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28 December 2009

Benefits of back braces for scoliosis under study

By Blythe Bernhard
St. Louis Post-Dispatch

Scoliosis screenings in middle schools find thousands of teenagers with curved spines each year.

What happens next isn’t as well planned.

Treatment for scoliosis hasn’t changed in five decades — if the spine is curved to a certain degree, the teenager gets a back brace. But research has not conclusively proved the benefits of the braces.

Some young people who don’t wear a brace never have any problems and their curves never worsen. Others wear the braces for years and still end up needing back surgery.

A long-term study at Washington University in St. Louis, Mo., and more than 20 other research centers hopes to figure out why.

“If we can say that bracing doesn’t change (the progression of a spinal curve) then it’s a treatment regimen that we shouldn’t offer,” said Dr. Matthew Dobbs, a pediatric orthopedic surgeon and lead investigator at Washington University. “Why do school screenings? Why identify a child with a small curve and put them through years of bracing if it’s not going to alter a natural curve?”

Half of the participants in the study will receive back braces to wear at least 18 hours a day, and the other half won’t wear braces. Both groups will receive regular x-rays to check their spinal curves.

Braces aren’t thought to correct the curves but to prevent progression.

“But again we have no data to support that, despite all of us doing this for years and years and years,” Dobbs said. “We don’t know what the best treatment is; we don’t know who’s going to progress.”

Curves that progress to 50 degrees — about 10 percent of cases — are generally thought to require spinal fusion surgery.

Dobbs predicts the research will show that certain patients benefit from bracing and others don’t, depending on the type of spinal curve.

Adolescent idiopathic scoliosis occurs in about one in 1,000 teenagers, and is 10 times more common in girls. It can cause back pain, and in severe cases can affect heart and lung function.

The cause is unknown, although Dobbs and other researchers are studying the disorder’s genetic factors.

Most states (including Rhode Island) conduct scoliosis screenings by checking students’ backs, typically in sixth and eighth grades.

Smaller spinal curves are typically monitored by a doctor, but patients whose curves reach between 20 and 40 degrees are usually recommended for back braces.

If it’s found that fewer teens need braces, the research could save money on treatments plus spare some teenagers the psychological stress of wearing a brace.

Braces are “mostly put on young teenage girls who are very concerned about appearance in general and don’t want anything that makes them look different,” Dobbs said.

That’s why patients in the study are also monitored psychologically to see how they’re handling the brace.

“If we see a child in the study who dips on their mood and mental health during the study, we need to figure out what’s going on,” Dobbs said.

Kelli Sargent of Belleview, Mo., has worn a brace for 20 hours every day since January, after doctors measured a 27-degree curve in her spine.

The seventh grader hasn’t let scoliosis keep her from activities including volleyball and basketball, which she plays without the brace.

But starting middle school this fall was sometimes tough when new children asked Kelli about the brace. She also had to start changing for gym class, making it obvious that she wears it.

But “if you just act like it’s no big deal,” then other kids will too, she said.

Kelli does have a difficult time picking up books from the bottom of her locker and tying her shoes, because the brace can dig into her upper thighs when she bends. And now she has to buy jeans and tops a little bit bigger to fit over the brace.

Otherwise, she’s gotten used to it and even nicknamed the brace “Shelly” since it feels like she’s wearing a shell.

24 December 2009

Cook With Stainless Steel

Aluminum may be a risk factor for breast cancer. To be cautious, avoid aluminum pots and pans, and aluminum-based deodorants.

Read more:

Like cadmium, aluminum is a metal that mimics estrogen. In addition, laboratory studies have shown that aluminum can cause direct damage to DNA in several biological systems. Although studies have not shown a direct causal link between aluminum and breast cancer risk (little work has been reported in this area), breast tissue has been shown to concentrate aluminum and it is found in highest levels in the quadrant of the breast near the underarm region, the same area where the highest proportion of breast cancers are originally diagnosed.
Read more:
Use alternatives to cooking utensils made out of aluminum, especially those that are older. Instead use pots or pans made out of stainless steel or cast iron. Newer anodized aluminum pots and pans are considerably safer than older, non-anodized forms as the process of anodizing prevents the aluminum from leaching into food as it is being cooked.

One other possible source of aluminum in breast tissue may be use of underarm antiperspirants. Try to avoid using underarm cosmetics that contain aluminum. Check for safer alternatives at the Environmental Working Group’s Safe Cosmetics database or use home-made solutions like diluted baking soda.

21 December 2009

Try Meditation to Lower Your Blood Pressure and Protect Your Heart

Meditation is no longer just for the groovy folk. A just published study in the American Journal of Hypertension suggests the practice may bring cardiovascular and mental-health benefits. The research, conducted at American University in Washington, followed 298 students, half of whom practiced transcendental meditation for 20 minutes once or twice daily over three months and half of whom did not. Results: A subgroup of subjects in the meditation group who were at increased risk for hypertension significantly lowered their blood pressure and psychological distress and also bolstered their coping ability. The average reduction in blood pressure in this group—a 6.3-mm Hg decrease in the top (systolic) number of a blood pressure reading and a 4-mm Hg decrease in the lower (diastolic) number, compared with the control group—was associated with a 52 percent reduction in the risk of developing hypertension in the future. Meditators who were not at increased risk for hypertension saw a reduction in psychological distress, depression, and anxiety as well as increased coping ability but no significant lowering of blood pressure.

The results are particularly meaningful at a time when "improvement in mental health is of great concern as greater numbers of college students are being treated for anxiety and depression than ever before," says lead study author, Sanford Nidich, professor of physiology and health at the Institute for Natural Medicine and Prevention at Maharishi University of Management in Iowa.
Lately, meditation has been garnering attention from a host of medical and scientific researchers. More than 120 meditation studies are listed on, a clearinghouse for research supported by the National Institutes of Health, investigating the intervention in patients with conditions from cancer and heart disease to post-traumatic stress disorder, insomnia, and binge eating. It's no cure-all, but early research is suggesting meditation could play a helpful role in mediating the stress response that contributes to a number of physical and mental conditions.

In a country famous for medical innovation and high-tech treatments—not to mention their high cost—Americans, too, have begun to embrace complementary and alternative interventions like meditation, acupuncture, and "natural" supplements. According to a recent study sponsored by the NIH's National Center for Complementary and Alternative Medicine, more than 1 in 3 adults sought such healthcare in 2007—and collectively spent $40 billion out of pocket. But with the exception of the classes, books, or CDs one might buy to learn the ins and outs of "om," focusing on one's breath, or becoming more mindful, the practice of meditation is free.

One simple thing seems clear: Find a type of meditation that you like. "What's really important," says Richard Davidson, neuroscience and meditation researcher at the University of Wisconsin-Madison," is that a person find a particular style [of meditation] they're comfortable with so they continue to practice." Some styles train practitioners to focus on an object or a mantra; others cultivate positive emotions; others still aim to train practitioners not to judge thoughts that arise but to just accept them and not get attached. More meditation, it seems, offers stronger effects; Davidson's research on monks who had practiced for tens of thousands of hours in their lifetimes managed to change their brains' functioning and structure. Benefits appear to be attainable with less of a time commitment, he adds—perhaps somewhere between 20 and 40 minutes daily.

That Tap Water Is Legal but May Be Unhealthy

The 35-year-old federal law regulating tap water is so out of date that the water Americans drink can pose what scientists say are serious health risks — and still be legal.

Only 91 contaminants are regulated by the Safe Drinking Water Act, yet more than 60,000 chemicals are used within the United States, according to Environmental Protection Agency estimates. Government and independent scientists have scrutinized thousands of those chemicals in recent decades, and identified hundreds associated with a risk of cancer and other diseases at small concentrations in drinking water, according to an analysis of government records by The New York Times.

But not one chemical has been added to the list of those regulated by the Safe Drinking Water Act since 2000.

Other recent studies have found that even some chemicals regulated by that law pose risks at much smaller concentrations than previously known. However, many of the act’s standards for those chemicals have not been updated since the 1980s, and some remain essentially unchanged since the law was passed in 1974.

All told, more than 62 million Americans have been exposed since 2004 to drinking water that did not meet at least one commonly used government health guideline intended to help protect people from cancer or serious disease, according to an analysis by The Times of more than 19 million drinking-water test results from the District of Columbia and the 45 states that made data available.

In some cases, people have been exposed for years to water that did not meet those guidelines.

But because such guidelines were never incorporated into the Safe Drinking Water Act, the vast majority of that water never violated the law.

Some officials overseeing local water systems have tried to go above and beyond what is legally required. But they have encountered resistance, sometimes from the very residents they are trying to protect, who say that if their water is legal it must be safe.

Dr. Pankaj Parekh, director of the water quality division for the City of Los Angeles, has faced such criticism. The water in some city reservoirs has contained contaminants that become likely cancer-causing compounds when exposed to sunlight.

To stop the carcinogens from forming, the city covered the surface of reservoirs, including one in the upscale neighborhood of Silver Lake, with a blanket of black plastic balls that blocked the sun.

