Health Research Report

91st Issue 10 OCT 2010

Compiled By Ralph Turchiano

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Editors Top Five:

1. Diabetes risk may fall as magnesium intake climbs

2. J&J, FDA leaders take heat for ‘phantom’ recall

3. Vitamin D deficiency rampant in patients undergoing orthopedic surgery, damaging patient recovery

4. Think saturated fat contributes to heart disease? Think again

5. Surprise: Scientists discover that inflammation helps to heal wounds

In this Issue:

1. Diabetes risk may fall as magnesium intake climbs

2. UM School of Medicine Center for Celiac Research finds rate of celiac disease is growing

3. Sparkling drinks spark pain circuits

4. Maternal diet high in trans fats doubles risk of excess body fat in breastfed babies, study finds

5. Garlic oil shows protective effect against heart disease in diabetes

6. Blueberries help fight artery hardening, lab animal study indicates

7. IU researchers: Chemotherapy alters brain tissue in breast cancer patients

8. Dirty hands, dirty mouths: U-M study finds a need to clean the body part that lies

9. Research examines vicious cycle of overeating and obesity

10. Dog ownership is associated with reduced eczema in children with dog allergies

11. Faith in God associated with improved survival after liver transplantation

12. Drugs for low libido raise concerns over industry ‘construction’ of new diseases

13. Bioethics scholars fault requirement that all women in clinical drug trials use contraception

14. J&J, FDA leaders take heat for ‘phantom’ recall

15. Vitamin D levels lower in African-Americans

16. Vigorous exercise reduces breast cancer risk in African-American women

17. Think saturated fat contributes to heart disease? Think again

18. Sleep loss limits fat loss

19. Walnuts, walnut oil, improve reaction to stress

20. Surprise: Scientists discover that inflammation helps to heal wounds

21. Amino acid supplement makes mice live longer

22. Shortfalls in carotenoid ( Pro-Vitamin A )intake may impact women’s health

23. Low Testosterone Linked to Alzheimer’s Disease

24. Vitamin D deficiency rampant in patients undergoing orthopedic surgery, damaging patient recovery

Public release date: 24-Sep-2010

Diabetes risk may fall as magnesium intake climbs

NEW YORK (Reuters Health) – Getting enough magnesium in your diet could help prevent diabetes, a new study suggests.

People who consumed the most magnesium in foods and from vitamin supplements were about half as likely to develop diabetes over the next 20 years as people who took in the least magnesium, Dr. Ka He of the University of North Carolina at Chapel Hill and colleagues found.

The results may explain in part why consuming whole grains, which are high in magnesium, is also associated with lower diabetes risk. However, large clinical trials testing the effects of magnesium on diabetes risk are needed to determine whether a causal relationship truly exists, the researchers note in Diabetes Care.

It’s plausible that magnesium could influence diabetes risk because the mineral is needed for the proper functioning of several enzymes that help the body process glucose, the researchers point out. Studies of magnesium and diabetes risk have had conflicting results, though.

To investigate the link, the researchers looked at magnesium intake and diabetes risk in 4,497 men and women 18 to 30 years old, none of whom were diabetic at the study’s outset. During a 20-year follow-up period, 330 of the subjects developed diabetes.

People with the highest magnesium intake, who averaged about 200 milligrams of magnesium for every 1,000 calories they consumed, were 47 percent less likely to have developed diabetes during follow up than those with the lowest intakes, who consumed about 100 milligrams of magnesium per 1,000 calories.

He and colleagues also found that as magnesium intake rose, levels of several markers of inflammation decreased, as did resistance to the effects of the key blood-sugar-regulating hormone insulin. Higher blood levels of magnesium also were linked to a lower degree of insulin resistance.

“Increasing magnesium intake may be important for improving insulin sensitivity, reducing systemic inflammation, and decreasing diabetes risk,” He and colleagues write. “Further large-scale clinical trials are needed to establish causal inference and elucidate the mechanisms behind this potential benefit.”

SOURCE: http://link.reuters.com/xuz35p Diabetes Care, published online August 31, 2010.

Public release date: 27-Sep-2010

UM School of Medicine Center for Celiac Research finds rate of celiac disease is growing

Study finds increasing number of celiac cases, particularly in the elderly

Working to solve the puzzle of when people develop celiac disease has led researchers from the University of Maryland School of Medicine Center for Celiac Research to some surprising findings. They have found that the autoimmune disorder is on the rise with evidence of increasing cases in the elderly. An epidemiological study published September 27 in the Annals of Medicine supports both trends—with interesting implications for possible treatment and prevention.

