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Friday, May 27, 2011 

Study Confirms Link Between Rheumatoid Arthritis and COPD

ScienceDaily

Friday, May 27, 2011

ScienceDaily (May 27, 2011) — Patients with rheumatoid arthritis are two times more likely to have concurrent chronic obstructive pulmonary disease (COPD) than healthy controls -- an association which was sustained even when variables such as age, gender, smoking and obesity were controlled for, according to a study presented at the EULAR 2011 Annual Congress.

The study of 15,766 patients with RA and 15,340 controls found that the prevalence of COPD was significantly higher in RA patients than healthy controls (8.9% vs 4.4%, p<0.001). Interestingly, the link was still significant (p<0.001) after risk factors common in both RA and COPD patients, such as smoking, obesity and socioeconomic status, were controlled for.

"We know that similar changes in core physiological processes cause symptoms in RA and COPD and we hope that the results of our study prompts new research into potential links between altered genetic and autoimmune processes in the two conditions" said Dr. Amital of the Sheba Medical Centre, Israel.

The large, population-based case-control study was performed using the patient database of Israel's largest healthcare provider, Clalit Health Services. The prevalence of COPD was compared between RA patients over 20 years of age and a sample of age- and gender-matched patients without RA (the control group). Group matching was performed and data on health-related lifestyles and other co-morbidities was collected. Multivariate logistic regression models were used to compare study groups and to control for the confounders of age, gender, socioeconomic status, smoking and obesity.

 

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.

Weight Loss in Heavy, Obese Women Boosts Vitamin D Levels

HealthDay News

Friday, May 27, 2011

FRIDAY, May 27 (HealthDay News) -- Older women who are overweight or obese and lose more than 15 percent of their body weight could significantly boost their levels of vitamin D, new research suggests.

The study, conducted by researchers at Fred Hutchinson Cancer Research Center, also indicates that the surge in vitamin D could help scientists explore new avenues for the prevention of chronic diseases such as cancer and diabetes.

"Since vitamin D is generally lower in persons with obesity, it is possible that low vitamin D could account, in part, for the link between obesity and diseases such as cancer, heart disease and diabetes," study author Caitlin Mason, a postdoctoral research fellow, said in a Hutchinson news release.

Vitamin D is fat-soluble nutrient that plays many important roles in the body, including promoting calcium absorption, reducing inflammation and influencing cell health and the immune system. It's found in certain foods, such as fatty fish, and produced naturally in the body through exposure to sunlight.

The study, published in the May 25 online issue of the American Journal of Clinical Nutrition, assigned 439 overweight or obese postmenopausal women to one of four regimens: exercise only, diet only, exercise plus diet and no intervention.

Although women who lost up to 10 percent of their body weight (10 to 20 pounds) through diet and exercise saw modest increases in vitamin D, those levels were roughly three times higher in women who dropped more than 15 percent of their body weight, regardless of what they ate.

"We were surprised at the effect of weight loss greater than 15 percent on blood vitamin D levels," study senior author Dr. Anne McTiernan, director of the Hutchinson Center's Prevention Center, said in the news release. "It appears that the relationship between weight loss and blood vitamin D is not linear but goes up dramatically with more weight loss."

McTiernan concluded the findings suggest the greater the weight loss, the more meaningful the surge in vitamin D levels.

The researchers noted, however, the degree to which vitamin D is available to the body during and after weight loss remains unclear. They also cautioned that more targeted research is needed to understand any link between vitamin D deficiency and chronic disease.

More information

The National Institutes of Health offers more information on the functions and sources of vitamin D.

Naturally Occurring Plant Alkaloids Could Slow Down Alzheimer's Disease, Study Suggests

ScienceDaily

Friday, May 27, 2011

ScienceDaily (May 27, 2011) — A family of naturally occurring plant compounds could help prevent or delay memory loss associated with Alzheimer's disease, according to a new study by the Translational Genomics Research Institute (TGen).

Beta-carboline alkaloids could potentially be used in therapeutic drugs to stop, or at least slow down, the progressively debilitating effects of Alzheimer's, according to the study published recently in the scientific journal Public Library of Science (PLoS) One.

One of these alkaloids, called harmine, inhibits a protein known as DYRK1A, which has been implicated by this and other studies in the formation tau phosphorylation. This process dismantles the connections between brain cells, or neurons, and has been linked in past TGen studies to Alzheimer's disease.

Tau is a protein critical to the formation of the microtubule bridges in neurons. These bridges support the synaptic connections that, like computer circuits, allow brain cells to communicate with each other.

"Pharmacological inhibition of DYRK1A through the use of beta-carboline alkaloids may provide an opportunity to intervene therapeutically to alter the onset or progression of tau pathology in Alzheimer's disease," said Dr. Travis Dunckley, Head of TGen's Neurodegenerative Research Unit, and the study's senior author.

Beta-carboline alkaloids are found in a number of medicinal plants. They have antioxidant properties, and have been shown to protect brain cells from excessive stimulation of neurotransmitters. "(They) are natural occurring compounds in some plant species that affect multiple central nervous system targets," the study said.

Under normal circumstances, proteins regulate tau by adding phosphates. This process of tau phosphorylation enables connections between brain cells to unbind and bind again, allowing neurons to connect and reconnect with other brain cells. However, this process can go awry, allowing the formation of neurofibrillary tangles, one of the signature indicators of Alzheimer's.

In this study, laboratory tests showed that harmine, and several other beta-carboline alkaloids, "potently reduced'' the expression of three forms of phosphorylated tau, and inhibited the ability of DYRK1A to phosphorylate tau protein at multiple genetic sites associated with tau pathology.

"These results suggest that this class of compounds warrant further investigation as candidate tau-based therapeutics to alter the onset or progression of tau dysfunction and pathology in Alzheimer's disease," Dr. Dunckley said.

The Arizona Alzheimer's Consortium, the National Institute on Aging, and the Louis Charitable Trust funded the study. The Consortium is funded in part by the Arizona Legislature through the Arizona Department of Health Services, which supported a portion of the study. Members of the Consortium also participated in the study. MediProPharma Inc. supported portions of the study.

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:

Danielle Frost, Bessie Meechoovet, Tong Wang, Stephen Gately, Marco Giorgetti, Irina Shcherbakova, Travis Dunckley. β-Carboline Compounds, Including Harmine, Inhibit DYRK1A and Tau Phosphorylation at Multiple Alzheimer's Disease-Related Sites. PLoS ONE, 2011; 6 (5): e19264 DOI: 10.1371/journal.pone.0019264

MSG linked to weight gain

By Adam Marcus

Reuters Health

Friday, May 27, 2011

NEW YORK (Reuters Health) – The flavor enhancer monosodium glutamate (MSG), most often associated with Chinese food and after-dinner headaches, may also be enhancing waistlines, a new study finds.

Researchers found that people who eat more MSG are more likely to be overweight or obese. And the increased risk wasn't simply because people were stuffing themselves with MSG-rich foods. The link between high MSG intake and being overweight held even after accounting for the total number of calories people ate.

Ka He, a nutrition expert at the University of North Carolina, Chapel Hill, who led the study, said that although the risk of weight gain attributable to MSG was modest, the implications for public health are substantial. "Everybody eats it," He told Reuters Health.

MSG is one of the world's most widely used food additives. Although it tends to be more popular in Asian countries, Americans manage to get their share in processed foods, from chips to canned soups, even when it's not labeled as such.

Americans' typical daily intake of MSG is estimated to be only about half a gram, whereas estimates for Japan and Korea put average intakes anywhere between a gram-and-a-half and 10 grams a day.

MSG is considered safe, but some people complain of headaches, nausea and other bad reactions it.

Several studies have examined the potential link between MSG and body weight, with conflicting results. Scientists have speculated that people may eat larger helpings of food with MSG because it just tastes better. Other evidence suggests that MSG might interfere with signaling systems in the body that regulate appetite.

In the latest research, published in the American Journal of Clinical Nutrition, He and his colleagues followed more than 10,000 adults in China for about 5.5 years on average.

The researchers measured MSG intake directly by before-and-after weighing of products, such as bottles of soy sauce, to see how much people ate. They also asked people to estimate their intake over three 24-hour periods.

Men and women who ate the most MSG (a median of 5 grams a day) were about 30 percent more likely to become overweight by the end of the study than those who ate the least amount of the flavoring (less than a half-gram a day), the researchers found. After excluding people who were overweight at the start of the study, the risk rose to 33 percent.

Obesity is not as much of a problem in China as it is in the United States, which might suggest that MSG is not a significant culprit in weight gain. But the Chinese tend to be physically active, which might help offset the pound-producing properties of the additive, He said.

Why MSG and weight gain may be linked isn't clear, He added, but it may have something to do with the hormone leptin, which regulates appetite and metabolism. He's group found that people who consumed more MSG produced more leptin. "MSG consumption may cause leptin resistance," He said, so that the body cannot properly process the energy it receives from food. That, He added, could explain why people who ate more MSG gained weight regardless of how many calories they consumed.

But Ivan E. de Araujo, a Yale University neurobiologist who has studied the effects of MSG on leptin, was not convinced by the new findings.

Leptin is released by fat cells, so as people gain weight they have more leptin in their blood, Araujo said. The effect of MSG on leptin levels, then, may simply be a reflection of growing body mass.

Araujo called the researchers' suggestion that prolonged exposure to high quantities of MSG may trigger leptin resistance by damaging an area of the brain called the hypothalamus, "rather speculative, given the current lack of direct evidence that" MSG in normal dietary amounts could produce a physical injury to that part of the brain.

Araujo added, it is "somewhat intriguing" that moderate weight gain was only seen in the group with the very highest MSG intakes. People who consumed the most MSG also consumed the most salt in their diets, Araujo noted, which can itself cause water retention and weight gain.

For a follow-up study, He and his colleagues hope to see whether people who stop using MSG experience any health benefits attributable to the change in diet.

Source:  http://bit.ly/kv9cvF

American Journal of Clinical Nutrition, June 2011.

Stress May Increase Risk for Alzheimer's Disease

ScienceDaily

Friday, May 27, 2011

ScienceDaily (May 27, 2011) — Protein deposits in nerve cells are a typical feature of Alzheimer's disease: the excessive alteration of the tau protein through the addition of phosphate groups -- a process known as hyperphosphorylation -- causes the protein in the cells to aggregate into clumps. As a result, nerve cells die, particularly in the hippocampus, a part of the brain that plays an important role in learning and memory, as well as in the prefrontal cortex which regulates higher cognitive functions.

Fewer than ten percent of Alzheimer cases have a genetic basis. The factors that contribute to the rest of the cases are largely unknown. Following up on epidemiological studies, scientists at the Max Planck Institute of Psychiatry hypothesized that adverse life events (stress) may be one trigger of Alzheimer's disease.

In cooperation with colleagues at the University of Minho in Braga, Portugal, the Munich-based researchers have now shown that stress, and the hormones released during stress, can accelerate the development of Alzheimer disease-like biochemical and behavioural pathology. They found increased hyperphosphorylation of tau protein in the hippocampus and prefrontal cortex of rats that has been subjected to stress (e.g. overcrowding, placement on a vibrating platform) for one hour daily over a period of one month. Animals showing these changes in tau also showed deficits in memories that depended on an intact hippocampus; also, animals with abnormally hyperphosphorylated tau were impaired in behavioural flexibility, a function that requires proper functioning of the prefrontal cortex.

These results complement previous demonstrations by the scientists that stress leads to the formation of beta-amyloid, another protein implicated in Alzheimer's disease. "Our findings show that stress hormones and stress can cause changes in the tau protein like those that arise in Alzheimer's disease," explains Osborne Almeida from the Max Planck Institute of Psychiatry.

The next challenge will be to see how applicable the results obtained in animals are to the development of non-familial forms of Alzheimer's disease. "Viewing stress as a trigger of Alzheimer's disease offers exciting new research possibilities aimed at preventing and delaying this severe disease. Moreover, since vulnerability to major depression is known to be increased by stress, it will be interesting to know the role of molecules such as beta-amyloid and tau in the onset and progress of this condition," says Osborne Almeida.

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:

Ioannis Sotiropoulos, Caterina Catania, Lucilia G. Pinto, Rui Silva, G. Elizabeth Pollerberg, Akihiko Takashima, Nuno Sousa, and Osborne F. X. Almeida. Stress Acts Cumulatively to Precipitate Alzheimer's Disease-Like Tau Pathology and Cognitive Deficits. Journal of Neuroscience, May 25, 2011; 31(21):7840-7847 DOI: 10.1523/JNEUROSCI.0730-11.2011

Scientists Discover 'Ultra-Bad' Cholesterol

HealthDay News

Friday, May 27, 2011

FRIDAY, May 27 (HealthDay News) -- A new, "ultra-bad" form of low-density lipoprotein (LDL) cholesterol has been discovered in people with a high risk for heart disease, according to British researchers.

They found that the cholesterol, called MGmin-LDL, is super-sticky, making it more likely to attach to the walls of arteries and form fatty plaques, which could lead to heart attacks and stroke.

The discovery provides a possible explanation for the increased risk of coronary heart disease in diabetics and could help researchers develop new anti-cholesterol treatments, the researchers suggested.

In the study, which was funded by the British Heart Foundation, University of Warwick researchers created MGmin-LDL in a lab through glycation, which is the adding of sugar groups to normal LDL cholesterol, commonly referred to as "bad" cholesterol. The process changed the cholesterol's shape, making it stickier and more likely to build fatty plaques, narrow arteries and reduce blood flow and turning it into what they called "ultra-bad" cholesterol.