Then complaints started from owners of expensive houses around the reservoir. “They supposedly discovered these chemicals, and then they ruined the reservoir by putting black pimples all over it,” said Laurie Pepper, whose home overlooks the manmade lake. “If the water is so dangerous, why can’t they tell us what laws it’s violated?”

Dr. Parekh has struggled to make his case. “People don’t understand that just because water is technically legal, it can still present health risks,” he said. “And so we encounter opposition that can become very personal.”

Some federal regulators have tried to help officials like Dr. Parekh by pushing to tighten drinking water standards for chemicals like industrial solvents, as well as a rocket fuel additive that has polluted drinking water sources in Southern California and elsewhere. But those efforts have often been blocked by industry lobbying.

Drinking water that does not meet a federal health guideline will not necessarily make someone ill. Many contaminants are hazardous only if consumed for years. And some researchers argue that even toxic chemicals, when consumed at extremely low doses over long periods, pose few risks. Others argue that the cost of removing minute concentrations of chemicals from drinking water does not equal the benefits.

Moreover, many of the thousands of chemicals that have not been analyzed may be harmless. And researchers caution that such science is complicated, often based on extrapolations from animal studies, and sometimes hard to apply nationwide, particularly given that more than 57,400 water systems in this country each deliver, essentially, a different glass of water every day.

Government scientists now generally agree, however, that many chemicals commonly found in drinking water pose serious risks at low concentrations.

And independent studies in such journals as Reviews of Environmental Contamination and Toxicology; Environmental Health Perspectives; American Journal of Public Health; and Archives of Environmental and Occupational Health, as well as reports published by the National Academy of Sciences, suggest that millions of Americans become sick each year from drinking contaminated water, with maladies from upset stomachs to cancer and birth defects.

18 December 2009

Drinking cups of tea and coffee 'can prevent diabetes'

Tea and coffee drinkers have a lower risk of developing type 2 diabetes, a large body of evidence shows.

And the protection may not be down to caffeine since decaf coffee has the greatest effect, say researchers in Archives of Internal Medicine.

They looked at 18 separate studies involving nearly 500,000 people.

This analysis revealed that people who drink three or four cups of coffee or tea a day cut their risk by a fifth or more, say researchers.

The same amount of decaffeinated coffee had an even bigger effect, lowering risk by a third.

Type 2 diabetes usually starts after the age of 40 and develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly. Type 2 diabetes is treated with a healthy diet and increased physical activity. In addition to this, medication and/or insulin is often required.

If the findings prove true, doctors may well start advising people to put the kettle on as well as take more exercise and watch their weight, say the researchers.

When the authors combined and analysed the data, they found that each additional cup of coffee consumed in a day cut diabetes risk by 7%.

Lead researcher Dr Rachel Huxley, from the University of Sydney in Australia, said because of the finding with decaffeinated coffee, the link is unlikely to be solely related to caffeine.

Instead, other compounds in coffee and tea - including magnesium and antioxidants known as lignans or chlorogenic acids - may be involved.

Special brew

"The identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus.

"If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes mellitus, or who are at future risk of developing it, would be substantial."

Dr Victoria King, of Diabetes UK, said: "Without full information about what other factors may be influencing the type 2 diabetes risk of the studies' participants - such as their physical activity levels and diet - as well as what the active ingredient in tea or coffee appears to be, we cannot be sure what, if anything, this observed effect is down to.

"What we can be sure of is that the development of type 2 diabetes is strongly linked to lifestyle, which means that many cases could be prevented by keeping active and eating a healthy balanced diet that is low in fat, salt and sugar with plenty of fruit and vegetables."

Antidepressants linked to increased stroke risk

MIddle-aged women who take antidepressants are at an increased risk of stroke, a major study has found.

A large study of women who have been through the menopause found those taking antidepressants were 45 per cent more likely to suffer a stroke than those of the same age not on the medicines.

The research also found that overall death rates were 32 per cent higher in women on the drugs.

Experts said patients would have to weigh the benefits of the drugs against the increased risk, adding that depression was a serious condition in itself that could prove fatal.

Antidepressants are one of the most commonly prescribed medicines in Britain and in 2008 there were 36 million prescriptions dispensed in England. It means around three million people were taking antidepressants in England last year.

The findings are from an analysis of the wider Women's Health Initiative Study and involved 136,000 women aged between 50 and 79.

Comparisons were made between the 5,500 women were had been prescribed antidepressants since being enrolled in the research and those who had not. There was no difference in the rates of heart attacks but those on antidepressants were 45 per cent more likely to suffer a stroke.

It is not known why there is a link and the researchers said they could not rule out that some of the effect may be due to the depression rather than just the drugs.

The drugs may affect how blood clots, the study said.

The findings were published in the journal Archives of Internal Medicine.

Lead author Dr Jordan Smoller, of the Massachusetts General Hospital, in Boston, America, wrote: "Although these results raise concerns about adverse effects of antidepressants, it is important to note that depression itself has been implicated as a risk factor for coronary heart disease, stroke, early death, and other adverse outcomes. In addition, inadequately treated depression is associated with substantial disability, impairments in quality of life, and health care costs.

"Nevertheless, our results suggest that physicians should be vigilant about controlling other modifiable cardiovascular risk factors in women taking antidepressants. Further research is needed to clarify the risk-benefit ratio of antidepressant use among older women."

The researchers said the risk of an individual woman suffering a stroke is low so even with the increase it remains relatively rare.

They said in the study the chance of an individual woman suffering a stroke in one year was 0.3 per cent for those not taking antidepressants and was 0.43 for those on the medicines.

They added that despite this, because antidepressants are prescribed in such large volumes there are important implications for public health.

Dr Jordan Smoller said: "While this study did find an association between antidepressants and cardiovascular events, additional research needs to be done to determine exactly what it signifies.

"Older women taking antidepressants, like everyone else, should also work on modifying their other risk factors for cardiovascular disease, such as maintaining a healthy weight and controlling cholesterol levels and blood pressure."

Joanne Murphy, Research Liaison Officer for The Stroke Association said: "This study seems to show a link between antidepressants and stroke; however the overall risk for women taking antidepressants is relatively small. More research needs to be done to determine the actual causes.

"We are already aware of links between depression and the risk of stroke and we are currently funding further studies to look into this.

"Everyone can help reduce their risk of stroke by making lifestyle changes, such as reducing their blood pressure, giving up smoking, reducing alcohol intake, improving their diet and getting plenty of exercise. Anyone who is at all concerned should consult their GP."

17 December 2009

Body clock link to heart disease

Scientists have raised the possibility that cardiovascular disease is linked to disturbances in the body's 24-hour clock.

Working on mice, the Japanese team found a genetic risk factor for a form of high blood pressure is influenced by 24-hour or circadian rhythms.

The study appears online in the journal Nature Medicine.

Malfunctions in the body clock - which influences much of the body's chemistry - have been linked to many diseases.

And lead researcher Professor Hitoshi Okamura said the latest study was in line with data which suggested shift workers, long-distance flight crews and people with sleep disorders have a heightened risk of heart problems.

High blood pressure - known as hypertension - can lead to heart attack, stroke, kidney damage, and many other medical problems.

Many genes have been identified as being essential elements making up the circadian clock.

For example, mice lacking a pair of molecules known as cryptochromes have an abnormal circadian rhythm.

The latest study, by Kyoto University, found these mice were vulnerable to high blood pressure because of abnormally high levels of a hormone called aldosterone that prompts water retention in the kidneys.

Strong correlation

The researchers showed that the circadian clock directly controls a gene that plays a key role in production of the hormone.

The researchers say a similar gene is found in humans.

They stress more work is needed to determine whether a misfiring circadian clock can lead to high blood pressure in humans.

But Professor Okamura said the research raised the prospect of new ways to treat hypertension.

Professor Bryan Williams, an expert in hypertension at the University of Leicester, described the study as "fascinating".

He said: "We know that there is a strong correlation between time of day and cardiovascular events, which often coincide with the early morning surge in blood pressure.

"So this does provide some insights into the mechanism that might underpin blood pressure deregulation in some people."

Professor Williams said some people with high blood pressure were known to have high levels of aldosterone.

But he added: "What we don't know is how common this mutation might be in human hypertension."

Professor Jeremy Pearson, associate medical director at the British Heart Foundation, said: "Hypertension is common, but the genes controlling blood pressure are not well understood.

"Their identification will help design better treatments for high blood pressure."

But he also stressed more research was needed before it became clear whether the study had identified a potential target for new treatments.

Fat in diet won't affect weight gain over time

The percentage of calories that a person got from fat, as opposed to protein or carbohydrates, had nothing to do with how much weight they gained in the coming years, the research team found.

The kinds of fat they ate didn't matter either, Dr. Nita Forouhi of the Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK and her colleagues found.

The findings, Forouhi noted in an email to Reuters Health, show that "it is more important to aim for a healthy lifestyle including a balanced healthy diet and regular physical activity, than to focus on fat intake alone as a factor for weight gain."

The role of dietary fat content in obesity and weight gain is still controversial, Forouhi and her team note. To investigate, they looked at data on nearly 90,000 men and women from six different countries participating in the European Prospective Investigation into Cancer and Nutrition Study. Participants were followed for up to 10 years.

