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Friday, January 20, 2012

Pomegranate seed oil fails to cool hot flashes

Lindsey Konkel

Reuters Health

Friday, January 20, 2012

NEW YORK (Reuters Health) - In the first clinical trial of pomegranate seed oil as a treatment for menopausal hot flashes, women taking the supplement twice a day for 12 weeks got no more relief than women taking a placebo pill containing sunflower oil.

Pomegranate seed oil has been marketed as an alternative remedy for menopausal symptoms, because it is rich in plant compounds, called phytoestrogens, that mimic estrogen.

"Like many herbal remedies, there's no clear evidence that it is effective at reducing menopause symptoms," said Dr. Silvina Levis, who specializes in geriatrics at the University of Miami Miller School of Medicine in Florida but was not involved in the study.

Previous research has found that soy supplements and red clover extract, which also contain phytoestrogens, are not effective at reducing menopause symptoms like hot flashes.

As many as 85 percent of women experience the symptom many times a day -- a sensation of heat, often accompanied by sweating, rapid heartbeat and anxiety -- before, during or after menopause, according to past studies.

In the current study, researchers led by Dr. Leo Auerbach at the Medical University of Vienna, in Austria, followed 81 postmenopausal women between the ages of 45 and 60. All women experienced a minimum of five hot flashes a day and had gone at least 12 months since their final menstrual period.

Each participant kept a daily diary of menopause symptoms and took two 30-milligram capsules of pomegranate seed oil or placebo pills daily for 12 weeks. At the start and the end of the study period, the researchers also tested the women's hormone levels.

At the beginning of the study, women in the treatment group reported having an average of 11.1 hot flashes a day, and women in the placebo group reported 9.9 hot flashes each day, on average.

After 12 weeks, the women taking pomegranate seed oil saw a nearly 39 percent reduction in hot flashes, to 6.8 per day, while women in the placebo group saw a drop of nearly 26 percent, to an average of 7.3 hot flashes a day.

Though women in both groups saw a marked decrease in the frequency of their hot flashes, the 13 percent difference between the effects seen in the two groups was too small to credit pomegranate seed oil with any real benefit.

Because both sets of women saw an improvement, it was likely attributable to the so-called placebo effect in both groups, according to the researchers.

Most placebo-controlled studies of treatments for menopausal symptoms show a pronounced placebo effect, they note. Other researchers have reported that women in the placebo groups of clinical trials had a reduction in the number of hot flashes of up to 60 percent.

This suggests that menopausal symptoms may be due to psychological as well as hormonal changes, Auerbach told Reuters Health in an email.

The study found no differences between the participants in their hormone levels before and after the 12-week treatment, but the women on pomegranate seed oil did report a statistically significant improvement in sleep quality and related symptoms.

The study, published in the journal Menopause, was funded by German herbal supplement maker, PEKANA, which also supplied the supplements.

Currently, the United States Food and Drug Administration approves only hormone therapy -- medications containing synthetic estrogens -- for the treatment of hot flashes.

Although hormone therapy is highly effective, it carries an increased risk of stroke and some cancers for certain groups of women, prompting many to seek alternative therapies for symptom relief.

Lifestyle modifications such as regular exercise, weight loss and drinking fewer caffeinated beverages can help cut down on hot flashes, according to Levis.

Source: http://bit.ly/xId2Ki

Menopause, online January 11, 2012. 

Overweight linked to acne in teen girls

By Kerry Grens

Reuters Health

Friday, January 20, 2012

NEW YORK (Reuters Health) - Overweight girls in their late teens were twice as likely as their normal-weight peers to report having a lot of acne in a large new survey of Norwegian teenagers that did not find the same link in boys.

Some 3,600 young people in Oslo, aged 18 and 19, provided information on their pimples, weight, diet and other health and lifestyle factors.

Only about a tenth of the girls and 15 percent of the boys fell into the overweight or obese categories, based on their body mass index (a measure of weight relative to height).

But among the overweight and obese girls, 19 out of every 100 said they had experienced a lot of acne in the past week, compared to 13 of every 100 normal-weight girls who reported recent acne

When the researchers took into account other potential influences, such as diet, smoking and "mental distress," they determined that overweight and obese girls were twice as likely to have acne.

Among the boys, acne afflicted about 14 out of every 100, regardless of weight.

In general, researchers say between 10 percent and 20 percent of adolescents experience moderate to severe acne. Many studies have documented the emotional and social difficulties that go along with the problem, especially during the sensitive teen years.

With a growing number of teens becoming overweight and obese - a circumstance that carries its own social stigma - the Norwegian team writes in the Archives of Dermatology, they wanted to investigate whether there's a connection.

There are physiological factors related to obesity that could explain the Norwegian results, said Dr. Nanette Silverberg, director of pediatric and adolescent dermatology at St. Luke's and Beth Israel Medical Centers in New York and a clinical professor at Columbia University.

For instance, high blood pressure, insulin resistance and hormonal changes, which frequently accompany obesity, "are in the pathway of influence" for acne, said Silverberg, who was not involved in the new study.

"Maybe changes in the level of insulin and other hormones are altered in overweight adolescents, and this can increase the formation of acne," said Dr. Jon Halvorsen, a researcher at Oslo University Hospital who led the study.

Although his results showed a link in girls between being overweight and having acne, they don't prove that one causes the other.

Because the pattern was confined to girls, though, "it is possible that polycystic ovarian syndrome can explain some of our findings," Halvorsen told Reuters Health in an email.

Polycystic ovary syndrome is a condition whose cause is poorly understood but symptoms include too-high levels of male hormones, and often both obesity and acne.

Halvorsen's team couldn't rule out that any of the girls had been diagnosed with the syndrome.

Genetics are also considered important in the development of acne.

Although diet contributes to weight gain, it's not clear that food is to blame for what the researchers found.

When they took into account how many sweets, potato chips and soft drinks the girls usually had, the higher acne rates among overweight girls remained.

"The role of nutrition is controversial, and more studies are needed," Halvorsen said.

Silverberg said there is some evidence from other studies showing that poor diets do contribute to acne.

"Whatever you think is bad for you, eating high-sugar foods, large amounts of carbohydrates, all these things have a negative long term affect on acne. And this is particularly true in the teenage years," she told Reuters Health.

Source: http://bit.ly/yWjZX3

Archives of Dermatology, January 2012.

Study links sleep apnea and sudden deafness

By Genevra Pittman

Reuters Health

Friday, January 20, 2012 

NEW YORK (Reuters Health) - Sudden hearing loss might be tied to an underlying sleep disorder that interrupts breathing, suggests a new study from Taiwan.

Consulting a large health insurance database, researchers found that people who'd suffered sudden deafness were more likely to have a previous diagnosis of sleep apnea than a comparison group without hearing loss.

The absolute difference was small: 1.7 percent of those with hearing loss had sleep apnea, compared to 1.2 percent without hearing trouble.

"If there is sudden hearing loss, I would investigate the presence of apnea as well, given that it's easy to diagnose and it's easy to treat," said Dr. Seva Polotsky, a sleep apnea researcher from Johns Hopkins University School of Medicine in Baltimore who wasn't involved in the new study.

"Obviously we don't know from this paper whether treating apnea will reduce hearing loss," or the chance of having hearing problems in the first place.

For now, he said, "There are more questions than answers."

Polotsky added, it's possible that sleep apnea, which is known to increase the buildup of plaque in blood vessels, could affect vessels in areas of the brain that control hearing, or vessels that feed the nerves responsible for hearing.

But he said more research will be needed to find out what could be behind this link -- or whether something besides the apnea, itself, might explain an increased risk of deafness.

There are about 4,000 new cases of sudden deafness each year in the United States, according to the National Institutes of Health, and there are many possible causes, including infections and head injuries.

Typically the deafness only occurs in one ear, and most people regain their hearing over a period of weeks, sometimes aided by steroid treatment. But occasionally the hearing loss becomes more serious.