The findings, released online May 26 in Diabetes, could have significant implications for the treatment of coronary heart disease, particularly in older people and those with type 2 diabetes. Specifically, the researchers said, the results of their study shed light on how a common type 2 diabetes drug, metformin, fights heart disease by blocking the transformation of normal LDL into the super-sticky LDL.

"We're excited to see our research leading to a greater understanding of this type of cholesterol, which seems to contribute to heart disease in diabetics and elderly people," the study's lead researcher, Naila Rabbani, an associate professor of experimental systems biology at Warwick Medical School, said in a university news release.

"The next challenge is to tackle this more dangerous type of cholesterol with treatments that could help neutralize its harmful effects on patients' arteries," she said.

More information

The American Heart Association has more on cholesterol.

Researchers Evaluate Red Wine Compound for Treating Concussions in Pro Boxers

ScienceDaily

Friday, May 27, 2011

ScienceDaily (May 27, 2011) — UT Southwestern Medical Center researchers are engaging the help of professional boxers and trainers to study whether a component in red wine and grapes could help reduce the short- and long-term effects of concussions.

R esearchers plan to recruit about two dozen professional boxers to take the neuroprotective compound resveratrol after a fight to see if it reduces damage to the brain after impact and helps restore subtle brain functions and connections via its antioxidant effects. If successful, researchers hope the results may be applicable not only to concussions in other sports such as football and hockey, but also to everyday incidents such as falls, auto accidents and other blows to the head.

"We know from animal studies that if we give the drug immediately after or soon after a brain injury, it can dramatically and significantly reduce the damage you see long term," said Dr. Joshua Gatson, assistant professor of surgery in Burn/Trauma/Critical Care and principal investigator for the study. "There haven't been any completed human studies yet, so this is really the first look at resveratrol's effect on traumatic brain injury."

Resveratrol is already being studied as an agent to lower blood sugar levels, for use against cancer, to protect cardiovascular health, and in stroke and Alzheimer's disease treatments.

"Even though resveratrol is found in red wine, you would need 50 glasses of wine to get the required dose to get the protection you would need," said Dr. Gatson.

He came up with the idea for the trial, called the REPAIR study, while watching ESPN. Being a sports fan, he saw frequent concussion issues in football.

"The only treatment available is rest and light exercise, but there is no drug therapy to protect the brain from consecutive concussions, which are actually a lot worse than the initial one," said Dr. Gatson, who investigates biomarkers and novel therapies for traumatic brain injury. "There's been a lot of work with resveratrol showing that it also protects the brain, so we thought this might be the ideal drug."

In this study, researchers are administering the required oral dose once a day for seven days. Pro boxers will take a supplement form of resveratrol within two hours of their match. Researchers will then use neurocognitive tests and novel MRI protocols to track subtle brain activity, inflammation, and restoration of cells and connections.

"The main goal of our research is to protect the brain after each episode so that we can decrease the cumulative effect of these sports concussions," Dr. Gatson said.

Because boxers can have several fights in a short period of time, the researchers decided to target pro boxers with the help of Joseph Mohmed, the study research coordinator, and a coach for USA Boxing, the governing body for all amateur boxing, including the Olympics. Mr. Mohmed also is a former facilities manager at UT Southwestern.

According to the American Association of Neurological Surgeons, 2009 figures showed that 446,788 sports-related head injuries were treated at U.S. hospital emergency rooms, an increase of nearly 95,000 from the year before, in sports ranging from diving and cycling to baseball, basketball, soccer and football. The annual incidence of football-related concussion in the U.S. is estimated at 300,000, with about 47,000 football-related head injuries treated in hospital emergency rooms. In addition, more than 85,000 people were treated for bicycle-related head injuries; about two-thirds of 600 bicycling deaths a year are attributed to traumatic brain injury.

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.

Thursday, May 26, 2011

High Risk of Parkinson's Disease for People Exposed to Pesticides Near Workplace: Pesticide Ziram Implicated as Possible Cause for Disease

ScienceDaily

Thursday, May 26, 2011

ScienceDaily (May 26, 2011) — In April 2009, researchers at UCLA announced they had discovered a link between Parkinson's disease and two chemicals commonly sprayed on crops to fight pests.

That epidemiological study didn't examine farmers who constantly work with pesticides but people who simply lived near where farm fields were sprayed with the fungicide maneb and the herbicide paraquat. It found that the risk for Parkinson's disease for these people increased by 75 percent.

Now a follow-up study adds two new twists. Once again the researchers returned to California's fertile Central Valley, and for the first time have implicated a third pesticide, ziram, in the pathology of Parkinson's disease. Second, instead of looking just at whether people lived near fields that were sprayed, they looked at where people worked, including teachers, firefighters and clerks who worked near, but not in, the fields.

They found that the combined exposure to ziram, maneb and paraquat near any workplace increased the risk of Parkinson's disease (PD) threefold, while combined exposure to ziram and paraquat alone was associated with an 80 percent increase in risk. The results appear in the current online edition of the European Journal of Epidemiology.

"Our estimates of risk for ambient exposure in the workplaces were actually greater than for exposure at residences," said Dr. Beate Ritz, senior author and a professor of epidemiology at the UCLA School of Public Health. "And, of course, people who both live and work near these fields experience the greatest PD risk. These workplace results give us independent confirmation of our earlier work that focused only on residences, and of the damage these chemicals are doing."

In addition, Ritz noted, this is the first study that provides strong evidence in humans that the combination of the three chemicals confers a greater risk of Parkinson's than exposure to the individual chemicals alone. Because these pesticides affect different mechanisms leading to cell death, they may act together to increase the risk of developing the disorder: Those exposed to all three experienced the greatest increase in risk.

"Our results suggest that pesticides affecting different cellular mechanisms that contribute to dopaminergic neuron death may act together to increase the risk of PD considerably," said Ritz, who holds a joint appointment in the UCLA Department of Neurology.

Scientists knew that in animal models and cell cultures, such pesticides trigger a neurodegenerative process that leads to Parkinson's, a degenerative disorder of the central nervous system that often impairs motor skills, speech and other functions and for which there is no cure. The disease has been reported to occur at high rates among farmers and in rural populations, contributing to the hypothesis that agricultural pesticides may be partially responsible.

In the past, data on human exposure had been unavailable, largely because it had been too hard to measure an individual's environmental exposure to any specific pesticide.

"This stuff drifts," Ritz said. "It's borne by the wind and can wind up on plants and animals, float into open doorways or kitchen windows -- up to several hundred meters from the fields."

So several years ago, Ritz and her colleagues developed a geographic information system-based tool that estimates human exposure to pesticides applied to agricultural crops, according to the distance from fields on which pesticides are sprayed. This GIS tool combined land-use maps and pesticide-use reporting data from the state of California. Each pesticide-use record includes the name of the pesticide's active ingredient, the amount applied, the crop, the acreage of the field, the application method and the date of application.

From 1998 to 2007, the researchers enrolled 362 people with Parkinson's and 341 controls living in the Central Valley, then obtained historical occupational and residential addresses from all the study participants. Employing their geographic information system model, they estimated ambient exposures to the pesticides ziram, maneb and paraquat, both at work and home, from 1974 to 1999.

The results reaffirmed what their previous research had suggested, that the data, "suggests that the critical window of exposure to toxicants may have occurred years before the onset of motor symptoms, when a diagnosis of Parkinson's is made."

Knowing that the fungicide ziram is commonly used in agriculture and suspecting its relationship to Parkinson's, Ritz turned to her colleague Jeff Bronstein, a UCLA professor of neurology and co-author of the study, for confirmation. His lab performed a genetic screen using genetically modified cells to identify pesticides that inhibit the breakdown of important proteins such as alpha-synuclein. Ziram was one of the best inhibitors they identified; they found, in fact, that synuclein accumulated in dopamine neurons, selectively killing them. When it was given systemically to rodents, it reproduced many of the features of Parkinson's disease.

"So the present study clearly demonstrates that exposure to ziram in humans is associated with a significant increased risk of developing PD," Bronstein said.

Funding for the study was provided by the National Institute of Environmental Health Sciences, he National Institute of Neurological Disorders and Stroke, the U.S. Department of Defense Prostate Cancer Research Program, and the American Parkinson's Disease Association.

Other authors included lead author Anthony Wang (UCLA), Sadie Costello (UC Berkeley) and Myles Cockburn and Xinbo Zhang (University of Southern California).

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:

Anthony Wang, Sadie Costello, Myles Cockburn, Xinbo Zhang, Jeff Bronstein, Beate Ritz. Parkinson’s disease risk from ambient exposure to pesticides. European Journal of Epidemiology, 2011; DOI: 10.1007/s10654-011-9574-5

Omega-3 Fatty Acids May Help Heart Patients With Stents

By Kathleen Doheny
HealthDay Reporter

HealthDay News

Thursday, May 26, 2011

THURSDAY, May 26 (HealthDay News) -- Combining omega-3 fatty acids with blood-thinning drugs may reduce the risk of heart attacks in patients who've had stents placed in their coronary arteries, a new European study suggests.

While other research suggests that foods rich in omega-3s, including fatty fish such as salmon, help reduce the risk of heart problems in those with existing coronary artery disease, the new study is thought to be the first to look at the effect of the omega-3s on those treated with blood-thinning medications after stent placement.

In people with heart disease, a stent is a small tube placed in a coronary artery to keep it open and to allow the normal flow of blood and oxygen to the heart. But if a blood clot forms at the stent site, it can block blood flow and result in life-threatening problems such as a heart attack.

"Our results demonstrated improved clot properties and decreased thrombin [a clot promoter] formation after treatment with the fish oil capsules," wrote Dr. Grzegorz Gajos of John Paul II Hospital in Krakow, Poland, in the report.

Gajos and colleagues studied 54 patients, on average about 63 years old. They all had their clogged arteries opened by a catheter procedure. They then had stents inserted to keep the vessels open.

All were on the standard medical therapy used in these patients, including a daily dose of aspirin and an anti-platelet drug, clopidogrel (Plavix), for four weeks after the stent was installed.

Twenty-four patients were randomly assigned to receive a placebo pill daily and 30 patients received 1,000 milligrams of omega-3s (EPA and DHA) in pill form daily. The study was a double-blind, placebo-controlled trial -- meaning that neither the patients nor the researchers knew who was getting the omega-3s and who was getting the placebo (or sham treatment).

The researchers found that those who took the omega-3 fatty acids had improved clot properties and decreased clot formation after the treatment compared to the placebo group. The clots that formed in those on the fish oil pills, for example, were easier to disrupt.

The patients taking omega-3s not only produced less of the clot-promoting thrombin, their clots had larger pores and so were easier to break up. Clot destruction time in those patients was also 14.3 percent shorter than in the patients taking placebo pills.

Because there were not differences in other clotting features between the groups, the investigators felt that the finding indicated that the changes were due to the fish oil.

The researchers concluded that giving omega-3 fatty acids to patients who are stable after stent placement could improve outcomes, although they did not track outcomes for the patients in this study. Fish oil is not a replacement for the blood-thinner drugs or other treatments, they explained, but simply an adjunct (added) treatment.

However, the study authors pointed out that they could not extend the findings to other groups, such as those who are healthy, those with a high risk of coronary artery disease, or those not on the blood-thinning drugs. They are planning a larger study that will go on indefinitely, they added.

The study is published in the May 26 issue of Arteriosclerosis, Thrombosis and Vascular Biology: Journal of the American Heart Association.

The study is "trying to figure out why we might want to believe that omega-3 fatty acids have some benefit in this," said Dr. Kirk Garratt, clinical director of interventional cardiovascular research at the Lenox Hill Heart and Vascular Institute of New York, who was not involved in the study.

For the last 15 to 20 years, Garratt said, the benefits of fish oil have been debated. What the new study shows -- in a relatively small number of people -- is that if fish oil supplements are added to the usual medicine and medical care, "[scientists] find the scale has been tilted toward tearing down the clots rather than building up clots," he explained.

The study does not clarify exactly how the omega-3 fatty acids are affecting the blood clots, Garratt added, noting that the body is constantly making blood clots and that "there are forces that want to make clots and forces that want to tear them down." It is known, he said, that oxidative stress tilts the body toward formation of clots and makes it hard to tear them down. That would point to the antioxidant properties of fish oil getting the credit, he concluded.

The researchers found that giving the omega-3 fatty acids did not take away the body's inherent ability to make clots, he said, which is important to preserve.

If the antioxidants are responsible for affecting the blood clotting process, Garratt said, it could be they are revving up the body's ability to destroy clots.

What is not known, he said, is whether the findings mean that fish oil might help prevent heart attacks in these patients.

However, Garratt sees no reason to withhold fish oil from patients. "Fish oils have had more of a positive track record than negative track record," he said. High-potency fish oil affects blood fats favorably, he said, especially the triglycerides.

More information

To learn more about omega-3 fatty acids and the heart, visit the American Heart Association.

Healthy Gut Flora Could Prevent Obesity, Rat Study Suggests

ScienceDaily (May 26, 2011) — Poor gut flora is believed to trigger obesity. In the same way, healthy gut flora could reduce the risk. This has shown to be the case in tests on rats. Daily intake of a lactic acid bacteria, which has been given the name Lactobacillus plantarum HEAL19, appears to be able to prevent obesity and reduce the body's low-level inflammation.

"Rats who were given this specific lactic acid bacterium from their time in the uterus up to adult age put on significantly less weight than other rats. Both groups ate the same amount of high-energy food," explains Caroline Karlsson, a researcher in food hygiene at Lund University.