Average fat intake ranged from 31.5 percent to 36.5 percent of total calories. On average, people gained about a quarter of a pound every year. But analyses that accounted for several factors found no relationship between how much weight people gained and how much fat they ate, or their intake of polyunsaturated fats versus saturated fats.

The findings shouldn't be seen as showing that people can eat as much fat as they want, Forouhi said. "That would be absurd, given so much evidence that already exists on the potential harms of diets high in saturated or trans-fats for heart health for instance," the researcher said.

In the US, she added, dietary recommendations state that people should maintain a fat intake that is 20 percent to 35 percent of total calories, and eat "healthy" fats from fish, nuts, and vegetable oils instead of "unhealthy" saturated and trans fats.

She added: "The healthiest way to avoid weight gain is to make sure that, when appropriate, total calorie intake is limited by reducing one's intake of added sugars, fats, and alcohol, which all provide calories but few or no essential nutrients, to watch portion sizes of food (so food portions consumed do not increase in size over time), and at the same time take regular physical activity."

SOURCE: American Journal of Clinical Nutrition, December 200

Antioxidants may boost colon health: Study

Selenium-based antioxidant supplements may prevent the development of new colon polyps in people with a history of polyp formation, says a new study.

Over 400 people participated in the study, which saw them receive either placebo or a antioxidant-rich supplement containing selenomethionnine, zinc, and vitamins A, C, and E. At the end of the study people in the antioxidant group experienced a 40 per cent reduction in the incidence of new polyps of the large bowel.

“Our study is the first intervention trial specifically designed to evaluate the efficacy of the selenium-based antioxidant compound on the risk of developing metachronous adenomas,” said lead researcher Luigina Bonelli, MD, from Italy’s National Institute for Cancer Research in Genoa.

The study represents another step on the ladder of supporting the potential anti-cancer effects of the mineral. Earlier this year, the US Food and Drug Administration said there is “no credible evidence” to support qualified health claims for selenium dietary supplements and a reduced risk of urinary tract cancers other than bladder cancer, lung and other respiratory tract cancers, colon and other digestive tract cancers, brain cancer, liver cancer, or breast cancer.

The research findings are being presented at the American Association for Cancer Research Frontiers in Cancer Prevention Research Conference, held in Houston. NutraIngredients has not seen the full data.

Adenomatous polyps (or adenoma) are benign lesions of the large bowel that, in time, could progress to cancer, explain the researchers. Even though only a small proportion of adenomas will develop into cancer, it is said that almost 70 to 80 per cent of colorectal cancer stems from an adenoma.

Study details

Bonelli and her co-workers randomly assigned the 411 participants aged between 25 and 75 to receive either placebo or the antioxidant supplement. The supplement provided daily doses of 200 micrograms of selenomethionnine, 30 milligrams of zinc, 6,000 IU of vitamin A, 180 milligrams of vitamin C, and 30 milligrams of vitamin E. All the participants had already undergone surgery to remove one or more colorectal adenomas.

“Our results indicated that individuals who consumed antioxidants had a 40 per cent reduction in the incidence of metachronous adenomas of the large bowel,” said Bonelli. “It is noteworthy that the benefit observed after the conclusion of the trial persisted through 13 years of follow up.”

Selenium and prostate health – controversial or convincing?

While the science may be lacking for selenium and colon health, a greater body of science exists for the mineral and prostate health. However, this subject is controversial. A number of studies, most notably the Nutritional Prevention of Cancer study and the Alpha-tocopherol, Beta-carotene Cancer Prevention study, have reported that the nutrients, alone or in combination, may reduce the risk of prostate cancer.

With over half a million new cases of prostate cancer are diagnosed every year world wide, and the cancer directly causing over 200,000 deaths, potential preventive measures are highly desirable. Despite great promise over vitamin E and selenium, recent results from the Selenium and Vitamin E Cancer Prevention Trial (SELECT) reported no significant differences between any of the groups in relation to prostate cancer risk.

The results were greeted with disappointment, while many in both academia and industry indicating that, given positive results from previous clinical trials and epidemiological studies, the design of SELECT, including the supplements used, may have undermined the results.

Oxygen Therapy Can Help Cluster Headaches

"It feels like a burning hot poker being shoved through your eye while an elephant stands on your temple, while someone is punching you in the back of the head and pulling on your hair," said Justin Ott, 31, when describing the pain of a cluster headache.

Ott has suffered from cluster headaches for 10 years, and was motivated to chronicle the debilitating pain -- sometimes called a "suicide headache" -- in a documentary film.

Doctors estimate only 0.3 percent of the population suffers from cluster headaches, and that men are much more likely to be affected.

"From when you first feel it start, and when it comes to full strength, it's five minutes, maybe," said Ott, a writer, producer, director and cinematographer from Weehawken, N.J. "Everybody's different, but if left untreated it can go on for 30 minutes to 60 minutes."

Now, new research suggests that sufferers like Ott can take advantage of a relatively simple treatment to help control the excruciating pain of cluster headaches -- a treatment called oxygen therapy.

Once a person feels a cluster headache coming on, he or she can often stop the headache in its tracks by breathing with a high-flow oxygen face mask.

Oxygen therapy has been used by some headache specialists for 30 years, but has, until now, been considered experimental because there have been no clinical trials proving its effectiveness. Researchers in the United Kingdom treated 76 adults with either high-flow oxygen or a placebo of high-flow normal air for 15 minutes.
Their study, published Tuesday in the Journal of the American Medical Association, found that 78 percent of those on oxygen reported immediate relief compared to only 20 percent receiving the placebo.

Dr. Allan Purdy of the Queen Elizabeth II Health Sciences Center in Canada said that he thought the research was an "excellent study… an evidence-based trial to confirm what we have known and used in practice for years."

Although the study was one of the first to investigate using oxygen to treat cluster headaches, Ott and other cluster headache survivors have taught each other to use the treatment for years.

"Oxygen really, is the best thing. If I'm at home and I get an attack, that's my first thing, is the oxygen," said Ott. "I have tanks all around my house."

14 December 2009

Adequate sleep tied to healthier diets in truckers

NEW YORK (Reuters Health) - Getting plenty of sleep not only helps keep truck drivers safe and alert on the road, it also seems to fuel healthy eating habits, new research hints.

In surveys of truckers working at U.S. trucking terminals, those who felt they regularly got adequate sleep tended to consume more fruits and vegetables and fewer sugary drinks and snacks, Dr. Orfeu M. Buxton, at Harvard Medical School in Boston, Massachusetts, and colleagues found.

These real-world findings are consistent with laboratory studies showing that insufficient sleep increases hunger and "induces greater eating, especially unnecessary snacking," Buxton noted in an email to Reuters Health.

Buxton and associates assessed self-reported diet, sleep, and job-related factors of 542 male Teamster union members who were 49 years old on average.

Sixty-six percent worked as pick-up and delivery truck drivers, 20 percent as over-the-road truckers, and 15 percent served dual roles as dockworkers and truck drivers, they note in the American Journal of Public Health.

Most of the workers (87 percent) were satisfied with their job and a little more than half (52 percent) said they got enough nightly shuteye "to feel rested upon waking up."

These well-rested truckers also said they ate an average of about 3 servings of fruits and vegetables (not including French fries), less than one serving of a sugar-added drink, and less than half a serving of a sugary snack daily.

By contrast, truckers reporting insufficient sleep reported eating about two fruit and vegetable servings, and slightly more than one sugary drink and nearly one sugary snack each day.

The investigators conclude that workplace programs to encourage adequate worker sleep may have positive benefits on employee health

The 7 foods experts won't eat

How healthy (or not) certain foods are—for us, for the environment—is a hotly debated topic among experts and consumers alike, and there are no easy answers. But when Prevention talked to the people at the forefront of food safety and asked them one simple question—“What foods do you avoid?”—we got some pretty interesting answers. Although these foods don’t necessarily make up a "banned” list, as you head into the holidays—and all the grocery shopping that comes with it—their answers are, well, food for thought:

1. Canned Tomatoes

The expert: Fredrick vom Saal, PhD, an endocrinologist at the University of Missouri who studies bisphenol-A

The problem: The resin linings of tin cans contain bisphenol-A, a synthetic estrogen that has been linked to ailments ranging from reproductive problems to heart disease, diabetes, and obesity. Unfortunately, acidity (a prominent characteristic of tomatoes) causes BPA to leach into your food. Studies show that the BPA in most people's body exceeds the amount that suppresses sperm production or causes chromosomal damage to the eggs of animals. "You can get 50 mcg of BPA per liter out of a tomato can, and that's a level that is going to impact people, particularly the young," says vom Saal. "I won't go near canned tomatoes."

The solution: Choose tomatoes in glass bottles (which do not need resin linings), such as the brands Bionaturae and Coluccio. You can also get several types in Tetra Pak boxes, like Trader Joe's and Pomi.

14 worst health mistakes even smart women make.

