93rd Health Research Report 14 NOV 2010 – Reconstruction

 

Editors Top Five:

 

Black raspberries may prevent colon cancer

Study finds Plantar Fasciitis? Stretching seems to do the trick

Obesity rate will reach at least 42 percent, say models of social contagion

Dangerous chemicals in food wrappers likely migrating to humans

U of T study Myth of a germ-free world:

A closer look at antimicrobial products

 

In This Issue:

1. Pregnant women who eat peanuts may put infants at increased risk for peanut allergy

2. Antibiotics have long-term impacts on gut flora

3. Common stomach bacteria may fight off inflammatory bowel disease caused by Salmonella

4. Black raspberries may prevent colon cancer, study finds

5. Daily dose of beet juice promotes brain health in older adults

6. Exposure of humans to cosmetic UV filters is widespread

7. Levels of coumarin in cassia cinnamon vary greatly even in bark from the same tree

8. Insufficient vitamin D levels in CLL patients linked to cancer progression and death

9. Obesity rate will reach at least 42 percent, say models of social contagion

10. Study shows a single shot of morphine has long lasting effects on testosterone levels

11. Plantar Fasciitis? Stretching seems to do the trick

12. Plant-based, olive oil diet also has health benefits for prostate cancer survivors

13. Canola-type rapeseed oil reduces the level of fibrinogen, a cause of thrombosis and inflammation

14. Mild painkillers in pregnancy are associated with an increased risk of male reproductive problems

15. Louisiana State University Health Sciences Center research shows fish oil component given up to 5 hours after stroke limits brain damage

16. Dangerous chemicals in food wrappers likely migrating to humans: U of T study

17. Soy May Stop Prostate Cancer Spread

18. DHA improves memory and cognitive function in older adults

19. Low blood levels of vitamin D linked to chubbier kids, faster weight gain

20. Exercise may reduce risk of endometrial cancer

21. Probiotics shorten diarrhea episodes

22. Myth of a germ-free world: a closer look at antimicrobial products

23. Fructose-rich beverages associated with increased risk of gout in women

Public release date: 1-Nov-2010

Pregnant women who eat peanuts may put infants at increased risk for peanut allergy

Researchers have found that allergic infants may be at increased risk of peanut allergy if their mothers ingested peanuts during pregnancy. The data are reported in the November 1 issue of the Journal of Allergy and Clinical Immunology.

Led by Scott H. Sicherer, MD, Professor of Pediatrics, Jaffe Food Allergy Institute at Mount Sinai School of Medicine, researchers at five U.S. study sites evaluated 503 infants aged three to 15 months with likely milk or egg allergies or with significant eczema and positive allergy tests to milk or egg, which are factors associated with an increased risk of peanut allergy. The study infants had no previous diagnosis of peanut allergy. A total of 140 infants had strong sensitivity to peanut based on blood tests, and consumption of peanut during pregnancy was a significant predictor of this test result.

“Researchers in recent years have been uncertain about the role of peanut consumption during pregnancy on the risk of peanut allergy in infants,” said Dr. Sicherer. “While our study does not definitively indicate that pregnant women should not eat peanut products during pregnancy, it highlights the need for further research in order make recommendations about dietary restrictions.”

In 2000, the American Academy of Pediatrics recommended that women whose infants were at increased risk of allergies based upon family history consider avoiding peanut products while pregnant and breast feeding. However, the recommendation was withdrawn in 2008 due to limited scientific evidence to support it. The Consortium of Food Allergy Research (CoFAR), which was just awarded a renewed $29.9 million grant from the National Institutes of Health, is conducting this ongoing, observational study to help better understand the risk factors behind a child’s developing peanut allergy, as well as allergies to milk and egg. The Consortium is also studying novel treatments for food allergies.

The authors caution that the study has limitations, including the reliance on the self-reporting of dietary habits among pregnant women. Importantly, the study has thus far only shown an increased risk for positive allergy test results to peanut.

Despite its limitations, the study has identified a potential risk factor that, if verified, could present an opportunity for risk reduction. The authors conclude that controlled, interventional studies should be conducted to explore these findings further.

“Peanut allergy is serious, usually persistent, potentially fatal, and appears to be increasing in prevalence,” said Dr. Sicherer. “Our study is an important step toward identifying preventive measures that, if verified, may help reduce the impact of peanut allergy.”

Public release date: 1-Nov-2010

Antibiotics have long-term impacts on gut flora

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Short courses of antibiotics can leave normal gut bacteria harbouring antibiotic resistance genes for up to two years after treatment, say scientists writing in the latest issue of Microbiology, published on 3 November.

The researchers believe that this reservoir increases the chances of resistance genes being surrendered to pathogenic bacteria, aiding their survival and suggesting that the long-term effects of antibiotic therapy are more significant than previously thought.

Antibiotics that are prescribed to treat pathogenic bacteria also have an impact on the normal microbial flora of the human gut. Antibiotics can alter the composition of microbial populations (potentially leading to other illnesses) and allow micro-organisms that are naturally resistant to the antibiotic to flourish.

The impact of antibiotics on the normal gut flora has previously been thought to be short-term, with any disturbances being restored several weeks after treatment. However, the review into the long-term impacts of antibiotic therapy reveals that this is not always the case. Studies have shown that high levels of resistance genes can be detected in gut microbes after just 7 days of antibiotic treatment and that these genes remain present for up to two years even if the individual has taken no further antibiotics.

The consequences of this could be potentially life-threatening explained Dr Cecilia Jernberg from the Swedish Institute for Infectious Disease Control who conducted the review. “The long-term presence of resistance genes in human gut bacteria dramatically increases the probability of them being transferred to and exploited by harmful bacteria that pass through the gut. This could reduce the success of future antibiotic treatments and potentially lead to new strains of antibiotic-resistant bacteria.”