Ms Karlsson also observed that the rats which were given lactobacilli had a richer and better composition of the bacteria which occur naturally in the intestines. A healthy gut flora should contain a large proportion of 'good bacteria', such as lactic acid bacteria, in order to keep the inflammation-causing bacteria in check.

A third group of rats were given the inflammation-causing Escherichia coli bacteria in their drinking water, in addition to the same high-energy food as the other rats. The E. coli supplement led to changes in gut flora and increased body fat. The findings were published recently in the British Journal of Nutrition and form part of the doctoral thesis that Caroline Karlsson recently presented.

In another study, Caroline Karlsson has studied the first faeces of 79 children born vaginally. A fetus lives in a sterile environment and therefore has no micro-organisms in its intestines, but during birth the baby swallows the lactobacilli that are naturally present in its mother's vagina.

"It had not previously been shown that all newborn babies born vaginally have lactobacilli in their gut flora as early as two days after birth. Thanks to the application of a gene-based technique, we have been able to show in our study that this is in fact the case," says Caroline Karlsson, who also found that babies with high birth weight had more inflammation-causing bacteria, such as E. coli, in their intestines than babies of normal weight.

A healthy gut flora at an early stage appears to play a part in children's wellbeing later in life. This is a conclusion in a further study, where Caroline Karlsson showed that children with allergic eczema at the age of 18 months had a lower diversity in the gut flora when they were just one week old compared with the children who did not develop allergic eczema.

In the aforementioned study on rats, it emerged that the mother's diet and bacteria consumption affect the development and health of her young.

"A number of female rats were given food with high energy content during pregnancy and while they were suckling their young. We saw that, at two weeks of age, the young whose mothers were given high-energy food had higher body weight and more fat in their bodies, as well as higher levels of inflammation, than young whose mothers were given a more balanced diet," explains Caroline Karlsson.

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.

Fish oil in pregnancy may not boost babies' vision

By Amy Norton

Reuters Health

Thursday, May 26, 2011

 

NEW YORK (Reuters Health) – Expectant moms who take fish oil supplements may not be doing much to sharpen their babies' vision, a new study suggests.

The findings fly in the face of some earlier research that had suggested docosahexaenoic acid (DHA), which is found in fish oil, improves vision in preterm babies who are given supplements in their first few months of life.

DHA is an omega-3 fatty acid involved in brain and visual development. Since the substance passes through the placenta primarily later in pregnancy, preemies miss out on much of their prenatal supply.

So extra DHA after birth might help make up for that.

In the new study, Australian researchers looked at whether prenatal fish oil helps improve vision in full-term infants.

They tested visual acuity in 185 4-month-olds whose mothers had been randomly assigned to either take DHA-rich fish oil capsules or a placebo (vegetable oil capsules) every day, from mid-pregnancy until delivery.

Overall, there was no benefit of DHA on infants' vision, the researchers report in the American Journal of Clinical Nutrition.

It's not clear why the supplements didn't have an impact, despite the benefits seen in preemies given DHA after birth.

But one reason may be that preemies need the extra DHA, whereas full-term babies get all they need for normal visual development while still in the womb, according to Dr. Maria Makrides, the lead researcher on the study.

"I think that if women are well nourished and have a good, varied diet, then supplementation with DHA during pregnancy to enhance visual development for their unborn baby is not necessary," Makrides, of the Women's and Children's Health Research Institute in North Adelaide, Australia, told Reuters Health in an email.

Researchers are still studying whether there might be other benefits for infants' development. But studies so far have come to mixed conclusions.

In a study published last year, Makrides' team found no evidence that fish oil during pregnancy boosted babies' cognitive and language skills at the age of 18 months (see Reuters Health story of October 19, 2010).

Makrides said that this and other studies are pointing out the fact that full-term babies born to well-nourished moms generally do well developmentally -- and it may be hard to improve upon that with DHA supplements.

There may be other benefits of fish oil during pregnancy. Some studies have suggested that it can curb the risk of preterm birth, for example, but the jury is still out on that question.

In general, experts recommend that pregnant women strive for 200 milligrams of DHA per day. Some prenatal vitamins now carry the fatty acid, which is also present in fish -- especially fatty ones like salmon, mackerel and tuna.

However, since fish can be contaminated with mercury, doctors advise pregnant women to limit themselves to two fish meals per week. They should also choose fish that have omega-3s but are likely to have low mercury levels, such as salmon, canned light tuna and shrimp.

Certain fish -- shark, swordfish, king mackerel and tilefish -- should be completely avoided during pregnancy, because they can have high mercury levels.

Makrides said her team is continuing to follow the children in this study to see if fish oil during pregnancy makes any difference in cognitive and language skills at age four.

As for visual development, if fish oil has any benefit for full-term babies, it would be most evident early in life.

"By the end of infancy," Makrides said, "it would be much harder to find differences between groups, as visual development would be well advanced."

Source: http://bit.ly/mTnKXD

American Journal of Clinical Nutrition, June 2011.

Folic Acid Given to Mother Rats Protects Offspring from Colon Cancer

ScienceDaily

Thursday, May 26, 2011

ScienceDaily (May 26, 2011) — Folic acid supplements given to pregnant and breast-feeding rats reduced the rate of colon cancer in their offspring by 64 per cent, a new study has found.

The research, led by Dr. Young-in Kim, a gastroenterologist at St. Michael's Hospital, adds to the growing but sometimes contradictory evidence that folic acid supplementation during pregnancy and lactation can increase or decrease the development or progression of some pediatric malignancies and common cancers in their offspring in adulthood.

For example, a separate study by Kim published in February found the daughters of rats who were given folic acid supplements before conception, during pregnancy and while breast-feeding have breast cancer rates twice as high as other rats who were not given the supplements. They also had more tumours and developed them at a faster rate.

Kim said these studies collectively suggest that folic acid may have drastically different effects on cancer development in different organs, that specific organs may have different needs for folate, its natural form, or metabolize it differently. He said more studies, including human studies, were needed.

Kim's new study, published in Gut, an international journal in gastroenterology, is the first to find that folic acid supplements at the level ingested by North American women of childbearing age "significantly protects against the development of colorectal cancer in the offspring."

Folate is known to help make DNA and help it replicate.

"It appears that giving folic acid during pregnancy and lactation reduces DNA damage and suppresses the proliferation of cells in the colon," Kim said. "It actually increases the stability of the DNA and this might be one of the mechanisms of how folic acid in utero may protect against colon cancer."

The amount of folic acid to which fetuses are exposed has increased dramatically in North America in the past decade. Natural folate is found in grains and dark, leafy vegetables. Women are routinely advised to take folic acid supplements before becoming pregnant and while pregnant to prevent neural tube birth defects such as spina bifida.

Since 1998, the Canadian and U.S. governments have required food manufacturers to add folic acid to white flour, enriched pasta and cornmeal products as a way of ensuring women receive enough of the B vitamin. In addition, up to 40 per cent of North Americans take folic acid supplements for possible but as yet unproven health benefits.

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. K. Y. Sie, A. Medline, J. van Weel, K.-J. Sohn, S.-W. Choi, R. Croxford, Y.-I. Kim. Effect of maternal and postweaning folic acid supplementation on colorectal cancer risk in the offspring. Gut, 2011; DOI: 10.1136/gut.2011.238782

U.S. Southeast 'Stroke Belt' Also Shows Higher Rates of Cognitive Decline

HealthDay News

Thursday, May 26, 2011

THURSDAY, May 26 (HealthDay News) -- People living in an area of the southeastern United States known as the "Stroke Belt" are also at greater risk for cognitive decline, or reduced brain function, than those living in other areas, new research suggests.

The Stroke Belt states -- known to have significantly higher rates of stroke deaths than the rest of the country -- include Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee. According to the researchers, shared risk factors for stroke and brain impairment appear to be to blame for the greater incidence of cognitive decline in this geographic region.

The new study, published online May 26 in Annals of Neurology, followed more than 30,000 Americans aged 45 or older for a period of four years to document signs of stroke as well as cognitive decline.

In assessing reduced cognitive function, the researchers included nearly 24,000 participants (38 percent were black, and 62 percent were white) with normal brain function and no history of stroke. More than half of those participating in the study, or 56 percent, were from Stroke Belt states, while 44 percent were from other parts of the country.

After subjecting participants to brain function tests, including memory and perception of time, the researchers found that roughly 8 percent showed cognitive impairment over the course of the study period. In addition, those living in the Stroke Belt states had an 18 percent higher risk of cognitive decline than those living elsewhere in the country.

"Our study is the first to document higher incidence of cognitive impairment in the Stroke Belt compared to remaining U.S. regions," Virginia Wadley, associate professor of medicine at the University of Alabama at Birmingham, said in a journal news release.

One expert called the finding "extremely interesting."

"It has been known for some time that the "stroke belt" is a geographical region with a significantly higher incidence of stroke," said Dr. Richard B. Libman, chief of the division of vascular neurology at Long Island Jewish Medical Center in New Hyde Park, N.Y. "Stroke by itself is a major contributor to cognitive impairment and dementia."

The study's authors also noted that more research is needed to examine other possible risk factors for reduced brain function, including migration patterns, urban vs. rural living, socioeconomic status and education.

"Risk factors for stroke, such as high blood pressure, diabetes, etc..., are in themselves independent risk factors for cognitive impairment," Libman added. "The important message is that careful analysis of what makes the stroke belt different from other areas of the country can lead to more insight into what is causing the cognitive impairment, and, hopefully, result in effective preventive measures and treatment."

More information

The American Stroke Association provides more information on the risk factors for stroke.

U.S. Health: Cognitive Decline Incidence Higher in Southern Stroke Belt

ScienceDaily

Thursday, May 26, 2011

ScienceDaily (May 26, 2011) — New research shows that residents of the Stroke Belt -- a southern portion of the U.S. with significantly elevated stroke morality rate -- also have a greater incidence of cognitive decline than other regions of the country. Researchers believe shared risk factors among members of this population are to blame. Results of this study, funded by the National Institute of Neurological Disorders and Stroke (NINDS), are published in Annals of Neurology, a journal of the American Neurological Association.

In 1965 the Stroke Belt first appeared in medical literature to describe the southeastern region of the U.S. where stroke mortality rates were 50% higher than the remaining U.S. regions. According to the Centers for Disease Control and Prevention (CDC) age-adjusted annual rates of stroke mortality among adults 35 and older in the eight Stroke Belt states (Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee) were on average, 125 per 100,000 individuals, compared to 96 per 100,000 Americans in the remaining 40 contiguous states and the District of Columbia (2000-2006).

The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, led by Principal Investigator George Howard, DrPH, recruited over 30,000 U.S. adults aged 45 or older from 2003 through 2007 and is following them for stroke and cognitive decline. REGARDS participants included 56% from the Stroke Belt states and 44% from the remaining states in the continental U.S. including D.C. which researchers collectively termed "non-Belt" states. For their report on cognitive decline, the investigators included 23,913 REGARDS participants, made up only of African Americans (38%) and European Americans (62%) who reported no history of stroke at baseline and had normal cognitive status at the first assessment.

"Our study is the first to document higher incidence of cognitive impairment in the Stroke Belt compared to remaining U.S. regions," said Virginia Wadley, Ph.D., Associate Professor of Medicine at the University of Alabama at Birmingham. Researchers assessed brain function using the Six-item Screener (SIS) -- a test of global cognitive function that includes item recall and temporal orientation. SIS scores range from 0 to 6 with a score of 4 or less representing cognitive impairment.

Results indicate that 8.1% of participants showed cognitive impairment at their most recent assessment, over a mean of 4.1 years following the initial assessment. Stroke Belt residents had a greater likelihood of cognitive impairment than non-Belt residents (odds ratio=1.18); all demographic factors and time independently predicted impairment. Risk of cognitive impairment was 18% higher in residents of the Stroke Belt than in those living in non-Belt states after adjusting for the influences of age, sex, race, and education level.

The research team suggests that future studies should examine the impact of migration patterns, urban versus rural residence, socioeconomic factors, and educational quality on cognitive decline. "Investigating regional patterns that contribute to modifiable risk factors affecting cognitive decline will allow for prevention and intervention efforts that are geographically concentrated," concluded Dr. Wadley. "Information obtained from the REGARDS study can be used to develop services for older Americans at both local and national levels to improve outcomes for those most vulnerable to diminished cognitive function."

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:

Virginia G. Wadley, Frederick W. Unverzagt, Lisa C. McGuire, Claudia S. Moy, Rodney Go, Brett Kissela, Leslie A. McClure, Michael Crowe, Virginia J. Howard, George Howard. Incident cognitive impairment is elevated in the stroke belt: The regards study. Annals of Neurology, 2011; DOI: 10.1002/ana.22432

No heart benefit seen in adding niacin to statin

By Julie Steenhuysen

Reuters

Thursday, May 26, 2011

CHICAGO (Reuters) – Giving a high dose of niacin to people with heart disease who are already taking a cholesterol-lowering statin does nothing more to prevent heart attacks and strokes, U.S. government researchers said on Thursday.

The findings from a large clinical trial challenge the notion that raising high-density lipoprotein, or HDL, the so-called "good" cholesterol, can further reduce heart risks in people who already have their "bad" cholesterol -- low-density lipoprotein, or LDL -- well under control.

Patients in the study who had a history of heart disease were treated with Abbott Laboratories' Niaspan, a nearly $1 billion-a-year seller, and Merck & Co Inc's Zocor, a statin available generically as simvastatin.

