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HHAL MEDICAL NEWS MAY 2012 What Are The Top 10 Healthy Foods?Imagine a selection of foods that were delicious, nutritious and good for you - i.e. they reduced your
risk of developing diseases. According to several different surveys and sources in North America and Western Europe, the following ten foods are generally considered to be the most healthy. 1) ApplesApples are an excellent source of antioxidants, which combat free radicals,
damaging substances generated in the body that cause undesirable changes and are involved in the aging process and some diseases.
Some animal
studies have found that an antioxidant found in apples (polyphenols) might extend lifespans. Tests on fruit flies found that
polyphenols also help them to preserve their ability to walk, climb and move about.
Another study found that adult females who regularly ate apples had a 13% to 22% lower risk of developing heart disease.
"An apple a day keeps the doctor away" is not just an old expression
that rhymes
A recent article on the health
benefits of apples:
"An Apple A Day Keeps The Grim
Reaper Away" 2) AlmondsAlmonds are rich in nutrients, including iron, calcium, vitamin E, fiber, riboflavin,
and magnesium. A scientific review published in Nutrition Reviews last year found that almonds as a food may help maintain healthy cholesterol levels.
The authors wrote:
"The message that almonds, in and of themselves, are a heart-healthy snack should be emphasized
to consumers. Moreover, when almonds are incorporated into a healthy, balanced diet, the benefits are even greater."
The fatty acid profile of almonds, which is made up of 91-94% unsaturated fatty acids,
may partly explain why it helps maintain healthy cholesterol levels. Almonds also have the highest fiber content of any tree
nut.
Almonds have more fiber than any other tree nut
A recent article on the health
benefits of almonds:
"Research Review Suggests Almonds
Contain Nutrients That Provide Cardioprotective Effects" 3) BroccoliBroccoli is rich in fiber, folate, potassium, calcium and phytonutrients. Phytonutrients
are compounds which reduce the risk of developing heart disease, diabetes and some cancers. Broccoli also contains beta-carotene,
an antioxidant, as well as vitamin C.
Boiling broccoli for too long can destroy much of its vital nutrients
If the enzyme myrosinase is not destroyed during cooking, broccoli can also
reduce the risk of developing cancer. The best way to cook broccoli and to preserve
the myrosinase is to steam the vegetable lightly - if it is overcooked, and the vegetable's beneficial effects can be
seriously undermined, researchers from the University of Illinois wrote in the peer-reviewed journal Nutrition
and Cancer.
The researchers said that adding broccoli to a meal can
often double its anticancer properties.
Another ingredient, sulforphane,
which exists in broccoli, is also said to have anti-cancer as well as anti-inflammatory qualities. However,
overcooking can destroy most of the benefits.
Broccoli powder does not contain
myrosinase.
A recent article on the health
benefits of broccoli:
"Lightly Steamed Broccoli Has
Powerful Anticancer Enzyme Myrosinase" 4) BlueberriesBlueberries are rich in phytonutrients, antioxidants and fiber.
According to a study
carried out at Harvard Medical School, elderly people who eat plenty of blueberries (and strawberries) are less likely to suffer from cognitive decline, compared to other people of their age who do not. (Link to article)
Blueberries were found in another
study carried out by scientists at Texas Woman's University, to help in curbing obesity. Plant polyphenols, which
are abundant in blueberries, have been shown to reduce the development of fat cells (adipogenesis), while inducing
the breakdown of lipids and fat (lipolysis). (Link to article)
Blueberries may
help in controlling body weight
Regular blueberry consumption can
reduce the risk of suffering from hypertension (high blood pressure) by 10%, because
of the berry's bioactive compounds, anthocyanins, scientists from East Anglia University, England, and Harvard University,
USA reported in the American Journal of Nutrition. (Link to article)
Blueberry consumption has
also been associated with a lower risk of artery hardening, and/or intestinal diseases. The
fruit has also been linked to stronger bones in animal studies. 5) Oily fishExamples of oily
fish include salmon, trout, mackerel, herring, sardines and anchovies.
These types of fish have oil in their tissues and around the gut. Their lean fillets contain up to 30% oil, specifically,
omega-3 fatty acids. These oils are known to provide benefits for the heart, as well as the nervous system. Oily fish are
also known to provide benefits for patients with inflammatory conditions, such as arthritis.
Oily fish also contain
vitamins A and D.
Scientists at UCLA's Jonsson Comprehensive Cancer
Center found that prostate cancer progression was significantly slowed when patients went
on a low-fat diet with fish oil supplements. (Link to article)
Oily fish are rich
in omega-3 fatty acids
The following benefits
linked to fish oils or fish oil supplements have been reported online
in Medical News Today: ·
"Fish Oil Aids Bi-Polar Behavior
In Mice, Hinders Alcohol Cravings" · "Fish Oil May Prevent Muscle
Loss In Breast Cancer Survivors" · "Fish Oil Boosts Responses
To Breast Cancer Drug Tamoxifen" · "Fish Oil Omegas Now Fight
Women's Vision Loss" · "Fish Oil And Omega-3s, Helping
Chemo Patients Gain Weight" 6) Leafy green
vegetablesStudies have shown that a high intake of dark-leafy
vegetables, such as spinach or cabbage may significantly lower a person's risk
of developing diabetes type 2. Researchers from Leicester University, England, said that the impact of dark green vegetables
on human health should be investigated further, after they gathered data from six studies.
Spinach, for example, is
very rich in antioxidants, especially when uncooked, steamed or very lightly boiled.
It is a good source of vitamins A, B6, C, E and K, as well as selenium, niacin, zinc, phosphorus, copper, folic
acid, potassium, calcium, manganese, betaine, and iron.
Boiling
spinach can significantly reduce its levels of good nutrients. 7) Sweet potatoesSweet potatoes are rich in dietary fiber, beta carotene, complex carbohydrates,
vitamin C, vitamin B6, as well as carotene (the pink, yellow ones).
The Center for Science in the Public Interest,
USA, compared the nutritional value of sweet potatoes to other vegetables. The sweet potato
ranked number one, when vitamins A and C, iron, calcium, protein and complex carbohydrates were considered.