The review highlights the necessity of using antibiotics prudently. “Antibiotic resistance is not a new problem and there is a growing battle with multi-drug resistant strains of pathogenic bacteria. The development of new antibiotics is slow and so we must use the effective drugs we have left with care,” said Dr Jernberg. “This new information about the long-term impacts of antibiotics is of great importance to allow rational antibiotic administration guidelines to be put in place,” she said.

Public release date: 1-Nov-2010

Common stomach bacteria may fight off inflammatory bowel disease caused by Salmonella

Helicobacter pylori in the mouse stomach put the brakes on colitis by reducing the immune response in the lower GI tract, U-M study shows

Ann Arbor, Mich. — Helicobacter pylori, a common stomach bacterium, reduced the severity of inflammation of the colon caused by Salmonella in mice, according to research from U-M Medical School scientists.

More than half the people in the world are infected with H. pylori, although it is very unusual to find it in the United States. But this research shows there may be an inflammation control benefit to hosting the H. pylori infection, says Peter Higgins, M.D., Ph.D., M.Sc., lead author of the study published last week in the journal Inflammatory Bowel Diseases.

“If we have evolved to live with certain bugs, maybe there is a reason,” said Higgins, assistant professor of gastroenterology in U-M’s Department of Internal Medicine. “This research demonstrates that having H. pylori in your stomach could have beneficial immune effects in other parts of the

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body.”

In the study, mice were infected with H. pylori, allowed to develop immune tolerance for a month, and then infected with Salmonella, which induces the inflammatory bowel disease colitis. The data provided the first evidence that H. pylori infection in the stomach alters the immunological environment of the lower gastrointestinal tract and reduced the severity of Salmonella-induced colitis.

“This was surprising because H. pylori infects the stomach, not the colon. It appears to have a more global effect on the gut immune system,” says John Kao, M.D., senior author of this study and assistant professor in U-M’s Department of Internal Medicine.

“But it may explain why people in regions with lots of H. pylori infection — such as Asia and Africa — get fewer inflammatory bowel diseases, like ulcerative colitis and Crohn’s disease.”

It also may explain why H. pylori infection is so common, Higgins says. Salmonella was historically a rampant fatal infection that caused the plague of Athens, which led to rise of Sparta. It also likely led to the early death of Alexander the Great. So it would make sense that many humans carry the H. pylori bacteria, if it truly reduces the severity of inflammation caused by Salmonella, Higgins says.

The H. pylori infection is now more commonly found in developing countries or those with poor sanitation, where Salmonella and inflammatory bowel diseases are more common. Most people contract H. pylori in their first seven years of life, most commonly through exposure to feces.

Higgins does not recommend that inflammatory bowel patients should be infected with H. pylori, however. In the U.S., H. pylori infection is treated with antibiotics because it can lead to stomach ulcers or cancer, even though most people don’t notice they have it.

“There may be a reason we co-exist with H. pylori. Maybe we should not be so quick to get rid of it in patients who do not have stomach ulcers,” Higgins says, adding that this may be especially true in places where Salmonella remains a common threat.

“It would be reasonable for researchers to look at whether H. pylori infection is associated with reduced severity of other gut infections like cholera or Clostridium difficile. Many more studies are needed, however, to see if H. pylori could actually prevent inflammatory bowel disease.”

About U-M’s Division of Gastroenterology: U-M is one of the largest gastroenterology practices in the country and is a leader in the prevention, diagnosis, and treatment of diseases of the gastrointestinal tract and liver. Our 50-plus physicians are experts in the diagnosis and treatment of all diseases of the gastrointestinal system, from simple to complex, including those of the esophagus, stomach, small intestine, colon, rectum, liver, gallbladder, pancreas and biliary tract.

In addition to being leaders in the clinic, our faculty are also leaders in their respective areas of research, which span such varied interests as the role of peptides in the brain-gut interactions in functional bowel diseases to innovative treatments of viral hepatitis and liver cancer.

Public release date: 2-Nov-2010

Black raspberries may prevent colon cancer, study finds

Black raspberries are highly effective in preventing colorectal tumors in two mouse models of the disease, according to a University of Illinois at Chicago study.

The findings are published in the November issue of Cancer Prevention Research.

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Colorectal cancer is the third most common cancer and the second leading cause of cancer-related death in both men and women in the U.S., according to the National Cancer Institute.

Building on previous research that found black raspberries have antioxidant, anti-cancer, anti-neurodegenerative and anti-inflammatory properties, the researchers looked at the fruit’s ability to prevent colon cancer.

“We saw the black raspberry as a natural product, very powerful, and easy to access,” said Dr. Wancai Yang, assistant professor of pathology at the UIC College of Medicine and senior author of the study, whose research focuses on the interactions of genetic and nutritional factors in the development of intestinal cancer and tumor prevention.

The researchers used two strains of mice, Apc1638 and Muc2, which each have a specific gene knocked out, causing the mice to develop either intestinal tumors (in the case of Apc1638) or colitis in the case of Muc2. Colitis is an inflammation of the large intestine that can contribute to the development of colorectal cancer.

Both mouse strains were randomized to be fed either a Western-style, high-risk diet (high in fat and low in calcium and vitamin D) or the same diet supplemented with 10 percent freeze-dried black raspberry powder for 12 weeks.

The researchers found that in both mouse strains the black raspberry-supplemented diet produced a broad range of protective effects in the intestine, colon and rectum and inhibited tumor formation.