Looking at health records of one million Taiwanese, researchers led by Dr. Jau-Jiuan Sheu, of Taipei Medical University Hospital, found almost 3,200 had been diagnosed with sudden deafness between 2000 and 2008. For each of those people, they picked out another five of the same age and sex without hearing loss to serve as a comparison.

Out of those 19,000 people in total, 240 had been diagnosed with sleep apnea before the episode of sudden deafness occurred.

When researchers took into account health and lifestyle factors that may be related to both sleep problems and hearing loss -- such as obesity and heart disease -- they found that men with sudden deafness were 48 percent more likely to have a previous sleep apnea diagnosis than men without hearing loss.

The association for women was less clear, the researchers reported in the Archives of Otolaryngology-Head & Neck Surgery.

Sleep apnea is characterized by closing off of the airways during sleep, leading to repeated drops in oxygen levels in the blood and frequent short wake-ups, along with snoring. It's often treated with a mask and breathing device, called continuous positive airway pressure, or CPAP, but one of the most effective treatments is weight loss.

The new study doesn't prove that sleep apnea causes sudden hearing loss. The researchers couldn't account for people's smoking and drinking, for example, which may affect the risk of both conditions.

Sheu and colleagues speculated, however, that inflammation and changes in blood vessels linked to sleep apnea could contribute to the risk of deafness.

Tinnitus, the sensation of ringing in the ears, has been linked to circulatory disorders, for example.

Polotsky added that most of the complications associated with sleep apnea, which include high blood pressure and diabetes, are thought to result from frequent oxygen fluctuations during the night.

And sudden hearing loss could fit into that category, he told Reuters Health.

But the current study, Polotsky said, "doesn't really establish that. It just shows us a new potential area to research."

Source: http://bit.ly/AgF7gE

Archives of Otolaryngology-Head & Neck Surgery, January 2012.

Thursday, January 19, 2012


Plant compounds tied to fewer heart deaths

By Amy Norton

Reuters Health

Thursday, January 19, 2012

NEW YORK (Reuters Health) - Older adults who get a moderate amount of certain plant compounds in their diets are less likely to die of heart disease or stroke, a large study finds.

The research, on nearly 100,000 older U.S. adults, found that those getting the most flavonoids in their diets were less likely to die of heart disease or stroke over the next seven years than those who ate the least flavonoids.

The compounds are found in a range of plant foods, including many fruits (like berries, citrus and apples) and vegetables (like kale, spinach and broccoli), nuts, soy, dark chocolate, tea and wine.

Research shows that flavonoids have a number of benefits, including fighting inflammation and acting as antioxidants -- which means they help protect body cells from damage that may lead to chronic diseases and cancer.

In the current study, the researchers divided participants into five groups according to the amount of flavonoids in their diets.

The one-fifth with the highest flavonoid intake were 18 percent less likely to die of heart problems or stroke than the fifth with the lowest intake.

That difference is "modest, but still relevant," said lead researcher Marjorie L. McCullough, of the American Cancer Society in Atlanta.

Given that heart disease and stroke are so common, even a modest risk reduction can make a big difference on the population level, McCullough noted in an interview.

It's not clear that flavonoids, themselves, actually lowered people's cardiovascular risks.

But flavonoid-rich foods are the types of foods we should be eating anyway, McCullough pointed out. "This provides further support for getting more of those foods in your diet," she said.

The findings, reported in the American Journal of Clinical Nutrition, are based on more than 98,000 men and women who filled out questionnaires on diet, lifestyle and medical history. At the time, they were about 70 years old, on average.

Over the next seven years, 2,771 people died of heart disease or stroke. That included 615 deaths in the fifth with the lowest flavonoid intake at the outset, and 515 deaths in the fifth with the highest intake.

When McCullough's team accounted for other factors -- like smoking, exercise habits and weight -- people getting the most flavonoids had an 18 percent lower risk of dying from cardiovascular trouble.

Flavonoid-rich foods also contain many other healthful nutrients, McCullough said. So it's hard to know whether the compounds, themselves, deserve the credit for the lower cardiovascular risks.

For example, another recent study linked magnesium-rich foods, which include nuts and dark leafy greens that are also high in flavonoids, to lowered stroke risk. (See Reuters Health story of January 13, 2012.)

The bottom line is that getting more plant foods in your diet may make a difference in your health and longevity, according to McCullough.

And these findings suggest it may not take a huge diet change, she said.

The people with the highest flavonoid intake in the study averaged about 20 servings of fruits and 24 servings of vegetables per week. The lowest-intake group got about 11 servings of fruit and 18 servings of vegetables per week.

Lower risks were also seen among older adults whose flavonoid intake fell in between the highest and lowest groups, however.

"So even adding one serving of flavonoid-rich food a day could be beneficial," McCullough said.

In general, experts recommend getting plenty of fruits and vegetables for the good of your overall health. The "DASH" diet recommended for lowering blood pressure and protecting your heart suggests four to five servings of fruit and the same number of vegetable servings each day.

A half cup of cooked vegetables or a medium-sized piece of fresh fruit would be examples of a serving.

One caveat, McCullough said, is to be careful not to douse your flavonoid-rich foods in sugar, fat or salt. "Try to keep them close to their natural form," she said.

Source: http://bit.ly/A9uZ9D

American Journal of Clinical Nutrition, online January 4, 2012.

Study Finds Potential Key to Immune Suppression in Cancer

ScienceDaily

Thursday, January 19, 2012

ScienceDaily (Jan. 19, 2012) — In a study investigating immune response in cancer, researchers from Moffitt Cancer Center in Tampa, Fla., and the University of South Florida have found that interaction between the immune system's antigen-specific CD4 T cells and myeloid-derived suppressor cells (MDSC) -- cells that play a major role in cancer-related immune suppression -- dramatically change the nature of MDSC-mediated suppression. By contrast, the same effect was not observed when MDSCs interacted with the immune system's CD8 T cells.

Their study appeared in a recent issue of Cancer Research, published by the American Association for Cancer Research.

According to the authors, it has been established that inadequate immune response in cancer is a critical element in tumor escape, and that myeloid-derived suppressor cells (MDSCs) -- cells that which normally keep the immune system in check and prevent it from attacking otherwise healthy tissue -- can suppress the anti-tumor response and play a major role in tumor associated immune abnormalities.

In addition, research has shown that MDSCs block other immune system cells (such as CD 8 "killer" T cells) from binding with proteins that identify foreign antigens on the surface of unhealthy cancer cells and, in doing so, mark them as targets.

"To better understand the biology of immune defects in cancer, our study investigated the antigen-specific nature of MDSCs and their ability to cause antigen specific CD4 T cell tolerance," said study corresponding author Dmitry Gabrilovich, M.D., Ph.D., who holds the Robert Rothman Endowed Chair in Cancer Research at Moffitt and whose research focus is on immunology. "We found that antigen specific CD4 T cells were able to dramatically enhance the immune suppressive activity of MDSC by converting them into powerful non-specific suppressors. But, to our surprise, we did not see the same response from CD8 T cells."

The researchers initially investigated several tumors modeled in mice but focused on two models of particular interest.

They reported that major histocompatability complex (MHC) class II molecules -- found only on a few specialized cell types -- played a role in this conversion to MDSC-mediated suppression when MHC class II and MDSC "cross-linked" through cell-to-cell contact. The effect, however, was dependent on the expression of MHC class II.

"This study showed for the first time that activated antigen-specific T-cells can potentiate the immune suppressive activity of MDSC by converting these cells to non-specific suppressors and, thus, limit the ability of the host to mount a potent immune response," concluded the authors.

The researchers suggested that their study might shed light on a mechanism that may act as a "negative feedback loop" aimed at controlling immune responses that become "dysregulated" in cancer.

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.