Researchers said Niaspan raised levels of HDL, the "good" cholesterol, but that did not translate into fewer fatal and non-fatal heart problems, prompting the National Heart, Lung, and Blood Institute to stop the study 18 months early. Abbott shares were down 2 percent on the news.

"Although we did not see the expected clinical benefit, we have answered an important scientific question about treatment for cardiovascular disease," Dr. Susan Shurin, acting director of the National Heart, Lung, and Blood Institute, part of the National Institutes of Health, said in a statement.

Niacin, also known as Vitamin B3, has long been known to raise HDL and lower triglycerides, another type of blood fat that raises heart risks.

Millions of heart patients take niacin to raise HDL and lower triglycerides on the assumption that this will reduce heart risks, but it has not been clear that these treatments actually lower that risk. Heart disease is the world's leading cause of death.

"This sends us back to the drawing board," Shurin told a conference call.

"Either the approach to raise HDL was not effective, or HDL is not a good target," she said.

Drug Raised HDL As Expected

The study, called the AIM-HIGH trial, enrolled 3,414 volunteers in the United States and Canada who were taking a statin to keep their LDL cholesterol low. More than half had suffered a heart attack before entering the trial.

All volunteers were given Zocor, and 515 participants were given a second LDL cholesterol-lowering drug, Merck's Zetia, or ezetimibe, to make sure their LDL stayed in the target range of 40 to 80 milligrams per deciliter, which are very low levels.

Researchers said the drug performed as expected, raising HDL by about 28 percent and lowering triglycerides by about 25 percent, in keeping with other studies.

Late last month, an independent panel looked at the interim results of the study and concluded that high-dose niacin offered no benefits beyond statins alone in reducing heart complications, prompting the decision to end the study early.

There was also a slightly higher rate of strokes among patients who took niacin, but the overall rate of strokes in both groups was low.

Abbott, which reported Niaspan sales rose 8.4 percent to $927 million last year, said the relevance of the findings outside the type of patients in the study "is currently unknown and it would be premature to extrapolate these results to a broader patient population at this time."

Wells Fargo Securities analyst Larry Biegelsen said the surprise findings could cut Niaspan sales by 20 to 30 percent.

The U.S. Food and Drug Administration says it will review the study but has made no new recommendations about niacin alone or in combination with statins.

The study is the latest to raise questions about whether increasing HDL helps prevent heart problems. With the success of statins to lower LDL, drugmakers have been looking to HDL-raising drugs as perhaps the next huge avenue for addressing cardiovascular disease.

One such promising drug, Pfizer Inc's torcetrapib, was thought to be a potential huge seller by raising HDL through a different mechanism than niacin.

But torcetrapib was found to increase heart problems in one of the highest-profile flameouts in the drug industry's history. Still, Merck and Switzerland's Roche are developing drugs in the same class as torcetrapib.

And a study testing Abbott's TriCor, or fenofibrate, a drug designed to lower triglycerides that also raises HDL, failed to cut heart problems in diabetics taking statins in the ACCORD trial despite improving both HDL and triglyceride levels.

(Reporting by Julie Steenhuysen in Chicago, additional reporting by Lewis Krauskopf and Bill Berkrot in New York; Editing by Eric Beech)

Caffeine May Interfere With Fertility in Women

HealthDay News

Thursday, May 26, 2011

THURSDAY, May 26 (HealthDay News) -- Caffeine, a known stimulant, has been shown to cause rapid heart rate, nausea, anxiety and depression. Now, new research reveals that caffeine consumption may make it harder for a woman to get pregnant.

By analyzing fallopian tubes in mice, researchers found that caffeine interferes with muscle contractions that help eggs travel from the ovaries through the fallopian tubes and into the womb -- a process critical for a successful pregnancy.

"Our experiments were conducted in mice, but this finding goes a long way towards explaining why drinking caffeinated drinks can reduce a woman's chance of becoming pregnant," Sean Ward, professor at the University of Nevada School of Medicine, said in a journal news release.

"This provides an intriguing explanation as to why women with high caffeine consumption often take longer to conceive than women who do not consume caffeine," Ward added.

Caffeine is found in coffee, tea, colas, chocolate and certain medications.

Researchers noted that the study's findings, published May 26 in the British Journal of Pharmacology, could further the understanding and treatment of infertility as well as some complications of pregnancy.

Previously, it was thought that eggs moved through the fallopian tubes assisted by hair-like projections called cilia, but this study suggests that specialized pacemaker cells coordinate the contractions that push the eggs along.

"As well as potentially helping women who are finding it difficult to get pregnant, a better understanding of the way fallopian tubes work will help doctors treat pelvic inflammation and sexually transmitted disease more successfully," said Ward. "It could also increase our understanding of what causes ectopic pregnancy, an extremely painful and potentially life-threatening situation in which embryos get stuck and start developing inside a woman's fallopian tube."

More information

The American Congress of Obstetricians and Gynecologists provides details on infertility. 

Wednesday, May 25, 2011

Does aspirin cut deaths? New study clouds picture

By Frederik Joelving

Reuters Health

Wednesday, May 25, 2011

NEW YORKS (Reuters Health) – Despite a lot of excitement about aspirin, scientists can't seem to agree on whether the drug helps healthy people live longer.

Just one month after a study failed to find an effect on overall death rates -- see Reuters Health report, April 20, 2011 -- a new report based on the same data has arrived at the opposite conclusion.

"This reduction in all-cause mortality tilts the balance between the benefits and risks of treatment in favor of the use of aspirin," researchers write in the American Journal of Medicine.

Experts agree that aspirin, one of the world's most widely used drugs, is worth taking for people who've already had one heart attack. While it has side effects, it lowers the chance of a second heart attack, fatal or not, enough to outweigh those risks.

But whether and when healthy people might benefit is a hotly debated question, the answer to which depends on which medical group you ask.

1,100 Aspirin-Takers To Prevent One Death

The new study is an attempt to weigh the overall harms and benefit by looking at all-cause mortality, or deaths for any reason.

Known as a meta-analysis, it pools the results of nine previous aspirin trials involving more than 100,000 men and women and lasting four to ten years. Some participants were healthy and some had diabetes, but none had chest pain or other symptoms of an ailing heart.

According to the authors of the report, 3.65 percent of the people randomly assigned to small doses of aspirin died during the trials, compared to 3.74 percent of people not taking the drug.

The researchers say that difference is enough to favor aspirin use in people without a history of heart disease, and should inform future guidelines.

But a closer look at the data shows 1,111 people would need to take aspirin daily for the duration of the trials to stave off just one death -- the so-called number needed to treat.

And there is a price tag, too: nine of those individuals would suffer bleeding ulcers due to the drug, and nearly four would have other major bleeds, like hemorrhagic stroke.

"The number needed to harm is much, much lower than the number needed to treat," said Dr. Franz Messerli, who heads the high blood pressure program at St. Luke's-Roosevelt Hospital in New York and was not involved in the new work.

"If the patient has no risk factors for heart disease, I see no reason to put them on aspirin," he told Reuters Health.

Are There Real Benefits?

Messerli also mentioned that the reduction in deaths is barely credible statistically speaking, and that the analysis differs from a previous one based on the same nine trials.

"That's what bothers me," he said. "One says the effect is statistically significant and the other says it's not. Why the heck that would be, I don't know."

The previous meta-analysis was supported by aspirin-maker Bayer AG, while the new one received no funding.

Dr. John Eikelboom of McMaster University in Hamilton, Canada, who worked on the new study, did not respond to a request for comments.

The researchers did find some clear-cut benefit, however.

For instance, 1.68 percent of people on aspirin suffered a heart attack, fatal and non-fatal, compared to 1.91 percent of those not taking the drug.

That means about 435 healthy people would have to take aspirin daily, at a cost of a cent or so per pill, to prevent one heart attack.

What The Recommendations Say

Heart disease is the leading killer worldwide and accounts for more than a third of deaths in the U.S., according to the American Heart Association. Every year, heart attacks alone kill some 400,000 Americans.

The association recommends that no one should start aspirin therapy without talking to their doctor first, although it does advise aspirin use when people are at increased risk of heart disease -- for instance due to smoking or obesity.

In general, doctors advise eliminating those risk factors through a healthy lifestyle. That will not only slash the risk of heart disease, but also a host of other health problems.

The U.S. Preventive Services Task Force (USPSTF), a federally supported expert panel, advises that men age 45 to 79 take aspirin to stave off heart attacks, as long as the benefit outweighs the risk of bleeding.

For women age 55 to 79, aspirin is recommended to prevent strokes, with the same caveat.

Last month, Dr. Michael L. LeFevre of the USPSTF told Reuters Health that recommendations should be made one patient at a time.

"The number of events that you prevent depends on your baseline risk," he said. "A blanket recommendation that everybody should take an aspirin is not a good idea."

Source: http://bit.ly/ihMIO7

The American Journal of Medicine, online May 18, 2011.

More U.S. women using medications during pregnancy

By Amy Norton

Reuters Health

Wednesday, May 25, 2011

NEW YORK (Reuters Health) – Most pregnant women in the U.S. use at least one prescription or over-the-counter medication -- even though the safety of those drugs during pregnancy is not always clear, a new study finds.

Looking at data from two long-running studies, researchers found that by 2008, more than 80 percent of pregnant women used at least one prescription or over-the-counter medication at some point.

What's more, half used a drug during the first trimester -- the point of pregnancy where there is the greatest concern about the potential effects of medications on birth defect risk.

Those numbers, the study found, represent a large shift from 30 years earlier, when about 30 percent of women used some type of medication during the first trimester.

The concern, researchers say, is that with many drugs, the safety of using them during pregnancy is not yet clear.

So the findings underscore a need to keep studying the safety of individual medications, according to lead researcher Dr. Allen A. Mitchell, of the Boston University Schools of Public Health and Medicine.

"That's not to say that these drugs are dangerous," Mitchell told Reuters Health. "But we just don't have enough information on them."

The difficulty is that medications are almost never tested in pregnant women before they come to market because it is considered unethical to expose a pregnant woman to a drug with unknown effects.

So usually the only way to uncover safety concerns is with post-marketing surveillance studies.

And those studies need to be large, Mitchell explained, in order to detect whether an individual medication is linked to any one birth defect. It's usually the case that a drug would cause only certain birth defects, as opposed to a broad spectrum of problems.

In general, the risk of having a baby with any birth defect is between 2 and 3 percent. So individual birth defects are relatively infrequent.

The current findings, which appear in the American Journal of Obstetrics & Gynecology, are based on data from two long-term studies on birth defects. More than 30,000 U.S. women were interviewed about their prenatal medication use.

Over time, the number of women using a prescription or over-the-counter drug rose, as did the percentage using four or more medications. By 2008, 28 percent of women said they'd used four or more drugs in the first trimester, up from 10 percent 30 years earlier.

Among the most common prescription drugs used were various antibiotics, asthma and allergy medications, and antidepressants.

The safety of those drugs during pregnancy is not entirely clear.

On the other hand, if a woman is taking a drug for a chronic medical condition, such as asthma, epilepsy or major depression, there could be risks to stopping the medication during pregnancy.

Mitchell pointed to the example of asthma. "Untreated asthma is not good for the mother or for the baby," he said.

These findings, he added, "should not discourage women from taking the medications they need for chronic conditions."

Instead, Mitchell suggested, these women should talk with their doctors about the risks and benefits of those drugs during pregnancy. Depending on the condition, there may be a particular drug that is recommended above others for pregnant women.

Women should also be aware that the safety of over-the-counter drugs during pregnancy is not completely clear either.

Again, Mitchell said, that's not to say that those medications are necessarily dangerous. But if a pregnant woman can find other ways to manage a stuffy nose or other minor symptom, then she might want to go that route.

"If you don't feel that you need the medication," Mitchell said, "then you might want to err on the side of caution."

Source: http://bit.ly/iQZqTu

American Journal of Obstetrics & Gynecology, online April 25, 2011.

Could 'Extreme' Low-Cal Diets Bring Longer, Healthier Life?

By Amanda Gardner
HealthDay Reporter

HealthDay News

Wednesday, May 25, 2011

WEDNESDAY, May 25 (HealthDay News) -- Science has shown that diets that veer close to starvation can make everything from mice to monkeys live longer.

But can such a strict eating regimen prolong human lives, and if so, would those extra years be healthy, happy ones?

Recent research from Washington University scientists found that people who slashed their calorie intake have lower core body temperatures than those who eat more. Core body temperature is the temperature at which all of the functions in the body can operate at maximum efficiency, so the link looks like a positive one, according to some researchers.

Trent Arsenault, a 35-year-old engineer in the Bay Area, certainly hopes so.

He has been a "calorie restrictor" since 2000, consuming just 1,800 calories a day or 25 percent less than what a male of his size -- 6-foot-1 and 150 pounds -- would normally consume, he said.

Since he started, he has shed 60 pounds and now has a body-mass index of 19, just one notch above underweight (which is 18). His body fat composition is only 10 percent.

Arsenault is also one of 28 participants in the first long-term clinical trial to look at extreme calorie restriction in humans, and its effects not only on longevity but also on health.

He was recruited with the help of the Calorie Restriction Society, an international organization with several thousand members.

The study is known as CRONA (Caloric Restriction with Optimal Nutrition and Aging Study). It is being done at the University of California, San Francisco, where participants from many different states as well as England and Japan are traveling for a weekend of tests including cognitive exams, body measurements and a visit to an egg-shaped chamber that measures body fat composition. They'll also complete surveys on everything from their medical history and eating habits to sleep patterns and stress levels.