“You’re never too old to develop celiac disease,” says Alessio Fasano, M.D., director of the University of Maryland’s Mucosal Biology Research Center and the celiac research center, which led the study. The Universita Politecnica delle Marche in Ancona, Italy; the Johns Hopkins Bloomberg School of Public Health; the Women & Children’s Hospital of Buffalo; and Quest Diagnostics Inc. of San Juan Capistrano, Calif., also participated.

Celiac disease is triggered by consuming gluten, a protein found in wheat, barley and rye. Classic symptoms include diarrhea, intestinal bloating and stomach cramps. Left untreated, it can lead to the malabsorption of nutrients, damage to the small intestine and other medical complications.

Since 1974, in the U.S., the incidence of the disorder has doubled every 15 years. Using blood samples from more than 3,500 adults, the researchers found that the number of people with blood markers for celiac disease increased steadily from one in 501 in 1974 to one in 219 in 1989. In 2003, a widely cited study conducted by the celiac research center placed the number of people with celiac disease in the U.S. at one in 133.

As the people in the study aged, the incidence of celiac disease rose, echoing the findings of a 2008 Finnish study in Digestive and Liver Disease that found the prevalence of celiac disease in the elderly to be nearly two and a half times higher than the general population. The recent findings challenge the common speculation that the loss of gluten tolerance resulting in the disease usually develops in childhood.

“You’re not necessarily born with celiac disease,” says Carlo Catassi, M.D., of the Universita Politecnica delle Marche in Italy. Dr. Catassi is the lead author of the paper and co-director of the Center for Celiac Research. “Our findings show that some people develop celiac disease quite late in life.” The trend is supported by clinical data from the center, notes Dr. Catassi, who urges physicians to consider screening their elderly patients.

Although researchers have identified specific genetic markers for the development of celiac disease, exactly how and why an individual loses tolerance to gluten remains a mystery. “Even if you have these genetic markers, it’s not your destiny to develop an autoimmune disease,” adds Dr. Fasano. “Our study shows that environmental factors cause an individual’s immune system to lose tolerance to gluten, given the fact that genetics was not a factor in our study since we followed the same individuals over time.”

The finding contradicts the common wisdom that nothing can be done to prevent autoimmune disease unless the triggers that cause autoimmunity are identified and removed. Gluten is one of the triggers for celiac disease. But if individuals can tolerate gluten for many decades before developing celiac disease, some environmental factor or factors other than gluten must be in play, notes Dr. Fasano.

Identifying and manipulating those factors could lead to novel treatment and possible prevention of celiac disease and other autoimmune disorders including type 1 diabetes, rheumatoid arthritis and multiple sclerosis. Researchers at the University of Maryland Center for Celiac Research are working toward that goal, says Dr. Fasano. As the third most common disease category after cancer and heart disease, autoimmune disorders affect approximately five to eight percent of the U.S. population, according to the National Institutes of Health.

“The groundbreaking research of Dr. Fasano and his team sheds new light on the development of celiac disease, a complex disorder that continues to present challenges to physicians and their patients,” says E. Albert Reece, M.D., Ph.D., M.B.A, vice president for medical affairs, University of Maryland, and John Z. and Akiko K. Bowers Distinguished Professor and dean, University of Maryland School of Medicine.

Diagnosis of celiac disease can be a challenge as patients who test positive for the disease may not display the classic symptoms of gastrointestinal distress linked to the disease. Atypical symptoms include joint pain, chronic fatigue and depression. In the study, only 11 percent of people identified as positive for celiac disease autoimmunity through blood samples had actually been diagnosed with the disease.

Public release date: 28-Sep-2010

Sparkling drinks spark pain circuits

Fizzy beverages light up same pain sensors as mustard and horseradish, a new study shows — so why do we drink them?

You may not think of the fizz in soda as spicy, but your body does.

The carbon dioxide in fizzy drinks sets off the same pain sensors in the nasal cavity as mustard and horseradish, though at a lower intensity, according to new research from the University of Southern California.

“Carbonation evokes two distinct sensations. It makes things sour and it also makes them burn. We have all felt that noxious tingling sensation when soda goes down your throat too fast,” said Emily Liman, senior author of a study published online in the Journal of Neuroscience.

That burning sensation comes from a system of nerves that respond to sensations of pain, skin pressure and temperature in the nose and mouth.

“What we did not know was which cells and which molecules within those cells are responsible for the painful sensation we experience when we drink a carbonated soda,” said Liman, an associate professor of neurobiology in the USC College of Letters, Arts and Sciences.

By flowing carbonated saline onto a dish of nerve cells from the sensory circuits in the nose and mouth, the researchers found that the gas activated only a particular type of cell.

“The cells that responded to CO2 were the same cells that detect mustard,” Liman said.

These cells express a gene known as TRPA1 and serve as general pain sensors.

Mice missing the TRPA1 gene showed “a greatly reduced response” to carbon dioxide, Liman said, while adding the TRPA1 genetic code to CO2-insensitive cells made them responsive to the gas.