Story Source:

The above story is reprinted from materials provided by H. Lee Moffitt Cancer Center & Research Institute.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:

S. Nagaraj, A. Nelson, J.-I. Youn, P. Cheng, D. Quiceno, D. I. Gabrilovich. Antigen-specific CD4 T cells regulate function of myeloid-derived suppressor cells in cancer via retrograde MHC class II signaling. Cancer Research, 2012; DOI: 10.1158/0008-5472.CAN-11-2863

Narrowed Artery Condition Often Goes Undiagnosed: Study

HealthDay News

Thursday, January 19, 2012

THURSDAY, Jan. 19 (HealthDay News) -- Millions of Americans have an undiagnosed artery disorder that can lead to high blood pressure, stroke and aneurysms, a new study reveals.

The disorder is fibromuscular dysplasia, an accumulation of fibrous tissues in the arteries that causes them to narrow. The condition can occur in any artery but occurs most often in kidney or neck arteries. It affects close to 4 percent of Americans.

If untreated, fibromuscular dysplasia can lead to a potentially fatal tear in the artery.

Most patients with the condition are women, and high blood pressure and headache are the most common symptoms, according to a presentation this week at the annual International Symposium on Endovascular Therapy in Miami Beach, Fla.

The data from 339 registry patients enrolled at seven U.S. centers showed that 91 percent of the patients were women and more than 95 had one or more symptoms. The most common symptoms were: high blood pressure (66 percent); headaches (53 percent); rhythmic ringing in the ears (30 percent); dizziness (28 percent); whooshing sound in the ear (24 percent); and neck pain (22 percent).

Nineteen percent of the patients had suffered a tear in an artery, most often in the carotid (neck) artery, and 17 percent had suffered an aneurysm (a bulge in an artery), most often in the renal (kidney) artery, the study authors reported in a symposium news release.

In a subgroup of 309 patients, fibromuscular dysplasia occurred in the kidney arteries of 69 percent of patients and in the neck arteries of 62 percent of patients. Many patients have fibromuscular dysplasia in both their kidney and neck arteries.

The disorder often goes undiagnosed because doctors rarely look for it. The condition is often found by accident when patients undergo medical imaging for other conditions. It can be diagnosed with ultrasound, angiography, CT angiography, and magnetic resonance angiography, the study authors pointed out.

"It's important to diagnose the disease because 20 percent of people who have fibromuscular dysplasia have an aneurysm somewhere in their body which could leak or burst, a life-threatening condition," Dr. Jeffrey Olin, director of vascular medicine at the Mount Sinai School of Medicine in New York City, said in the news release.

"Doctors need to look for fibromuscular dysplasia, particularly in patients younger than 35 who have high blood pressure or migraine-type headaches," he added.

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

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about fibromuscular dysplasia.

Nanoparticles Refined for More Accurate Delivery of Cancer Drugs

ScienceDaily

Thursday, January 19, 2012

ScienceDaily (Jan. 19, 2012) — A new class of nanoparticles, synthesized by a UC Davis research team to prevent premature drug release, holds promise for greater accuracy and effectiveness in delivering cancer drugs to tumors. The work is published in the current issue of Angewandte Chemie, a leading international chemistry journal.

In their paper, featured on the inside back cover of the journal, Kit Lam, professor and chair of the Department of Biochemistry and Molecular Medicine, and his team report on the synthesis of a novel class of micelles called dual-responsive boronate cross-linked micelles (BCMs) , which produce physicochemical changes in response to specific triggers.

A micelle is an aggregate of surfactant molecules dispersed in water-based liquid such as saline. Micelles are nano-sized, measuring about 25-50 nanometers (one nanometer is one billionth of a meter), and can function as nanocarriers for drug delivery.

BCMs are a unique type of micelle, which releases the payload quickly when triggered by the acidic micro-environment of the tumor or when exposed to an intravenously administered chemical compound such as mannitol, an FDA-approved sugar compound often used as a diuretic agent, which interferes with the cross-linked micelles.

"This use of reversibly cross-linked targeting micellar nanocarriers to deliver anti-cancer drugs helps prevent premature drug release during circulation and ensures delivery of high concentrations of drugs to the tumor site," said first author Yuanpei Li, a postdoctoral fellow in Lam's laboratory who created the novel nanoparticle with Lam. "It holds great promise for a significant improvement in cancer therapy."

Stimuli-responsive nanoparticles are gaining considerable attention in the field of drug delivery due to their ability to transform in response to specific triggers. Among these nanoparticles, stimuli-responsive cross-linked micelles (SCMs) represent a versatile nanocarrier system for tumor-targeting drug delivery.

Too often, nanoparticles release drugs prematurely and miss their target. SCMs can better retain the encapsulated drug and minimize its premature release while circulating in the blood pool. The introduction of environmentally sensitive cross-linkers makes these micelles responsive to the local environment of the tumor. In these instances, the payload drug is released primarily in the cancerous tissue.

The dual-responsive boronate cross-linked micelles that Lam's team has developed represent an even smarter second generation of SCMs able to respond to multiple stimuli as tools for accomplishing the multi-stage delivery of drugs to the complex in vivo tumor micro-environment. These BCMs deliver drugs based on the self-assembly of boronic acid-containing polymers and catechol-containing polymers, both of which make these micelles unusually sensitive to changes in the pH of the environment. The team has optimized the stability of the resulting boronate cross-linked micelles as well as their stimuli-response to acidic pH and mannitol.

This novel nano-carrier platform shows great promise for drug delivery that minimizes premature drug release and can release the drug on demand within the acidic tumor micro-environment or in the acidic cellular compartments when taken in by the target tumor cells. It also can be induced to release the drug through the intravenous administration of mannitol.

The study was funded by grants from the National Institutes of Health and a Department of Defense Breast Cancer Research Program Postdoctoral Award. Other authors are Wenwu Xiao, Kai Xiao, Lorenzo Berti, Harry P. Tseng, and Gabriel Fung of UC Davis; and Juntao Luo of SUNY Upstate Medical University, Syracuse, New York.

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.

Story Source:

The above story is reprinted from materials provided by University of California - Davis Health System.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:

Yuanpei Li, Wenwu Xiao, Kai Xiao, Lorenzo Berti, Juntao Luo, Harry P. Tseng, Gabriel Fung, Kit S. Lam. Well-Defined, Reversible Boronate Crosslinked Nanocarriers for Targeted Drug Delivery in Response to Acidic pH Values and cis-Diols. Angewandte Chemie International Edition, 2012; DOI: 10.1002/anie.201107144

Study Hints That Statins Might Fight Breast Cancer

By Denise Mann
HealthDay Reporter

HealthDay News

Thursday, January 19, 2012

THURSDAY, Jan. 19 (HealthDay News) -- Amid hints that statins -- cholesterol-lowering drugs -- might also play a role in preventing or treating certain types of cancer, new research sheds some light on how these drugs may help stop breast cancer in its tracks among certain women.

The p53 tumor suppressor gene stops the uncontrolled growth of cancer cells, but some women with breast cancer have mutant forms of this gene. In the new study, when the mutant p53 cells were treated in the laboratory with statins, the cells stopped their erratic growth, and even died in some cases.

It seems that the mutated p53 genes may activate the same pathway that the statins inhibit -- the mevalonate pathway, the study suggests. The mevalonate pathway is important in the body's production of cholesterol.

In the study, the effects of the statin drugs were erased when the mevalonate pathway was reactivated, supporting the potential mechanism. The new research is published in the Jan. 20 issue of the journal Cell.

Study author Dr. Carol Prives, chair of the department of biological sciences at Columbia University in New York City, is cautious in her enthusiasm about the results and their implications.

"The study is adding the possibility that there may be classes of breast cancer patients who will respond better to statins than others," she said, but noted that this research is far away from the bedside.