"It's an interesting paradox because restriction in animals seems to be the fountain of youth, but all my prior work in humans has shown not such great outcomes," said Janet Tomiyama, a psychologist who is a Robert Wood Johnson Foundation Health & Society Scholar at UCSF and principal investigator of this trial.

And the animal studies haven't had clear data on how well the animals are actually living.

"The animal data seems good with all the longevity studies but what people really don't know is how healthy the animals actually are," said Heidi A. Tissenbaum, an associate professor in the Program in Gene Function and Expression and in molecular medicine at the University of Massachusetts Medical School in Worcester. "How happy are the people? Are they feeling restricted all their life?"

Not only will the investigators be looking at cholesterol and other markers of health, but they will also measure the length of telomeres. These are pieces of DNA which, when shortened, seem to be linked with health problems and a shorter lifespan.

Among other things, the study will look at how personality might differ in calorie restrictors compared to normal eaters or overweight/obese people, as well as cognitive ability, impulse control and how stress is handled.

The study participants are mostly male (as are most calorie restrictors), well-educated and middle-aged.

It will take decades to have results from the trial but Arsenault feels he already has seen a difference.

He doesn't catch colds or the flu, has plenty of energy and neither his sexual drive nor his fertility have been affected, he said. In fact, he has fathered at least 15 children through a sperm bank since he started restricting calories.

Unlike many calorie restrictors, Arsenault did not have a mid-life health scare which propelled him into action. Instead, at the age of 25, he realized he wanted to concentrate on his career, postponing marriage and children.

"[I wanted to] keep myself looking decent enough so that in 10 years I could get married and still be healthy enough to spend time with kids," he explained.

The study is funded by the Appleby Foundation, the Robert Wood Johnson Foundation Health & Society Scholars program and the University of California, Berkeley Population Center.

Researchers Elizabeth Blackburn, Elissa Epel and Jue Lin are also co-founders of a new company called Telome Health Inc., which is developing applications of telomere biology to improve health.

More information

For more information on this type of lifestyle, visit the Calorie Restriction Society.

One in five young adults may have high blood pressure

By Julie Steenhuysen

Reuters

Wednesday, May 25, 2011

CHICAGO (Reuters) – Nearly one in five young U.S. adults may have high blood pressure, researchers said on Wednesday in a study suggesting the problem of hypertension is more widespread than previously thought.

Hypertension is easy to prevent and inexpensive to treat through diet, exercise and drugs, yet it is the second-leading cause of death in the United States. The Institute of Medicine, part of the National Academy of Sciences that often conducts studies for the government, last year declared high blood pressure a "neglected disease" that costs the U.S. health system $73 billion a year.

The latest findings by a team at the University of North Carolina at Chapel Hill are in sharp contrast to a federal government study by the National Health and Nutrition Examination Survey that suggested only 4 percent of young adults might have high blood pressure, a condition that raises the risk of strokes and heart attacks.

Both studies used the same definition of hypertension: a blood pressure reading of 140 over 90 millimeters of mercury or more. Normal blood pressure is considered to be 120 over 80 or lower.

"The findings are significant because they indicate that many young adults are at risk of developing heart disease, but are unaware that they have hypertension," said Quynh Nguyen, a doctoral student at the University of North Carolina at Chapel Hill, whose study appears online in the journal Epidemiology.

The researchers did not study why the numbers may be rising or relate the findings to U.S. intake of sodium, a major contributor to high blood pressure.

U.S. health officials say the study is a worrisome signal, but are cautious to embrace the new findings until they have been confirmed in other studies.

High blood pressure, or too much force exerted by blood as it moves against vessel walls, is the leading risk factor for premature death worldwide.

For the study, the team analyzed data on more than 14,000 men and women between 24 and 32 years old in 2008 from the National Longitudinal Study of Adolescent Health, known as Add Health, funded by the National Institutes of Health.

They found 19 percent had elevated blood pressure, and only about half of these individuals had ever been told by their doctor that they had the condition.

The team considered several explanations for the discrepancy between the two studies, including differences in the participants, where they were examined, and the accuracy and reliability of the measured blood pressures.

None could account for the gap in the hypertension estimates between the two surveys.

"What we have is a new observation and we need to examine why did the numbers come out this way," Dr. Steven Hirschfeld of the National Institute of Child Health and Human Development, one of the National Institutes of Health, said in a telephone interview.

"This one study by itself shouldn't lead us to a revision of health policy or health assessment. it is just a signal we need to examine in greater detail," he said.

Kathleen Mullan Harris of the University of North Carolina at Chapel Hill who led the study said the findings may differ, but the message is clear.

"Young adults and the medical professionals they visit shouldn't assume they're not old enough to have high blood pressure. This is a condition that leads to chronic illness, premature death and costly medical treatment," Harris said in a statement.

(Editing by Cynthia Osterman)

Lecithin Component May Reduce Fatty Liver, Improve Insulin Sensitivity

ScienceDaily

Wednesday, May 25, 2011

ScienceDaily (May 25, 2011) — A natural product called DLPC (dilauroyl phosphatidylcholine) increases sensitivity to insulin and reduces fatty liver in mice, leading Baylor College of Medicine researchers to believe it may provide a treatment for prediabetic patients. DLPC is an unusual phospholipid and a trace component of the dietary supplement lecithin.

Dr. David D. Moore, professor of molecular and cellular biology at BCM, and his colleagues at first thought that DLPC would provide a useful tool in studying the function of a receptor protein -- liver receptor homolog -1 or LRH-1 -- that regulates the production of bile acids in the liver.

Stimulating LRH-1 activity

Studies in mice soon showed that DLPC could stimulate LRH-1 activity. In addition to a small increase in bile acid levels, DLPC improved regulation of glucose and fat within the liver. A report on this work appears in the current issue of the journal Nature. Moore is collaborating with Dr. Lawrence Chan, director of the Diabetes and Endocrine Research Center at BCM, on a pilot study to find out how well DLPC works in patients with prediabetes.

"We know it works well in mice," said Moore. The link of LRH-1 to bile acids may contribute to its effect on glucose levels and fat because small, non-toxic increases in bile acid levels can improve metabolic disorders.

Dr. Jae Man Lee, then a graduate student in Moore's laboratory, first proposed screening compounds to see which activated LRH-1. He found that DLPC, a structurally unusual phosphatidylcholine (a form of phospholipid that is important in the formation of cell membranes) enhanced LRH-1 activity in cells.

In mice, DLPC induced the production of bile acid enzymes and lowered fat in the liver. It also increased levels of bile acids and regulated glucose or sugar circulating in the blood. In two kinds of mice that had resistance to insulin, DLPC also decreased fatty liver and lowered glucose levels in the blood. However, DLPC had no effect in mice that had no LRH-1 in the liver.

Effect on insulin resistant mice was striking

"Their overall body weight was not changed," said Moore. "But they had improved sensitivity to insulin (which helps keep glucose levels in check) and less fatty livers. We are interested in why it gets rid of the fat in the liver."

DLPC decreased the levels of proteins associated with formation of fatty acids and triglycerides, including a key regulator called SREBP-1c that encourages the deposition of fat in tissues.

"DLPC is a natural product," said Moore. "Lecithin is a mixture of many compounds but DLPC is one of them."

Clinical study underway

The ongoing clinical study, which involves people who are overweight but not diabetic, employs an approved form of DLPC that is used in liposomes, little globules of fat that take drugs into the body. An initial glucose tolerance test to determine how sensitive the people are to insulin at the start of the study is followed by another after the subjects take DLPC or a placebo for two months. Neither the patients in study nor the physicians know who is getting DLPC and who is getting the placebo.

Others who took part in the basic science research include Dr. Yoon Kwang Lee and Jennifer L. Mamrosh of BCM, Dr. Scott A. Busby and Dr. Patrick R. Griffin of Scripps Research Institute in Jupiter, Florida and Dr. Manish C. Pathak and Dr. Eric A. Ortlund of Emory University School of Medicine in Atlanta. (Yoon Kwang Lee is now at Northeastern Ohio Colleges of Medicine and Pharmacy in Rootstown, Ohio).

Funding for this work came from the National Institutes of Health, the Alkek Foundation, the National Institute of Diabetes and Digestive and Kidney Diseases and the Robert R.P. Doherty Jr. -- Welch Chair in Science.

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:

Jae Man Lee, Yoon Kwang Lee, Jennifer L. Mamrosh, Scott A. Busby, Patrick R. Griffin, Manish C. Pathak, Eric A. Ortlund, David D. Moore. A nuclear-receptor-dependent phosphatidylcholine pathway with antidiabetic effects. Nature, 2011; DOI: 10.1038/nature10111

Menopause age related to when mom went through it

By Alison McCook

Reuters Health

Wednesday, May 25, 2011

NEW YORK (Reuters Health) – The age at which women go through menopause depends a lot on when their relatives did, according to new study findings.

Specifically, women whose mothers or sisters experienced menopause by age 45 were roughly 6 times more likely to do the same. Women who underwent menopause at a relatively late age - 54 or older - were also 6 times more likely to have seen the same thing happen to their mothers, and twice as likely to see it in their sisters.

But age of menopause is not entirely inherited, the authors found - a significant component also depends on so-called environmental factors.

"Genes have an important effect on age at menopause, but lifestyle also matters, and so women can affect their age at menopause by their behaviors," study author Danielle Morris at the Institute of Cancer Research in the UK told Reuters Health.

Scientists know that certain aspects of a woman's environment directly impact her age at menopause, Morris explained - for instance, women who smoke tend to undergo menopause roughly 1-2 years earlier than former or non-smokers. Women who have never given birth also experience menopause earlier, she said.

Age at menopause is an essential aspect of fertility, Morris and her team write in the journal Menopause, since a woman's ability to conceive ends roughly 10 years before she experiences menopause. Previous research has also found that women who experience menopause relatively late in life have a higher risk of breast and endometrial cancers, and a lower risk of cardiovascular disease.

According to the National Institute on Aging, 51 is the average age at which a woman reaches menopause, or has her last period. But some women have their last period in their 40s and some have it later in their 50s.

To investigate how much of a woman's age at menopause is inherited, Morris and her team compared women who were more or less related, reasoning that different relatives will share different amounts of genes and their environment.

"For example, if identical twins have more similar menopausal ages than non-identical twins, then this suggests that genes are important because identical twins have more genes in common than non-identical twins," said Morris in an email.

"Similarly, if sisters have more similar menopausal ages than mothers and daughters, then this (suggests) that environment is important, because sisters have the same amount of genes in common as mothers and daughters do, but sisters tend to have more similar lifestyles than mothers and daughters."

The sample came from a large study designed to investigate the causes of breast cancer among women living in the UK. Among those participants, the researchers selected 2,060 women between the ages of 31 and 90 who had a first-degree relative who was also participating in the same study.

Both early and late menopause appeared to run in families, the authors found - but so did usual-age menopause, they note. Specifically, women whose sisters and mothers underwent menopause during a typical age were between 2 and 7 times more likely to do the same.

Source: http://bit.ly/ilCV4B

Menopause, online April 18, 2011.

Tuesday, May 24, 2011

Too Many Kids Getting Antibiotics for Asthma

By Steven Reinberg
HealthDay Reporter

HealthDay News

Tuesday, May 24, 2011

TUESDAY, May 24 (HealthDay News) -- Although guidelines don't recommend antibiotics for asthma, almost 1 million children with the respiratory condition are prescribed the medications each year in the United States, a new study finds.

"We are trying to reduce unnecessary antibiotic prescriptions, and this suggests that we as pediatricians are prescribing them way too often," said lead researcher Dr. Ian M. Paul, an associate professor of pediatrics at the College of Medicine of Pennsylvania State University in Hershey.

Why doctors are prescribing antibiotics for asthma is not clear, Paul said. One reason might be that doctors treating severe asthma attacks "feel the need to cover all their bases by also prescribing antibiotics," he suggested.

Sometimes parents may ask doctors to give their child antibiotics, but it doesn't seem to be a big factor, Paul noted. "It probably exists to some degree in clinical practice, but I don't think it happens all that frequently -- certainly not in one in every six visits for asthma," he said.

"The one encouraging finding was, when asthma education was delivered as part of the visit, antibiotics were less likely to be prescribed," he added. When asthma education was not part of the visit, 19 percent of the time antibiotics were prescribed, compared with 11 percent when asthma education was given.

"This suggests that we can educate families and patients and explain the causes of asthma and, hopefully, reduce unnecessary antibiotic prescribing," Paul said.

The dangers of overprescribing antibiotics are that it promotes the development of antibiotic-resistant bacteria and there are side effects for the drugs themselves, Paul pointed out.

The report was published in the May 23 online edition of Pediatrics.

For the study, Paul's team used data from the National Ambulatory Medical Care Surveys and National Hospital Ambulatory Medical Care Survey to see the rate of antibiotics prescribed for children between 1998 and 2007.

Over that time, there were some 60.4 million medical care visits for children with asthma for which no prescription for antibiotics was warranted. However, antibiotics were prescribed 16 percent of the time, the researchers found.

Primary care doctors were most likely to prescribe antibiotics, while emergency department doctors were least likely to prescribe them, Paul said.

Other factors that were linked with increased antibiotic prescribing included use of inhaled corticosteroids and being treated in the winter, the researchers noted.

However, when visits to primary care doctors included asthma education, the rate of antibiotic prescribing went down, Paul stated.