In the Apc1638 mice, tumor incidence was reduced by 45 percent and the number of tumors by 60 percent. The researchers found that black raspberries inhibited tumor development by suppressing a protein, known as beta-catenin, which binds to the APC gene.

In the Muc2 mice, tumor incidence and the number of tumors were both reduced by 50 percent, and black raspberries inhibited tumor development by reducing chronic inflammation associated with colitis.

The researchers now hope to obtain funding to begin clinical trials in humans, said Yang. Because black raspberries not only prevent cancer but also inflammation, they may also protect against other diseases, such as heart disease.

Public release date: 2-Nov-2010

Daily dose of beet juice promotes brain health in older adults

Winston-Salem, N.C. – Researchers for the first time have shown that drinking beet juice can increase blood flow to the brain in older adults – a finding that could hold great potential for combating the progression of dementia.

The research findings are available online in Nitric Oxide: Biology and Chemistry, the peer-reviewed journal of the Nitric Oxide Society and will be available in print soon. (Read the abstract.)

“There have been several very high-profile studies showing that drinking beet juice can lower blood pressure, but we wanted to show that drinking beet juice also increases perfusion, or blood flow, to the brain,” said Daniel Kim-Shapiro, director of Wake Forest University’s Translational Science Center; Fostering Independence in Aging. “There are areas in the brain that become poorly perfused as you age, and that’s believed to be associated with dementia and poor cognition.”

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High concentrations of nitrates are found in beets, as well as in celery, cabbage and other leafy green vegetables like spinach and some lettuce. When you eat high-nitrate foods, good bacteria in the mouth turn nitrate into nitrite. Research has found that nitrites can help open up the blood vessels in the body, increasing blood flow and oxygen specifically to places that are lacking oxygen.

In this study, the first to find a link between consumption of nitrate-rich beet juice and increased blood flow to the brain, Translational Science Center researchers looked at how dietary nitrates affected 14 adults age 70 and older over a period of four days.

On the first day, the study subjects reported to the lab after a 10-hour fast, completed a health status report, and consumed either a high- or low-nitrate breakfast. The high-nitrate breakfast included 16 ounces of beet juice. They were sent home with lunch, dinner and snacks conforming to their assigned diets.

The next day, following another 10-hour fast, the subjects returned to the lab, where they ate their assigned breakfasts. One hour after breakfast, an MRI recorded the blood flow in each subject’s brain. Blood tests before and after breakfast confirmed nitrite levels in the body.

For the third and fourth days of the study, the researchers switched the diets and repeated the process for each subject.

The MRIs showed that after eating a high-nitrate diet, the older adults had increased blood flow to the white matter of the frontal lobes – the areas of the brain commonly associated with degeneration that leads to dementia and other cognitive conditions.

“I think these results are consistent and encouraging – that good diet consisting of a lot of fruits and vegetables can contribute to overall good health,” said Gary Miller, associate professor in the Department of Health and Exercise Science and one of the senior investigators on the project.

To make the sometimes-bitter beet juice tastier – so a greater number of people will drink it and reap its health benefits – the university has worked with a company to create a new beet juice-based beverage. The university is currently looking into ways of marketing the beverage.

Public release date: 2-Nov-2010

Exposure of humans to cosmetic UV filters is widespread

UV filters were present in 85 percent of human milk samples of a research published in Chemosphere

Amsterdam, 2 November, 2010 – An investigation conducted in the context of the Swiss National Research Programme (NRP50), Endocrine Disrupters: Relevance to Humans, Animals and Ecosystems, demonstrates for the first time that internal exposure of humans to cosmetic UV filters is widespread.

In the course of the Summer and Fall 2004, 2005 and 2006 (3 cohorts), human milk was sampled by mothers who had given birth at the University Women’s Hospital in Basel. The participants filled out a detailed questionnaire with general questions and, as special feature, in depth questions on use of different types of cosmetic products.

Chemicals out of a large range of products including “modern” chemicals and classical persistent organic pollutants (POPs) were analyzed in the same human milk sample by analytical laboratories in Freiburg, Erlangen and Baden. The list comprised cosmetic UV filters, synthetic musk fragrances, pesticides, phthalates, parabens, flame retardants (polybrominated diphenylethers), and polychlorinated biphenyls

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(PCBs); in total 89 analyses per milk sample. The chemical analytical data of milk samples of individual mothers were then compared with the information obtained through the questionnaire.

The investigation revealed that one and the same human milk sample contained a large range of chemical contaminants, most of which are known to interact with endocrine systems. Individual exposure patterns differed between different types of chemicals. The study demonstrates for the first time that internal exposure of humans to cosmetic UV filters is widespread. Cosmetic UV filters were present in 85% of human milk samples, at concentrations comparable to PCBs. Synthetic musk fragrances were also present in the milk samples. The presence of UV filters in human milk was significantly correlated with the use of cosmetic products containing these UV filters. As a result, exposure patterns differed between individuals.

It seems plausible that exposure to other cosmetic constituents such as synthetic fragrances is also linked to the use of the corresponding products. However, this could not be investigated because musk fragrances are not declared. In contrast, classical contaminants such as PCBs, DDT and metabolites of DDT as well as some other persistent organochlor pesticides represented a rather uniform background exposure. Their levels were in part correlated with each other and also with fat-rich nutrition.

A total daily intake of each individual chemical was calculated for each individual infant from their individual levels in human milk. Calculation included fat content of individual milk samples, total daily milk intake per infant and body weight of the infant. Some infants exhibited values of daily intake of PCBs and several organochlor pesticides that were above US EPA reference dose values.