Now that carbonated beverages have been linked to pain circuits, some may wonder why we consume them. A new park in Paris even features drinking fountains that dispense free sparkling water.

Liman cited studies going back as far as 1885 that found carbonation dramatically reduced the growth of bacteria.

“Or it may be a macho thing,” she speculated.

If only a sip of San Pellegrino were all it took to prove one’s hardiness.

The pain-sensing TRPA1 provides only one aspect of carbonation’s sensory experience. In 2009, a group led by Charles Zuker of the University of California, San Diego and Nicholas Ryba of the National Institutes of Health showed that carbonation trips cells in the tongue that convey sourness.

Public release date: 29-Sep-2010

Maternal diet high in trans fats doubles risk of excess body fat in breastfed babies, study finds

Athens, Ga. – A new University of Georgia study suggests that mothers who consume a diet high in trans fats double the likelihood that their infants will have high levels of body fat.

Researchers, whose results appear in the early online edition of the European Journal of Clinical Nutrition, found that infants whose mothers consumed more than 4.5 grams of trans fats per day while breastfeeding were twice as likely to have high percentages of body fat, or adiposity, than infants whose mothers consumed less than 4.5 grams per day of trans fats.

The researchers investigated different fatty acids, but determined trans fats to be the most important contributor to excess body fat. “Trans fats stuck out as a predictor to increased adiposity in both mothers and their babies,” said study co-author Alex Anderson, assistant professor in the UGA College of Family and Consumer Sciences.

Anderson explained that although breast milk is optimal for the health of infants, it could also contain high levels of trans fats, depending on the mother’s diet. A better understanding of how a mother’s consumption of trans fats may impact the health of her baby would aid nutritionists in making more accurate dietary recommendations to prevent chronic disease later in life by encouraging mothers to select a diet low in trans fats, he said.

To determine the effect of the intake of trans fats by the child through breast milk, the researchers studied three different groups; mothers who only breast fed their infants, those that only used formula and those that used a combination of breast milk and formula.

It is important to measure body fat in addition to weight, said Anderson, since being overweight does not always mean having a high percent of body fat and vice versa. “It’s not just the weight, but the amount of body fat in the person that affects their health,” Anderson said. “That is why adiposity is such an important measure of cardiovascular risk.”

The researchers also found that mothers who consumed more than 4.5 grams of trans fats per day increased their own risk of excessive fat accumulation, independent of pre-pregnancy weight, by almost six times. This data suggests that trans fats intake could have a more significant weight-gain effect on breastfeeding mothers than it does at other times in their lives, Anderson said.

The researchers studied 96 women, many of whom were highly educated non-Hispanic white women, and note that the study should be replicated in a larger, more diverse group to strengthen information about the health dangers of eating trans fats. “It would help to be able to follow the child from when the mother was pregnant, through birth, and then adolescence, so that we can confirm what the type of infant feeding and maternal diet during breastfeeding have to do with the recent epidemic of childhood obesity,” said Anderson.

Maternal diet high in trans fats doubles risk of excess body fat in breastfed babies, study finds

Athens, Ga. – A new University of Georgia study suggests that mothers who consume a diet high in trans fats double the likelihood that their infants will have high levels of body fat.

Researchers, whose results appear in the early online edition of the European Journal of Clinical Nutrition, found that infants whose mothers consumed more than 4.5 grams of trans fats per day while breastfeeding were twice as likely to have high percentages of body fat, or adiposity, than infants whose mothers consumed less than 4.5 grams per day of trans fats.

The researchers investigated different fatty acids, but determined trans fats to be the most important contributor to excess body fat. “Trans fats stuck out as a predictor to increased adiposity in both mothers and their babies,” said study co-author Alex Anderson, assistant professor in the UGA College of Family and Consumer Sciences.

Anderson explained that although breast milk is optimal for the health of infants, it could also contain high levels of trans fats, depending on the mother’s diet. A better understanding of how a mother’s consumption of trans fats may impact the health of her baby would aid nutritionists in making more accurate dietary recommendations to prevent chronic disease later in life by encouraging mothers to select a diet low in trans fats, he said.

To determine the effect of the intake of trans fats by the child through breast milk, the researchers studied three different groups; mothers who only breast fed their infants, those that only used formula and those that used a combination of breast milk and formula.

It is important to measure body fat in addition to weight, said Anderson, since being overweight does not always mean having a high percent of body fat and vice versa. “It’s not just the weight, but the amount of body fat in the person that affects their health,” Anderson said. “That is why adiposity is such an important measure of cardiovascular risk.”