Sweet potato roots are rich in fiber and several important nutrients
8) Wheat germWheat germ is the part of wheat that germinates to grow
into a plant - the embryo of the seed. Germ, along with bran, is commonly a by-product of the milling; when cereals
are refined, the germ and bran are often milled out.
Wheat germ is high in several vital nutrients, such as vitamin E, folic
acid (folate), thiamin, zinc, magnesium, phosphorus, as well as fatty alcohols and essential fatty acids.
Wheat germ is also a good source of fiber. 9) AvocadosMany people avoid avocados because of its high fat content; they believe that avoiding all fats leads to better
health and easier-to-control body weight - this is a myth. Approximately 75% of the calories in an avocado come from fat;
mostly monosaturated fat.
Weight-for-weight, avocadoes have 35% more potassium than bananas.
Avocados are also very rich in B
vitamins, as well as vitamin K and vitamin E.
Avocados also have a very high fiber content of
25% soluble and 75% insoluble fiber.
Studies have shown that regular avocado consumption lowers
blood cholesterol levels.
Avocado extracts are currently being studied in the laboratory to see whether they might be useful for treating diabetes
or hypertension.
Researchers from Ohio State University found that nutrients
taken from avocados were able to stop oral cancer cells, and even destroy some of the pre-cancerous cells.
An article on avocados and oral cancer prevention:
"Avocados May Help Prevent
Oral Cancer, OSU Study Shows") 10) OatmealOatmeal is meal made from rolled or ground oats, or porridge made from ground or rolled oats. In the United Kingdom
and the Republic of Ireland, the term "porridge" or "porridge oats" are common terms for the breakfast
cereal that is usually cooked.
Interest in oatmeal has increased considerably over the last twenty years because of
its health benefits.
Studies have shown that if you eat a bowl of oatmeal everyday your blood cholesterol levels, especially if they are too high, will drop, because
of the cereal's soluble fiber content. When findings were published in the 1980s, an "oat
bran craze" spread across the USA and Western Europe. The oats craze
dropped off in the 1990s.
In 1997, the FDA (Food and Drug Administration)
agreed that foods with high levels of rolled oats or oat bran could include data on their labels about their cardiovascular
heart benefits if accompanied with a low-fat diet. This was followed by another surge in oatmeal popularity.
Oats is rich in complex carbohydrates, as well as water-soluble
fiber, which slow digestion down and stabilize levels of blood-glucose.
Oatmeal porridge is very rich in B vitamins, omega-3 fatty acids, folate, and potassium.
http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=245259 Egg Proteins
For Breakfast Keeps You Feeling Full For LongerIndividuals who consume egg proteins for breakfast
are more likely to feel full during the day than those whose breakfasts contain wheat protein. Results from the study, conducted
by Dr. Nikhil Dhurandhar, Pennington Biomedical Research Center, Louisiana, USA, and colleagues were presented at the 19th
European Congress on Obesity in Lyon, France.
The researchers enrolled 20 overweight or obese, but
otherwise healthy individuals to participate in the study in order to compare the satiating (hunger-satisfying) effect of
an egg breakfast (EB) to that of a ready-to-eat cereal breakfast (CB) - matched for
macronutrient composition and energy density (ED) - but containing differing protein quality.
Participants were randomly assigned to eat either an EB or CB for one week under supervision.
After a two-week gap period, the two groups swapped over. On days 1 and 7 of each test week, the researchers provided a structured
buffet lunch in order to examine how hungry participants were after their breakfasts.
The researchers found that participants who ate an EB felt fuller before lunch, and
ate less at lunch on days 1 and 7 during the EB week, than during the CB week.
During the three hour period between breakfast and lunch, the team found that participants
in the EB group also had lower concentrations of the hunger-stimulating hormone acylated ghrelin, as well as increased PYY3-36
(a hormone that signals satiety secreted by the intestines).
Dhurandhar explained:
"This study shows that diets with higher protein quality may
enhance satiety, leading to better compliance and success of a weight loss diet." Does Drinking Coffee Lower Mortality?Apparently so, according to results of the largest-ever study to examine the relation. Many epidemiologic studies on the effects of coffee drinking
on total mortality and disease-specific mortality have been small and underpowered and have produced conflicting results.
In the mid-1990s, epidemiologists at the National Cancer Institute administered a detailed diet and lifestyle questionnaire
to 402,260 members of the AARP. The participants (age range, 50–71), who were
free of heart disease, stroke, and cancer at study onset, were followed for a decade — more than 5.1 million person-years
of follow-up. After adjusting for many potential confounders, a graded
and inverse relation was found between the amount of coffee consumed and total mortality, as well as disease-specific mortality
from heart disease, stroke, respiratory disease, diabetes, and infection, but not death from cancer. The results were similar
in men and women, and for caffeinated and decaffeinated coffee. Freedman ND et al. Association of coffee drinking
with total and cause-specific mortality. N Engl J Med 2012
May 17; 366:1891. (http://dx.doi.org/10.1056/NEJMoa1112010) Waist Less Than Half Of Height Helps You Live LongerA
new study reveals that waist-to-height ratio (WHtR) is a significantly better predictor of cardiometabolic risk than waist
circumference (WC) and body-mass index (BMI). In addition WHtR takes account of differing heights, therefore making it the
best proxy to use across all countries.
Findings from the study, conducted by Dr. Margaret Ashwell and Sigrid
Gibison, are being presented at the 19th European Congress on Obesity in Lyon, France.
The researchers examined 31 studies involving around 300,000 participants that used
specificity and sensitivity analysis for evaluating the discriminatory power of anthropometric indices in individuals with
type 2 diabetes, metabolic syndrome, high blood pressure, abnormal body fat levels, and general cardiovascular outcomes (CVD).
They found that compared with
BMI, WHtR had considerably greater discriminatory power. WC and WHtR also improved discrimination of adverse outcomes by 3%
and 4-5%, respectively, compared with BMI.
Furthermore, WHtR was found to be considerably better for diabetes, CVD, hypertension and all outcomes in men and women
compared with WC, and also better than BMI and WC at detecting cardiometabolic risk factors in both sexes. As a result WHtR
should be considered as a screening tool.
