5 percent.

The findings show that carefully designed physical education programs can enhance students' academic achievement. The results add to growing evidence that exercise is good for the mind as well as the body, said the researchers, from the Medical University of South Carolina Children's Hospital.

The study was slated for presentation May 1 at the annual meeting of the Pediatric Academic Societies in Denver. Experts note that research presented at meetings isn't subjected to the same type of scrutiny given to research published in peer-reviewed journals.

More information

The Nemours Foundation has more about kids and exercise.

US mothers feed infants variety of herbal products

The Associated Press

Monday, May 2, 2011

CHICAGO – New research suggests many U.S. babies are fed herbal supplements or teas.

Food and Drug Administration researchers led the study. It was released Monday in the journal Pediatrics and is billed as the first to examine broad use of such products in American infants.

About 9 percent studied had been fed supplements at least once. The 2005-2007 study oversampled whites mothers, so authors say the true national prevalence is likely between 3 percent and 10 percent. About 2,600 mothers were questioned.

Gripe water for colic and chamomile tea were the most common products, but many others were used for reasons including fussiness and digestive problems. Side effects weren't examined.

Supplements aren't strictly regulated. The authors say there's a potential for harm, and the variety used means some probably were unsafe.

Breast-feeding May Influence Long-Term Health: Study

HealthDay News

Monday, May 2, 2011

MONDAY, MAY 2 (HealthDay News) -- Infants who aren't breast-fed may experience long-term health consequences, a new study suggests.

French researchers compared growth, body composition (fat mass vs. lean body mass) and blood pressure in three groups of newborns. One group was breast-fed for the first four months of life, while infants in the two other groups received one of two types of formula: a lower-protein formula with 1.8 grams (g) of protein per 100 kilocalories (kcal) or a higher-protein formula with 2.7 g/100 kcal.

The protein content of both formulas fell within the recommended range of formula protein levels, researchers noted.

After four months, the infants in the formula-fed groups continued to receive the same formula while the breast-fed infants were switched to the low-protein formula, if needed.

Researchers then followed the 234 children for three years.

By age 3, diastolic and average blood pressure for babies fed the higher-protein formulas was higher than for breast-fed kids, though the blood pressure was still within the normal range.

Children who were breast-fed also showed a different pattern of growth and metabolic profile than formula-fed infants. The breast-fed infants had lower blood insulin levels when they were 15 days and 4 months old, but not when they were 9 months old.

The breast-fed infants also had different growth patterns during their first year of life, but by age 3, there were no differences in length, weight or body composition (fat. vs. lean mass).

Though what these differences mean over a lifespan is unclear, researchers said it may be evidence of a "metabolic programming effect," or the concept that nutritional experiences at critical points early in life can influence a person's future metabolism and health.

"It appears that formula feeding induces differences in some hormonal profiles as well as in patterns of growth compared with breast-feeding," study co-author Dr. Guy Putet said in an American Academy of Pediatrics news release. "The long-term consequences of such changes are not well-understood in humans and may play a role in later health. Well-designed studies with long-term follow-up are needed."

The study was to be presented Monday at the annual meeting of the Pediatric Academic Societies in Denver. The data and conclusions should be viewed as preliminary until confirmed in large long-term studies.

More information

The U.S. National Women's Health Information Center has more about breastfeeding.

Tailored medicine could prevent more heart attacks

By Amy Norton

Reuters Health

Monday, May 2, 2011

NEW YORK (Reuters Health) – National guidelines help doctors decide how to treat high blood pressure. But tailoring those guidelines to better fit individuals could prevent many more heart attacks and strokes, say developers of a computer model that makes those calculations.

Their study, published Monday in the Annals of Internal Medicine, estimated the effects of using "individualized guidelines" to make decisions on treating high blood pressure.

It found that the tailored approach could prevent 43 percent more heart attacks and strokes than the simpler, general recommendations used now.

Currently, U.S. guidelines recommend treatment if blood pressure rises above 140/90 mm Hg, or above 130/80 mm Hg if a person has diabetes or chronic kidney disease.

Doctors generally add their own judgment to that decision as well. If, for instance, a person has slightly elevated blood pressure but is otherwise at low risk for heart problems, then lifestyle changes might be enough.

But the new study looked at a more sophisticated way of estimating individual patients' needs. Researchers used a computer-based "risk calculator" that took into account a person's age, cholesterol levels, family history of heart disease and any diabetes diagnosis.