In a second study in the same journal, Belgian investigators led by Dr. Kris De Boeck, from the department of pediatric pulmonology and infectious diseases at the University Hospital of Leuven, found similar overprescribing of antibiotics to asthmatic children.

These researchers found children treated with asthma medications were 1.9 times more likely to also get a prescription for antibiotics, compared with children not treated with asthma drugs.

In fact, 35.6 percent of children who were prescribed asthma drugs were also prescribed antibiotics, the researchers found.

"This finding highlights the need for educational opportunities to inform clinicians that such co-prescription should be limited," the authors concluded.

Commenting on both studies, Dr. Paul Krogstad, a professor of pediatric infectious diseases at the University of California, Los Angeles, and co-author of an accompanying journal editorial, said that "these articles indicate that asthma medications and antibiotics were very commonly prescribed in tandem both here and in Belgium, which conflicts with domestic and international recommendations that point out that antibiotics have no routine use in the care of asthmatics."

Antibiotic overuse confuses patients and family, Krogstad said. "They don't understand the true nature of asthma as an inflammatory, not an infectious disorder," he explained.

In addition, overprescribing antibiotics entails personal and societal risks, Krogstad said.

"Personal risks include allergic reactions, side effects, drug interactions and expense. Societal costs include medication-related costs and selection for drug-resistant bacteria. Antibiotic overuse is being reduced, but this remains an area where improvement is sorely needed," he said.

More information

For more information on asthma, visit the U.S. National Library of Medicine.

Acetaminophen Linked to Lower Prostate Cancer Risk in New Study

ScienceDaily

Tuesday, May 24, 2011

ScienceDaily (May 24, 2011) — A new study from American Cancer Society researchers finds use of 30 tablets a month or more of acetaminophen for five or more years was associated with an estimated 38% lower risk of prostate cancer. The study appears in Cancer Epidemiology, Biomarkers and Prevention and is one of only two studies of prostate cancer to date that have examined the association with acetaminophen use that was both long-term and regular.

Use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), particularly long-term use, has been associated with modestly reduced risk of prostate cancer in some previous epidemiologic studies. Acetaminophen, a commonly used pain-reliever, is not traditionally considered an NSAID but can have anti-inflammatory effects.

For the current study, researchers led by Eric Jacobs, Ph.D., American Cancer Society epidemiologist, examined the association between acetaminophen use and prostate cancer incidence among 78,485 men in the Cancer Prevention Study II Nutrition Cohort. Information on acetaminophen use was obtained from a questionnaire completed at study enrollment in 1992 and updated using follow-up questionnaires in 1997 and every two years thereafter.

During follow-up from 1992 through 2007, there were 8,092 incident prostate cancer cases identified. Current regular use of acetaminophen (> 30 pills per month) for 5 years or more was associated with lower risk of overall prostate cancer (RR = 0.62, 95% CI 0.44-0.87) as well as lower risk of aggressive prostate cancer (RR = 0.49, 95% CI 0.27-0.88). Current regular use of < 5 years duration was not associated with prostate cancer risk.

"While the results of this observational study suggest that long-term regular acetaminophen use may be associated with lower prostate cancer risk, our findings require replication by other studies, and do not justify use of acetaminophen to prevent prostate cancer. Acetaminophen is considered relatively safe when used at recommended doses but unintentional acetaminophen overdose is an important cause of acute liver failure." said Dr. Jacobs. "Still, results of this study could lead to further research on acetaminophen that might provide biological insights about the process of prostate cancer development and how this process could be slowed."

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:

Eric J Jacobs, Christina C Newton, Victoria L Stevens, and Susan M Gapstur. A Large Cohort Study of Long-term Acetaminophen Use and Prostate Cancer Incidence. Cancer Epidemiology, Biomarkers and Prevention, 2011; DOI: 10.1158/1055-9965.EPI-11-0210

Simply Eating Less Fat May Cut Diabetes Risk

HealthDay News

Tuesday, May 24, 2011

TUESDAY, May 24 (HealthDay News) -- Losing weight may not be required to lower a person's risk for diabetes, a new study contends.

Rather, the study found, small dietary changes can make a big difference in risk, even without weight loss and particularly among blacks.

For the study, published online May 18 in the American Journal of Clinical Nutrition, the researchers put 69 overweight people at risk for diabetes on diets for eight weeks with only small reductions to their fat or carbohydrate intake. Those in the lower-fat group consumed a diet comprised of 27 percent fat and 55 percent carbohydrate. The low-carb group's diet was 39 percent fat and 43 percent carbohydrate.

"At eight weeks, the group on the lower-fat diet had significantly higher insulin secretion and better glucose tolerance and tended to have higher insulin sensitivity," the study's lead author, Barbara Gower, a nutrition sciences professor at the University of Alabama at Birmingham, said in a university news release. The findings were described as stronger among black participants.

"These improvements indicate a decreased risk for diabetes," Gower said.

Surprisingly, she added, the study participants were at lower risk for the disease regardless of whether they lost any weight.

"People find it hard to lose weight," Gower said. "What is important about our study is that the results suggest that attention to diet quality, not quantity, can make a difference in risk for type 2 diabetes."

Limiting daily fat intake to about 27 percent of a person's diet can lower diabetes risk over the long term, the study concluded.

The researchers pointed out that the needed dietary changes are minimal and therefore manageable.

"The diets used in this study were actually fairly moderate," Laura Lee Goree, a dietitian at the university and a study co-author, said in the news release. "Individuals at risk for diabetes easily could adopt the lower-fat diet we employed."

More information

The American Diabetes Association offers information on type 2 diabetes.

With Calcium, More May Not Be Better

By Steven Reinberg
HealthDay Reporter

TUESDAY, May 24 (HealthDay News) -- Getting enough calcium for bone health is essential, but getting more than that doesn't appear to confer any additional benefit, Swedish researchers have found.

With age, bones start to lose calcium, their major building block. This puts older people, especially women, at risk for fractures and osteoporosis, a disease in which the bones become fragile and break easily.

To help prevent these devastating injuries, women with a low intake of calcium should increase their intake to avoid fractures caused by osteoporosis, "while women with a satisfactory intake should not," said lead researcher Eva Warensjo, a researcher in the department of surgical sciences section of orthopedics at Uppsala University.

"Dietary intake of less than 700 milligrams (mg) of calcium a day was associated with a higher risk of both fractures and osteoporosis, while higher intakes did not further reduce the risk in [a population-based] cohort of Swedish women," she added.

The researchers also found there was an increased risk of hip fracture at the highest intake level. "But, this result should be cautiously interpreted and needs to be investigated further," Warensjo said.

The report was published in the May 24 online edition of the BMJ.

For the study, Warensjo and colleagues collected data on 61,433 women born between 1914 and 1948 who took part in the Swedish Mammography Cohort study in 1987.

Women in the study responded to questions about their diet and use of calcium supplements and multivitamins. In addition, researchers used information they provided to adjust for weight, height, smoking, educational status and the use of estrogen-replacement therapy for menopause, among other factors.

During 19 years of follow-up, 24 percent of the women had a fracture for the first time. Of these, 6 percent were hip fractures, the researchers noted. In addition, an analysis of 5,022 women in a study subgroup found 20 percent had developed osteoporosis.

Warensjo's team found that women who consumed about 750 mg of calcium a day had the lowest risk of fracture. However, women who consumed more than 750 mg did not see their risk for fracture or osteoporosis decline further. On the contrary, they appeared have a higher risk of hip fracture, with a hazard ratio of 1.19, the researchers reported.

Hip fractures and other broken bones caused by osteoporosis result in higher health costs and widespread individual suffering, the authors noted.

The answer to the question of how much daily calcium is the right amount for people over 50 is still under debate globally, and recommendations vary from country to country. In the United States, for example, health agencies recommend 1,200 mg a day for women 50 and older, while U.K. scientists recommend 700 mg. The recommendation in Scandinavia is 800 mg and in Australia it's 1,300 mg, the researchers noted.

Another important caveat in interpreting the findings of the study is that this is an observational study and conclusions about cause-and-effect cannot be made, said Warensjo, who said that further research was needed.

Commenting on the study, Dr. Robert R. Recker, president of the National Osteoporosis Foundation, said the benefit of calcium levels off at some point and 1,000 to 1,200 mg a day is not too high because it takes into account daily variation in intake.

"This study does not shift that paradigm," Recker said. "I would not even consider changing my recommendation to patients based on this," he added.

Recker's approach is to ask patients about their diet and then he recommends calcium supplements if the patient is not getting enough calcium from diet alone. "I tell them between 1,000 and 1,200 mg per day is what's called for," he said.

Speaking of supplements, Recker noted that the body absorbs calcium only under certain conditions. Supplements, for example, need to be taken with food, he said.

More than 40 million people in the United States have or are at high risk for osteoporosis due to low bone mass, according to federal health agencies.

More information

For more information on osteoporosis, visit the U.S. National Library of Medicine.

New Protein Linked to Alzheimer's Disease

ScienceDaily

Tuesday, May 24, 2011

ScienceDaily (May 24, 2011) — After decades of studying the pathological process that wipes out large volumes of memory, scientists at The Feinstein Institute for Medical Research discovered a molecule called c-Abl that has a known role in leukemia also has a hand in Alzheimer's disease. The finding, reported in the June 14th issue of the Journal of Alzheimer's Disease, offers a new target for drug development that could stave off the pathological disease process.

Peter Davies, PhD, head of the Feinstein Institute's Litwin-Zucker Center for Research in Alzheimer's Disease, became interested in c-Abl when he found that the protein was part of the plaques and tangles that crowd the brains of Alzheimer's patients. The protein c-Abl is a tyrosine kinase involved in cell differentiation, cell division and cell adhesion. In patients with chronic myeloid leukemia (CML), c-Abl is turned up in B cells. Inhibiting c-Abl with the cancer drug Gleevec prevents cell division. There was quite a lot known about c-Abl when Dr. Davies began thinking about its possible role in Alzheimer's. He was looking at kinases that phosphorylate tau, the protein that accumulates inside of the neurons during the disease process.

Dr. Davies questioned whether activated c-Abl turned on the cell cycle and could kill adult cells. He designed the study to test this idea and found that turning on the cell cycle in adult brain damages the cells. In their current study, the investigators devised a clever way to activate c-Abl in neurons of normal adult mice. They turned on human c-Abl genes in two different regions -- the hippocampus and the neocortex -- in adult mice and discovered abundant cell death, especially in the hippocampus. "You don't even need to count, you can just look and see holes in the cell layers of the hippocampus," said Dr. Davies. "It is stunning. Even before the neurons die, there is florid inflammation."

He said that the animal model is ideal for testing the benefit of drugs that turn off c-Abl. While Gleevec works in CML, it does not cross the blood-brain barrier so it would not be useful. Dr. Davies and his colleagues are looking for other drugs that inhibit c-Abl and can get into the brain. "We have a great model to test compounds for Alzheimer's disease. Will regulating c-Abl make a difference for patients? We won't know unless we try it in double blind clinical trials."

The researchers are now working to understand the mechanism of cell death. They are also investigating why males die considerably sooner than females -- 12 to 15 weeks compared to 24 to 26 weeks. "It is an incredibly interesting model," said Dr. Davies. "If c-Abl is important we can learn how it works."

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.

Irregular Heartbeat Linked to Raised Death Risk in Women

By Serena Gordon
HealthDay Reporter

HealthDay News

Tuesday, May 24, 2011

TUESDAY, May 24 (HealthDay News) -- Women newly diagnosed with an irregular heartbeat known as atrial fibrillation have a significantly higher risk of death than women without this condition, suggests new research.

Analyzing data on more than 34,000 middle-aged women, researchers found that women with recently diagnosed atrial fibrillation had an all-cause mortality rate of 10.8 per 1,000 person-years, compared to 3.1 per 1,000 person-years for women without atrial fibrillation.

After adjusting the data for other factors that might contribute to the increased risk of death, the researchers still found that a new diagnosis of atrial fibrillation more than doubled the risk of mortality.

"In a population of women with a low burden of cardiovascular disease at baseline, participants with new-onset atrial fibrillation had approximately a twofold increased risk of death compared to women without new-onset atrial fibrillation," said the study's lead author, Dr. David Conen, an assistant professor of internal medicine at the University Hospital Basel in Switzerland.

"However, it is important to emphasize that in our study, the absolute risk of adverse events among women with new-onset atrial fibrillation was fairly low, with only 2.2 percent of the deaths in this population attributable to atrial fibrillation," said Conen.

Results of the study are published in the May 25 issue of the Journal of the American Medical Association.

Atrial fibrillation is a type of irregular heartbeat. Instead of pumping blood effectively, the atria (the heart's top chambers) momentarily quiver, which allows blood to pool in the heart, according to the American Heart Association (AHA). When blood pools, clots can form that can be expelled into the bloodstream when the heart starts beating properly again. If such a clot travelled to the brain, it could cause a stroke, reports the AHA.

Atrial fibrillation often causes no noticeable symptoms, according to Dr. Teresa S.M. Tsang, author of an accompanying journal editorial. Some people feel atrial fibrillation as heart palpitations.

The current study included an analysis of 34,722 women who participated in the U.S. Women's Health Study from 1993 to 2010. The women were all older than 45 (median age was 53), and 95 percent were white. At the start of the study, none of the women had atrial fibrillation or signs of any other cardiovascular disease.

During the study, which had an average follow-up of 15.4 years, 1,011 women developed atrial fibrillation. Three-quarters of these women also had high blood pressure. Sixty-three women with atrial fibrillation died during the study period.