The average proposed values, i.e. the first risk level for people of different ethnic backgrounds, calculated from
the study size for both men and women was 0.5, which was determined in a separate analysis of suggested WHtR cut-off values
from the people's specificity and sensitivity analysis.
If you keep your waist to less than half your height measurement, you will probably live longer
In other words, in order to avoid increasing risk of these adverse risk factors "Keep
your waist circumference to less than half of your height." According
to Ashwell, if a second level of increased risk is needed, keep your waist to below 60% of height (0.6).
WC and BMI both require differing values to be considered for different ethnicities,
thus making things considerably more difficult than they need to be. The UK's National Institute for Health and Clinical
Excellence are currently considering new guidelines on WC. However, Ashwell states that this would be a waste of resources,
as using WHtR instead would be a one-size fits-all approach. This approach is gaining support in a variety of countries, including
the UK, USA, Australia, Japan, India, Iran, and Brazil.
Dr Ben Rickayzan and Professor Les Mayhew, from Cass Business School, City University, London, UK,
estimate that a 30-year-old non-smoking man could increase his life expectancy by up to 14% if his WHtR is 0.7 and by up to
one third if his WHtR is 0.8. http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=245352 Waist To Height Ratio Better Than BMIWaist to
height ratio is a better predictor of heart disease and diabetes risk than BMI, according to new research presented at a scientific meeting
recently.
Study leader Dr Margaret Ashwell, an independent consultant and former science director of the British Nutrition Foundation,
presented the findings at the 19th Congress on Obesity in Lyon, France, on Saturday 12 May.
"Keeping your waist circumference to less than half your height can help increase life expectancy for every person
in the world," said Ashwell, as reported in the Telegraph.
Thus a man
who is 6ft or 72 inches tall (183 cm), should keep his waist under 36 inches (91 cm), and a woman who is 5ft 4 in or 64 inches
tall (163 cm), should keep her waist measurement under 32 inches (81 cm).
Ashwell
said the measure should be considered as a screening tool.
The idea of using
Waist to Height Ratio (WHtR) to predict cardiometabolic risk is not new, but is coming to prominence as more studies reveal
its value.
At the meeting, Ashwell presented the findings of a study that
analyzed the health of 300,000 people and found WHtR was better able to predict high blood pressure, diabetes, heart attacks
and strokes than BMI.
BMI (short for Body Mass Index) is a widely used
measure of obesity. It is a ratio of a person's weight in kilos to the square of their height in metres. However, it does
not take into account the distribution of fat around the body.
Abdominal fat affects organs like the heart, liver and
kidneys more adversely than fat around the hips and bottom, in terms of cardiometabolic risk.
Last year, Ashwell co-authored a paper on the increasing importance of using Waist-to-Height Ratio (WHtR) to assess
cardiometabolic risk, and pleaded for scientists to use a consistent terminology to express the ratio so it can easily be
searched for in the literature.
An advantage of WHtR is the simplicity of
the health message "keep your waist circumference to less than half your height". This is a much easier thought
to hold in mind than BMI, where not only do you have to work out the ratio of your weight in kilos to the square of your height
in metres, but also remember what the healthy range is.
To measure the waist
circumference accurately, you should measure it mid-way between the lower rib and the iliac crest (the top of the pelvic bone
at the hip), this is the method recommended by the World Health Organization, says Ashwell http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=245328 Higher Omega-3 Intake Linked
to Lower Levels of Alzheimer's Biomarker Patients
may ask about a study suggesting that increased dietary intake of omega-3s is associated with lower serum levels of amyloid-β (Aβ), an early indicator of Alzheimer disease. The cross-sectional
study appears online in Neurology. Some 1200 people aged 65 and older who were free of dementia answered food-frequency questionnaires
and then underwent serum Aβ measurement about a year later. After adjustment for confounders, participants with higher
omega-3 intake had lower levels of Aβ42. Other nutrients did not show an association. Participants obtained their omega-3s
mainly through salad dressing, fish, poultry, margarine, and nuts. The
authors say their findings suggest "that the potential beneficial effects of [omega-3] intake on AD and cognitive function in the literature might be at least partly explained by an [Aβ]-related mechanism." http://www.neurology.org/content/early/2012/05/02/WNL.0b013e318258f7c2.abstract The Secrets To Successful
Aging
Aging may seem unavoidable, but that's not necessarily
so when it comes to the brain. So say researchers in the Cell Press journal Trends
in Cognitive Sciences explaining that it is what you do in old age that
matters more when it comes to maintaining a youthful brain not what you did earlier in life.
"Although some memory functions
do tend to decline as we get older, many elderly show well preserved functioning and this is related to a well-preserved,
youth-like brain," says Lars Nyberg of Umeå University in Sweden.
Education won't save your brain - PhDs
are as likely as high-school dropouts to experience memory loss with old age, the researchers say. Don't count on your job either. Those with a complex or demanding career may enjoy a limited advantage, but those
benefits quickly dwindle after retirement.
Engagement is the secret to success. Those who are socially,
mentally and physically stimulated reliably show better cognitive performance with a brain that appears younger than its years.
"There is quite solid evidence that staying physically and mentally active is
a way towards brain maintenance," Nyberg says.
The researchers say this new take on successful aging represents an important shift in focus for
the field. Much attention in the past has gone instead to understanding ways in which the brain copes with or compensates
for cognitive decline in aging. The research team now argues for the importance of avoiding those age-related brain changes
in the first place. Genes play some role, but life choices and other environmental factors,
especially in old age, are critical.
Elderly people generally do have more trouble remembering meetings or names, Nyberg says. But those memory losses often
happen later than many often think, after the age of 60. Older people also continue to accumulate knowledge and to use what
they know effectively, often to very old ages.
"Taken together, a wide range of findings provides converging evidence for marked heterogeneity in brain aging,"
the scientists write. "Critically, some older adults show little or no brain changes
relative to younger adults, along with intact cognitive performance, which supports the notion of brain maintenance.