Margret Schlumpf and Walter Lichtensteiger, who lead the research said, “Research on the effects of endocrine disrupters (chemicals interfering with hormone actions) has shown that it is of utmost importance to obtain information on simultaneous exposure of humans to different types of chemicals because endocrine active chemicals can act in concert. Information on exposure is particularly important for the developing organism at its most sensitive early life stages. Human milk was chosen because it provides direct information on exposure of the suckling infant and indirect information on exposure of the mother during pregnancy.”

An important question during the research was: To what extent lifestyle can influence the presence of chemicals in breast milk? This question was the foundation for the preparation of the questionnaire. The questions were focused particularly on the use of cosmetic products; information on the relationship between the exposure of human populations to constituents of cosmetics and the presence of these constituents in the human body was limited and, in the case of UV filters, absent.

Gert-Jan Geraeds, Executive Publisher of Chemosphere commented, “This study once again emphasizes the importance of global research on the impact of contaminants in the human environment and the need for continuous critical assessment of our priorities in environmental health and consumer habits. I am sure that this investigation will also spark debate at the upcoming first Environmental Health conference in Brazil, February 2011”.

Public release date: 3-Nov-2010

Levels of coumarin in cassia cinnamon vary greatly even in bark from the same tree

A “huge” variation exists in the amounts of coumarin in bark samples of cassia cinnamon from trees growing in Indonesia, scientists are reporting in a new study. That natural ingredient in the spice may carry a theoretical risk of causing liver damage in a small number of sensitive people who consume large amounts of cinnamon. The report appears in ACS’ bi-weekly Journal of Agricultural and Food Chemistry.

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Friederike Woehrlin and colleagues note that cinnamon is the second most popular spice, next to black pepper, in the United States and Europe. Cinnamon, which comes from the bark of trees, is sold as solid sticks and powder with the country of origin rarely declared on the package label. There are two main types: Ceylon cinnamon (also known as “true” cinnamon) and cassia cinnamon. Ceylon grows in Sri Lanka (formerly Ceylon), the Seychelles, and Madagascar. Cassia generally comes from China and Indonesia. Both types can contain coumarin, a natural flavoring found in plants. Studies have linked high coumarin intake to liver damage in a small number of sensitive people.

The scientists analyzed 91 cinnamon samples purchased from stores in Germany. They found that coumarin levels varied widely among different bark samples of Cassia cinnamon. Therefore they analyzed cassia bark samples of five trees received directly from Indonesia and found a huge variation even among samples collected from a single tree. The study confirmed that cassia cinnamon has the highest levels of coumarin, while Ceylon had the lowest levels. On average, cassia cinnamon powder contained up to 63 times more coumarin than Ceylon cinnamon powder and cassia cinnamon sticks contained 18 times more coumarin than Ceylon sticks. “Further research is necessary to identify factors influencing the coumarin levels in cassia cinnamon and to possibly allow the harvesting of cassia cinnamon with low coumarin levels in the future,” the report notes.

Health officials say it is almost impossible for consumers to distinguish between Ceylon and cassia in cinnamon powder. Cinnamon sticks, however, do look different. Cassia cinnamon sticks consist of a thick layer of rolled bark, while Ceylon cinnamon sticks have thin layers of bark rolled up into a stick.

Public release date: 3-Nov-2010

Insufficient vitamin D levels in CLL patients linked to cancer progression and death

ROCHESTER, Minn. — Researchers at Mayo Clinic (http://www.mayoclinic.org/) have found a significant difference in cancer progression and death in chronic lymphocytic leukemia (CLL) patients who had sufficient vitamin D (http://www.mayoclinic.com/health/vitamin-d/NS_patient-vitamind) levels in their blood compared to those who didn’t.

In the Mayo Clinic study, published online in the journal Blood (http://bloodjournal.hematologylibrary.org/), the researchers found that patients with insufficient levels of vitamin D when their leukemia was diagnosed progressed much faster and were about twice as likely to die as were patients with adequate levels of vitamin D.

They also found solid trends: increasing vitamin D levels across patients matched longer survival times and decreasing levels matched shortening intervals between diagnosis and cancer progression. The association also remained after controlling for other prognostic factors associated with leukemia progression.

The finding is significant in a number of ways. For the first time, it potentially offers patients with this typically slower growing form of leukemia a way to slow progression, says the study’s lead author, Tait Shanafelt, M.D., (http://mayoresearch.mayo.edu/staff/shanafelt_td.cfm) a hematologist at Mayo Clinic in Rochester, Minn.

“This finding may be particularly relevant for this kind of leukemia because although we often identify it at an early stage, the standard approach is to wait until symptoms develop before treating patients with chemotherapy,” Dr. Shanafelt says. “This watch and wait approach is difficult for patients because they

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feel there is nothing they can do to help themselves.”

“It appears vitamin D levels may be a modifiable risk factor for leukemia progression. It is simple for patients to have their vitamin D levels checked by their physicians with a blood test,” he says. “And if they are deficient, vitamin D supplements are widely available and have minimal side effects.”

While the researchers have not yet determined if vitamin D replacement in patients with initially low levels will reverse the more rapid progression associated with insufficiency, they are planning a study to explore that hypothesis.

This research adds to the growing body of evidence that vitamin D deficiency is a risk factor for development and/or progression of a number of cancers, the researchers say. Studies have suggested that low blood vitamin D levels may be associated with increased incidence of colorectal, breast and other solid cancers. Other studies have suggested that low vitamin D levels at diagnosis may be associated with poorer outcomes in colorectal, breast, melanoma and lung cancers, as well as lymphoma.

Replacing vitamin D in some patients has proven to be beneficial, the researchers say. For example, they cite a placebo-controlled clinical trial that found women who increased their vitamin D intake reduced their risk of cancer development.