The researchers also found that mothers who consumed more than 4.5 grams of trans fats per day increased their own risk of excessive fat accumulation, independent of pre-pregnancy weight, by almost six times. This data suggests that trans fats intake could have a more significant weight-gain effect on breastfeeding mothers than it does at other times in their lives, Anderson said.

The researchers studied 96 women, many of whom were highly educated non-Hispanic white women, and note that the study should be replicated in a larger, more diverse group to strengthen information about the health dangers of eating trans fats. “It would help to be able to follow the child from when the mother was pregnant, through birth, and then adolescence, so that we can confirm what the type of infant feeding and maternal diet during breastfeeding have to do with the recent epidemic of childhood obesity,” said Anderson.

Public release date: 29-Sep-2010

Garlic oil shows protective effect against heart disease in diabetes

Garlic has “significant” potential for preventing cardiomyopathy, a form of heart disease that is a leading cause of death in people with diabetes, scientists have concluded in a new study. Their report, which also explains why people with diabetes are at high risk for diabetic cardiomyopathy, appears in ACS’ bi-weekly Journal of Agricultural and Food Chemistry.

Wei-Wen Kuo and colleagues note that people with diabetes have at least twice the risk of death from heart disease as others, with heart disease accounting for 80 percent of all diabetes-related deaths. They are especially vulnerable to a form of heart disease termed diabetic cardiomyopathy, which inflames and weakens the heart’s muscle tissue. Kuo’s group had hints from past studies that garlic might protect against heart disease in general and also help control the abnormally high blood sugar levels that occur in diabetes. But they realized that few studies had been done specifically on garlic’s effects on diabetic cardiomyopathy.

The scientists fed either garlic oil or corn oil to laboratory rats with diabetes. Animals given garlic oil experienced beneficial changes associated with protection against heart damage. The changes appeared to be associated with the potent antioxidant properties of garlic oil, the scientists say, adding that they identified more than 20 substances in garlic oil that may contribute to the effect. “In conclusion, garlic oil possesses significant potential for protecting hearts from diabetes-induced cardiomyopathy,” the report notes.

Public release date: 29-Sep-2010

Blueberries help fight artery hardening, lab animal study indicates

Blueberries may help fight atherosclerosis, also known as hardening of the arteries, according to results of a preliminary U.S. Department of Agriculture (USDA)-funded study with laboratory mice. The research provides the first direct evidence that blueberries can help prevent harmful plaques or lesions, symptomatic of atherosclerosis, from increasing in size in arteries.

Principal investigator Xianli Wu, based in Little Rock, Ark., with the USDA Agricultural Research Service (ARS) Arkansas Children’s Nutrition Center and with the University of Arkansas for Medical Sciences, led the investigation. The findings are reported in the current issue of the Journal of Nutrition.

Atherosclerosis is the leading cause of two forms of cardiovascular disease–heart attacks and strokes. Cardiovascular disease is the number one killer of Americans.

The study compared the size, or area, of atherosclerotic lesions in 30 young laboratory mice. Half of the animals were fed diets spiked with freeze-dried blueberry powder for 20 weeks; the diet of the other mice did not contain the berry powder.

Lesion size, measured at two sites on aorta (arteries leading from the heart), was 39 and 58 percent less than that of lesions in mice whose diet did not contain blueberry powder.

Earlier studies, conducted elsewhere, have suggested that eating blueberries may help combat cardiovascular disease. But direct evidence of that effect has never been presented previously, according to Wu.

The blueberry-spiked diet contained 1 percent blueberry powder, the equivalent of about a half-cup of fresh blueberries.

All mice in the investigation were deficient in apolipoprotein-E, a trait which makes them highly susceptible to forming atherosclerotic lesions and thus an excellent model for biomedical and nutrition research.

Wu’s group wants to determine the mechanism or mechanisms by which blueberries helped control lesion size. For example, by boosting the activity of four antioxidant enzymes, blueberries may have reduced the oxidative stress that is a known risk factor for atherosclerosis.

In followup studies, Wu’s group wants to determine whether eating blueberries in infancy, childhood and young adulthood would help protect against onset and progression of atherosclerosis in later years. Early prevention may be especially important in light of the nation’s epidemic of childhood obesity. Overweight and obesity increase atherosclerosis risk.

Public release date: 29-Sep-2010

IU researchers: Chemotherapy alters brain tissue in breast cancer patients

INDIANAPOLIS — Researchers at the Indiana University Melvin and Bren Simon Cancer Center have published the first report using imaging to show that changes in brain tissue can occur in breast cancer patients undergoing chemotherapy.

The cognitive effects of chemotherapy, often referred to as “chemobrain,” have been known for years. However, the IU research is the first to use brain imaging to study women with breast cancer before and after treatment, showing that chemotherapy can affect gray matter. The researchers reported their findings in the October 2010 edition of Breast Cancer Research and Treatment.