In other words, maintaining a youthful brain, rather than responding to and compensating for changes, may be the key to successful
memory aging
http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=244728 USPSTF Reviews Evidence on Menopausal Hormone
Therapy for Chronic Conditions A
new evidence review from the U.S. Preventive Services Task Force reaffirms that menopausal
hormone therapy offers fracture-prevention benefits — but at the cost of increased
risks for venous thromboembolism, stroke, and other adverse outcomes. The
review, appearing in the Annals of Internal Medicine, included nine
trials published since 2002 on hormone therapy for the primary prevention of chronic conditions. Most results came from the
Women's Health Initiative, including: ·
Estrogen-progestin
therapy reduced risks for diabetes and fractures (hip, vertebral, total) but
raised risks for invasive breast cancer, stroke, venous thromboembolism, lung cancer mortality,
gallbladder disease, dementia, and urinary incontinence. ·
Estrogen
alone lowered risks for fractures, invasive breast cancer, and mortality, while it increased risks for stroke, deep venous
thrombosis, gallbladder disease, and incontinence. The review
will inform a forthcoming guideline update from the USPSTF. (In 2002, the task force advised against estrogen-progestin
use to prevent chronic conditions; in 2005, it issued the same advice against estrogen alone.) Annals of Internal Medicine evidence review Fish and cancer risk
Our findings from this meta-analysis suggest that fish consumption
is inversely associated with colorectal cancer. The American
Journal of Medicine Can the sunshine vitamin melt
the fat?
The authors investigated whether correction of hypovitaminosis D in a cohort
of overweight adults can improve the prevalence of metabolic syndrome and its components. Adult nondiabetic Saudis were advised
to expose themselves to sunlight for set periods twice a week and to follow a vitamin D-enriched
diet. Mean serum 25-OHD level increased and there was a concomitant significant decrease in the prevalence of metabolic syndrome. Metabolism -- Clinical and Experimental NSAID use reduces skin cancer
risk, study finds
People who use common nonsteroidal anti-inflammatory drugs, such as aspirin
and ibuprofen, are less likely to develop melanoma and squamous-cell skin cancer than non-NSAID users, according to a study
published online in Cancer. Reuters Study: Exercise may lower heart
risk in prediabetes
Prediabetes patients who underwent a regular aerobic exercise regimen showed vascular benefits such
as improved flow-mediated brachial artery dilation and reduced levels of fasting triglycerides,
C-reactive proteins and leptin as well as other markers at the study's conclusion, researchers reported at the
American Association of Clinical Endocrinologists meeting. However, the patients did not attain
lower body weight, fat mass or blood pressure by the end of the study, researchers said. Endocrine Today Potential Benefit of Interrupting Prolonged Sitting A few
minutes of exercise hourly improved glucose metabolism. Dunstan DW et al. Diabetes Care 2012
May 35:976 Zinc
and the Common Cold, Redux In the latest meta-analysis,
zinc was mildly effective, but we still have little reason to endorse its use. Science
M et al. CMAJ 2012
May 7; Lower-Risk
People Should Be Treated with Statins, Meta-Analysis Suggests Even patients with a low 5-year risk for major vascular events may benefit from LDL-lowering
statin therapy, according to a government-funded meta-analysis in the Lancet. The study included 27 trials comparing statins with control therapy in nearly 175,000 participants. During 5 years' follow-up, statins lowered the risk for major vascular events
by 21% per 1.0 mmol/L (39 mg/dL) reduction in LDL cholesterol. In particular, the lowest-risk patients (i.e., estimated
5-year risk for major vascular events <10%) had reductions in coronary events, revascularizations, and stroke that were
similar to reductions in higher-risk patients. Statins were not
associated with cancer or nonvascular mortality. The authors say statins' benefits in lower-risk patients greatly exceed "any known hazards."
They continue: "Under present guidelines, such individuals would not typically be regarded as suitable for LDL-lowering
statin therapy. ... These guidelines might need to be reconsidered." They do, however, raise concerns about the costs
of widespread treatment. Lancet article BMI
Associated with Lumbar Disk Degeneration The findings help explain the link between obesity and low back pain. Samartzis D et al. Arthritis Rheum 2012
May 64:1488 Eating
Certain Fish Might Prevent Liver Cancer In a large prospective
study in Japan, higher consumption of fish with n-3 polyunsaturated fatty acids translated
to lower risk for hepatocellular carcinoma. Sawada N et al. Gastroenterology 2012
Feb 16 Neurotranmitters(dopamines) Identified That Lead To ForgettingThe Two Faces of Dopamine
To better understand the mechanisms for forgetting, Davis and his colleagues
studied Drosophila or fruit flies, a key model for studying memory that has been found to be highly applicable to humans.
The flies were put in situations where they learned that certain smells were associated with either a positive reinforcement
like food or a negative one, such as a mild electric shock. The scientists then observed changes in the flies' brains
as they remembered or forgot the new information.
The results showed that a small subset of dopamine neurons actively
regulate the acquisition of memories and the forgetting of these memories after learning, using a pair of dopamine receptors
in the brain. Dopamine is a neurotransmitter that plays an important role in a number of processes including punishment
and reward, memory, learning and cognition.
But how can a single neurotransmitter,
dopamine, have two seemingly opposite roles in both forming and eliminating memories? And how can these two dopamine receptors
serve acquiring memory on the one hand, and forgetting on the other?
The study suggests that when a new memory is first formed, there also exists an active,
dopamine-based forgetting mechanism - ongoing dopamine neuron activity - that begins to erase those memories unless
some importance is attached to them, a process known as consolidation that may shield important memories from the dopamine-driven
forgetting process.
The
study shows that specific neurons in the brain release dopamine to two different receptors known as dDA1 and DAMB,
located on what are called mushroom bodies because of their shape; these densely packed networks of neurons are vital
for memory and learning in insects. The study found the dDA1 receptor is responsible for
memory acquisition, while DAMB is required for forgetting.
When dopamine neurons begin the signaling
process, the dDA1 receptor becomes overstimulated and begins to form memories, an essential
part of memory acquisition. Once that memory is acquired, however, these same dopamine neurons continue signaling.