2. Corn-Fed Beef

The expert: Joel Salatin, co-owner of Polyface Farms and author of half a dozen books on sustainable farming

The problem: Cattle evolved to eat grass, not grains. But farmers today feed their animals corn and soybeans, which fatten up the animals faster for slaughter. More money for cattle farmers (and lower prices at the grocery store) means a lot less nutrition for us. A recent comprehensive study conducted by the USDA and researchers from Clemson University found that compared with corn-fed beef, grass-fed beef is higher in beta-carotene, vitamin E, omega-3s, conjugated linoleic acid (CLA), calcium, magnesium, and potassium; lower in inflammatory omega-6s; and lower in saturated fats that have been linked to heart disease. "We need to respect the fact that cows are herbivores, and that does not mean feeding them corn and chicken manure," says Salatin.

The solution: Buy grass-fed beef, which can be found at specialty grocers, farmers' markets, and nationally at Whole Foods. It's usually labeled because it demands a premium, but if you don't see it, ask your butcher.

25 ridiculously healthy foods you should be eating now.

3. Microwave Popcorn

The expert: Olga Naidenko, PhD, a senior scientist for the Environmental Working Group,

The problem: Chemicals, including perfluorooctanoic acid (PFOA), in the lining of the bag, are part of a class of compounds that may be linked to infertility in humans, according to a recent study from UCLA. In animal testing, the chemicals cause liver, testicular, and pancreatic cancer. Studies show that microwaving causes the chemicals to vaporize—and migrate into your popcorn. "They stay in your body for years and accumulate there," says Naidenko, which is why researchers worry that levels in humans could approach the amounts causing cancers in laboratory animals. DuPont and other manufacturers have promised to phase out PFOA by 2015 under a voluntary EPA plan, but millions of bags of popcorn will be sold between now and then.

The solution: Pop natural kernels the old-fashioned way: in a skillet. For flavorings, you can add real butter or dried seasonings, such as dillweed, vegetable flakes, or soup mix.

Your nutritional guide to grocery shopping.

4. Nonorganic Potatoes

The expert: Jeffrey Moyer, chair of the National Organic Standards Board

The problem: Root vegetables absorb herbicides, pesticides, and fungicides that wind up in soil. In the case of potatoes—the nation's most popular vegetable—they're treated with fungicides during the growing season, then sprayed with herbicides to kill off the fibrous vines before harvesting. After they're dug up, the potatoes are treated yet again to prevent them from sprouting. "Try this experiment: Buy a conventional potato in a store, and try to get it to sprout. It won't," says Moyer, who is also farm director of the Rodale Institute (also owned by Rodale Inc., the publisher of Prevention). "I've talked with potato growers who say point-blank they would never eat the potatoes they sell. They have separate plots where they grow potatoes for themselves without all the chemicals."

The solution: Buy organic potatoes. Washing isn't good enough if you're trying to remove chemicals that have been absorbed into the flesh.

14 ways to make veggies less boring.

5. Farmed Salmon

The expert: David Carpenter, MD, director of the Institute for Health and the Environment at the University at Albany and publisher of a major study in the journal Science on contamination in fish.

The problem: Nature didn't intend for salmon to be crammed into pens and fed soy, poultry litter, and hydrolyzed chicken feathers. As a result, farmed salmon is lower in vitamin D and higher in contaminants, including carcinogens, PCBs, brominated flame retardants, and pesticides such as dioxin and DDT. According to Carpenter, the most contaminated fish come from Northern Europe, which can be found on American menus. "You can only safely eat one of these salmon dinners every 5 months without increasing your risk of cancer," says Carpenter, whose 2004 fish contamination study got broad media attention. "It's that bad." Preliminary science has also linked DDT to diabetes and obesity, but some nutritionists believe the benefits of omega-3s outweigh the risks. There is also concern about the high level of antibiotics and pesticides used to treat these fish. When you eat farmed salmon, you get dosed with the same drugs and chemicals.

The solution: Switch to wild-caught Alaska salmon. If the package says fresh Atlantic, it's farmed. There are no commercial fisheries left for wild Atlantic salmon.

Delicious and easy fish recipes

6. Milk Produced with Artificial Hormones

The expert: Rick North, project director of the Campaign for Safe Food at the Oregon Physicians for Social Responsibility and former CEO of the Oregon division of the American Cancer Society

The problem: Milk producers treat their dairy cattle with recombinant bovine growth hormone (rBGH or rBST, as it is also known) to boost milk production. But rBGH also increases udder infections and even pus in the milk. It also leads to higher levels of a hormone called insulin-like growth factor in milk. In people, high levels of IGF-1 may contribute to breast, prostate, and colon cancers. "When the government approved rBGH, it was thought that IGF-1 from milk would be broken down in the human digestive tract," says North. As it turns out, the casein in milk protects most of it, according to several independent studies. "There's not 100% proof that this is increasing cancer in humans," admits North. "However, it's banned in most industrialized countries."

The solution: Check labels for rBGH-free, rBST-free, produced without artificial hormones, or organic milk. These phrases indicate rBGH-free products.

Don’t be fooled by these 11 health food imposters.

7. Conventional Apples

The expert: Mark Kastel, former executive for agribusiness and codirector of the Cornucopia Institute, a farm-policy research group that supports organic foods

The problem: If fall fruits held a "most doused in pesticides contest," apples would win. Why? They are individually grafted (descended from a single tree) so that each variety maintains its distinctive flavor. As such, apples don't develop resistance to pests and are sprayed frequently. The industry maintains that these residues are not harmful. But Kastel counters that it's just common sense to minimize exposure by avoiding the most doused produce, like apples. "Farm workers have higher rates of many cancers," he says. And increasing numbers of studies are starting to link a higher body burden of pesticides (from all sources) with Parkinson's disease.

The solution: Buy organic apples. If you can't afford organic, be sure to wash and peel them first.

11 December 2009

Omega-3 Fatty Acids May Reduce Risk of Colon Cancer

ScienceDaily (Dec. 8, 2009) — Long-chain omega-3 fatty acids, primarily found in fish and seafood, may have a role in colorectal cancer prevention, according to results presented at the American Association for Cancer Research Frontiers in Cancer Prevention Research Conference, held Dec. 6-9, 2009, in Houston.

"Experimental data have shown benefits of long-chain omega-3 fatty acids in colorectal carcinogenesis, ranging from reduced tumor growth, suppression of angiogenesis and inhibition of metastasis," said Sangmi Kim, Ph.D., a postdoctoral fellow at the National Institute of Environmental Health Sciences, Research Triangle Park, N.C. "Our finding of inverse association between dietary intakes of long-chain omega-3 fatty acids and distal large bowel cancer in white participants adds additional support to the hypothesis."

Although experimental and clinical data suggest that long-chain omega-3 fatty acids possess anti-neoplastic properties in the colon, epidemiologic data to date has been inconclusive.

Kim and colleagues studied the link between polyunsaturated fatty acid intake and distal large bowel cancer using data from a population-based control study. They recruited 1,509 white participants (716 cancer cases and 787 controls) and 369 black participants (213 cancer cases and 156 controls) using the State Cancer Registry and Division of Motor Vehicles records.

Nineteen polyunsaturated fatty acids were assessed using a validated food frequency questionnaire, which included 124 questions on food items. The researchers used the questionnaire to collect information on the frequency and amount of foods typically consumed in the past 12 months. Patients who consumed more long-chain omega-3 fatty acids had a reduced risk of distal large bowel cancer. Compared to the lowest quartile, fat intake in the highest quartile was linked with a 39 percent reduced risk of cancer.

The researchers detected these associations in white participants, but not in black participants.

"We were surprised that the association was not also observed among blacks," Kim said. "We considered several possible explanations but were not able to account for this difference with the data we had. This finding warrants future study, but we should be careful about drawing conclusions about potential racial differences in the benefit from long-chain omega-3 fatty acids from this study."

"An increase in dietary intake of long-chain omega-3 fatty acids, which mainly come from fish and seafood, may be beneficial in the prevention of distal large bowel cancer," Kim said.

Spices halt growth of breast stem cells, U-M study finds

Curcumin, piperine could play role in preventing breast cancer

ANN ARBOR, Mich. — A new study finds that compounds derived from the spices turmeric and pepper could help prevent breast cancer by limiting the growth of stem cells, the small number of cells that fuel a tumor’s growth.

Researchers at the University of Michigan Comprehensive Cancer Center have found that when the dietary compounds curcumin, which is derived from the Indian spice turmeric, and piperine, derived from black peppers, were applied to breast cells in culture, they decreased the number of stem cells while having no effect on normal differentiated cells.

“If we can limit the number of stem cells, we can limit the number of cells with potential to form tumors,” says lead author Madhuri Kakarala, M.D., Ph.D., R.D., clinical lecturer in internal medicine at the U-M Medical School and a research investigator at the VA Ann Arbor Healthcare System.

Cancer stem cells are the small number of cells within a tumor that fuel the tumor’s growth. Current chemotherapies do not work against these cells, which is why cancer recurs and spreads. Researchers believe that eliminating the cancer stem cells is key to controlling cancer. In addition, decreasing the number of normal stem cells – unspecialized cells that can give rise to any type of cell in that organ – can decrease the risk of cancer.