"By understanding better what sort of cells would respond to statins, one might have a better idea of whether or not to consider using them," she added. "The next step could be a trial of statins in women with breast cancer who have a mutated copy of the p53 gene."

Commenting on the study, cancer expert Marc Symons said, "This paper unravels a mechanism whereby p53, a frequently mutated cancer gene, promotes the aberrant behavior of cancer cells."

The mutated protein stimulates the mevalonate pathway, explained Symons, an investigator at the Center for Oncology and Cell Biology at the Feinstein Institute for Medical Research in Manhasset, N.Y.

"Statins, drugs that are widely used to lower cholesterol levels, block a key step in the mevalonate pathway," Symons said. "The new results may well give new momentum to the use of statins as anti-cancer agents."

Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, is also intrigued by the potential of the new findings.

"This paper addresses a possible new target for therapeutic agents based on a well-known tumor suppressor gene that is common in many cancers," Bernik said. "Identifying novel pathways that lead to tumor formation is the first step to developing new drugs that can specifically target some of the complex mechanisms that contribute to the development of cancer," she pointed out.

"This work and other projects like this raise the hope that we will one day be able to cure cancers on a molecular level," Bernik said.

More information

Learn more about how breast cancer is treated at the U.S. National Cancer Institute.

Another Clue in the Mystery of Autism

ScienceDaily

Thursday, January 19, 2012

ScienceDaily (Jan. 19, 2012) — Although the genetic basis of autism is now well established, a growing body of research also suggests that environmental factors may play a role in this serious developmental disorder affecting nearly one in 100 children. Using a unique study design, a new study suggests that low birth weight is an important environmental factor contributing to the risk of autism spectrum disorder (ASD).

"Our study of discordant twins -- twin pairs in which only one twin was affected by ASD -- found birth weight to be a very strong predictor of autism spectrum disorder," said Northwestern University researcher Molly Losh. Losh, who teaches and conducts research in Northwestern's School of Communication, is lead author of the study that will be published in the journal Psychological Medicine and is now available online.

Prior twin studies have shown that when one identical twin had ASD, the other twin was much more likely to have ASD than not. "Because identical twins share virtually 100 percent of their genes, this is strong evidence for the role of genetics in autism," said Losh. "Yet it is not 100 percent the case that ASD affects both identical twins in a twin pair."

"That only one twin is affected by ASD in some identical twin pairs suggests that environmental factors may play a role either independently or in interaction with autism risk genes," she added. "And because autism is a developmental disorder impacting brain development early on, it suggests that prenatal and perinatal environmental factors may be of particular importance."

The researchers found that lower birth weight more than tripled the risk for autism spectrum disorder in identical twin pairs in which one twin had ASD and the other did not.

To control for shared genetic and environmental factors, the researchers used a co-twin control study design in which the ASD-affected twin served as the case and the unaffected twin served as the control. They found the risk for autism spectrum disorder rose 13 percent for every 100 gram- (3.5 ounce-) decrease in birth weight.

"There's been a great deal of misinformation about the causes of autism -- from the 1950s misconception that the distant maternal behavior of what were dubbed "refrigerator mothers" was at fault to the ill-informed myth that vaccines can cause autism," said Losh.

Losh and her colleagues' findings add to a growing body of knowledge about the complex causes of autism and suggest that birth weight could be one of the environmental features that interacts with underlying genetic predisposition to autism.

Losh, who directs Northwestern's Neurodevelopmental Disabilities Laboratory, warned that the findings from twin studies might not extend to singletons, as the prenatal and perinatal conditions for twins and singletons differ in important ways.

The researchers studied a population-based sample of 3,725 same-sex twin pairs that were part of the Swedish Twin Registry's Child and Adolescent Twin Study that was directed by Paul Lichtenstein of Sweden's Karolinska Institute. The discordant twins they studied were pairs in which one twin was more than 400 grams (about 14 ounces) or at least 15 percent heavier at birth than the other.

In addition to Lichtenstein, Losh -- the Jane Steiner Hoffman and Michael Hoffman Assistant Professor of Communication Sciences and Disorders -- co-authored "Lower birth weight indicates higher risk of autistic traits in discordant twins," with D. Esserman and P.F. Sullivan (University of North Carolina at Chapel Hill), H. Anckarsater (Lund University, Sweden) and P. Lichtenstein (Karolinska Institute, Sweden).

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.

Story Source:

The above story is reprinted from materials provided by Northwestern University. The original article was written by Wendy Leopold.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:

M. Losh, D. Esserman, H. Anckarsäter, P. F. Sullivan, P. Lichtenstein. Lower birth weight indicates higher risk of autistic traits in discordant twin pairs. Psychological Medicine, 2011; : 1 DOI: 10.1017/S0033291711002339

Wednesday, January 18, 2012

Antidepressants Might Raise Fall Risk in Nursing Homes

HealthDay News

Wednesday, January 18, 2012

WEDNESDAY, Jan. 18 (HealthDay News) -- Antidepressants called selective serotonin reuptake inhibitors (SSRIs) are associated with an increased risk of falls in nursing home residents with dementia, a new study finds.

Researchers in the Netherlands analyzed data about daily prescription medicine use and falls among 248 nursing home residents with dementia. The dataset collected between Jan. 1, 2006 and Jan. 1, 2008 included 85,074 person-days.

Antidepressants were used on 13,729 days (16 percent), with SSRIs used on 11,105 of these days, the investigators found.

A total of 683 falls were experienced by 152 (61.5 percent) of the 248 nursing home residents, which works out to fall incidence of 2.9 falls per person-year. Thirty-eight residents had one fall but 114 had frequent falls.

Injury or death resulted from 220 of the falls: 10 were hip fractures, 11 were other types of fractures, and 198 were injuries such as sprains, bruises, swelling and open wounds. One person died after falling, according to the results.

The researchers found that the risk of having an injury-causing fall was three times higher for residents taking SSRIs than for those who didn't take the antidepressants. For example, the absolute daily risk of a fall was 0.28 percent for an 80-year-old woman taking a daily dose of an SSRI, compared with 0.09 percent for a woman the same age who didn't take an SSRI.

Similar increases in risk were found for both women and men of different ages, according to the study published Jan. 19 in the British Journal of Clinical Pharmacology.

"Our study also discovered that the risk of an injurious fall increased even more if the residents were also given hypnotic or sedative drugs as sleeping pills," lead author Carolyn Shanty Sterke, who works in the section of geriatric medicine at Erasmus University Medical Center in Rotterdam, said in a journal news release.

Falls are a major issue for nursing home residents with dementia, and one-third of falls among nursing home residents result in an injury, the study authors noted.

"Staff in residential homes are always concerned about reducing the chance of people falling and I think we should consider developing new treatment protocols that take into account the increased risk of falling that occurs when you give people SSRIs," Sterke said in the news release.

While the study uncovered an association between injury-causing falls and SSRI use, it did not prove a cause-and-effect relationship.

More information

The U.S. Centers for Disease Control and Prevention has more about falls in nursing homes.

First Link Between Potentially Toxic PFCs in Office Air and in Office Workers' Blood

ScienceDaily

Wednesday, January 18, 2012

ScienceDaily (Jan. 18, 2012) — In a first-of-its-kind study, scientists are reporting that the indoor air in offices is an important source of worker exposure to potentially toxic substances released by carpeting, furniture, paint and other items. Their report, which documents a link between levels of these so-called polyfluorinated compounds (PFCs) in office air and in the blood of workers, appears in ACS' journal Environmental Science & Technology.

Michael McClean and colleagues explain that PFCs, used in water-repellent coatings on carpet and furniture, may have adverse effects on human health. The substances are widespread in the environment and in humans around the world. Scientists know that potential sources of exposure include food, water, indoor air, indoor dust and direct contact with PFC-containing objects. But the link between levels in air and blood had not been explored previously, so McClean's group set out to fill that gap with a study of 31 office workers in Boston.