Except this time, the signal goes through the DAMB receptor, which triggers forgetting of
those recently acquired, but not yet consolidated, memories. http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=245228 Ultrasound-Guided Corticosteroid Injection Relieves Plantar Fasciitis Pain —
in the Short-Term Ultrasound-guided
corticosteroid injection relieves plantar fasciitis pain at 4 weeks — but offers no significant benefit over placebo
at 8 and 12 weeks, according to a randomized, double-blind study in BMJ. Eighty-two adults with ultrasound-confirmed plantar fasciitis unrelated to systemic inflammatory disease
received an ultrasound-guided injection of dexamethasone or saline. (To limit pain during heel injection, all patients first
received a tibial nerve block with lidocaine.) At 4 weeks, pain
scores were 11 points lower (on a 100-point scale) with dexamethasone than with saline. At 8 and 12 weeks, pain scores still
favored dexamethasone, but the between-group differences were no longer significant. Dexamethasone significantly reduced plantar
fascia thickness more than saline at all time points. The authors
calculated that roughly three patients would need to be treated for one successful pain outcome at 4 weeks. They call their
findings "important for clinical practice," while advising providers to note that pain relief was not significant
beyond the short term. BMJ article Aspirin Prevents Recurrent
Unprovoked Venous Thromboembolism Aspirin is probably less effective ––
but safer –– than warfarin. Patients with unprovoked venous thromboembolism (VTE)
face a dilemma: Recurrent VTE is common after warfarin anticoagulation is stopped, but the cumulative incidence of serious
bleeding is high when patients continue warfarin therapy indefinitely. This difficult tradeoff provides an impetus to see
whether aspirin is a suitable alternative for such patients. Italian researchers identified 403 patients
with a first symptomatic VTE event that was unprovoked (i.e., not associated with standard VTE risk factors); 63% had proximal
deep venous thrombosis, and 37% had pulmonary embolism. After 6 to 18 months of treatment with a vitamin K antagonist, patients
were randomized to either aspirin (100 mg daily) or placebo for 2 years. The incidence of recurrent
VTE was significantly lower in the aspirin group than in the placebo group (6.6% vs. 11.2% annually; P=0.02).
The frequency of bleeding events was identical in the two groups (1 major bleed and 3 nonmajor bleeds). Aspirin afforded protection
both to patients whose index event was deep venous thrombosis and to those whose index event was pulmonary embolism. Becattini C et al. N Engl J Med 2012
May 24; 366:1959 Lung Cancer Screening with Low-Dose CT 'May Benefit' People at High Risk Screening for lung cancer with low-dose
computed tomography may be effective in older patients at high risk, but "substantial uncertainties" remain, according
to a JAMA study. (Clinical Conversations has an interview with
the study's first author.) Researchers examined published evidence
on the benefits and harms of CT screening. Most data came from the National Lung Screening Trial, comprising over 50,000 people
randomized to screening with either CT or chest radiographs. On
behalf of the American College of Chest Physicians and the American Society of Clinical Oncology, they recommend annual low-dose
CT screening for those aged 55 to 74 with a 30 pack-year history who either currently smoke or have quit within the past 15
years. They further recommend prescreening counseling to delineate the benefits (an absolute risk reduction of less than 1%)
and harms (the risks of procedural complications after positive findings, more than 90% of which are benign). The authors call the CT screening an "intervention in its infancy" and remind readers that
questions on overdiagnosis and radiation risks remain unresolved. JAMA article (Free) Coronary
artery calcium as predictor of heart disease
In this study of asymptomatic individuals without known cardiovascular disease, the addition of coronary artery calcium but not biomarkers substantially improved the risk reclassification for future
cardiovascular disease events beyond traditional risk factors. The American
Journal of Cardiology § Calorie restriction cuts inflammation in older obese women
Overweight and obese postmenopausal women who underwent a caloric restriction weight-loss diet alone
or with exercise attained significant reductions in inflammation markers, including high-sensitivity
C-reactive protein, compared with the control group, according to a study in Cancer Research. PhysiciansBriefing.com/HealthDay News § § Curbing stress boosts health status in diabetes
patients
Patients with type 2 diabetes who underwent a mindfulness-based stress-reduction
program attained lower depression levels and improvements in health status after a year compared with those in the control
group, according to a study in Diabetes Care.PhysiciansBriefing.com/HealthDay News Gout: Nature or nurture
Hyperuricemia is a genetic trait. Outside the context of rare genetic disorders, risk for gout is determined by the environment. This has implications for prevention and treatment approaches. The American
Journal of Medicine Study links arthritis to depression,
anxiety
One-third of people ages 45 and up with arthritis or other rheumatic conditions reported having anxiety
or depression, while 84% of respondents with depression also reported suffering from anxiety, according to a study in Arthritis
Care & Research. "Given their high prevalence and the effective treatment options that are available, we suggest
that all people with arthritis be screened for anxiety and depression," lead researcher Dr. Louise Murphy said. HealthDay News “Good” cholesterol
reduces heart attack risk ... Or does it?