In this study, a solution of curcumin and piperine was applied to the cell cultures at the equivalent of about 20 times the potency of what could be consumed through diet. The compounds are available at this potency in a capsule form that could be taken by mouth. (Note: This work has not been tested in patients, and patients are not encouraged to add curcumin or piperine supplements to their diet at this time.)

The researchers applied a series of tests to the cells, looking at markers for breast stem cells and the effects of curcumin and piperine, both alone and combined, on the stem cell levels. They found that piperine enhanced the effects of curcumin, and that the compounds interrupted the self-renewal process that is the hallmark of cancer-initiating stem cells. At the same time, the compounds had no affect on cell differentiation, which is the normal process of cell development.

“This shows that these compounds are not toxic to normal breast tissue,” Kakarala says. “Women at high risk of breast cancer right now can choose to take the drugs tamoxifen or raloxifene for prevention, but most women won’t take these drugs because there is too much toxicity. The concept that dietary compounds can help is attractive, and curcumin and piperine appear to have very low toxicity.”

Curcumin and piperine have been explored by other researchers as a potential cancer treatment. But this paper, published online in the journal Breast Cancer Research and Treatment, is the first to suggest these dietary compounds could prevent cancer by targeting stem cells.

In addition, tamoxifen or raloxifene are designed to affect estrogen, which is a factor in most, but not all breast cancers. In fact, the aggressive tumors that tend to occur more often in women with a family history or genetic susceptibility are typically not affected by estrogen. Because curcumin and piperine limit the self renewal of stem cells, they would impact cancers that are not estrogen sensitive as well as those that are.

Researchers are planning an initial Phase I clinical trial to determine what dose of curcumin or piperine can be tolerated in people. The trial is not expected to begin accruing participants until spring.

Breast cancer statistics: 194,280 Americans will be diagnosed with breast cancer this year and 40,610 will die from the disease, according to the American Cancer Society

Additional authors: Dean Brenner, Hasan Korkaya, Connie Cheng, Karim Tazi, Christophe Ginestier, Suling Liu, Gabriel Dontu and Max Wicha, all from U-M

Feeding the World : Organic Production Delivers

Today's global population is around six billion people, and our dominant form of agriculture is based on using synthetic chemical inputs to produce high-yielding monocultures. Crops such as corn, wheat and soya are grown to be processed into foods for people, or for animals that then suffer short, miserable lives in factory conditions, before being fed to people as well.

According to population experts, by 2050 there will be nine billion of us. If our government-agreed target on greenhouse gas (GHG) is to be met, we will also have cut emissions by 80%. Oil and phosphate supplies, on which much modern agriculture is heavily dependent, will be tow. Climate change will present all kinds of challenges - with extreme and unpredictable weather events, increased flooding and drought. How can we meet the challenge of feeding more people in what will undoubtedly be a more resource-constrained and 'climate-difficult' future?

The current picture

Farming, food, forestry and land use change are together responsible for a third of total GHG emissions according to the International Panel on Climate Change (IPCC). Particularly in developed countries, a significant proportion of agricultural GHG emissions are nitrous oxide (N20), arising from the manufacture and use of artificial nitrogen fertiliser - N20 is around 300 times more powerful a GHG than CO2. However, the most significant GHG emissions associated with agriculture come from converting forests and permanent grassland to cropland, because this releases carbon stored in the soil.

Taking account of carbon stored in soil is vitally important when assessing the environmental impact of agriculture. Globally our soils are a carbon sink that hold more than five times as much carbon as all our forests. Organic farming, with its reliance on pasture rotation, grazing manure and compost to build fertility, generally stores more soil organic matter (and therefore carbon) than intensive farming, with its reliance on synthetic fertiliser. But because intensive systems currently dominate global systems, our soil is not sequestering as much carbon as it easil, could - Professor Pete Smith from the University of Aberdeen, who lead the agriculture work for the IPCC, estimates that better soil management could take around 4,000 million tons of CO2 out the atmosphere; a 'no brainer' he says in terms of trying to cut our GHG emissions.

Historically, the environmental cost of intensive agriculture has been justified by the high yields that such systems have produced. The policy of maximising food production has its origins in the food shortages caused by World War II. And modern methods do produce a lot of food; global increased yields have seen food production more than double since 1950 - all be it by an increasing inefficient use of non-renewable resources (oil at mineral phosphates, for example), and at huge cocost to our soil, water, wildlife and environment.

The problem is that much of this food has been produced in the developed world, with the help of subsidy that has the effect of reducing global prices - sometimes below the cost of production. Exporting these subsidised surpluses has frequently had the effect of making it impossible for farmers in developing countries to sell what they produce at a reasonable price. Intensive farming has gone hand in hand with increased control of the food chain by a smaller number of large companies (although many thriving small and artisan producers are increasingly bucking this trend).

Farmers in the global South haven't been able to compete on price, so have been encouraged, often through active development policy, to rely on growing cash-crops for export in order to earn enough to buy the food they need to eat. Today, while there is more than enough food in the world to feed us all comfortably, around one billion people in the developing world are going hungry each day.

Radical change?

If change to our food and farming systems is needed in the wake of the 'perfect storm of population growth, climate change, diet related ill-health and diminishing resources, what should it look like? The bio-tech and agribusiness sectors have not been slow to suggest that even more intensification of agriculture, based on new technology such as genetic modification (GM), is the only way to guarantee higher yields.

The aphorism that only GM and high-input farming can drive high-yields is accepted by many policy makers. However, this assumption isn't backed up by evidence. In recent years several studies have started to examine how yields in organic and low-input systems compare to intensive systems of farming. In 2006 a paper by Catherine Badgley found that, while yields from organic systems in temperate regions were typically 9% less than in non-organic systems, in. tropical regions, organic agriculture can increase yields by over 50%, with the possibility of more than doubling the production of some types of food. A report in 2006, by the UN Conference on Trade and Development (UNCTAD), based on 114 studies in Africa, found that organic agriculture could increase yields by up to 116% - more than double.

Combined with ecological, environmental and social benefits, the report was clear that these yields meant organic agriculture in the developing world could guarantee both food supply and equitable development.

This evidence is backed by Gathuru Mburu, the director of the Institute for Culture and Ecology (ICE) in Kenya, who has been working with communities in the Lari Division of central Kenya to move away from farming tea for export, and towards using indigenous seeds and plant varieties to organically farm food for consumption. 'The community was growing tea, in order to sell it and then buy food,' Mburu explains. 'But they weren't receiving enough income to cover their costs, because the price was controlled by the global market. We've encouraged them to take control by growing food to eat.' In 18 months since they started the project, the 100 or so households have produced enough surplus to sell at the local market; this in a time when 10 million Kenyans are heading towards famine brought on by the failure of the (intensively farmed, non-indigenous) maize crop.

Hand Sanitizer: Good Hygiene or Just Hype?

The H1N1 flu pandemic has made cleanliness a national obsession. From classrooms to theme parks, Americans are being reminded to wash their hands to prevent the spread of the flu.

But when soap and a sink aren't close by, people rely on the convenience of hand sanitizer.

Sales of the disinfecting gel are soaring, up more than 70 percent since this time last year, according to research by the Nielsen Company.

Casey Beard is a self-proclaimed "germ freak" who uses hand sanitizer up to 40 times a day. He keeps bottles in his bathroom, kitchen, bedroom and car. He even went as far as purchasing hand sanitizer for colleagues at his office. While he's always been wary of germs, reports of the H1N1 virus have made him even more diligent about hygiene.

"I hate shaking people's hands who I know are sick, but if they're not visibly sick or audibly sick, I'm completely OK with it -- because I have hand sanitizer everywhere," he said.

He uses it most frequently when commuting to work or traveling, but he's even careful to use it in his own car.

"The second I get in the car, I like to do a squirt there and rub it on my steering wheel," he said.

His methods may seem excessive, but it's hard to argue with the result.

"I haven't been sick in three years," said Beard.
Sandra Turco is the mother of two daughters, and she keeps the hand sanitizer close at all times.

In the wake of the H1N1 flu outbreak, she's focused on keeping her family healthy. She reminds her eight-year-old daughter to use hand sanitizer during the school day, especially before recess and when she gets off the school bus.

Turco's daughter Allesandra is well trained.

"She said use it a lot," Allesandra said. "It's sort of a pain because mommy always tells me to."

"We have not been sick, knock on wood," said Turco. "So far, we've had a lot of friends who have had the H1N1 [virus], so we were exposed to them. And I'm not sure if it was the hand sanitizer that did it, but we're still healthy and going strong."

How Clean Is Your Drinking Water?

Officials from the U.S. Environmental Protection Agency were under fire today as members of Congress demanded an explanation into reports that the agency has not enforced violations of the Safe Drinking Water Act.

The enforcement chief at the EPA responded by announcing new enforcement protocols designed to determine the most serious and repeating water pollution offenders and established a new mechanism to hold violators responsible.

"The new enforcement approach that we announced today is intended to target the violations that we find," Cynthia Giles, assistant administrator for enforcement and compliance assurance at the EPA, said. "What we are doing is implementing a targeting system that will identify the health threats where there's violation of health-based standards, and especially where there's been repeated violations at a system, and put those to the top of the list for enforcement potential."
The chairwoman of the Senate Environmental and Public Works Committee, Sen. Barbara Boxer, D-Calif., dismissed Giles' plan as "bureaucratic rhetoric," emphasizing that state and local water quality agencies are the first line of defense to ensure the water is safe enough to drink.