They found concentrations of a PFC called fluorotelomer alcohol (FTOH) in office air that were 3-5 times higher than those reported in previous studies of household air, "suggesting that offices may represent a unique and important exposure environment." In addition, the study found a strong link between concentrations of FTOH in office air and perfluorooctanoic acid (a metabolite of FTOH) in the blood of office workers. The results also suggested that workers in newly renovated office buildings may receive considerably higher doses of PFCs than workers in older buildings.

The authors acknowledge funding from the National Institute of Environmental Health Sciences.

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.

Story Source:

The above story is reprinted from materials provided by American Chemical Society.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:

Alicia J. Fraser, Thomas F. Webster, Deborah J. Watkins, Jessica W. Nelson, Heather M. Stapleton, Antonia M. Calafat, Kayoko Kato, Mahiba Shoeib, Verónica M. Vieira, Michael D. McClean. Polyfluorinated Compounds in Serum Linked to Indoor Air in Office Environments. Environmental Science & Technology, 2012; 46 (2): 1209 DOI: 10.1021/es2038257

Study suggests how often to test bone density

By Gene Emery

Reuters Health

Wednesday, January 18, 2012 

NEW YORK (Reuters Health) - Older women with thin bones should be screened every year and those with denser bones can safely wait up to 17 years to have their next bone mineral density test, according to new research.

Current recommendations have relied on bone mineral density readings to try to predict the speed at which bones weaken with time, said lead author Dr. Margaret Gourlay of the University of North Carolina at Chapel Hill School of Medicine. "This is the first U.S. study to do it based on patients."

Based on results from 4,957 women who were studied for 15 years, the report, "makes a major contribution toward filling a significant knowledge gap in the field of osteoporosis," said Dr. Margery Gass, executive director of the North American Menopause Society, whose guidelines for brittle bone disease suggest testing postmenopausal women every two to five years.

About 10 million Americans over 50, most of them women, have osteoporosis, according to the National Institutes of Health. The cost to the U.S. health care system is as much as $18 billion per year.

Gourlay's team found that the best time to have a subsequent bone density test depended on a woman's starting point, as gauged by the so-called T score derived from using X-rays to measure the density of bones in the hip. The lower the score, the weaker the bones.

Among women age 67 or older who started out with a normal T score of -1.00 or higher, it took an average of 16.8 years for 10 percent of the group to develop osteoporosis, indicated by a score of -2.50.

They also looked at women with osteopenia, in which "your bones are thinner but not at the osteoporosis level yet," Gourlay told Reuters Health. As those T scores fell, it took less time for osteoporosis to develop in 10 percent of the women.

For women with the lowest starting scores of -2.00 to -2.49, the interval was just 1.1 years. For women with a score of -1.50 to -1.99, it was 4.7 years. And among women who scored -1.01 to -1.49, it took 17.3 years for one in 10 to progress to osteoporosis.

The researchers adjusted the analysis to account for estrogen use and risk factors for osteoporosis. The volunteers were women from Maryland, Minnesota, Pennsylvania and Oregon.

"We knew that the groups that had thinner bones to start with were going to transition to osteoporosis faster," said Gourlay. However, "we were not expecting this kind of separation between the low risk and high risk group. For those women with a T score above -1.5 to have just a 10 percent chance of making the transition to osteoporosis after 17 years was a great surprise. This was very good news."

However, the time intervals were not the same for all women age 67 and older. They shrank as women aged.

"For example, among women with moderate osteopenia, the estimated (bone density) testing interval was approximately 5 years for women who were 70 years old and approximately 3 years for those who were 85 years old," the researchers wrote in the New England Journal of Medicine.

Gourlay cautioned that the time scales may also be very different for women under 67.

"The findings in this paper will enable clinicians to recommend bone mineral density testing from an evidence-based position," Gass said in an e-mail, adding that testing has been both under-used and over-used, depending on the setting, "primarily because of lack of data to inform guidelines."

It's under-used in women over 65 and over-used "in early postmenopausal women, the majority of whom are at very low risk of fracture," she said. "Some clinicians are even getting a 'baseline' in early postmenopausal women, something no medical society is recommending."

Her group recommends screening for all women who are age 65 and older and for women ages 50 to 64 if they are smokers, consume alcohol daily, weigh less than 127 pounds, have rheumatoid arthritis, have already had a fracture suggesting that their bones might be weak or had a parent who suffered a hip fracture.

The test itself typically costs $250.

Gourlay said it's not clear if the guidelines will save money. "This tells us how to use the test better, but we're still concerned that overall the test is not ordered enough."

She cited a 2008 study of female Medicare beneficiaries over age 64 in which only 13 percent had ever gotten an initial bone density test. "This is 13 percent of the women who, everyone agrees, should have the first test."

Source: http://bit.ly/zpvV8U

New England Journal of Medicine, online January 18, 2012.

Lack of Sleep Makes Your Brain Hungry

ScienceDaily

Wednesday, January 18, 2012 

ScienceDaily (Jan. 18, 2012) — New research from Uppsala University shows that a specific brain region that contributes to a person's appetite sensation is more activated in response to food images after one night of sleep loss than after one night of normal sleep. Poor sleep habits can therefore affect people's risk of becoming overweight in the long run.

The findings are published in The Journal of Clinical Endocrinology & Metabolism.

Researchers Christian Benedict and Helgi Schiöth, of the Department of Neuroscience at Uppsala University, showed in an earlier article, published in American Journal of Clinical Nutrition, that a single night of total sleep loss in young normal weight men curbed the energy expenditure the next morning. This research also showed that subjects had increased levels of hunger, which indicates that an acute lack of sleep may affect human's food perception.

In a new study, Christian Benedict, together with Samantha Brooks, Helgi Schiöth and Elna-Marie Larsson from Uppsala University and researchers from other European universities, have now systematically examined which regions in the brain, involved in appetite sensation, are influenced by acute sleep loss. By means of magnetic imaging (fMRI) the researchers studied the brains of 12 normal-weight males while they viewed images of foods. The researchers compared the results after a night with normal sleep with those obtained after one night without sleep.

Christian Benedict explains: "After a night of total sleep loss, these males showed a high level of activation in an area of the brain that is involved in a desire to eat. Bearing in mind that insufficient sleep is a growing problem in modern society, our results may explain why poor sleep habits can affect people's risk to gain weight in the long run. It may therefore be important to sleep about eight hours every night to maintain a stable and healthy body weight."

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.

Story Source:

The above story is reprinted from materials provided by Uppsala University, via AlphaGalileo.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:

Christian Benedict, Samantha J. Brooks, Owen G. O'Daly, Markus S. Almèn, Arvid Morell, Karin Åberg, Malin Gingnell, Bernd Schultes, Manfred Hallschmid, Jan-Erik Broman, Elna-Marie Larsson, Helgi B. Schiöth. Acute Sleep Deprivation Enhances the Brain's Response to Hedonic Food Stimuli: An fMRI Study. The Journal of Clinical Endocrinology & Metabolism, 2012; DOI: 10.1210/jc.2011-2759

Melanoma Drug's Link to Other Skin Cancers Identified

By By Madonna Behen
HealthDay Reporter

Wednesday, January 18, 2012

WEDNESDAY, Jan. 18 (HealthDay News) -- The recently approved drug vemurafenib (Zelboraf) has been hailed as a breakthrough in the treatment of melanoma, the deadliest form of skin cancer. But roughly one-quarter of patients who take the medication develop a troublesome side effect: secondary skin cancers called squamous cell carcinomas.

Now, a new study by researchers at the Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, and colleagues identifies the specific genetic mechanism that causes this side effect.

"What we found is that vemurafenib blocks the mutation that makes the melanoma grow, but when patients have skin cells with another mutation that's probably induced from sun exposure, there the drug has the exact opposite effect and causes these squamous cell cancers to grow," said Dr. Antoni Ribas, co-senior author of the study and an associate professor of hematology/oncology at UCLA.