“This is the first prospective study,” said Andrew Saykin, Psy.D., director of the Indiana University Center for Neuroimaging and a researcher at the IU Simon Cancer Center. “These analyses, led by Brenna McDonald, suggest an anatomic basis for the cognitive complaints and performance changes seen in patients. Memory and executive functions like multi-tasking and processing speed are the most typically affected functions and these are handled by the brain regions where we detected gray matter changes.”

Dr. Saykin, who is Raymond C. Beeler Professor of Radiology at the IU School of Medicine, and colleagues studied structural MRI scans of the brain obtained on breast cancer patients and healthy controls. The scans were taken after surgery, but before radiation or chemotherapy, to give the researchers a baseline. Scans were then repeated one month and one year after chemotherapy was completed.

The researchers found gray matter changes were most prominent in the areas of the brain that are consistent with cognitive dysfunction during and shortly after chemotherapy. Gray matter density in most women improved a year after chemotherapy ended.

For many patients, Dr. Saykin said, the effects are subtle. However, they can be more pronounced for others. Although relatively rare, some patients — often middle-aged women — are so affected that they are never able to return to work. More commonly, women will still be able to work and multi-task, but it may be more difficult to do so.

The study focused on 17 breast cancer patients treated with chemotherapy after surgery, 12 women with breast cancer who did not undergo chemotherapy after surgery, and 18 women without breast cancer.

“We hope there will be more prospective studies to follow so that the cause of these changes in cancer patients can be better understood,” Dr. Saykin said.

Dr. Saykin and his colleagues started their research at Dartmouth Medical School before finishing the data analyses at IU. A new, independent sample is now being studied at the IU Simon Cancer Center to replicate and further investigate this problem affecting many cancer patients.

Public Release: 29-Sep-2010

Dirty hands, dirty mouths: U-M study finds a need to clean the body part that lies

ANN ARBOR, Mich.—Apparently your mom had it right when she threatened to wash your mouth out with soap if you talked dirty. Lying really does create a desire to clean the “dirty” body part, according to a University of Michigan study.

“The references to ‘dirty hands’ or ‘dirty mouths’ in everyday language suggest that people think about abstract issues of moral purity in terms of more concrete experiences with physical purity,” said Spike W.S. Lee, a U-M doctoral candidate in psychology, who conducted the study with Norbert Schwarz, a psychologist at the U-M Institute for Social Research (ISR), the Ross School of Business, and the U-M psychology department.

The findings of the study, published in the current (October) issue of Psychological Science, support that connection.

For the study, Lee and Schwarz asked 87 students to play the role of lawyers competing with a colleague, “Chris,” for a promotion. Each was asked to imagine they found an important document that Chris had lost, and that returning the document would help his career and hurt their own career. Each participant was instructed to leave Chris a message by either voice mail or email, telling him who they were and either lying that they could not find his document or telling the truth that they had found the document.

Next, participants rated the desirability of several products as part of a supposed marketing survey and reported how much they were willing to pay for each product. The products included mouthwash and hand sanitizer.

Study participants who lied on the phone, leaving an untrue and malevolent voicemail, felt a stronger desire for mouthwash and were willing to pay more for it than those who lied on e-mail. And conversely, those who lied on e-mail, typing the same mean message, felt a stronger desire for hand sanitizer and were willing to pay more for that. Saying nice and ethical things, on the other hand, made it less appealing to clean the body part involved in conveying the message.

In scientific terms, the findings showed that “the embodiment of moral purity is specific to the motor modality involved in the moral transgression.” Verbal lying increased participants’ assessment of mouthwash while lying on e-mail, using their hands, increased the assessment of hand sanitizer’s value.

“This study shows how ‘concrete’ the metaphorical links are between abstract and concrete domains of life,” Schwarz said. “Not only do people want to clean after a dirty deed, they want to clean the specific body part involved.”

Public release date: 29-Sep-2010

Research examines vicious cycle of overeating and obesity

New research provides evidence of the vicious cycle created when an obese individual overeats to compensate for reduced pleasure from food.

Obese individuals have fewer pleasure receptors and overeat to compensate, according to a study by University of Texas at Austin senior research fellow and Oregon Research Institute senior scientist Eric Stice and his colleagues published this week in The Journal of Neuroscience.

Stice shows evidence this overeating may further weaken the responsiveness of the pleasure receptors (“hypofunctioning reward circuitry”), further diminishing the rewards gained from overeating.

Food intake is associated with dopamine release. The degree of pleasure derived from eating correlates with the amount of dopamine released. Evidence shows obese individuals have fewer dopamine (D2) receptors in the brain relative to lean individuals and suggests obese individuals overeat to compensate for this reward deficit.