"We already know kids are being exposed to these contaminants and they're deadly and we already know there are problems," Boxer said. "We're not tracking schools, we're tracking public systems. And we don't know which public systems serve the schools. I need a lot more specificity from you. I'm not confident that we are now ready to go."

The Safe Drinking Water Act of 1974 does not authorize the EPA to monitor schools directly. Instead, the agency depends on the schools' water providers to comply with its monitoring requirements, and it relies on states to enforce violations.

A New York Times report published today said that more than 49 million people in the United States were exposed to drinking water containing illegal concentrations of chemicals like arsenic and radioactive substances, such as uranium. The report also found that just 6 percent of drinking water violations were actually enforced since 2004.

10 December 2009

Pregnant Women's Bodies Polluted With Chemicals Found In Consumer Products

The "Earliest Exposures" study, a research project conducted by Washington Toxics Coalition in collaboration with the Commonweal Biomonitoring Resource Center and the Toxic-Free Legacy Coalition found pregnant women's bodies were polluted with chemicals found in consumer products. This first-of-its kind study investigated the living environment of nine fetuses through testing the blood and urine of the nine mothers taking part in the biomonitoring study. Tests measured the levels of five chemical groups, including phthalates, mercury, perfluorinated compounds or "Teflon chemicals," bisphenol A (BPA), and the flame retardant tetrabromobisphenol A.

The women, all in their second trimester, were all found to have BPA, phthalates, mercury, and "Teflon chemicals" in their bodies. Cause for concern is that these toxic chemicals, known to disrupt development and hormonal systems cross the placenta and are absorbed by the fetus. They not only hinder fetal development, but the growing fetus has limited ability to detoxify these foreign substances.

Of the more than 80,000 chemicals found in consumer products today, only approximately 200 have been tested for safety since the inception of The Toxic Substances Control Act (TSCA) of 1976. Until more strict regulations govern the use of ingredients in consumer products, consumers can take an active role in lowering their toxic exposure. Start by purchasing Phthalate and BPA free products, switching from flame retardant clothing and bedding to organic, and substituting conventional body care for third-party certified organic body care.

Karen Ciesar, Founder and Formulator of Trillium Organics states, "I am sadly not surprised at these findings. The pervasiveness of petrochemicals in the modern world makes avoiding exposures a task which requires research and vigilance. Luckily, there are many non-profit organizations dedicated to informing consumers, some of my favorites are; (searchable database of cosmetic safety), (searchable database of family product safety),, a comprehensive and informative site about environmental exposures, (an activist website about all issues surrounding Organic, food, personal care and fibers). It takes some time and effort to find safe products for your family, but every green purchasing choice you make increases your child's chance at a healthy future in a greener world."

Trillium Organics has recently been endorsed by the Organic Consumers' Association as a "brand to trust" in their recent BUYcott campaign. Trillium Organics has been a leader in the movement for clean, safe personal care since 1994.

LONDON (Reuters) - Measuring body mass index or waist size in overweight people can accurately predict the risk of heart disease, Dutch scientists

A large 10-year study found that half of all fatal heart disease cases and a quarter of all non-fatal cases are linked to being overweight and having a high body mass index (BMI) or large waist.

Body mass index and waist circumference are well known risk factors for cardiovascular diseases but the Dutch researchers said their work showed BMI and waist size could actually help predict the risk of dying from or developing heart disease.

"What this study shows is the substantial effect which (being) overweight and obesity have on cardiovascular disease, whether fatal of non-fatal," said Ineke van Dis from the Netherlands Heart Foundation, who led the study.

"In the near future the impact of obesity on the burden of heart disease will be even greater."

Dis and colleagues at the monitoring project on risk factors for chronic diseases at the Dutch National Institute for Public Health and the Environment measured between both BMI and waist circumference in 20,500 men and women 1993 and 1997.

When age-adjusted BMI and waist sizes were correlated with hospital records and cause-of-death data over 10 years, more than half (53 percent) of all fatal heart disease cases and around a quarter (25-30 percent) of all non-fatal cases were in people defined as overweight and obese.

Overweight people are defined as having a BMI of between 25 and 30 and obese people of 30 or more, according to the World Health Organization (WHO). BMI is calculated by dividing weight in kilograms by height in meters squared.

Waist circumference measurements in men were defined as between 94 and 101.9 cm for overweight and more than 102 cm for obese. In women these measurements were 80-87.9 cm for overweight and more than 88 cm for obese.

Obesity is increasing throughout the world and is now recognized as a major global public health concern.

"These findings underline the need for policies and activities to prevent overweight in the general population," Dis said in the study, which was published in the European Journal of Cardiovascular Prevention and Rehabilitation.

8 December 2009

Breast-feeding may protect moms' health

Breast-feeding may offer mothers long-term protection against a condition linked to diabetes and heart disease, researchers report today.
The longer women breast-fed, the lower their chance of developing metabolic syndrome, a cluster of risk factors such as high blood pressure and high triglycerides associated with obesity, the scientists found.

"Pregnancy may have some adverse effects on some of these cardiovascular risk factors," lead author Erica Gunderson says, "and lactation (breast-feeding) may offset some of these effects."

The impact of breast-feeding on the risk of metabolic syndrome was "slightly stronger" in women who'd had gestational — or pregnancy-induced — diabetes, says Gunderson, an epidemiologist and research scientist at Kaiser Permanente's Division of Research in Oakland. "This is the first study to really look at lactation and the metabolic syndrome in women with GDM (gestational diabetes)."

Kavitha T. Ram, a New York Medical College obstetrician/gynecologist, called the study's suggestion that breast-feeding might reverse the metabolic changes associated with gestational diabetes exciting. "There's this emerging evidence that breast-feeding may confer long-term health benefits to the mom," says Ram, who wasn't involved in the study.

About 18%-37% of U.S. women ages 20 to 59 have metabolic syndrome, Gunderson says. A study she published in August found women with gestational diabetes are 2½ times more likely than other women to develop the condition after pregnancy.

Gunderson and her co-authors based their new findings on 704 women in an ongoing, government-funded study of heart-disease risk factors. When the women entered the study in 1985-1986, they were ages 18-30 and had never given birth; testing confirmed they didn't have metabolic syndrome.

They all went on to deliver at least one child; only 16% had more than two children. They returned for measurements of metabolic syndrome components seven, 10, 15 and 20 years after entering the study; 120 developed metabolic syndrome.

In women who didn't have gestational diabetes, breast-feeding cut metabolic syndrome risk 39%-56%. In those who did, it cut the risk 44%-86%. In both, the authors write in Diabetes: The Journal of the American Diabetes Association, the longer women breast-fed, the lower their risk.

Breast-feeding is associated with a quicker loss of pregnancy weight, but that's only "a little bit of the explanation," Gunderson says. Another possibility, she says: Breast-feeding might minimize the accumulation of belly fat, fat linked to type 2 diabetes risk.

Green Tea Chemical Combined With Another May Hold Promise for Treatment of Brain Disorders

Scientists at Boston Biomedical Research Institute (BBRI) and the University of Pennsylvania have found that combining two chemicals, one of which is the green tea component EGCG, can prevent and destroy a variety of protein structures known as amyloids. Amyloids are the primary culprits in fatal brain disorders such as Alzheimer's, Huntington's, and Parkinson's diseases. Their study, published in the current issue of Nature Chemical Biology (December 2009), may ultimately contribute to future therapies for these diseases.

"These findings are significant because it is the first time a combination of specific chemicals has successfully destroyed diverse forms of amyloids at the same time," says Dr. Martin Duennwald of BBRI, who co-led the study with Dr. James Shorter of University of Pennsylvania School of Medicine.

For decades a major goal of neurological research has been finding a way to prevent the formation of and to break up and destroy amyloid plaques in the brains and nervous systems of people with Alzheimer's and other degenerative diseases before they wreak havoc.

Amyloid plaques are tightly packed sheets of proteins that infiltrate the brain. These plaques, which are stable and seemingly impenetrable, fill nerve cells or wrap around brain tissues and eventually (as in the case of Alzheimer's) suffocate vital neurons or brain cells, causing loss of memory, language, motor function and eventually premature death.

To date, researchers have had no success in destroying plaques in the human brain and only minimal success in the laboratory. One reason for these difficulties in finding compounds that can dissolve amyloids is their immense stability and their complex composition.

Yet, Duennwald experienced success in previous studies when he exposed amyloids in living yeast cells to EGCG. Furthermore, he and his collaborators also found before that DAPH-12, too, inhibits amyloid production in yeast.

In their new study, the team decided to look in more detail at the impact of these two chemicals on the production of different amyloids produced by the yeast amyloid protein known as PSI+. They chose this yeast amyloid protein because it has been studied extensively in the past, and because it produces varieties of amyloid structures that are prototypes of those found in the damaged human brain. Thus, PSI+ amyloids are excellent experimental paradigms to study basic properties of all amyloid proteins.