It also factored in what's known about different types of patients' responses to various blood pressure medications.

The researchers then used data from a long-term study of 15,800 Americans to estimate the effects of applying the individualized guidelines.

Overall, they found, the tailored method could prevent 43 percent more heart attacks and strokes than national guidelines, if healthcare costs were kept the same.

If, on the other hand, the number of heart attacks and strokes prevented were kept the same, the individualized guidelines would accomplish that result at a 67 percent cost savings versus the national guidelines.

The goal of using the risk calculator "is the same as the physician's desire to take into account the 'whole patient' when discussing treatment options with patients," said lead researcher Dr. David M. Eddy.

The problem with the old-fashioned way, he told Reuters Health in an email, is that there are many pieces of information about a patient to consider.

"It is impossible for the human brain to digest it all and estimate accurately the patient's risks or how they would benefit from treatments," he said.

According to Eddy, risk calculators like the one in the study could, eventually, help doctors give patients real numbers. A doctor might tell you, for example, what your risk is of developing diabetes in the next 20 years, and how much you could cut that risk if you lose a certain amount of weight (and keep it off).

Eddy is a founder of Archimedes, Inc., a San Francisco-based company that has developed a computer-based mathematical model to aid in healthcare decisions. The calculator used in this study is a simplified version of that model.

Eddy said that the calculator, or others like it, could be integrated into electronic health records. A patient's information could be automatically fed to the calculator, and the results would then be displayed on a computer for the doctor and patient to discuss.

A researcher not involved in the work said it was a "nice study" that is a first step toward showing that tailored guidelines could have benefits.

"This shows that there might be better ways for physicians to choose who gets treated and who does not," said Dr. Douglas K. Owens of the VA Palo Alto Health Care System in California, who wrote an editorial published with the study.

General guidelines, like those for treating high blood pressure, are kept fairly simple so they are easy to remember, Owens told Reuters Health in an interview. Doctors, ideally, then adapt those guidelines to individual patients' situations.

However, Owens said, "it's hard to do all of that in your head. This gives them a tool."

Now the looming questions are how to implement risk calculators in doctors' practices -- and, Owens said, whether that benefits patients' health in the real world.

"The general theme is that we can do better, and we may have an opportunity to improve patients' health outcomes," Owens said. "That's the hope."

He said he thinks electronic health records will be key to putting individualized guidelines into practice.

And right now, there is a way to go before most doctors will have those systems in place.

A recent government survey found that the percentage of U.S. doctors using electronic health records is on the rise, but still fairly low.

About one-quarter of surveyed doctors said they had "basic" electronic medical record systems in their offices. Only about 10 percent had a "fully functional" system that included extensive information on patients' medical history.

Source: http://bit.ly/an7XRm

Annals of Internal Medicine, online May 2, 2011.

Obese Pregnant Women May Have Tougher Time Fighting Infections

HealthDay News

Monday, May 2, 2011

MONDAY, May 2 (HealthDay News) -- Obese pregnant women may have a harder time fighting off infections than leaner women do, new research suggests.

Researchers tested the blood of 30 women who were about six months pregnant. Half were obese and had a body-mass index (BMI) of more than 30 prior to becoming pregnant, while half had a normal BMI of 20 to 25.

Obese women had fewer immune system cells that fight infections -- including T-cells and natural killer cells, researchers found. Obese women also had an impaired ability to produce those cells.

The difference could threaten the health of babies born to obese women, study author Dr. Sarbattama Sen, a researcher in the Mother Infant Research Institute at Tufts Medical Center and Floating Hospital for Children in Boston, said in an American Academy of Pediatrics news release.

"Women who are obese before pregnancy have critical differences in their immune function during pregnancy compared to normal-weight women, which has negative consequences for both mother and baby," Sen said.

The issue is taking on added urgency due to the increasing numbers of obese women of reproductive age, Sen added. "Maternal obesity has consequences for the mother and baby, which we are only beginning to understand."

The study was to be presented Sunday at the Pediatric Academic Societies annual meeting in Denver. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

For more about obesity, try the U.S. National Library of Medicine.

Saturday,  April 30, 2011

Aspirin's Clot-Prevention Ability Blunted by Dietary Fat: Study

HealthDay News

Saturday,  April 30, 2011

SATURDAY, April 30 (HealthDay News) -- Aspirin's ability to prevent potentially deadly blood clots may be hindered by elevated levels of fatty acids in the bloodstream, a new study suggests.