Vitamin D insufficiency, in general, is widespread, Dr. Shanafelt says. “Between one-fourth and one-half of patients seen in routine clinical practice have vitamin D levels below the optimal range, and it is estimated that up to 1 billion people worldwide have vitamin D insufficiency,” he says.

Vitamin D is obtained from skin exposure to sunlight, from certain foods (fatty fish and eggs) and from supplements.

In this study, the research team, including physicians at the University of Iowa (http://www.uihealthcare.com/), enrolled 390 CLL patients into a prospective, observational study. They tested the blood of these newly diagnosed patients for plasma concentration of 25-hydroxyl-vitamin D and found that 30 percent of these CLL patients were considered to have insufficient vitamin D levels, which is classified as a level less than 25 nanograms per milliliter.

After a median follow-up of three years, CLL patients deficient in vitamin D were 66 percent more likely to progress and require chemotherapy; deficient patients also had a two-fold increased risk of death.

To confirm these findings, they then studied a different group of 153 untreated CLL patients who had been followed for an average of 10 years. The researchers found that about 40 percent of these 153 CLL patients were vitamin D deficient at the time of their diagnosis. Patients with vitamin D deficiency were again significantly more likely to have had their leukemia progress and to have died, Dr. Shanafelt says.

“This tells us that vitamin D insufficiency may be the first potentially modifiable risk factor associated with prognosis in newly diagnosed CLL,” he says.

Public release date: 4-Nov-2010

Obesity rate will reach at least 42 percent, say models of social contagion

Projections suggest obesity among American adults may not plateau until 2050

CAMBRIDGE, Mass. — Researchers at Harvard University say America’s obesity epidemic won’t plateau until at least 42 percent of adults are obese, an estimate derived by applying mathematical modeling to 40

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years of Framingham Heart Study data.

Their work, published this week in the journal PLoS Computational Biology, runs counter to recent assertions by some experts that the obesity rate, which has been at 34 percent for the past five years, may have peaked. An additional 34 percent of American adults are overweight but not obese, according to the federal government’s Centers for Disease Control and Prevention.

The Harvard scientists say that their modeling shows that the proliferation of obesity among American adults in recent decades owes in large part to its accelerating spread via social networks.

“Our analysis suggests that while people have gotten better at gaining weight since 1971, they haven’t gotten any better at losing weight,” says lead author Alison L. Hill, a graduate student in Harvard’s Program for Evolutionary Dynamics, Biophysics Program, and at the Harvard-MIT Division of Health Sciences and Technology. “Specifically, the rate of weight gain due to social transmission has grown quite rapidly.”

The projections by Hill and colleagues are a best-case scenario, meaning that America’s obesity rate could rise above 42 percent of adults. One silver lining is that their model suggests the U.S. population may not reach this level for another 40 years, making the future rate of increase much more gradual than over the past 40 years. Only 14 percent of Framingham Heart Study participants were obese in 1971.

Along with co-authors David G. Rand, Martin A. Nowak, and Nicholas A. Christakis, Hill broke down the spread of obesity into three components:

•the rate at which obesity has spread through social networks, via transfer from person to person; •the rate of non-social transmission of obesity, such as through easier access to unhealthy foods or increasingly sedentary lifestyles;

•the rate of “recovery” from obesity, defined as weight loss sufficient to push body mass index (BMI) back below 30.

“We find that while non-social transmission of obesity remains the most important component in its spread, social transmission of obesity has grown much faster in the last four decades,” says Rand, a research scientist in the Program for Evolutionary Dynamics and a fellow in Harvard’s Department of Psychology and Berkman Center for Internet & Society.

Hill, Rand, and colleagues found that a non-obese American adult has a 2 percent chance of becoming obese in any given year — a figure that has risen in recent decades — and that this number rises by 0.4 percentage points with each obese social contact, meaning that five obese contacts doubles the risk of becoming obese.

By comparison, an obese adult has a 4 percent chance of losing enough weight to fall back to merely “overweight” in any given year. This figure has remained essentially constant since 1971.

“These results suggest that social norms are changing the propensity for becoming obese by non-social mechanisms, and also magnifying the effect that obese individuals have on their non-obese contacts,” the scientists write in PLoS Computational Biology

Public release date: 4-Nov-2010

Study shows a single shot of morphine has long lasting effects on testosterone levels

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A single injection of morphine to fight persistent pain in male rats is able to strongly reduce the hormone testosterone in the brain and plasma, according to a new paper published in Molecular Pain. The study, led by Anna Maria Aloisi, M.D., of the Department of Physiology – Section of Neuroscience and Applied Physiology at the University of Siena, Italy, Sbarro Institute for Cancer Research and Molecular Medicine at Temple University in Philadelphia, University of Siena, and the Human Health Foundation in Spoleto, Italy, showed that opioids had “long lasting genomic effects in body areas which contribute to strong central and peripheral testosterone levels” including the brain, the liver and the testis.

The study showed increases in aromatase, an enzyme that is responsible for a key step in the biosynthesis of estrogen. The findings are particularly important since testosterone is the main substrate of aromatase, which is involved in the formation of estradiol. Both testosterone and estradiol are important hormones, engaged in cognitive functions as well as in mood, motor control and in many other functions, such as bone structure remodeling.

“Our lab became interested in gonadal hormones several years ago when it became clear that there were many differences in pain syndromes between the sexes,” says Dr. Aloisi. “In looking at differences, it was immediately apparent that these changes were introduced by different treatments, opioids in particular.”