Some genetic mechanisms that raise plasma high-density lipoprotein (HDL) cholesterol do not seem to
lower risk of myocardial infarction. These data challenge the concept
that raising of plasma HDL cholesterol will uniformly translate into reductions in risk of myocardial infarction. The Lancet § Fewer diabetes patients die
of heart disease, stroke, CDC finds
The risk of heart disease- and stroke-related deaths declined 40% and the overall mortality rate fell 23% in patients
with diabetes from 1997 to 2006, CDC researchers reported in Diabetes Care. Diabetes patients were more likely to be obese
but less likely to smoke and more likely to be physically active than in the past. Reuters §
USPSTF: PSA prostate cancer screening offers more
harm than good
The U.S. Preventive Services Task Force advised against the routine screening of men for prostate cancer using
the prostate-specific antigen blood test, saying that the screening's harms outweigh its benefits. PSA screening leads
to overdiagnosis and unneeded treatment that can lead to impotence and incontinence, the panel said. HealthDay News The U.S. Preventive Services Task Force is officially recommending
against routine PSA-based screening for prostate cancer in men of all ages (grade D recommendation). The statement, published
in the Annals of Internal Medicine, follows
the group's much-debated draft recommendation released last October. One Annals commentator, an
oncologist in support of the guidance, writes, "it is my hope that the current USPSTF recommendation ends mass screening,"
as the "harms are well-proven" and "the evidence of benefit is weak." On the other side of the debate, a group of specialists and primary care providers say they believe
the USPSTF "either overlooked or misinterpreted the effect of significant methodological flaws in the 2 major clinical
trials of screening." They suggest that clinicians "review the evidence, follow the continuing dialogue closely,
and individualize prostate cancer screening decisions on the basis of informed patient preferences." Annals of Internal Medicine recommendation statement (Free) Annals of Internal Medicine commentary supporting the guidance (Free) Annals of Internal Medicine commentary against the guidance (Free) § § Fitness reduces hypertension
risk, study says
Physically fit adults with a family history of hypertension were up to 34% less likely to develop high
blood pressure compared with those who exercised infrequently, U.S. researchers reported in the journal Hypertension. Researchers
said moderate exercise, such as brisk walking for 150 minutes per week, had big health benefits for people predisposed to
hypertension. WebMD §
Secondhand smoke may cause vascular damage,
study says
Nonsmokers who are exposed to just 30 minutes of secondhand smoke can suffer impaired vascular function, which may
lead to atherosclerosis and heart disease, including heart attack or stroke, according to a study to be published in the Journal
of the American College of Cardiology. The researchers said that comprehensive policies are needed to ban public smoking and
that physicians should talk to patients about their exposure to secondhand smoke.HealthDay News Silent myocardial infarction
in diabetic women vs. men
Using Action to Control Cardiovascular Risk in Diabetes (ACCORD) data, women
had lower odds of silent myocardial infarction (MI) than men with a similar history. Race and ethnicity were significantly
associated with silent MI, with Asians having the highest and African-Americans and Hispanics having lower odds relative to whites. The main findings provide
no evidence that silent MI was more common in women than in men in the ACCORD cohort. Journal of Diabetes and Its Complications Is increased use of vena cava
filters warranted?
At present, it seems prudent to consider a vena cava filter in patients with pulmonary embolism who
are receiving thrombolytic therapy and in unstable patients who may not be candidates for thrombolytic therapy. Future prospective
study is warranted to better define in which patients a filter is appropriate. The American Journal of Medicine Epicardial adipose tissue
and risk of atherosclerosis
This study found that cardiomegaly on chest X-ray can be caused by
excessive epicardial adipose tissue and can be associated with a number of coronary risk factors, and with coronary
calcification and stenosis. Cardiomegaly in this setting may be regarded as another non-invasive marker of coronary atherosclerosis. The American Journal of Cardiology Does Azithromycin Raise Risk for Cardiovascular-Related Death? Risk was most pronounced for those with the highest baseline risk for cardiovascular
diseases. Several
macrolide antibiotics have proarrhythmic effects, but azithromycin is thought to be less cardiotoxic than others. Researchers
at Vanderbilt University investigated this assumption using Medicaid records for 402,260
patients. They monitored deaths from heart disease and other causes during 3.3 million 5-day windows during which some patients
received azithromycin and other clinically similar patients did not take antibiotics, or took amoxicillin, ciprofloxacin,
or levofloxacin. Patients
who took azithromycin had significantly elevated rates of cardiovascular-related death compared with people in each of the
control groups (except the levofloxacin group). For example, compared with patients who
took no antibiotics or amoxicillin, patients who took azithromycin had hazard ratios of 2.9
and 2.5, respectively. The increase in absolute risk, however, was quite small.
When comparing azithromycin recipients with amoxicillin recipients, the elevated absolute risk per million courses of azithromycin
therapy was 47 additional cardiovascular-related deaths in patients at average cardiovascular risk and 245 in patients at
greatest risk. Medline abstract FDA Responds to Study on Azithromycin and Cardiovascular Death Patients should not stop taking the antibiotic azithromycin without first
consulting with their physician, the FDA said in a statement following a study published in the New
England Journal of Medicine — and covered here Thursday. That study linked the drug with increased risk for cardiovascular death during short-term therapy.
The FDA notes that other macrolide antibiotics also carry warnings about possible QT interval prolongation. The agency says it's reviewing the work and that "healthcare
professionals should be aware of the potential for QT interval prolongation and heart arrhythmias when prescribing or administering
macrolides." FDA MedWatch safety alert Adverse Neuropsychiatric Effects of GlucocorticoidsElevated incidence of suicide attempts, depression, mania, and delirium Glucocorticoids can have severe adverse neuropsychiatric
effects, but the range and community-based population risk of such effects are unclear. In this U.K. study, researchers used
a population-based general practice database to identify 370,000 patients with glucocorticoid exposure and compared them with
1.2 million patients with similar diseases (mostly asthma, lower respiratory tract infection, chronic obstructive pulmonary
disease, and polymyalgia rheumatica) who had not taken glucocorticoids. The
overall incidence of any adverse neuropsychiatric effects that occurred within 3 months of
a glucocorticoid prescription was 22.2 per 100 person-years of exposure. The incidence of adverse effects, adjusted