People with fewer of the dopamine receptors need to take in more of a rewarding substance — such as food or drugs — to get an effect other people get with less.

“Although recent findings suggested that obese individuals may experience less pleasure when eating, and therefore eat more to compensate, this is the first prospective evidence to show that the overeating itself further blunts the award circuitry,” says Stice, a senior scientist at Oregon Research Institute, a non-profit, independent behavioral research center. “The weakened responsivity of the reward circuitry increases the risk for future weight gain in a feed-forward manner. This may explain why obesity typically shows a chronic course and is resistant to treatment.”

Using Functional Magnetic Resonance Imaging (fMRI), Stice’s team measured the extent to which a certain area of the brain (the dorsal striatum) was activated in response to the individual’s consumption of a taste of chocolate milkshake (versus a tasteless solution). Researchers tracked participants’ changes in body mass index over six months.

Results indicated those participants who gained weight showed significantly less activation in response to the milkshake intake at six-month follow-up relative to their baseline scan and relative to women who did not gain weight.

“This is a novel contribution to the literature because, to our knowledge, this is the first prospective fMRI study to investigate change in striatal response to food consumption as a function of weight change,” said Stice. “These results will be important when developing programs to prevent and treat obesity.”

Public release date: 30-Sep-2010

Dog ownership is associated with reduced eczema in children with dog allergies

Cincinnati, OH, September 30, 2010 — Children with eczema, a chronic skin condition that often begins in childhood, have a greater risk of developing asthma and food allergies. The number of children with eczema is rising, but the reasons for this are unclear. A new study soon to be published in The Journal of Pediatrics examines the relationship between pet ownership and eczema. Researchers found that dog ownership among children with dog allergies may reduce the risk of developing eczema by age 4 years; cat ownership, however, may increase the risk among children with cat allergies.

Dr. Tolly Epstein and colleagues from the University of Cincinnati and Cincinnati Children’s Hospital Medical Center gathered data from 636 children enrolled in the Cincinnati Childhood Allergy & Air Pollution Study (CCAAPS), a long-term epidemiologic study examining the effects of environmental particulates on childhood respiratory health and allergy development. Children enrolled in the study are considered at high risk for developing allergies because they were born to parents with allergies. The researchers focused on several potential risk factors for developing eczema, including dog and cat ownership. The children were tested for 17 separate allergies on a yearly basis from ages 1 through 4 years, and the parents completed yearly surveys.

The results provided interesting information regarding pet ownership. The researchers found that children who tested positive for dog allergies were less likely to develop eczema by age 4 years if they owned a dog before age 1 year. According to Dr. Epstein, “Children with dog allergies who did not own dogs were 4 times more likely to develop eczema.”

Unlike dog ownership, cat ownership seemed to have a negative effect on children with cat allergies. “Children who owned a cat before age 1 year and were allergic to cats based on a skin allergy test were 13 times more likely to develop eczema by age 4 years,” Dr. Epstein explains. She notes, however, that children who were not allergic to cats were not at an increased risk for eczema if they owned a cat. Dr. Epstein suggests that parents of children at risk for eczema may want to consider these findings when choosing a family pet.

Public release date: 30-Sep-2010

Faith in God associated with improved survival after liver transplantation

Study reveals religiosity prolongs life span

Italian researchers report that liver transplant candidates who have a strong religious connection have better post-transplant survival. This study also finds that religiosity—regardless of cause of death—prolongs the life span of individuals who underwent liver transplantation. Full findings are now available online and in the October issue of Liver Transplantation. a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases (AASLD).

Much of the medical profession today is focused on the delivery of services, rather than whole patient care which not only takes into account physical well-being, but psychological, social, and spiritual aspects as well. Although there is a lack of interest in religion by the medical community, the authors point out that 90% of the world’s population today is involved in some form of religion or spiritual pursuit. Prior studies have demonstrated that religiosity allows individuals to better cope with illness, and may even influence disease progression. Furthermore, a report by McCullough et al. that included a meta-analysis of 42 studies (surveying roughly 126,000 people) found active religious involvement increased the odds of being alive at follow-up by 26%.

“Our study tested the hypothesis that religiosity—seeking God’s help, having faith in God, trusting in God, trying to discern God’s will even in the disease—improves survival of patients with end-stage liver disease who underwent liver transplantation,” explains Franco Bonaguidi, D.Psych., and lead author of the study. The study team selected 179 patients who received a liver transplant between January 2004 and December 2007, and who also completed the religiosity questionnaire. Participants (129 males and 50 females) had a media age of 52 years and were followed for 4 years (median = 21 months) post-transplantation. Indications for liver transplant included: viral hepatitis (68%), alcoholic liver disease (17%), and autoimmune hepatitis (7%).