“The research findings are very relevant to the management of patients with chronic pain,” said Marco Pappagallo, M.D., professor and director of pain research and development, Department of Anesthesiology, Mount Sinai School of Medicine, New York, NY. “Today, primary care physicians, pain specialists, and a variety of health care professionals are asked not only to treat pain but how to manage side effects of drugs and to strive for the best possible comprehensive care and wellness of patients who experience chronic pain. Opioid induced hypogonadism can cause health complications to which patients with pain can be overly susceptible, including chronic fatigue, loss of stamina, emotional and sexual disturbances, as well painful skeletal and muscular complications.”

It has been known that patients treated with opioids for short or long periods show low levels of gonadal hormones. Hypogonadism was already described in opioid users and applied to pain patients as OPIAD (opioid induced androgen deficiency). It is also known that patients treated with opioids, including newer drugs (fentalyl, tramadol) have a high probability to be hypogonadic, with menopausal symptoms occurring in women and andropausal symptoms in men.

“The use of opioids puts a ‘physiological’ block on the reproductive system and can induce a long lasting absence of these essential hormones from the blood and the brain,” says Dr. Aloisi. “The normal effect of opioids to restrict reproduction in stressed subjects is multiplied by the higher levels/ long duration of opioids in the body.”

“Until a few years ago this condition was completely unrecognized by physicians although some reports clearly showed it in many kinds of patients,” notes Dr. Aloisi. “Today there remains some ignorance on this condition but gonadal hormones are more commonly cited as responsible for many chronic degenerative pathologies.”

Despite the side effects of opioids, Antonio Giordano, M.D., Ph.D., Director of the Sbarro Institute for Cancer Research and Molecular Medicine, warns that the study’s message is not meant to limit the use of opioids for pain. Instead, he suggests that doctors should “take into consideration this side effect, since it is very easy to find hormone replacement therapies. Using HRTs, patients can get relief from their pain, and improve their quality of life.”

Public release date: 4-Nov-2010

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Plantar Fasciitis? Stretching seems to do the trick

New study compares two treatment methods for acute plantar

Rosemont, IL

According to a new study from the Journal of Bone and Joint Surgery (JBJS), patients with acute plantar fasciitis who perform manual plantar fasciitis stretching exercises, as opposed to shockwave therapy, had superior results and higher patient satisfaction.

Study details and findings:

A total of 102 patients who had acute plantar fasciitis pain, were randomly assigned to two groups. Acute is defined as any patient that experiences pain for less than six weeks. 54 people performed an eight-week stretching program, while 48 people received repetitive low-energy radial shock-wave therapy once a week for three weeks. Each group was asked to refrain from any other forms of physical therapy.

Patients in the stretching group, were told to perform stretching exercises three times a day, for eight weeks. All patients were contacted by phone every two weeks to check on training compliance. After four weeks, the patients were told to slowly return to their previous sport and/or recreational activity. Patients in group two received three sessions of radial shock-wave therapy, three times a week.

Patients were given follow-up evaluations at two, four and fifteen months. At both the two and fourth month evaluation, 65 percent of patients who performed the plantar fascia-specific stretch reported total satisfaction with treatment or satisfaction with treatment with minor reservations. Only 29 percent did so after shockwave therapy.

John Furia, MD, an orthopaedic surgeon in Pennsylvania and one of the study authors added that those who develop plantar fascia pain should begin non-operative treatment promptly. “The earlier you understand how stretching fits in, and the earlier you learn how frequently to perform the simple plantar stretch, the less likely you will require a more invasive treatment method,” stated Dr. Furia. “Shockwave therapy has been shown to be a very effective treatment for patients with chronic plantar fasciitis (pain for more than six to eight weeks), however acute cases are probably best treated with more simple measures,” he added.

How to do the stretch: According to the American Academy of Orthopaedic Surgeons (AAOS), this stretch should be performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and bring your ankle up and your toes up. Place your thumb along the plantar fascia and rub it to stretch it. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 10-20 times for each foot. Dr. Furia and Dr. Judy Baumhauer, orthopaedic surgeon and president-elect of the American Orthopaedic Foot and Ankle Society (AOFAS) recommend that this exercise be performed initially in the morning, before getting out of bed and after any long periods of sitting. If there is a sharp pain in your heel when getting up, a stretch should have been done before standing or walking. Dr. Baumhauer gives her patients a visual as a reference for this exercise.

Dr. Baumhauer, who was not involved in this study, has been counseling patients on the plantar fascia stretch for 15 years. “I am a firm believer in this type of stretch and nearly 80 percent of my patients have shown improvement in just eight weeks of stretching therapy.”

Relevant statistics:

•Plantar fasciitis is the most common cause of pain on the bottom of the heel, and approximately two

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million patients are treated for plantar fasciitis each year.

•More than 80 percent of patients with plantar fasciitis will improve within 10 months of starting simple treatment methods.

•Dr. Furia suggests that approximately 20 percent of patients with plantar fasciitis develop a chronic condition.

Public release date: 7-Nov-2010

Plant-based, olive oil diet also has health benefits for prostate cancer survivors

PROVIDENCE, RI – Researchers from The Miriam Hospital say a plant-based, olive oil diet similar to the Mediterranean diet can improve the health of men with recurrent prostate cancer.

The findings may be of significance to men who have been treated with androgen deprivation therapy (ADT), a common treatment that blocks the level of circulating androgens (male hormones), which can fuel the growth of prostate cancers. This therapy has been associated with increased body mass index, excess body fat around the waist and elevated insulin levels – all symptoms of metabolic syndrome. Metabolic syndrome increases the risk of heart disease, stroke and diabetes.

According to Miriam researchers, the men who followed the olive oil diet lost an average of 12.4 pounds in an eight-week period. As a result of the diet and weight loss, participants also experienced a significant improvement in some of the risk factors of metabolic syndrome, particularly triglyceride levels (a type of fat found in the blood that can cause plaque buildup in artery walls).