What's more, the findings suggest that combining vemurafenib, a BRAF inhibitor, with a drug called an MEK inhibitor -- which blocks the other mutation -- may not only prevent this side effect, but may also lead to an even more effective melanoma treatment, Ribas said.

"It needs to be demonstrated in clinical trials, but the theory is that if we give these two medications together up front, we will be punching the melanoma where it really hurts twice, and also preventing the growth of secondary skin cancers," Ribas said.

For the study, which appears in the Jan. 19 issue of the New England Journal of Medicine, Ribas and his colleagues analyzed cells from squamous cell lesions in patients treated with vemurafenib to look for specific genetic mutations.

In a set of 21 tumor samples, the researchers found 13 had what's known as an RAS mutation, which predisposes someone to develop squamous cell cancer. In a separate set of 14 samples, eight had RAS mutations.

"Our data suggest that about 60 percent of patients who develop skin squamous cell cancers while treated with a BRAF inhibitor have an RAS mutation," Ribas said.

In experiments in mice with the RAS mutation, the researchers showed that the combination of a BRAF inhibitor and an MEK inhibitor successfully blocked the growth of squamous cell cancers.

This result may need replication in humans, since many findings in animals do not translate into effective treatments for people.

Ribas noted that the findings have implications beyond just melanoma, since RAS mutations are common in lung, pancreatic and colon cancer. "What this data also warns us is that we have to be very careful about using BRAF inhibitors in a setting where we don't know what other mutations may be driving [the cancer]," he said.

In an editorial accompanying the study, a cancer researcher at the Wistar Institute in Philadelphia sounded a similar note. "Patients being given BRAF inhibitors should be tested to determine their RAS status, since the potential for secondary tumor development is of concern," wrote Ashani Weeraratna, an assistant professor in Wistar's Molecular and Cellular Oncogenesis Program.

In an interview, she added, "While cutaneous squamous cell carcinomas are not usually life-threatening, a small portion are. And further, squamous cell carcinomas of other cell types can be very aggressive. So understanding how to solve this problem is critical."

Another skin cancer expert said that although the findings were important and timely, more studies were needed before making broad recommendations. "Patients need to be aware of the risk of development of squamous cell carcinomas, and dermatology exams need to be included as part of the care for these patients," said Dr. Iman Osman, an associate professor of dermatology and oncology at NYU Langone Medical Center in New York City.

"I believe any other recommendation, such as adding a MEK inhibitor from the beginning, or doing biopsies of any squamous cell carcinoma for RAS mutation at the time of starting BRAF inhibition, will require more data," Osman said.

Other researchers who took part in the study included investigators from the Institute of Cancer Research in London and the pharmaceutical companies Roche and Plexxikon.

More information

Visit the U.S. National Cancer Institute to learn about melanoma. 

Tuesday, January 17, 2012


Blood Test Shows Promise in Spotting Pancreatic Cancers Early

By Amanda Gardner
HealthDay Reporter

HealthDay News

Tuesday, January 17, 2012

TUESDAY, Jan. 17 (HealthDay News) -- A new blood test may hold promise as a means of early detection and diagnosis for often deadly pancreatic cancers.

Reporting Tuesday at the annual Gastrointestinal Cancers Symposium in San Francisco, researchers said the test, which measures levels of a protein known as PAM4, was able to identify two-thirds of patients who had pancreatic cancer at an early stage of their disease.

Early pancreatic tumors typically fly under the radar, causing no symptoms and going undetected until they have spread. This partially accounts for the dismal prognosis faced by most people diagnosed with the illness.

That's why any means of spotting these cancers early would be critical. According to the researchers, PAM4 is a protein that is present in normal cells but is greatly elevated in cancerous ones.

"When a person gets cancer, this protein spills into the bloodstream," explained Dr. Igor Astsaturov, an assistant professor of medical oncology at Fox Chase Cancer Center in Philadelphia. Astsaturov, who was not involved with the study, said the results were "certainly welcome news."

When the researchers combined PAM4 with another test, CA19-9, which is already approved to monitor pancreatic cancer during treatment, the combination showed even stronger results and correctly identified 85 percent of patients with pancreatic ductal adenomcarcinoma (PDAC), by far the most common form of pancreatic cancer.

More study of PAM4 may even point to possible targets for therapy, the authors stated.

"For providers of care for patients with pancreatic cancer, hampered by their inability to readily detect these cancers in some cases, especially in earlier stages, this shows tremendous promise that blood-based assay can add to our ability to diagnose pancreatic cancer at an earlier stage, thereby impacting patients lives," said Dr. Morton S. Kahlenberg, a gastrointestinal cancers expert with the American Society of Clinical Oncology and moderator of a Tuesday press briefing on the findings.

In previous research by the same group of authors, the PAM4 test was able to identify 82 percent of patients with PDAC. That study included about 80 participants, said study author David V. Gold, director of laboratory administration and a senior member with Garden State Cancer Center in Morris Plains, N.J.

The current study updates those results by including blood samples from almost 300 people previously diagnosed with PDAC, 99 with other types of cancer, 126 with benign pancreatic disease and 79 healthy controls.

Meanwhile, the test had relatively few false positives, mistakenly identifying only 19 percent of benign pancreatic disease patients and 23 percent of chronic pancreatitis patients.

The tests did not appear to be helpful in finding other forms of pancreatic cancer, the researchers stressed.

A second abstract being presented at the symposium also demonstrated the potential utility of these types of diagnostic "biomarkers," this time in identifying which people with Barrett's esophagus are more likely to develop esophageal cancer.

Barrett's esophagus involves changes to the esophageal lining, which sometimes continues into cancer. People with long-term gastroesophageal reflux disease (GERD) are at particular risk.

Right now, doctors use endoscopy and standard biopsies along the length of the esophagus to monitor for cancer However, this isn't able to sort out tiny changes that separate those at very high risk for cancer from those at much lesser risk.

In this study, "optical biomarkers," which combine a special microscope with a broad-band white-light source, was able to sort out three characteristics of the cell nucleus that signaled a person was at risk for cancer.

In 60 patients with Barrett's esophagus, the biomarkers were able to correctly identify 89 cases of cancer and 76 percent of those without cancer.

If these biomarkers were affirmed in future studies, it would preclude the need for repeated biopsies in people with Barrett's, the authors said.

Data presented at medical meetings is typically considered preliminary until published in peer-reviewed medical journals.

More information

Find out more about pancreatic cancer at the U.S. National Cancer Institute.

Fish oil plus exercise may do older muscles good

By Amy Norton

Reuters Health

Tuesday, January 17, 2012

NEW YORK (Reuters Health) - Older women may be able to boost their muscle strength by adding fish oil supplements to their exercise routine, a small clinical trial suggests.

Researchers found that three months of strength training helped increase muscle strength among 45 healthy women in their 60s. But those who used fish oil at the same time had somewhat greater gains.

Whether older women should run out to buy fish oil for the sake of their muscles remains to be seen.

It's not clear whether the extra strength gain would be meaningful in a woman's life -- and, therefore, worth the cost and potential side effects of fish oil pills.

The findings are "intriguing" and deserve further study, said Catherine Jackson, a professor of kinesiology at California State University in Fresno who was not involved in the study.

But, she told Reuters Health in an email, "I would be a bit cautious about over-interpretation."

The researchers themselves echoed that thought. The findings "should be viewed with caution," according to Luiz Claudio Fernandes and colleagues at Parana Federal University in Brazil.

"Other studies involving a larger sample and other combinations of training and supplementation period are required," they write in the American Journal of Clinical Nutrition.

What Does Fish Oil Do?

Fish oil, which is rich in omega-3 fatty acids, is probably best known for its link to heart health. Fish oil supplements can lower triglycerides (a type of blood fat), and people who get more omega-3 have been found to have a lower risk of heart disease.