The team's first step was to expose two different amyloid structures produced by yeast (e.g., a weak version and a strong version) to EGCG. They found that the EGCG effectively dissolved the amyloids in the weaker version. To their surprise, they found that the stronger amyloids were not dissolved and that some transformed to even stronger versions after exposure to EGCG.

The team then exposed the yeast amyloid structures to a combination of the EGCG and the DAPH-12 and found that all of the amyloid structures broke apart and dissolved.

The next steps for the research team will be to explore the mechanism and potency of such a combinatorial therapy for the treatment of diverse neurodegenerative diseases.

"Our findings are certainly preliminary and we need further work to fully comprehend the effects of EGCG in combination with other chemicals on amyloids. Yet, we see our study as a very exciting initial step towards combinatorial therapies for the treatment of amyloid-based diseases," says Duennwald.

Cigarette smoking increases colorectal cancer risk

PHILADELPHIA – New study results strengthen the evidence that people who smoke cigarettes over a long period of time have an increased risk for developing colorectal cancer, even after adjusting for other risk factors.

"This provides one more reason not to smoke, or to quit as soon as possible," said senior author Michael J. Thun, M.D., M.S., vice president emeritus, epidemiology and surveillance research at the American Cancer Society. "Colorectal cancer should be added to the list of cancers caused by smoking."

Findings are published in the December issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, as part of a special focus on tobacco.

Thun and colleagues tested the association between long-term cigarette smoking and colorectal cancer after adjusting for multiple other factors that are generally associated with risk, including screening. From 1992 through 2005 the researchers followed almost 185,000 participants aged 50 to 74 years old; participants described their behaviors and medical conditions.

Participants who smoked cigarettes for 40 or more years, or who did not quit before age 40, had a 30 percent to 50 percent increased risk of developing colon or rectal cancer during the follow-up, even in analyses that adjusted for 13 other potential risk factors, according to Thun. After 13 years of follow-up, the researchers identified 1,962 cases of invasive colorectal cancer.

While previous large studies conducted in long-term smokers showed similar results, Thun stated that this study is the first to control for screening and all of the suspected risk factors for colorectal cancer, such as alcohol consumption, physical inactivity and consumption of red or processed meat.

"These findings contributed to the evidence recently reviewed by the International Agency for Research on Cancer (IARC) in October of this year," Thun said. "IARC upgraded the evidence that smoking causes colorectal cancer from 'limited' to 'sufficient'."

This IARC reclassification brings the number of cancer organ sites causally related to cigarette use to 17, which includes cancers of the oral cavity, pharynx, nasopharynx, nasal cavity and paranasal sinuses, larynx, lung, esophagus (both squamous cell and adenocarcinoma), stomach, colorectum, liver, pancreas, kidney (both renal cell and transitional cell carcinoma), urinary bladder and lower urinary tract, uterine, cervix, and myeloid leukemia.

7 December 2009

Calcium and vit D show promise for colorectal health

Supplements of calcium and vitamin D may promote the health of the cells in the colon and rectum, offering potential protection from tumour development, says a new study.

The mineral-vitamin combination was found to normalise the health of cells in the colon and rectum, according to findings published in Cancer Epidemiology, Biomarkers & Prevention.

Researchers from Emory University, the University of Minnesota, and the National Cancer Institute and the National Institutes of Health conducted a pilot, randomized, double-blind, placebo-controlled, clinical trial in 92 men and women with a history of benign colorectal tumours.

Led by Veronika Fedirko, the researchers randomly assigned the participants to receive daily calcium (2.0 g) and/or vitamin D3 supplements (800 IU), or placebo for six months.

Markers of the health of cells were found to increase by 201, 242, and 25 per cent in the calcium, vitamin D, and calcium plus vitamin D groups relative to the placebo, said the researchers.

“These results indicate that calcium and vitamin D promote colorectal epithelial cell differentiation and may ‘normalize’ the colorectal crypt proliferative zone in sporadic adenoma patients, and support further investigation of calcium and vitamin D as chemopreventive agents against colorectal neoplasms,” wrote Febirko and her co-workers.

A wider view of the science

The potential benefits for the vitamin-mineral combination in relation to colorectal cancer is somewhat controversial, with some studies reporting benefits while others report null results.

Indeed, back in 2006 results from the Women's Health Initiative (WHI) stated that daily supplements of vitamin D and calcium 'had no effect' on the risk of colorectal cancer. The results were questioned however and independent cancer experts said at the time that the claims should be interpreted in the light of the complexities of the study.

Michele Forman and Bernard Levin from the MD Anderson Cancer Center at the University of Texas, noted that the WHI trial had three overlapping components, with 69 per cent of the women enrolled on the Dietary Modification trial, 54 per cent enrolled on the Hormone Therapy trial, and 14 per cent enrolled on both.

"The enrolment in three overlapping trials maximised the participation and size of the WHI trial but created a complex approach with potential confounders for biological interpretation," said Forman and Levin.

Colorectal cancer accounts for nine per cent of new cancer cases every year worldwide. The highest incidence rates are in the developed world, while Asia and Africa have the lowest incidence rates.

It remains one of the most curable cancers if diagnosis is made early.

4 December 2009

The Flu Fighters—in Your Food

While many people are still waiting for swine-flu vaccine to become available in their area, there is a lot they can do in their own kitchens to help fight off disease and build a strong immune system.

Scientists in the growing field of nutritional immunology are unveiling new evidence of the complex role that nutrition plays in fighting off infectious diseases like influenza. A diet rich in nutrients such as vitamin A, found in colorful fruits and vegetables, and zinc, found in seafood, nuts and whole grains, can provide the critical fuel the body needs to fight off disease, heal injuries, and survive illness when it does strike, experts say.

Scientists are still studying all the complex ways in which nutrients interact with the immune system. There is still much that they don't know about minerals such as zinc, for instance, including how they are absorbed and all the roles they play in the body. But scientists do know that certain vitamins and minerals can improve the body's ability to fight off infection: Studies in healthy elderly adults, for example, have shown an improved immune response to vaccination and fewer infections after receiving extra doses of vitamin E.

To create immune cells to fight off a specific infection, the body has to rapidly draw nutrients from the bloodstream, says Anuraj Shankar, a researcher at the Harvard School of Public Health. "If you don't have an adequate intake of vitamins and minerals, you won't be able to produce the number of immune cells you need, and the immune cells you do produce may be compromised," Dr. Shankar says. That makes it impossible to mount an effective response to infection, he says.

The benefits of good nutrition may have been recognized first by Hippocrates, the ancient Greek physician who declared "let food be thy medicine, and medicine be thy food." An 18th century naval surgeon's discovery that citrus fruits could cure scurvy in sailors was later recognized as a vitamin C deficiency, and after the 1930s, when dairies began to fortify milk with vitamin D, the disease known as rickets was virtually eliminated in the U.S.

Researchers warn that malnourished people may be a breeding ground for more dangerous infectious diseases. Animal studies at the University of North Carolina show that in a host with poor nutrition, viruses mutate in the face of a weak immune response to become more powerful. And once those mutations occur, even well-nourished hosts are susceptible to the newly virulent virus. "A lot of people may think malnutrition on the other side of the world isn't their problem," says Melinda A. Beck, a researcher at the University of North Carolina, Chapel Hill. But malnutrition "is a driving force in emerging infectious diseases that are spreading around the world," she says.

The human body doesn't have to be starving to suffer from malnutrition. Studies show that obesity, in addition to its other health risks, may also make people more susceptible to infections like the flu. A diet heavy on processed and fast foods may be low in the vitamins and minerals important for health. And diets that are high in saturated fat appear to actually depress the body's immune response, increasing the risk of infections.

Dr. Beck says studies of mice show that only 4% of lean animals infected with the flu virus die. That compares with a death rate of between 40% and 60% in obese mice infected with the virus. And after a small study showed that obese people vaccinated for the flu didn't mount a strong immune response, the University of North Carolina is expanding its trials to compare vaccination response rates in lean and obese people.

3 December 2009

Diabetes expected to double, costs to triple by 2034

According to estimates from researchers at the University of Chicago, the total number of Americans with diabetes will double in the next 25 years, from the current 23.7 million to some 44.1 million in 2034. During that same time frame, annual costs for treating those patients are expected to soar—nearly tripling from the current $113 billion to some $336 billion.

If these new estimates seem troubling, they are, and what's more concerning is that they may even be on the conservative side. The figures, published in the December issue of the journal Diabetes Care, are based on obesity levels remaining stable over the next few decades. The authors based their calculations on the belief that obesity levels will plateau, and even decline, by 2033. Yet, if actual prevalence outpaces these estimates, the cases of diabetes, and resulting costs, could be even higher.

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These new estimates paint a grim vision of the future, but, the researchers say, a realistic one. Past estimates too indicated a surge in diabetes cases, but often dramatically underestimated just how quickly the problem would grow. Researchers point to figures from 1991, which projected that some 11.6 million Americans would have diabetes by 2030. In fact, that's fewer than half of the total number of Americans with diabetes today, two decades earlier than researchers had predicted.