The findings were presented today at the American Dietetic Association’s 2010 Food & Nutrition Conference & Expo in Boston.

“My plant-based olive oil diet is based on foods that research suggests will improve health, such as vegetables, nuts and olive oil, so it is a healthy diet for weight loss,” says lead author Mary Flynn, PhD, RD, LDN, a research dietitian at The Miriam Hospital. “Our study shows that the diet was not only successful as a weight loss tool for these men, but our participants liked the diet and planned to stay on it.”

According to the American Heart Association, metabolic syndrome is characterized by a group of metabolic risk factors in one person. These include abdominal obesity, blood fat disorders (including high triglycerides, low HDL cholesterol and high LDL cholesterol), elevated blood pressure, and insulin resistance or glucose intolerance (excessive fat tissue in and around the abdomen). Metabolic syndrome has become increasingly common in the United States, and it’s estimated that more than 50 million Americans are affected by it.

Extra virgin olive oil has been shown to decrease blood pressure, fasting insulin, glucose, oxidation and inflammation – all risk factors for heart disease and some cancers. Not only does extra virgin olive oil improve the taste of the meal, but because it’s a healthy fat, it also keeps the stomach fuller longer, so individuals are less likely to snack between meals. According to Flynn, the health benefits of olive oil start at about two tablespoons per day.

The health benefits of a plant-based diet are due to the phytonutrients found in plant products. In particular, carotenoids, which are found in dark vegetables, have been shown to help decrease the risk of cancer. Studies also have shown that olive oil – the only oil that is from a fruit – has numerous

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phytonutrients that can improve health; it has been associated with decreasing oxidation, inhibiting tumors from forming or growing and decreasing inflammation. Research also suggests that about two tablespoons a day will improve insulin function and lower blood pressure.

The Miriam study included 11 men treated with ADT who developed metabolic syndrome. For eight weeks, they followed a plant-based olive oil diet, which included a minimum of three tablespoons of extra virgin olive oil daily, as well as four servings of vegetables a day. Nuts were allowed and poultry and seafood were limited to eight ounces a day. Men also kept daily food records for key food items and were asked to keep three-day food diaries at weeks four and eight. Participants’ weight loss goal was five percent of their baseline weight.

In addition to shedding an average of 12.4 pounds, men in the study lost an average of just over two inches in their waistline. They also experienced significant improvements in their triglyceride levels. At the start of the study, the average triglyceride level was more than 100 mg/dl; after eight weeks, it dropped down to a healthy range of less than 100 mg/dl.

“It’s possible that someday we may be able to recommend a diet that will prevent the development of metabolic syndrome in men being treated for recurrent prostate cancer, which would greatly decrease their risk of heart disease,” said Flynn.

A separate study led by Flynn earlier this year also showed that a plant-based, olive oil diet produced greater weight loss in breast cancer survivors compared to a more traditional low-fat diet.

Public release date: 8-Nov-2010

Canola-type rapeseed oil reduces the level of fibrinogen, a cause of thrombosis and inflammation

According to research on fatty acids conducted at the universities of Helsinki and Tampere, the consumption of canola-type rapeseed oil decreases the level of fibrinogen detrimental to health in the body. The increased fibrinogen level, caused by an imbalance in essential fats in one’s diet, decreases when saturated fatty acids are replaced with rapeseed oil. The research results were published in the journal Prostaglandins, Leukotrienes and Essential Fatty Acids.

A complex state of balance, the haemostatic balance, prevails in the bloodstream. One player in this balancing act is fibrinogen, the single most important blood coagulation factor. A high level of fibrinogen promotes the creation of thrombosis and maintains inflammation within the body. An increase in the fibrinogen level is closely linked with, for example, cardiovascular disease, strokes, diabetes, Alzheimer’s disease and dementia.

The new research demonstrates for the first time that an increase in the fibrinogen level of the blood is largely caused by the lack of omega-3-alpha-linolenic acid in the diet. When there is too little of this beneficial fatty acid found in one’s diet, an imbalance between fatty acids in the body is created. When the omega-3-alpha-linolenic acid level is too low, the body starts to manufacture more harmful omega-6-arachidonic acid out of the omega-6-linoleic acid, creating hormone-like compounds that cause thrombosis and inflammation. According to the researchers, the fat composition of rapeseed oil is optimal with regard to fatty acids essential to the body and consequently is well-suited to reduce the fibrinogen levels in the blood.

Levels of fibrinogen and cholesterol reduced

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In all 42 research subjects, many of whom with high levels of fibrinogen and cholesterol, participated in the research. The study subjects replaced one-fourth of the food fat (margarine, cheese, butter) they used to rapeseed oil. The oil used was canola-quality spring turnip rape oil. They took about a tablespoon of oil a day, for example, mixed with a salad. The rapeseed oil dose doubled the intake of omega-3-alpha-linolenic acid during the experiment period of six weeks. Due to the regime, all higher-than-average fibrinogen levels decreased by approximately 30 per cent.

The research shows that controlling fibrinogen and cholesterol by changing the fat consumed is a point of departure in the prevention of diseases as well as from the perspective of successful individual medical treatment. According to Into Laakso, Ph.D. from the Faculty of Pharmacy at the University of Helsinki, harmful effects of fats in, for example, elderly people could be easily rectified by switching one-fourth of fats to rapeseed oil. Laakso also recommends that, in addition to cholesterol, healthcare centres should measure patients’ fibrinogen levels.