After adjusting for other factors that could contribute to an increased risk of death -- such as body mass, diabetes, high blood pressure, high cholesterol, smoking and more -- the researchers found that women who were diagnosed with atrial fibrillation during the study had a 2.14 greater risk of all-cause mortality and a 4.18 times greater risk of dying from a cardiovascular cause, compared to women without atrial fibrillation.

"The main message from this study is that atrial fibrillation is not benign. It's associated with an increased death risk, and a number of studies have shown this association," said Tsang, director of cardiovascular research at the University of British Columbia and Vancouver General Hospital in Canada.

When women are diagnosed with atrial fibrillation, it's important that they receive a full cardiac work-up, preferably one that includes echocardiography (ultrasound of the heart) to see if there are any underlying issues with the heart, she said. It's critical to identify other cardiac risk factors, such as high blood pressure and high cholesterol, and to aggressively treat such conditions and to encourage healthy lifestyle changes for these women, Tsang added.

"Once it's first detected, don't just treat atrial fibrillation. Aggressively modify cardiac risk factors. Or, ideally, deal with these risk factors before atrial fibrillation even happens," said Tsang.

Conen said that major risk factors for atrial fibrillation are age, obesity and elevated blood pressure. "Therefore, weight loss and the treatment of elevated blood pressure can help reduce the development of atrial fibrillation," said Conen.

"There is an opportunity to improve the risk of death among individuals with new-onset atrial fibrillation through both prevention and optimal management of associated co-morbidities, including elevated blood pressure and obesity," he added.

More information

To learn more about atrial fibrillation, visit the American Heart Association.

Cooked Right, Fish Can Help a Woman's Heart

By Maureen Salamon
HealthDay Reporter

HealthDay News

Tuesday, May 24, 2011

TUESDAY, May 24 (HealthDay News) -- Long known as heart-healthy, fish that's baked or broiled also protects against developing heart failure, a new study suggests.

Research tracking more than 84,000 postmenopausal women for an average of 10 years found that those whose diets included more baked and broiled fish -- defined as five or more servings per week -- had a 30 percent lower risk of heart failure compared to women who ate less than one serving per month.

"A direct relationship between fish and heart failure is not necessarily intuitive because you might expect it protects against heart attacks," said senior study author Dr. Donald Lloyd-Jones, a preventive cardiologist and chair of the department of preventive medicine at Northwestern University Feinberg School of Medicine, in Chicago. "But that's not the mechanism in place here . . . and I think that's kind of interesting. It's also interesting that how you prepare fish is just as important as the kind of fish you're eating."

The study is published May 24 in the journal Circulation: Heart Failure.

Eating fried fish -- previously tied to greater risks for strokes -- is linked to a higher danger of heart failure, the study found, with even one serving per week associated with a 48 percent greater risk.

Additionally, dark fish such as salmon, mackerel and bluefish were associated with lower risks than either tuna or white fish such as sole, snapper or cod.

Prior research has suggested that omega-3 fatty acids in fish reduced risks for cardiovascular disease by lowering inflammation and improving blood pressure and cardiac and blood vessel function.

Lloyd-Jones said his study showed no specific link between omega-3s and heart failure, as compared to overall heart disease, but noted that science is still teasing out all the nutritional aspects of fish. Heart failure is characterized by the inability of the heart to pump sufficient blood to the rest of the body.

"We may not know the other components . . . but that's why eating fish is better than taking a supplement," he said. "You really need to eat the food. This is clearly an important part of a healthy dietary eating pattern."

Lloyd-Jones' study was based on data from 84,493 women aged 50 to 79 from the Women's Health Initiative study. The vast majority of participants were white (85 percent), while 7 percent were black and 3 percent were Hispanic.

The main limitation of the study was its observational nature and the self-reported eating habits of participants, said Lona Sandon, an assistant professor of clinical nutrition at the University of Texas Southwestern in Dallas.

"What we don't know is have these women been eating five servings of baked and broiled fish all of their lives, or is this something they started in their fifties?" Sandon said. "They may also have a more active lifestyle and eat less saturated fat. So there are a lot of differences, probably, in overall nutrition intake."

Indeed, the study indicated that participants whose diets included more baked and broiled fish tended to be healthier and younger than peers who ate fried fish, as well as more physically active and fit. They were also more educated, less likely to smoke and had fewer incidences of diabetes, high blood pressure and cardiovascular disease.

"Certainly it's promising that [baked and broiled fish] essentially had a protective effect," Sandon said. "That goes along with what we know in other studies - something about fish is good for us. Something about unfried fish is good for us as well."

More information

The U.S. National Institutes of Health has more on heart failure.

MS in Blacks Linked to Low Vitamin D

HealthDay News

Tuesday, May 24, 2011

TUESDAY, May 24 (HealthDay News) -- Black people with multiple sclerosis are more likely to have vitamin D deficiencies than blacks who don't have the disease, a new study shows.

The study, published in the May 24 issue of the journal Neurology, also said the deficiency is due primarily to differences in climate and geography.

"MS is not as common in African-Americans as it is in whites, although the disease tends to be more severe in African-Americans," study author Dr. Ari J. Green, of the University of California, San Francisco, said in an American Academy of Neurology news release.

"We have known that vitamin D levels are associated with MS and that African-Americans are at increased risk for having low vitamin D levels, but little research has been done to look at vitamin D levels in African-Americans with MS," he said.

The study involved 339 people with MS and 342 people who did not have the disease. Researchers analyzed the blood vitamin D levels and the severity of the disease in each participant.

Since skin pigment acts as a filter of ultraviolet light, hence limiting the amount of vitamin D that can be produced by the body in response to sunlight, researchers also looked at the amount of UV exposure participants likely received based on where they lived, and the proportion of European genetic ancestry of each participant.

Vitamin D deficiency was found in 77 percent of the people with MS, compared to 71 percent of those without the disease. The people with MS were also exposed to a lower monthly UV index (average of 3.8) than those without MS (average of 4.8). Those with MS also lived an average of 1 degree of latitude farther north (about 69 miles) than those without the disease.

The researchers said the findings should open a dialogue between patients and their doctors about how much UV exposure they need, blood testing for vitamin D levels, and whether supplements would be a good choice.

"These findings may provide a mechanism to help explain how genes and the environment interact to produce MS," Green said.

More information

For more on MS, visit the National Multiple Sclerosis Society. 

Monday, May 23, 2011

Regular Brisk Walks May Protect Prostate Cancer Patients

By Alan Mozes
HealthDay Reporter

HealthDay News

Monday, May 23, 2011

MONDAY, May 23 (HealthDay News) -- Prostate cancer patients who take brisk walks on a regular basis fare better than those who don't, a new study suggests.

They not only lower their risk for disease progression, they lower their chances of dying from the disease, the researchers reported.

The finding builds on earlier research from the same group of scientists that had indicated that "vigorous physical activity" reduces the risk of dying from prostate cancer.

"Men who engaged in brisk walking, defined as three miles per hour or faster, after a diagnosis of clinically localized prostate cancer, had a reduced risk of prostate cancer progression compared to men who walked at an easy pace [less than two miles per hour]," said study author Erin L. Richman, a research associate in the department of epidemiology and biostatistics at the University of California, San Francisco.

"Men who engaged in three hours per week or more of brisk walking had the greatest benefit," Richman added, "with a 57 percent lower risk of disease progression compared to men who walked less than three hours per week at an easy pace. These results were independent of clinical prognostic factors, dietary factors and lifestyle factors such as obesity and smoking."

Richman's report appears in the June 1 issue of Cancer Research.

The study authors pointed out that about 2.2 million men now struggle with a prostate cancer diagnosis in the United States, and the disease is the second most common cause of cancer deaths among American men. In 2010, approximately 217,000 new cases were diagnosed.

To explore how lifestyle might impact disease progression following a diagnosis, the study team focused on 1,455 prostate cancer patients who were enrolled at one of 40 urology clinics in 2004 and 2005.

At the time the study launched, all the men had localized cancer, meaning that their disease had not yet spread beyond the prostate.

All the men completed a survey to assess their physical activity routines. Richman noted that most of the men had initially undergone "curative therapy," including radical prostactectomy and/or radiation treatment.

The researchers observed that walking accounted for about half of all the physical activity exerted by the patients, and that those who were observed to walk in a so-called "brisk" manner tended to be younger and more fit than those who walked more slowly. Brisk walkers were also less likely to smoke.

By stacking up exercise regimens against telltale signs of disease progression (such as PSA levels, the spread of the disease, and/or death), the research team found that patients who walked briskly for a minimum of three hours per week had a significantly lower rate of disease progression (57 percent lower) than those who walked at an easy pace for less than three hours per week.

In fact, the pace of walking seemed to be more important than the amount of time spent walking. Walking at an easy pace conferred no particular protective benefit against prostate cancer progression.

Richman's team cautioned that more research is needed to confirm the findings. She also suggested that other types of exercise might also prove helpful.

Dr. Lionel L. Banez, an assistant professor in the division of urologic surgery in the department of surgery at Duke University Medical Center, agreed that further research might find that other forms of exercise convey a similar protection.

"It is very reasonable to extrapolate these findings to include other forms of physical activity," he noted. "Our own previous study did show that moderate exercise, which included various forms of physical activity, was associated with lower risk for aggressive prostate cancer among veterans."

More information

There's more on prostate cancer at the American Cancer Society.

Ulcer Bacteria May Contribute to Development of Parkinson's Disease

ScienceDaily

Monday, May 23, 2011

ScienceDaily (May 23, 2011) — The stomach bacteria responsible for ulcers could also play a role in the development of Parkinson's disease according to research presented May 22 at the 111th General Meeting of the American Society for Microbiology.

"Infection of late middle-aged mice with a particular strain of the bacteria Helicobacter pylori results in development of Parkinson's disease symptoms after 3-5 months," says Traci Testerman of Louisiana State University Health Sciences Center, Shreveport, who presented the research. "Our findings suggest that H. pylori infection could play a signficant role in the development of Parkinson's disease in humans."

Physicians have noted a correlation between stomach ulcers and Parkinson's disease as far back as the 1960s, before it was even known that H. pylori was the cause of ulcers. More recently, a number of studies found that people with Parkinson's disease were more likely to be infected with the bacterium, and that Parkinson's patients who were treated and cured of infection showed slight improvement compared to controls that continued to deteriorate.

In Guam, a study of why some populations had a high risk of developing a Parkinson's-like disease discovered that a specific compound in cycad seeds eaten by these populations was neurotoxic. The compound, which resembles a cholesterol with an attached sugar group, is almost identical to a compound produced by H. pylori.

Testerman and her colleagues developed an animal model to more effectively understand the role of H. pylori and its modified cholesterol in Parkinson's disease. They infected young and aged mice with three different strains of the bacteria and monitored their locomotor activity and dopamine levels in the brain. Mice infected with one of the strains showed significant reductions in both.

"The results were far more dramatic in aged mice than in young mice, demonstrating that normal aging increases susceptibility to Parkinsonian changes in mice, as is seen in humans," says Testerman.

In order to determine whether the modified cholesterol or other substances could be responsible for Parkinson's disease development, they fed aged mice with H. pylori extracts. The mice did not become infected but developed the same symptoms as those infected with the bacteria, suggesting that the modified cholesterol or some other product contained within the bacteria contribute to disease development.

"Our mouse model demonstrates a direct effect of H. pylori infection on the development of Parkinson's disease. The observation that not all H. pylori strains are equally able to cause symptoms will allow us to investigate bacterial factors and/or immune response to H. pylori infection that increase the risk for Parkinson's disease," says Testerman.

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.

Losing Baby Weight Cuts Odds of Pregnancy-Linked Diabetes

HealthDay News

Monday, May 23, 2011

MONDAY, May 23 (HealthDay News) -- Women who gained 18 or more pounds after their first baby was born are more than three times more likely to develop gestational diabetes during their second pregnancy, according to new research.

On the bright side, the study, published in the May 23 online issue of Obstetrics & Gynecology, also found that women who were able to shed six or more pounds between babies cut their risk of the condition by 50 percent.

Gestational diabetes, a condition that occurs during pregnancy, can cause serious complications in the final weeks of pregnancy, birth and right after a baby is born. Research shows that women who have had the condition during one pregnancy have a greater chance of developing the condition again. Excess weight gain before or during pregnancy also boosts a woman's risk.

But women who trim extra pounds after the birth of a baby could significantly reduce their risk of developing gestational diabetes in a subsequent pregnancy. The benefits of this weight loss are even greater for women who were overweight before they had their first child.

Over the course of a decade, more than 22,000 women from Northern California were studied. Women who gained 12 to 17 pounds between pregnancies were more than twice as likely to develop gestational diabetes compared with women whose weight remained relatively unchanged. A weight gain of 18 or more pounds tripled a woman's risk of developing the condition.

Losing more than six pounds after giving birth could cut women's risk of gestational diabetes in half -- especially among women who were obese to begin with.

"The results also suggest that the effects of body mass gains may be greater among women of normal weight in their first pregnancy, whereas the effects of losses in body mass appear greater among overweight or obese women," the study's lead investigator Samantha Ehrlich, project manager at the Kaiser Permanente Division of Research, said in a news release.

The study's authors noted that women diagnosed with gestational diabetes at a healthy weight could be genetically predisposed to the condition. In these cases, weight loss may not be as effective in reducing their risk of the condition in a later pregnancy.

More information

The American Diabetes Association provides detailed information on the symptoms and treatment of gestational diabetes.