Results indicate that the Search for God factor (hazard ratio = 2.95) and length of stay in the intensive care unit (1.05) were independently associated with survival. Furthermore, it was the personal relationship between the patient and God, regardless of religious creed (Christian, Muslim, or other) rather than formal church attendance that positively affected survival. As one participant described, “I recovered my life by the will of Someone up there…I had great faith in Him. This closeness made me feel strong and calm.”

Dr. Bonaguidi concluded, “We found that an active search for God—the patient’s faith in a higher power rather than a generic destiny—had a positive impact on patient survival.” The authors caution that this study focuses on a severely ill patient population, therefore the conclusions may not be applicable to individuals with different illnesses or degrees of disease severity.

Public release date: 30-Sep-2010

Drugs for low libido raise concerns over industry ‘construction’ of new diseases

Feature: Merging of marketing and medical science: female sexual dysfunction

Drug companies have not only sponsored the science of a new condition known as female sexual dysfunction, they have helped to construct it, in order to build global markets for new drugs, reveals an article in this week’s BMJ.

Researching his new book ‘Sex, Lies and Pharmaceuticals’ Ray Moynihan, journalist and lecturer at the University of Newcastle in Australia, discovered that drug industry employees have worked with paid key opinion leaders to help develop the disease entity; they have run surveys to portray it as widespread; and they helped design diagnostic tools to persuade women that their sexual difficulties deserve a medical label and treatment.

He believes that “drug marketing is merging with medical science in a fascinating and frightening way” and he asks whether we need a fresh approach to defining disease.

He quotes a company employee saying that her company was interested in “expediting the development of a disease” and he reveals how companies are funding surveys that portray sexual problems as widespread and creating tools to assess women for “hypoactive sexual desire disorder.”

Many of the researchers involved in these activities were drug company employees or had financial ties to the industry, writes Moynihan. Meanwhile, scientific studies conducted without industry funding were questioning whether a widespread disorder of low desire really existed.

Industry is also taking a leading role in “educating” both professionals and the public about this controversial condition, he adds.

For example, a Pfizer funded course designed for doctors across the United States claimed that up to 63% of women had sexual dysfunction and that testosterone and sildenafil (Viagra) may be helpful, along with behavioural therapy. And he points out that German drug company Boehringer Ingelheim’s “educational” activities “went into overdrive” as the planned 2010 launch of its desire drug, flibanserin, approached.

In June, flibanserin was rejected by advisors to the US Food and Drug Administration and Pfizer’s sildenafil was also pulled after studies showed virtually no difference from placebo. But although the drugs have so far failed, Moynihan warns that “the edifice of scientific evidence about the condition remains in place … creating the impression that there is a massive “unmet need” for treatment.”

And with more experimental drugs in the pipeline, “the drug industry shows no signs of abandoning plans to meet the unmet need it has helped to manufacturer,” he says.

“Perhaps it’s time to reassess the way in which the medical establishment defines common conditions and recommends how to treat them,” he suggests.

“Perhaps it is time to develop new panels to take responsibility for defining treatable illness, made up of people without financial ties to those with vested interests in the outcomes of their deliberations and much more broadly representative of the wider public … and start the slow process of untangling the marketing from the medical science.” he concludes.

“Faced with a woman in tears whose libido has disappeared and who is terrified of losing her partner, doctors can feel immense pressure to provide an immediate, effective solution,” says Dr Sandy Goldbeck-Wood, a specialist in psychosexual medicine, in an accompanying commentary.

She says Moynihan’s research clarifies both the conflicts of interest at work and the relative paucity of good quality evidence for pharmacological solutions to women’s sexual problems. However, she argues: “his argument that female sexual dysfunction is an illness constructed by pathologising doctors under the influence of drug companies will fail to convince clinicians who see women with sexual dysfunction, or their patients.”

Women who have struggled to overcome the psychological and cultural barriers to requesting help with their sexual difficulties will not welcome the argument that they are to be “left alone,” she writes.

She believes the problem is one of oversimplification and believes that more studies are needed that reflect the complexity of sexual life. “It’s time to invest in more research into the most realistic, respectful and evidence based treatments, rather than narrow biological ones founded on poor evidence,” she says.

Public release date: 30-Sep-2010

Bioethics scholars fault requirement that all women in clinical drug trials use contraception

(Garrison, NY) Research ethics review committees often require all women of childbearing age who enroll in clinical trials to use contraceptives to protect against a developing fetus being exposed to potentially harmful drugs. A mandatory contraceptive policy is often imposed even when there is no evidence that a trial drug could harm a fetus or when women have no chance of becoming pregnancy. This requirement is excessive and can safely be relaxed in many cases, according to a report in IRB: Ethics & Human Research.