Public release date: 8-Nov-2010

Mild painkillers in pregnancy are associated with an increased risk of male reproductive problems

New evidence has emerged that the use of mild painkillers such as paracetamol (Tylenol, acetaminophen) , aspirin and ibuprofen, may be part of the reason for the increase in male reproductive disorders in recent decades. Research published in Europe’s leading reproductive medicine journal Human Reproduction today (Monday 8 November) shows that women who took a combination of more than one mild analgesic during pregnancy, or who took the painkillers during the second trimester of pregnancy, had an increased risk of giving birth to sons with undescended testicles (cryptorchidism) – a condition that is known to be a risk factor for poor semen quality and testicular germ cell cancer in later life. [1]

The researchers from Denmark, Finland and France found that women who used more than one painkiller simultaneously (e.g. paracetamol and ibuprofen) had a seven-fold increased risk of giving birth to sons with some form of cryptorchidism compared to women who took nothing.

The second trimester appeared to a particularly sensitive time. Any analgesic use at this point in the pregnancy more than doubled the risk of cryptorchidism. Of the individual painkillers, ibuprofen and aspirin approximately quadrupled the risk of cryptorchidism, while a doubling of the risk (although non-statistically significant) was found for paracetamol. Simultaneous use of more than one painkiller during this time increased the risk 16-fold.

These findings were supported by work that the researchers Dr Ulla Hass at the Technical University of Denmark (Søborg, Denmark) and Dr Bernard Jégou from INSERM (Institut National de la Santé at de la Recherche Médicale) at the University of Rennes (Rennes, France) carried out in rats. They found that analgesics disrupted androgen production, leading to insufficient supplies of the male hormone testosterone during the crucial early period of gestation when the male organs were forming. The effects of the analgesics on the rats was comparable to that caused by similar doses of known endocrine (hormone) disrupters such as phthalates – a family of chemical compounds used in the manufacture of plastics such as PVC.

Dr Henrik Leffers, senior scientist at the Rigshospitalet in Copenhagen (Denmark), who led the research, said: “If exposure to endocrine disruptors is the mechanism behind the increasing reproductive problems among young men in the Western World, this research suggests that particular attention should be paid to the use of mild analgesics during pregnancy, as this could be a major reason for the problems.”

The study looked at two groups of women, 834 in Denmark and 1463 in Finland, who joined the study

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while they were pregnant. In Finland the women answered written questionnaires about their use of medication during pregnancy and in Denmark the women did the same or took part in a telephone interview, or both. The telephone interview asked specifically about the use of painkillers during pregnancy, while the written questionnaires did not. The baby boys were examined at birth for any signs of cryptorchidism, ranging from a mild form of the condition, in which the testis is located high in the scrotum, to the more severe form, in which the testis is so high up in the abdomen that it is non-palpable.

The researchers found that women significantly under-reported the use of painkillers in the written questionnaire because they did not consider mild painkillers to be “medication”. Among the 298 Danish mothers who took part in both the self-administered questionnaire and the telephone interview, 30.9% reported using painkillers in the questionnaire, but 57.2% reported it in the telephone interview.

The researchers could find no statistically significant effect in the group of Finnish women, but found significant effects amongst the Danish women.

Dr Leffers said: “We do not quite understand why the Finnish cohort does not show the same associations as the Danish cohort. However, the use of mild analgesics in the Finnish cohort was only examined by questionnaires, not by telephone interviews, and the telephone interviews gave the most reliable information in the Danish cohort, which may explain some of the differences. Moreover, the prevalence of cryptorchidism is much lower in Finland (2.4%) compared to Denmark (9.3%) and, therefore, this would require a larger cohort to find the same number of cases.”

The work examining the effects of the analgesics in rats showed that intrauterine exposure to paracetamol reduced the anogenital distance (the distance between the anus and the genitals) in the offspring. AGD is a sensitive marker for reduced intrauterine androgen levels and effects on AGD predicts increased risk for impaired reproductive performance of the adult animal. The researchers also found that mild analgesics reduced levels of testosterone in the rat foetal testis by approximately 50%.

Dr Jégou said that the mechanism by which mild analgesics reduced testosterone was poorly understood. “It seems to be related to their mode of action which involves inhibiting the production of prostaglandins – locally acting messenger molecules. In another study by David Kristensen et al., we have shown that endocrine disruptors of the phthalate type are almost as potent inhibitors of prostaglandin synthesis as pharmaceutical inhibitors such as mild analgesics. However, currently we do not know how a reduction of prostaglandin synthesis can reduce testosterone production.”

The researchers say that there has been a marked increase in the incidence of congenital cryptorchidism in recent decades, notably in Denmark where it has increased from 1.8% in 1959-1961 to 8.5% in 1997-2001. “The magnitude of this difference is too large to be accounted for by random fluctuations and differences in ascertainment. Moreover, this finding is in accordance with the reported decline in reproductive health in the adult male population over the past five decades,” they write in their paper.

Dr Leffers said: “Although we should be cautious about any over-extrapolation or over-statement, the use of mild analgesics constitutes by far the largest exposure to endocrine disruptors among pregnant women, and use of these compounds is, at present, the best suggestion for an exposure that can affect a large proportion of the human population.”

The researchers say that the risk from the analgesics is markedly higher than that seen for known endocrine disrupters such as phthalates, and that, as most Western women are inevitably exposed to low levels of endocrine disrupters, these together with analgesic use, could be contributing to the increased incidence of cryptorchidism and later life reproductive problems.

Dr Leffers said: “A single paracetamol tablet (500 mg) contains more endocrine disruptor potency than the combined exposure to the ten most prevalent of the currently known environmental endocrine

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Health Research Report

93rd Issue 14 NOV 2010

Compiled By Ralph Turchiano

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