for age, sex, and history of neuropsychiatric disorder, was roughly 3-fold higher for glucocorticoid recipients than for nonrecipients,
ranging from roughly 4- to 6-fold higher for suicidal behavior, mania, and delirium or confusion, to about 1.5 times higher
for panic disorder and depression. Incidence rose with history of neuropsychiatric disorder and with higher dosage of
glucocorticoids, particularly at a
prednisone equivalence of 40
mg daily. Fardet L et al. Suicidal behavior and severe
neuropsychiatric disorders following glucocorticoid therapy in primary care. Am
J Psychiatry 2012 May 1; 169:491. (http://dx.doi.org/10.1176/appi.ajp.2011.11071009) Medline abstract CT Colon Screening Without Laxatives Reliably Finds Lesions Above 10 mm in Size Computed tomographic colonography (CTC) without use of laxatives
finds significant favor among patients, but lesions smaller than 10 mm may escape detection, according to a multicenter study
in the Annals of Internal Medicine. U.S. investigators examined some 600 patients. First, all underwent CTC with use of a marker (but not
laxatives) that allowed feces to be "subtracted" from the image. The same patients underwent optical colonoscopy
5 weeks later, with laxative preparation. The sensitivity for
detecting lesions 10 mm or larger was roughly the same with both methods: 91% for CTC and 95% for colonoscopy. For smaller
lesions, however, sensitivity was much less: for lesions 6 mm or larger, for example, CTC scored only 59%, versus 76% with
optical colonoscopy. Patients preferred CTC over colonoscopy by a nearly two-to-one
margin. Annals of Internal Medicine article FDA Questions Whether Long-Term Use of Bisphosphonates Provides Fracture Benefit An FDA analysis, published in the New
England Journal of Medicine, calls into question the fracture-prevention benefits of long-term bisphosphonate use. The FDA examined three randomized trials in which bisphosphonates were given initially for at least
3 years, and then extended for an additional 3 to 6 years (total duration, 6–10 years). Pooled
data showed that women receiving bisphosphonates for at least 6 years had similar overall fracture rates as those who switched
to placebo (roughly 10% and 8.5%, respectively). The authors
say there are not enough data to determine which subgroups of patients may benefit from use beyond 3 to 5 years. But commentators
provide the following recommendations: · Patients with low bone-mineral density
at the femoral neck (T score below −2.5) following 3 to 5 years' treatment have the highest risk for vertebral fracture
and seem to benefit most from treatment continuation. ·
Those
with existing vertebral fractures who have T scores below −2.0 may also benefit. ·
Those
with femoral neck T scores above −2.0 have low vertebral fracture risk and are not likely to benefit. NEJM perspective 1 from FDA (Free) NSAIDs
Associated with Reduced Skin Cancer Risk Use
of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with reduced risk for skin cancer, according to a case-control
study in Cancer. Using
health registries, researchers identified 18,500 cases of skin cancer among adults in northern Denmark and matched them to
population controls without skin cancer. Patients who had ever used NSAIDs (more than two prescriptions) had reduced risks
for squamous cell carcinoma (incidence rate ratio, 0.85) and malignant melanoma (IRR, 0.87), compared with those who had two
or fewer prescriptions. A similar risk reduction was not observed in patients with basal cell carcinoma. The risk reduction was seen in patients taking aspirin, nonselective nonaspirin NSAIDs, and older COX-2
inhibitors. Long-term and high-intensity use conferred the strongest associations. The
authors note that NSAIDs block COX enzymes, which are involved in the inhibition of apoptosis, in immunosuppression, and in
stimulating angiogenesis. Cancer article (Free abstract) Meta-Analysis: Probiotics Associated with Lower Risk for Antibiotic-Related Diarrhea Probiotics seem to lower the risk for antibiotic-associated
diarrhea (AAD), a JAMA meta-analysis
finds, but the available research doesn't support conclusions about which preparations work best or which patients benefit
most. Researchers examined over 80 randomized trials in which probiotics
were used to either prevent or treat AAD. In a subset of 63 trials including some 12,000 participants, they found a lower
pooled risk for AAD among those receiving probiotics (0.58), compared with controls. They estimate the number needed to treat
at 13 to prevent one case of AAD. However, the authors found poor documentation
of the probiotic strains used, unexplained heterogeneity among the trials, and little reporting on adverse effects of treatment. JAMA article Treatment
of Subclinical Hypothyroidism Is Associated with Fewer Ischemic Cardiac Events But only in patients younger
than 70 Razvi S et al. Arch
Intern Med 2012 Apr 23; Why
Sleep Patterns Matter Prolonged
experimental shortening or disruption of sleep led to a prediabetic condition. Buxton OM et al. Sci Transl Med 2012
April 11; 4:129ra43 Chronic
Urticaria Might Be a Harbinger of Other Autoimmune Diseases Subsequently diagnosed autoimmune diseases were 17 times more common
in patients with idiopathic urticaria. Confino-Cohen R et
al. J Allergy Clin Immunol 2012
May 129:1307 How Does ApoE4 Affect Alzheimer's Risk? New Clues
http://mnt.to/l/46k5
New
Clues On How ApoE4 Affects Alzheimer's Risk
http://mnt.to/l/46gq Anxiety Disorders And Cellular Metabolism Linked
http://mnt.to/l/46hZ
New
Mechanism For Anxiety Disorders Revealed By Mystery Gene
http://mnt.to/l/46fd When You Eat Is As Important As What You Eat
http://mnt.to/l/46mv How Many Calories Should I Eat?
http://mnt.to/l/46j2
Certain
Types Of Fat Associated With Worse Memory And Overall Cognitive Function
http://mnt.to/l/46hK Sleep Apnea Has Higher Risk Of Cancer Mortality
http://mnt.to/l/46kg
Obstructive
Sleep Apnea Can Be Managed Successfully In The Primary Care Setting
http://mnt.to/l/46jT
Association
Between Sleep Disordered Breathing And Increased Risk Of Cancer Mortality
http://mnt.to/l/46jC
Could A Compound Found In Red Wine And Red Grapes
Change The Course Of Alzheimer's Disease?
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Purpose In Life May Protect Against Harmful Changes In The Brain Associated With Alzheimer's Disease
http://mnt.to/l/4666
Investigating Potential Link Between Sunscreen Ingredient And Endometriosis
http://mnt.to/l/468x Stroke Prevention Procedure For Patients With A-Fib Who Can't
Take Blood Thinners
http://mnt.to/l/466w Waist Less Than Half Of Height Helps You Live Longer
http://mnt.to/l/46cc Offspring Likely Suffer When Mother Is Overweight During Pregnancy
http://mnt.to/l/46cD
Protein
Identified That Stimulates Brown Fat To Burn Calories
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Waist
To Height Ratio Better Than BMI
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Hazardous To Health - Social Jet Lag
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Novel Surgery Using Capsaicin May Reduce 'Beer Belly' Visceral Fat
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Testosterone Treatment Helps Obese Older Males Lose Weight, Other
Health Gains Too
http://mnt.to/l/467J CHORI Bar Improves Cognitive and Metabolic
Benefits In Just 2 Weeks
http://mnt.to/l/46dS
Egg
Proteins For Breakfast Keeps You Feeling Full For Longer
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What
Are The Top 10 Healthy Foods?