But there's also evidence that fish oil can improve nerve function and the ability of heart muscle to contract. So it's "reasonable to hypothesize" that fish oil could boost muscles' response to strengthening exercises, according to Fernandes' team.

To study the question, the researchers randomly assigned 45 older women to one of three exercise groups: In one, the women performed strengthening exercise three times a week for three months; the other two groups followed the same regimen, but also took fish oil -- 2 grams per day, either starting on the same day as their exercise program, or starting two months beforehand.

On average, all three groups increased their muscle strength, which was measured in tests where the women contracted their leg muscles. But the change was greater in the two fish-oil groups.

On top of that, only women who used fish oil showed changes in nerve activity in the muscles.

Exactly what that all means for women's well-being is not clear.

One issue, Jackson said, is that "strength measurement is difficult at best and shows huge differences among subjects."

The study participants did take four "functional" tests that gauged strength, balance, agility and how far they could walk in 6 minutes. And women using fish oil did slightly better on one of those tests -- where they had to sit down and rise up from a chair several times in a row, as fast as they could.

Whether any of that could translate into better fitness, a lower risk of falls or other health benefits is unknown for now.

A question with any supplement study, Jackson noted, is whether users were "deficient" in a nutrient -- omega-3 fats, in this case -- to begin with. If so, the supplement might have brought them to a more "normal" level, and the benefit of a supplement beyond a healthful, balanced diet would be unclear.

In the U.S., a monthly supply of one-gram fish oil capsules can run well over $15.

And while fish oil is generally considered safe at recommended doses, it can have side effects; the more common side effects include bad breath, heartburn, nausea and loose stools.

At higher doses -- more than 3 grams per day -- fish oil might interfere with blood clotting and raise the risk of internal bleeding, according to the National Institutes of Health.

People using medications -- as most older adults are -- should also check with their doctor about possible interactions. Fish oil can, for example, boost the effects of blood pressure drugs, which could send your blood pressure too low.

Source: http://bit.ly/AnRGII

American Journal of Clinical Nutrition, January 4, 2012.

US obesity epidemic shows no hint of reversing

By Lindsey Tanner|

Associated Press 

The Associated Press

Tuesday, January 17, 2012

CHICAGO (AP) — America's obesity epidemic is proving to be as stubborn as those maddening love handles, and it shows no sign of reversing course.

That's according to the latest figures from the federal Centers for Disease Control and Prevention. The numbers appear in two reports released Tuesday in the Journal of the American Medical Association.

They show that more than one-third of adults and almost 17 percent of children were obese in 2009-2010. That echoes results since 2003. The CDC says it means that more than 78 million adults and almost 13 million children aged 2-19 were obese.

Online:

JAMA: http://jama.ama-assn.org

CDC: http://www.cdc.gov

How much iodine is too much?

By Amy Norton

Reuters Health

Tuesday, January 17, 2012

NEW YORK (Reuters Health) - Iodine deficiency is a major health problem worldwide, but a new study points to the potential downsides of too much iodine.

Iodine is a mineral found in iodized salt, seafood, eggs, dairy and some breads. It is used by the thyroid gland to help regulate metabolism and development, especially in babies and children.

Iodine deficiency during fetal and early-childhood development is a leading cause of brain impairments in much of the world. So most research has been directed at the effects of inadequate iodine.

Less is known about how much iodine is too much. So for the new study, reported in the American Journal of Clinical Nutrition, Chinese researchers randomly assigned healthy adults to take various doses of iodine supplements for four weeks.

They found that at relatively higher doses -- 400 micrograms a day and up -- study participants began developing what's called subclinical hypothyroidism.

That refers to a dip in the body's thyroid hormone levels, but with no obvious symptoms of hypothyroidism -- which include problems like fatigue, depression, dry skin and weight gain.

In this study, people taking 400-microgram supplements were getting around 800 micrograms of iodine per day when diet was factored in.

So the findings suggest that people -- at least in China -- should get no more than 800 micrograms a day, according to the researchers, led by Wanqi Zhang of Tianjin Medical University.

That's different from what's recommended in the U.S., where National Institutes of Health guidelines say the safe upper limit for adults is 1,100 micrograms of iodine per day.

Still, the typical American would get much less than 800 micrograms of iodine a day through diet anyway, according to Dr. Elizabeth Pearce, an associate professor of medicine at Boston University who was not involved in the study.

That said, Pearce cautioned against taking iodine supplements with more than 150 micrograms in a daily dose. And most Americans could skip supplements altogether.

"Overall, we're iodine-sufficient," said Pearce, who studies iodine sufficiency and thyroid function.

But she said there are certain people who may need supplements, including pregnant women.

In the U.S., adults are advised to get 150 micrograms of iodine each day; pregnant women should get 220 micrograms, while breastfeeding moms are told to get 290 micrograms.

The American Thyroid Association recommends that pregnant and breastfeeding women take a vitamin with iodine because low iodine can increase the risk of miscarriage and thyroid problems in moms, in addition to mental disabilities in babies.

According to Pearce, vegans may also want to take a supplement. In a recent study, Pearce and her colleagues found that the average iodine level in a group of 63 vegans was lower than what's recommended -- though their thyroid hormone levels were in the normal range.

Vegans eschew all animal products, including dairy and eggs, so their iodine sources may be few.

Who You Are, Where You Live

The current findings are based on 256 healthy adults who had normal thyroid when they entered the study. Zhang's team, which did not respond to requests for comment, randomly assigned them to take one of 12 doses of supplemental iodine -- anywhere from 0 to 2,000 micrograms per day, for four weeks.

Of the people who took 400 micrograms, 5 percent developed subclinical hypothyroidism. And the numbers rose in tandem with the iodine dose: Of people on the highest dose (2,000 micrograms per day), 47 percent developed subclinical hypothyroidism.

"These are interesting data," Pearce said, "because we don't have a lot of information on iodine excess."

Subclinical hypothyroidism has no obvious symptoms, but studies have linked it to an increased risk of heart disease over the long term, Pearce noted.

Those studies don't prove that subclinical hypothyroidism is to blame. Still, they raise concerns that there could be health consequences.

But in general, Pearce said, it's thought that the effects of your iodine intake may depend on "who you are and where you live."

In certain parts of the world, the soil is low in iodine, and people who eat mainly local foods have a high risk of deficiency. In other parts of the world -- Japan, for example -- people have a high iodine intake starting early in life, and they seem to "tolerate" that high level, Pearce explained.

In China, natural iodine levels vary by region. The country introduced universal salt iodization in 1996, so the problem of iodine deficiency has been controlled in most areas.

But Pearce said it's not clear if the adults in this study had adequate iodine intake early in life. If not, that could be a factor in their response to iodine supplements.

Source: http://bit.ly/zQWJF4

American Journal of Clinical Nutrition, online December 28, 2011.

Monday, January 16, 2012


Vitamin D doesn't ease lung disease symptoms: study

By Genevra Pittman

Reuters Health

Monday, January 16, 2012

NEW YORK (Reuters Health) - In a new study of people with moderate or severe lung disease, taking large amounts of vitamin D was not linked to any symptom relief, researchers from Belgium report.

Prior research suggested that up to three quarters of people with severe chronic obstructive pulmonary disease, or COPD, are deficient in the vitamin. So it was thought that giving them extra vitamin D might help prevent exacerbations in symptoms or trips to the hospital because of shortness of breath or mucus in the airways -- but that turned out not to be the case.

"Supplementation with vitamin D is not going to cure their disease," said Dr. Wim Janssens, one of the study's authors from University Hospitals Leuven.

"It is again clear for COPD patients that these exacerbations are really hard to treat" and prevent, Janssens told Reuters Health.

"There are a lot of relapses. We're basically failing in treating these."