More Americans Praying About Health, Study Says; No Correlation Found Between Prayer for Health and Lack of Health Insurance

ScienceDaily

Monday, May 23, 2011

ScienceDaily (May 23, 2011) — Praying about health issues dramatically increased among American adults over the past three decades, rising 36 percent between 1999 and 2007, according to a study published by the American Psychological Association.

Researchers analyzed data from the Centers for Disease Control and Prevention's 1999, 2002 and 2007 National Health Interview Surveys for an article in the May issue of the APA journal Psychology of Religion and Spirituality. The study primarily focused on comparisons of results between the 2002 and 2007 surveys, which included, respectively, 30,080 adults (over 18 years old) from 44,540 households and 23,393 adults from 40,377 households.

"The United States did have an increase in worship attendance across multiple religious faiths immediately after the 9/11 attack, but that has not stayed elevated. However, people continued to use informal and private spiritual practices such as prayer," said lead author Amy Wachholtz, PhD, of the University of Massachusetts Medical School. "There is also a greater public awareness of Buddhist-based mindfulness practices that can include prayerful meditation, which individuals may also be using to address a variety of health concerns."

People who had a decline in health as well as those with improved health reported more prayer, suggesting that individuals who experience a progressive disease or an acute health change are more likely to use prayer to cope with the changing circumstances, the article states.

While prayer about health issues increased across all groups, from 43 percent in 2002 to 49 percent in 2007, the data indicated that people with the highest incomes were 15 percent less likely to pray than those with the lowest incomes, and people who exercised regularly were 25 percent less likely to pray those who didn't exercise. Women, African-Americans and the well-educated were most likely to pray about their health.

"We're seeing a wide variety of prayer use among people with good income and access to medical care," Wachholtz said. "People are not exchanging health insurance for prayer."

A significantly greater proportion of women prayed compared to men, with 51 percent of women reporting prayer in 2002 and 56 percent in 2007, in contrast with 34 percent and 40 percent, respectively, among men. African-Americans were more likely to pray for their health than Caucasians, with 61 percent of African-Americans reporting having done so in 2002 and 67 percent in 2007, compared to 40 percent and 45 percent for Caucasians during the same periods. People who were married, educated beyond high school or had experienced a change in health for better or worse within the last 12 months were also more likely to pray about health concerns, the study found.

The study did not reveal the type of prayer people used, or which occurred first -- prayer or the health issue.

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:

Amy Wachholtz, Usha Sambamoorthi. National trends in prayer use as a coping mechanism for health concerns: Changes from 2002 to 2007.. Psychology of Religion and Spirituality, 2011; 3 (2): 67 DOI: 10.1037/a0021598

Certain COPD Meds Linked to Urinary Troubles in Men

HealthDay News

Monday, May 23, 2011

MONDAY, May 23 (HealthDay News) -- New research suggests that a certain class of drugs used to treat chronic obstructive pulmonary disease (COPD) boosts the risk that male patients will be unable to urinate.

The disease, which makes breathing difficult due to inflammation and blockage in the body's air passages, affects an estimated 10 percent of people aged 40 and older.

A class of drugs called "inhaled anticholinergic" medications are used to treat the conditions, but there are concerns about their side effects. These drugs include tiotropium (Spiriva), ipratropium bromide (brand name Atrovent) or Combivent, which is ipratropium combined with albuterol.

In the new Canadian study, Dr. Anne Stephenson of St. Michael's Hospital in Toronto and colleagues examined medical records from people in Ontario, aged 66 and older, who suffered from chronic obstructive pulmonary disease.

Of the more than 565,000 patients studied, 9,432 men and 1,806 women developed an inability to urinate. Among men, the researchers found a statistically significant link between those who took the drugs and those who didn't. Among those taking the drugs, the odds of the urinary condition were about 40 percent higher in those who'd been using the drugs for 4 weeks or less, and they were 80 percent higher among those with enlarged prostate glands.

"Physicians should highlight for patients the possible connection between urinary symptoms and inhaled respiratory medication use to ensure that changes in urinary flow (i.e., incomplete voiding, urinary incontinence, and decreased urinary flow) are reported to the physician," the authors wrote.

The researchers added that low doses of the drugs may reduce a patient's risk for these urinary problems.

The study is published in the May 23 issue of the Archives of Internal Medicine.

More information

To find out more about the treatment of COPD, head to the U.S. National Heart, Lung, and Blood Institute.

Comfort Food: Protein from Probiotic Bacteria May Alleviate Inflammatory Bowel Disorders

ScienceDaily

Monday, May 23, 2011

ScienceDaily (May 23, 2011) — A protein isolated from beneficial bacteria found in yogurt and dairy products could offer a new, oral therapeutic option for inflammatory bowel disorders (IBD), suggests a study led by Vanderbilt University Medical Center researcher Fang Yan, M.D., Ph.D.

The study, published May 23 in the Journal of Clinical Investigation, shows that the protein, called p40, was effective as an intervention in animal models of colitis (colon inflammation). The investigators demonstrated that the protein supports intestinal epithelial cell growth and function, and reduces inflammatory responses that can cause intestinal cells to die. Importantly, the investigators showed that oral consumption of p40 by mice in a protective delivery system prevents and treats colitis in multiple models of the disease.

Many of the hundreds of bacterial species that live in our gut (known as the "human microbiome") are helpful to us: they help us digest certain substances, produce vitamins and fight off more dangerous bacteria. But miscommunication between these bacteria and our gut lining can lead to conditions like ulcerative colitis and Crohn's disease. According to the Centers for Disease Control and Prevention, as many as 1.4 million persons in the United States alone may suffer from these diseases.

One type of helpful bacteria often used in yogurt production and in nutritional supplements, Lactobacillus rhamnosus GG (LGG), has been used in attempts to prevent intestinal disorders such as IBD and diarrhea, as well as other conditions such as dermatitis (skin inflammation). However, results generated using whole bacteria have been mixed.

Yan began studying LGG in 2001 while working in the lab of D. Brent Polk, M.D., the former director of the Division of Pediatric Gastroenterology, Hepatology and Nutrition at Vanderbilt.

This research was sparked when a colleague in Pediatric Infectious Diseases asked him, "Is there anything to this probiotic stuff?" said Polk, co-author on the study and currently director the Saban Research Institute of Children's Hospital Los Angeles.

"Probiotic bacterial function is not very clear right now," said Yan, a research associate professor of Pediatrics at Vanderbilt.

Polk and Yan showed that LGG prevented epithelial cells from inflammation-induced apoptosis -- a kind of cell suicide. They then isolated and characterized two specific proteins secreted by LGG (which they called p75 and p40) responsible for the bacterium's beneficial effects.

In the current study, Yan investigated the mechanisms by which one of these proteins, p40, prevents and treats colitis.

In cell experiments, Yan and colleagues showed that p40 activates the epidermal growth factor receptor (EGFR), a protein critical for cell survival and growth. Activation of EGFR protected epithelial cells in two ways: by preventing both apoptosis and inflammation-induced disruption of the "tight junctions" between epithelial cells, which form a barrier to keep toxic substances and pathogens out of the bloodstream.

To test the isolated protein's effectiveness in animal models of disease, the investigators developed a gel bead system to deliver the protein specifically to the colon while protecting the protein from being degraded by stomach acid and digestive enzymes.

In three different mouse models of intestinal inflammation, they showed that p40 prevented and treated intestinal injury and acute colitis.

This study is one of the few to identify and use individual molecules from beneficial microbes as potential therapeutics. In clinical applications, Yan says that the isolated protein could provide at least two advantages to using whole bacteria.

"One is bioavailability," she said. "Even if you eat live bacteria (as in yogurt), that does not mean 100 percent of bacteria will still be alive (and active) in your body."

Another advantage is safety. Although LGG is generally safe for most people, "in patients with immune deficiency, it could be a problem because it may induce an abnormal immune response," she noted.

As for the question that initiated these studies, Polk said, "Dr. Yan has answered this with a resounding 'yes.'"

"It has been my privilege to collaborate with Dr. Yan on this exciting work."

Polk is also professor and chair of Pediatrics and professor of Biochemistry and Molecular Biology at the University of Southern California, and an adjunct professor of Pediatrics and Cell and Developmental Biology at Vanderbilt. Other authors on the study were: Hanwei Cao, Timothy Cover, M.D., M. Kay Washington, M.D., Ph.D., Rupesh Chaturvedi, Ph.D., Yan Shi, Ph.D., Richard Peek, Jr., M.D., and Keith Wilson, M.D., from Vanderbilt; and LinShu Liu, Ph.D., from the U.S. Department of Agriculture.

The research was supported by grants from the National Institute of Diabetes and Digestive and Kidney Disorders, the Crohn's and Colitis Foundation of America, the National Center for Complementary and Alternative Medicine, the National Cancer Institute and the Department of Veterans Affairs.

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 References:

  1. Fang Yan, Hanwei Cao, Timothy L. Cover, M. Kay Washington, Yan Shi, LinShu Liu, Rupesh Chaturvedi, Richard M. Peek, Keith T. Wilson, D. Brent Polk. Colon-specific delivery of a probiotic-derived soluble protein ameliorates intestinal inflammation in mice through an EGFR-dependent mechanism. Journal of Clinical Investigation, 2011; DOI: 10.1172/JCI44031
  2. Fayez K. Ghishan, Pawel R. Kiela. From probiotics to therapeutics: another step forward? Journal of Clinical Investigation, 2011; DOI: 10.1172/JCI58025

Younger Docs More Likely to Prescribe Drugs for Heart Disease: Study

HealthDay News

Monday, May 23, 2011

MONDAY, May 23 (HealthDay News) -- Older doctors are more likely to recommend lifestyle changes for patients with heart disease risk factors, while younger doctors are more likely to prescribe medications, a new study finds.

But despite seeing doctors that prescribed more medications, the patients of younger doctors had no better control of their heart disease risk factors, according to the study by Italian researchers in the June issue of the International Journal of Clinical Practice.

"Although younger doctors prescribed more drugs, this did not result in significantly better control of their patients' major CV [cardiovascular] risk factors, suggesting that other factors have an important role to play in the clinical management of CV risk, including lifestyle changes," Professor Massimo Volpe from the Faculty of Medicine at Sapienza University in Rome said in a journal news release.

Volpe and his colleagues looked at the attitudes and prescribing habits of 1,078 family physicians, cardiologists and diabetes specialists, along with data from nearly 10,000 of their outpatients, whose average age was 67.

The study found that 75 percent of the patients had high blood pressure, making it the most common cardiovascular disease risk factor. That was followed by abnormal lipid levels (cholesterol and/or fat in the blood), which affected 59 percent of patients, and diabetes (37 percent).

Blood pressure drugs were the most commonly prescribed medications -- by 83 percent of doctors younger than 45, 78 percent of doctors aged 46-55, and 80 percent of doctors over 55.

Younger doctors were also more likely to prescribe diabetes drugs, lipid-lowering and anti-platelet agents than older doctors.

Older doctors were most likely to recommend lifestyle changes. For example, doctors over 55 were most likely to tell patients to quit smoking and doctors aged 46 to 55 were most likely to recommend a healthier diet and exercise.

"We believe these findings have important implications for the ongoing professional education of doctors treating patients with CV risk," Volpe added.

More information

The American Heart Association outlines lifestyle changes to boost heart health.

Pre-Meal Dietary Supplement Can Help Overcome Fat and Sugar Problems, Study Suggests

ScienceDaily

Monday, May 23, 2011

ScienceDaily (May 23, 2011) — A little bitter with a little sweet, in the form of a nano-complex dietary supplement taken before meals, can result in a substantial reduction of fat and sugar absorption in the body, Hebrew University of Jerusalem and Harvard University researchers have found.

The researchers previously showed that naringenin, the molecule responsible for the bitter taste in grapefruits, could potentially be used in the treatment of diabetes, arteriosclerosis and hyper-metabolism.

However, the absorption of naringenin in its natural form is very low. To overcome this obstacle, the Hebrew University-Harvard research team, led by Dr. Yaakov Nahmias of the Benin School of Engineering and Computer Science at the Hebrew University and his graduate student, Maria Shulman, has now created, through further research, a nano-complex of naringenin within a ring of sugar called cyclodextrin. This complex increased the absorption of naringenin by 11 times.

What the researchers found is that a single dose of this complex, taken just before a high fat and high sugar meal given to rats, was able to reduce the generation of VLDL (bad cholesterol) by 42%, and increase insulin sensitivity by 64%.

This is the first demonstration that a dietary supplement can change the way our body can react beneficially to a meal. The discovery is detailed in an article that has been published in the scientific journal, PLoS One.

"The complex is special in that it is taken just before a meal, as a preventative measure. In comparison, existing medications are given only after the chronic development of abnormal lipid levels in the blood," said Dr. Nahmias.

The scientists say that considering the sugary taste of cyclodextrin, naringenin, the cause of the bitter taste in grapefruit, is "no longer such a bitter pill to swallow."

Patents for the development have been applied for by Harvard University and Yissum, the technology transfer company of the Hebrew University, and clinical tests are now under way in the United States.

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:

Maria Shulman, Merav Cohen, Alejandro Soto-Gutierrez, Hiroshi Yagi, Hongyun Wang, Jonathan Goldwasser, Carolyn W. Lee-Parsons, Ofra Benny-Ratsaby, Martin L. Yarmush, Yaakov Nahmias. Enhancement of Naringenin Bioavailability by Complexation with Hydroxypropoyl-β-Cyclodextrin. PLoS ONE, 2011; 6 (4): e18033 DOI: 10.1371/journal.pone.0018033