Later research similarly undershot the magnitude of the problem. In 1998, researchers estimated there would be 22 million cases of diabetes in the U.S. by 2025. Yet, the University of Chicago team points out, we've already passed that mark—and more than 15 years earlier than anticipated.

Going forward, the incredible surge in diabetes cases and correspondingly high medical costs will largely depend on the aging population of Baby Boomers. Currently some 8.2 million diabetes patients are covered by Medicare, costing $45 billion per year. By 2034, researchers estimate that 14.6 billion diabetes patients will be covered by Medicare, and costs will balloon to a staggering $171 billion.

The study, which was originally conducted to help analyze long-term implications of the different proposals for future health care policy, underscores the essential nature of tackling this problem while it is still of relatively manageable size. And how exactly can we stop it from steamrolling into the coming decades? It's no small feat, the researchers say: as a nation, we need to completely overhaul our eating and exercise habits, and find practical, applicable ways to curb the cost of treating diabetes.

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Exercise Prevents Aging of Cells

Exercise is known to have a bounty of health benefits that can ward off age-related diseases, but a new study shows that regular physical activity has an anti-aging effect at the cellular level.

The research found that intensive exercise prevents the shortening of telomeres — the DNA that bookends chromosomes and protects the ends from damage — much like the cap on the end of a shoelace.

The shortening of telomeres limits cells to a fixed number of divisions and can be regarded as a "biological clock." Gradual shortening of telomeres through cell divisions leads to aging on the cellular level and may limit lifetimes. When the telomeres become critically short, the cell dies.

The researchers measured the length of telomeres in blood samples from two groups of professional athletes and two groups who were healthy nonsmokers, but not regular exercisers.

"The most significant finding of this study is that physical exercise of the professional athletes leads to activation of the important enzyme telomerase and stabilizes the telomere," said Ulrich Laufs, the study's lead author and professor of clinical and experimental medicine at Saarland University in Homburg, Germany.

"This is direct evidence of an anti-aging effect of physical exercise," Laufs said. "Physical exercise could prevent the aging of the cardiovascular system, reflecting this molecular principle."

In addition, the animal studies of Laufs and colleagues show that exercise exerts important cellular functions beyond the regulation of telomere length, such as protecting the cell from deterioration and programmed cell death.

In the clinical study, the researchers analyzed 32 young professional runners, average age 20, from the German National Team of Track and Field. They compared the young professional athletes with middle-aged athletes who had a history of continuous endurance exercise since their youth.

The two groups were evaluated against untrained athletes who were healthy nonsmokers, but who did not exercise regularly. They were matched for age with the professional athletes.

Long-term exercise training activates telomerase and reduces telomere shortening in human white blood cells, the researchers found. The age-dependent telomere loss was lower in the older athletes who had performed endurance exercising for several decades.

"Our data improves the molecular understanding of the protective effects of exercise on the vessel wall and underlines the potency of physical training in reducing the impact of age-related disease," Laufs said.

The study will be published in December in Circulation, a journal of the American Heart Association.

The Claim: Exercise More During the Day, and You Will Sleep Better at Night

THE FACTS It has long been said that regular physical activity and better sleep go hand in hand. Burn more energy during the day, the thinking goes, and you will be more tired at night.

But only recently have scientists sought to find out precisely to what extent. One extensive study published this year looked for answers by having healthy children wear actigraphs — devices that measure movement — and then seeing whether more movement and activity during the day meant improved sleep at night. The results should be particularly enlightening to parents.

The study found that sleep onset latency — the time it takes to fall asleep once in bed — ranged from as little as roughly 10 minutes for some children to more than 40 minutes for others. But physical activity during the day and sleep onset at night were closely linked: every hour of sedentary activity during the day resulted in an additional three minutes in the time it took to fall asleep at night. And the children who fell asleep faster ultimately slept longer, getting an extra hour of sleep for every 10-minute reduction in the time it took them to drift off.

Studies on adults have reached generally similar results, showing that an increase in physical activity improves sleep onset and increases sleep duration, particularly in people who have trouble sleeping.

THE BOTTOM LINE Studies suggest that being more physically active can lead to better sleep.

1 December 2009

New study questions effectiveness of popular cholesterol drugs

By Lyndsey Layton
Washington Post Staff Writer
Monday, November 16, 2009

A widely prescribed and expensive cholesterol drug is not as effective as niacin, a cheap vitamin, in helping to unclog coronary arteries in people already taking statins, the standard medicines used to lower cholesterol, according to a new study.

The research, which appears Monday in the New England Journal of Medicine, is sending rumbles through the medical community because it is the third recent study to raise questions about the effectiveness of Zetia and its sister drug, Vytorin, highly profitable pharmaceuticals made by Merck & Co.

"This is the third strike," said Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic. "The studies are telling us that it doesn't appear to produce benefits. This is a drug used by millions of Americans, a very big seller, in a health-care system where costs are a major issue. And the question has to be, is this the right approach?"

Vytorin and Zetia are among the most popular prescription drugs. Last year, physicians in the United States wrote a total of more than 29 million prescriptions for them, and worldwide sales totaled $4.56 billion, according to Merck.

Although the drugs have been shown to reduce cholesterol, there is no evidence that they prevent heart attacks, strokes and other cardiovascular problems.

Top Merck executives are vigorously defending their drugs and have dismissed the new research as limited.

"I don't think a clinician or a doctor or a patient should use this as the basis for any decision-making whatsoever," said Richard Pasternak, vice president of Merck research laboratories. "I worry that people might unnecessarily come off a drug that is approved and accepted."

He and other critics said the study appearing Monday involved just 200 patients, was ended early, and examined what is known as a surrogate marker -- the amount of plaque on artery walls -- rather than evaluating the rate of heart attacks and stroke.

Because plaque can clog arteries and restrict blood flow to the heart and brain, cardiologists view plaque as a good indication for the risk of heart attack and stroke.

The study has been highly anticipated by the medical community and financial analysts, and is the buzz at the annual meeting of the American Heart Association, which began Sunday in Orlando.

Introduced in 2002 and 2004 amid heavy direct-to-consumer marketing, Zetia and Vytorin became blockbusters for Merck and Schering-Plough, which had collaborated on their development. The companies recently merged.

But new research has placed the drugs under greater scrutiny and the number of written prescriptions has been slipping, although together they still represent big business for Merck.

Last year, a study released by Merck showed that Zetia did not reduce plaque in arteries compared with patients taking only statins, which are much less expensive and available in generic form. Although released in January, the study had been completed in 2006, prompting a class-action lawsuit alleging that Merck intentionally withheld unfavorable results of a clinical trial. The company paid $41.5 million in August to settle the claims.

Another study published last year showed a potential increase in cancer among patients taking Zetia and Vytorin, compared with those taking only statins.

Taken as a whole, the new research is unnerving, said Harlan Krumholz, a Yale University cardiologist. "The accumulating evidence isn't giving you any confidence," he said. "This is a very expensive drug being used without any strong evidence that it's benefiting patients." Zetia and Vytorin should be "drugs of last resort, if used at all," Krumholz said. "And anyone who uses it should make sure patients are informed that they're taking a gamble."

Statins, such as Lipitor, have long been used to lower cholesterol and reduce cardiovascular disease. They inhibit the production of LDL, or low-density lipoprotein, often called "bad" cholesterol, which can lead to plaque buildup in arteries.

Zetia, the brand name for ezetimibe, uses a different mechanism. It blocks the absorption of cholesterol from food in the intestines. It has been shown by Merck to lower LDL by 18 percent on average. It is designed for patients who cannot tolerate statins, or for whom high-dose statins are not working.

Vytorin is Zetia combined with a statin, simvastatin, in one pill.

The study released Monday followed about 200 patients who were already taking statins. Some were also given Niaspan, a modified form of Vitamin B, or niacin. The rest took Zetia. Researchers took images of the artery leading to the brain to measure the thickness of the artery walls over 14 months.

The patients who took Niaspan had less plaque in their arteries and also had higher levels of high-density lipoprotein or HDL. Known as "good" cholesterol, HDL is believed to remove cholesterol from the arteries and carry it back to the liver, where it is passes from the body.

The patients who took Zetia had more plaque in their arteries but lower levels of LDL. They also had more heart attacks, strokes and other cardiovascular problems than the patients taking niacin. Merck President Peter Kim said the fact that Zetia lowers LDL cholesterol makes it valuable. "It's very well established that lowering LDL saves lives," he said.

Roger S. Blumenthal, a cardiologist at Johns Hopkins, criticized the new study in an editorial also published Monday in the New England Journal of Medicine. Blumenthal, who has been a paid speaker for Merck, noted that the new study was halted early, which meant results from 40 percent of the participants were not included in the final analysis.

The study's author, Allen J. Taylor of Walter Reed Army Medical Center and Washington Hospital Center, said the trial ended early because the results were quickly apparent. "It couldn't be more clear," Taylor said. "It would have been unreasonable to continue the experiment because the trial had met its objective -- niacin is superior to ezetimibe."

Kim said any conclusions about Zetia and Vytorin should wait until Merck completes a large-scale clinical trial. It involves 15,000 patients and is not expected to yield results until at least 2012.