Though vitamin D is most often associated with bone health and osteoporosis, Janssens said the theory has been that the vitamin may help reduce inflammation, including inflammation in the airways that worsens COPD symptoms, such as coughing and trouble breathing.

COPD is irreversible impairment of lung function, including emphysema and chronic bronchitis, often caused by smoking. One large national health survey suggests some 24 million Americans have the condition, according to the Centers for Disease Control and Prevention.

Janssens and his colleagues randomly assigned 182 people at their hospital with moderate to severe forms of the disease to take high-dose vitamin D pills, or a vitamin-free placebo pill, every four weeks for a year. One hundred and fifty of them finished the study.

Over that year, patients on vitamin D reported a total of 229 exacerbations in symptoms, for an average of 2.8 exacerbations in each patient. That was not statistically different from the 239 exacerbations, or 2.9 per patient, among those taking the placebo.

Symptoms were severe enough to send patients taking vitamin D to the hospital 79 times during the study, and people in the placebo group 73 times.

There was also no difference between the two groups in the amount of time until patients had their first exacerbation, or in measures of lung functioning, fatigue or the risk of death.

The researchers did find that among 30 people who had a very severe vitamin D deficiency at the start of the study, those taking the supplements had fewer problems with symptoms.

But because they didn't plan to explore that question from the beginning, and only found it on a second look at the data, it's hard to tell what the finding means.

"That would indicate that if there's any effect, there might be something in patients with really low levels. That's not the majority of patients with COPD," said Dr. Ken Kunisaki, from the Minneapolis VA Healthcare System.

More research would be needed to confirm if the vitamin is of any benefit even in those very deficient patients, added Kunisaki, who has also studied vitamin D in COPD but wasn't involved in the new research.

He said the current findings are in line with other research suggesting that although vitamin D deficiency might be more common in people with COPD, higher levels don't necessarily seem to equate with fewer symptoms.

"Unfortunately the results have been somewhat disappointing," Kunisaki said. "Right now there's no evidence that patients with COPD are going to benefit from additional vitamin D."

Researchers have also proposed that vitamin D may be helpful in patients with multiple sclerosis or tuberculosis, among other diseases, but studies generally haven't panned out, Janssens and his colleagues wrote in their report, published Monday in the Annals of Internal Medicine.

He said that in spite of his team's lack of positive findings, people with or without COPD shouldn't ignore very low vitamin D levels.

"If you're deficient, you need supplementation to normal levels just to treat your bone, to protect from osteoporosis and fractures," he said. "If you (have) severe deficiency, supplementation might also be effective for inflammation" associated with COPD.

Kunisaki cautioned that researchers still don't know whether there are long-term risks associated with taking high doses of vitamin D or other vitamins.

Source: http://bit.ly/atTzv0

Annals of Internal Medicine, online January 16, 2012.

Broken Arm? Brain Shifts Quickly When Using a Sling or Cast

ScienceDaily

Monday, January 16, 2012

ScienceDaily (Jan. 16, 2012) — Using a sling or cast after injuring an arm may cause your brain to shift quickly to adjust, according to a study published in the January 17, 2012, print issue of Neurology®, the medical journal of the American Academy of Neurology. The study found increases in the size of brain areas that were compensating for the injured side, and decreases in areas that were not being used due to the cast or sling.

"These results are especially interesting for rehabilitation therapy for people who've had strokes or other issues," said study author Nicolas Langer, MSc, with the University of Zurich in Switzerland. "One type of therapy restrains the unaffected, or "good," arm to strengthen the affected arm and help the brain learn new pathways. This study shows that there are both positive and negative effects of this type of treatment."

For the study, researchers examined 10 right-handed people with an injury of the upper right arm that required a sling for at least 14 days. The entire right arm and hand were restricted to little or no movement during the study period. As a result, participants used their non-dominant left hand for daily activities such as washing, using a toothbrush, eating or writing. None of the people in the study had a brain injury, psychiatric disease or nerve injury.

The group underwent two MRI brain scans, the first within two days of the injury and the second within 16 days of wearing the cast or sling. The scans measured the amount of gray and white matter in the brain. Participants' motor skills, including arm-hand movements and wrist-finger speed, were also tested.

The study found that amount of gray and white matter in the left side of the brain decreased up to ten percent, while the amount of gray and white matter in the right side of the brain increased in size.

"We also saw improved motor skills in the left, non-injured hand, which directly related to an increase in thickness in the right side of the brain," said Langer. "These structural changes in the brain are associated with skill transfer from the right hand to the left hand."

Langer noted that the study did not look at whether the decreases would be permanent.

"Further studies should examine whether using a restraint for stroke patients is really a necessity for improving arm and hand movement," he said. "Our results also support the current trauma surgery guidelines stating that an injured arm or leg should be immobilized 'as short as possible, as long as necessary.'"

The study was supported by the National Center of Competence in Research and the Swiss National Science Foundation.

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.

Story Source:

The above story is reprinted from materials provided by American Academy of Neurology (AAN).

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Smaller servings mean more balanced meals for kids: study

By Genevra Pittman

Reuters Health

Monday, January 16, 2012

NEW YORK (Reuters Health) - Feeding preschoolers smaller portions of the main dish at lunchtime means they'll eat more fruit and vegetables on the side and fewer total calories, according to a new study.

Researchers said the finding may give parents one extra strategy to encourage youngsters to eat more greens, as childhood obesity rates continue rising and research suggests that kids lag well behind guidelines for fruit and veggie consumption.

With main courses, "you need to be careful and use the age-appropriate serving," said Sara Sweitzer, a nutrition researcher from the University of Texas at Austin.

"If they fill up on the entrée, obviously the fruit and the vegetable are the last to get eaten," added Sweitzer, who wasn't involved in the new study.

Parents can make sure they're providing the right amount of food both by inspecting what's left in the lunch box when kids come home, and by talking to their kids about how much they eat.

"Go ahead and ask your child, 'Do you want a whole sandwich or do you want just half a sandwich?'" she advised.

For the new study, researchers at a Pennsylvania preschool served 17 kids six different variations of the same meal, one day each week for lunch. The meals had anywhere from less than half a cup to more than a cup and a half of macaroni and cheese, the main dish.

That was presented along with plenty of green beans and unsweetened applesauce, plus a whole grain roll and milk.

Jennifer Savage of The Pennsylvania State University in University Park and her colleagues found that the bigger the entrée size, the more mac and cheese -- and the less of the healthy side dishes -- kids ate.

Preschoolers finished almost all of their smallest portion of mac and cheese, for an average of about 145 calories. But they still ate the majority of much bigger portions, and put away 390 calories worth of the main course when they started with the most on their plate.

When they were served the smallest entrée, kids ate almost half of their healthy side dishes, including fruits and veggies, compared to only a quarter when they were served the biggest mac and cheese portion, Savage's team reports in the American Journal of Clinical Nutrition.

Kids' total lunchtime calorie counts varied based on entrée size as well: they ate an average of 506 calories with the biggest portion, and 315 with the smallest.

Sweitzer said that packing too much of the main course for lunch is a problem she sees all the time with parents, in part because they're concerned they won't include enough food and their kids will be hungry.

"You will see parents pack the whole easy mac and cheese portion," she said. "That would be a huge amount -- it would be adequate for an adult to eat as part of lunch, and they'll pack that whole thing for the child to eat."

And a four-year-old, she said, won't make balanced food choices on their own in that situation.

"If you give the child an option for a large portion of an entrée food that they really like, they will eat that more and they'll fill up. They'll reach their satiety point and they'll just stop eating," Sweitzer told Reuters Health.

She added that another strategy to encourage kids to eat their fruits and veggies is for parents and older siblings to set a good example by choosing those as healthy snacks and making sure they're loading up on their nutrient-packed side dishes at meals.

Source: http://bit.ly/zwu62n

 American Journal of Clinical Nutrition, online December 28, 2011.