http://mnt.to/l/469j What Is Diabetic Neuropathy?
http://mnt.to/l/46bm
Neurotranmitters
Identified That Lead To Forgetting http://mnt.to/l/468G New Study Discovers Powerful Function Of Single
Protein That Controls Neurotransmission
http://mnt.to/l/46bX Breast And Colon Cancer Survivors Live Longer
When Physically Active
http://mnt.to/l/4676 Study Suggests Nature Walks Improve Cognitive
Abilities For People With Clinical Depression
http://mnt.to/l/46cW Promising Diagnostic Technique To Screen For
Breast Cancer, Without X-Rays
http://mnt.to/l/466D Diabetics Had Decreased Blood Sugar And Improved
Blood Lipids On High-Fat Diet
http://mnt.to/l/46bR
Diagnosing And Treating Diabetes In Asian Patients - Unique Physiology Is Key
http://mnt.to/l/4699 If You Have A Family History Of Hypertension,
Physical Fitness May Reduce Your Risk
http://mnt.to/l/46cs The Immune System May Protect Against
Alzheimer's Changes In Humans
http://mnt.to/l/46r9 Working Night Shifts May Result In Higher Risk
Of Breast Cancer
http://mnt.to/l/46rG Breast Cancer Risk Associated With Sex Hormones
Reduced By Losing Weight
http://mnt.to/l/46qN Chronic Inflammation Gene May Destroy Tumors
http://mnt.to/l/46rJ New Clues About Cancer Cell Metabolism Emerge
http://mnt.to/l/46qt What Is The Best Way To Obtain Vitamin D?
http://mnt.to/l/46qL
Hormone Boosts Immune Response When Vitamin D Levels Are Low, Plays Surprise Role In
Fighting Skin Infections
http://mnt.to/l/46p8 Lower Risk Of Psoriasis Linked WIth Physical
Activity
http://mnt.to/l/46pB
Vigorous
Physical Activity Reduces Risk Of Psoriasis
http://mnt.to/l/46mx Kidney Failure In Type 2 Diabetes May Not Be
Reduced By Aggressive Glucose Control
http://mnt.to/l/46rQ
What
Effects Do High-Fat Foods Have On Metabolic Syndrome And Diabetes?
http://mnt.to/l/46rz Prednisolone's Considerable Effect On Bells
Palsy Symptoms
http://mnt.to/l/46nC Determining How Brain Acid Affects Brain Function
http://mnt.to/l/46np
Exercise Affects The Brain
http://mnt.to/l/46nm New Biological Role Identified For Compound
In Turmeric, Popular In Curries, Used In Ancient Medicine
http://mnt.to/l/46qT Protection Against Childhood Cancers May Be
Provided By Folic Acid Fortification
http://mnt.to/l/46mH Link Between A Child's Body Fat And Vitamin
D Insufficiency In The Mother
http://mnt.to/l/46p5 Food Choices, Eating Patterns Likely Influenced
By "Obesity Genes"
http://mnt.to/l/46nV Low Vitamin D In Diet Increases Stroke Risk
In Japanese-Americans
http://mnt.to/l/46qr |
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Seasonal Allergies May Be A Good Thing
http://mnt.to/l/45VR Seniors' Exercise Program May Prevent Dementia
http://mnt.to/l/45QK Chronic Stress Found To Increase Cancer Severity In Mouse Model
http://mnt.to/l/45T5 Cancer Survivors Told To Exercise, Eat Healthily, And Maintain Ideal Bodyweight
http://mnt.to/l/45Xd Optimal Nutrition, Physical Activity Recommended After Cancer Diagnosis
http://mnt.to/l/45Vn Healthy Living For Cancer Survivors
http://mnt.to/l/45TV Anatomic
Existence Of The Elusive G-Spot Confirmed By Study
http://mnt.to/l/45Sz
G-Spot
Scientifically Identified
http://mnt.to/l/45SF
Prostate Cancer Cells Destroyed By The Common Herb
Oregano
http://mnt.to/l/45RB
The
Secrets To Successful Aging
http://mnt.to/l/45Wt Anti-Depressants May Be Doing More Harm Than Good
http://mnt.to/l/45S5 Subclinical Hyperthyroidism Linked To Higher Atrial Fibrillation And Coronary Heart Disease Risk
http://mnt.to/l/45SP Stendra (Avanafil) For Erectile Dysfunction Approved By FDA
http://mnt.to/l/45Wj Opening A Novel Window On Neuronal Circuits Enabled Researchers To Watch Neurons Learn
http://mnt.to/l/45T9
Reduced
Activity In Brain's 'Reward Center' Found In Chronic Fatigue Syndrome Patients
http://mnt.to/l/45RJ No Association Found Between White Potato Consumption (Baked, Boiled Mashed) And Obesity, Type 2 Diabetes
Or Systemic Inflammation
http://mnt.to/l/45TD
A
New Study Found That Certain Berries May Delay Memory Decline In Older Women
http://mnt.to/l/45Tw
Beware
Of Dietary Supplements For Cancer Prevention
http://mnt.to/l/45Tc
Consuming Pistachios May Promote A Beneficial Gut Environment
http://mnt.to/l/45Sq
Strawberries
And Blueberries Halt Cognitive Decline In Elderly
http://mnt.to/l/45TP
Positive
Impact On Metabolic Syndrome And Satiety Offered By Eggs
http://mnt.to/l/45RP
A
Serving A Day Of Dark Chocolate Might Keep The Doctor Away
http://mnt.to/l/45RH
Sucralose
Causes Cancer Concern
http://mnt.to/l/45SV Protection Against Many Cancers Provided By Vitamin E In Diet But Not The Form Commonly Used In Supplements
http://mnt.to/l/45R6
The
Importance Of Fibers In The Diet, Including Bone Health
http://mnt.to/l/45QL Long-Overlooked Protein May Be The Gateway To The Storage And Burning Of Fat, Diabetes Treatment
http://mnt.to/l/45Sx Plenty Of Sleep Helps Keep You Slim
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