It's common for doctors to prescribe aspirin as a blood thinner for patients at high risk of a heart attack. Aspirin inhibits the activity of the COX-1 enzyme, which plays a role in blood clot formation.

It's known that free fatty acids -- released into the bloodstream during the breakdown of fat cells -- also inhibit COX-1 activity.

In this study, researchers looked at the effect that two fatty acids -- oleic acid and palmitic acid -- have on aspirin's effectiveness in preventing clots. Oleic acid is found in various animal and vegetable fats, and palmitic acid is one of the most common saturated fats found in plants and animals.

The researchers found that both types of fatty acids interfered with aspirin's ability to reduce the risk of clots, according to an American Heart Association news release.

The study was to be presented Saturday at the American Heart Association's Arteriosclerosis, Thrombosis and Vascular Biology 2011 Scientific Sessions in Chicago.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. Food and Drug Administration has more about the use of aspirin to prevent heart attack or stroke.

Plant Extract May Be New Therapy for Hay Fever, Study Suggests

ScienceDaily

Saturday,  April 30, 2011

ScienceDaily (Apr. 30, 2011) — Fighting hay fever with a plant extract -- this works, as was shown in a clinical study conducted by researchers of the Center of Allergy & Environment (ZAUM) of Helmholtz Zentrum München and Technische Universität München. Allergic symptoms were alleviated significantly better than with the usual histamine receptor antagonists. In a paper published in the Journal of Allergy and Clinical Immunology the scientists explained how this plant extract works and how effective it is.

Antihistamine medications have long been considered the treatment of choice to alleviate the symptoms of hay fever sufferers. Now, in a randomized double-blind study, Dr. Adam Chaker and Prof. Dr. Carsten Schmidt-Weber demonstrated that the plant extract Ze 339 (Petasol butenoate complex) combats nasal mucosa swelling faster and more effectively.

Apparently, however, the extract not only works in acute cases -- "Our data indicate that the extract also has a preventive effect, which must be investigated further," said Dr. Schmidt-Weber, head of the Center of Allergy & Environment (ZAUM) in Munich. The results look promising for improving the quality of life of people with allergies.

So far the plant extract has only been approved as a drug in Switzerland and South Korea. Further studies need to be carried out in order to allow it to be sold as a prescription drug elsewhere.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff

Journal Reference:

Alina F. Dumitru, Mohamed Shamji, Martin Wagenmann, Simone Hindersin, Kathrin Scheckenbach, Jens Greve, Thomas Klenzner, Lorenzo Hess, Sabine Nebel, Christian Zimmermann, Catherine Zahner, Carsten B. Schmidt-Weber, Adam M. Chaker. Petasol butenoate complex (Ze 339) relieves allergic rhinitis–induced nasal obstruction more effectively than desloratadine. Journal of Allergy and Clinical Immunology, 2011; DOI: 10.1016/j.jaci.2011.02.045

Location of Body Fat May Predict Stiff Arteries: Study

HealthDay News

Saturday,  April 30, 2011

SATURDAY, April 30 (HealthDay News) -- A new study finds that different patterns of fat distribution in black and white women may predict increased arterial stiffness, which is associated with cardiovascular disease.

Stiff arteries force the heart to work harder to pump blood and are also associated with a buildup of plaque in the arteries (atherosclerosis) that can block blood flow and lead to a heart attack.

In this study, Dr. Danny Eapen of Emory University in Atlanta, and colleagues used skin calipers to measure fat at several sites on the bodies of 102 black and 228 white middle-aged women. Fat was measured on the upper chest, the armpit, triceps, below the shoulder blade, the abdomen, above the hip bone and the thigh.

The women were also assessed for arterial stiffness.

Compared to white women, black women had more arterial stiffness and more fat in the armpit, triceps, shoulder blade and hip bone areas, the investigators found.

After adjusting for other factors that could be related to arterial stiffness, the researchers concluded that fat in the armpit area predicts increased arterial stiffness in black women, while fat in the abdominal and triceps areas was a predictor in white women.

The study was to be presented Saturday at the American Heart Association's Arteriosclerosis, Thrombosis and Vascular Biology meeting in Chicago.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The American Academy of Family Physicians has more about vascular disease.