Policies on contraceptive use in research should reflect the level of potential risk the study drug poses to the fetus, write Chris Kaposy, an assistant professor of Health Care Ethics at Memorial University of Newfoundland, Canada; and Françoise Baylis, professor and Canada Research Chair in Bioethics and Philosophy at Dalhousie University in Halifax. They point to the U.S. Food and Drug Administration’s categories for prescription drug labeling for drug use in pregnancy as a helpful guide. The FDA has five categories, each with different degrees of evidence of risk to fetuses.

Category A, for example, indicates that “adequate, well-controlled studies in pregnant women have not shown increased risk of fetal abnormalities.” And yet the policy of the University of Nebraska Medical Center’s institutional review board – which Kaposy and Baylis reviewed as a typical example of IRB contraceptive use policies – permits researchers to petition the IRB to impose a mandatory contraception or abstinence requirement for trial participants in studies that use Category A drugs. However, the authors argue that an ideal policy for Category A drugs would not require contraception or abstinence.

The authors also say that contraception should not be mandated for women who have no chance of becoming pregnant while participating in a clinical drug trial. “Consider, for example, women who are not sexually active (e.g., nuns) or who are not sexually active in a heterosexual relationship (e.g., lesbians),” they write. Mandating contraception for these groups sends “a paternalistic message of mistrust” that undermines the normal practice of treating research participants as autonomous decision-makers.

“Our recommendations are an attempt to find an appropriate balance between the interests of potential fetuses and the autonomy and well-being of women,” they write.

Public release date: 30-Sep-2010

J&J, FDA leaders take heat for ‘phantom’ recall

By MATTHEW PERRONE, AP Health Writer Matthew Perrone, Ap Health Writer

Thu Sep 30, 5:58 pm ET

WASHINGTON – Johnson & Johnson executives and the Food and Drug Administration both shouldered the blame Thursday for a secret recall in which hired contractors quietly bought up defective painkillers to clear them from store shelves.

J&J Chief Executive William Weldon told House lawmakers the company “made a mistake” in conducting the so-called “phantom recall,” which is one of a string of problems that have drawn congressional scrutiny

In the same committee hearing, the FDA’s deputy commissioner, Dr. Joshua Sharfstein, said his agency should have acted sooner to halt J&J’s plan. At the same time, though, he stressed that regulators were not aware of the deceptive nature of the recall.

Sharfstein and Weldon testified before the House Committee on Oversight and Government Reform, which held its second hearing on J&J’s unprecedented spate of recalls. The largest, involving more than 135 million bottles of infants’ and children’s Tylenol and other medicines, triggered the committee’s investigation.

“We recognize that we need to do better, and we will work hard to restore the public’s trust and faith in Johnson & Johnson,” Weldon told lawmakers.

Democrats and Republicans pressed Weldon on its “phantom” recall involving 88,000 packets of Motrin, which Weldon acknowledged as “not one of our finer moments.”

But lawmakers also pressed the FDA on when and what it knew about the activity. New Brunswick, N.J.-based J&J has repeatedly claimed it alerted the agency’s officials in Puerto Rico, where the defective Motrin was originally manufactured.

Sharfstein said J&J informed the FDA of its plan to repurchase the pills – which did not dissolve correctly – in April 2009.

“From this point, it took until July for the FDA to tell the company that a recall should be conducted,” Sharfstein said in his testimony. “In my opinion that message should have been given sooner.”

But Sharfstein stressed that the FDA did not know J&J had instructed contractors to pose as regular customers while buying the product and to not alert store employees to their activity.

“Based on the documents I reviewed, I don’t see any indication that the FDA was aware of the surreptitious, lying nature of the recall,” he said.

Republican lawmakers criticized a “too cozy” relationship between FDA and J&J employees, citing months-long e-mail exchanges between the two before regulators took action. But Sharfstein said ultimate blame lies with J&J, pointing out that the FDA does not have the authority to order when and how companies conduct recalls.

“I think fundamentally the responsibility is with the company to handle their quality problems in a much different way,” Sharfstein said.

Companies are advised to work with the FDA on recalls, although that isn’t a legal requirement.

Committee Chairman Edolphus Towns, D-N.Y., has introduced a bill that would give the agency the power to order recalls.

The maker of trusted brands like Tylenol and Benadryl, J&J has announced nine recalls of drugs for children and adults since last September with problems ranging from too much active ingredient to tiny shards of metal.

In May, J&J closed its Fort Washington, Pa., facility, the largest manufacturing site for children’s medications. J&J announced Thursday it would begin shipping its grape-flavored Children’s Tylenol next week, the first of its children’s formulas to return to the market.

Weldon said the company plans to invest $100 million across the company to improve facilities, equipment and operations around the world.

Weldon, who has been CEO since 2002, missed the committee’s last hearing because of back surgery.

Testifying beside him Thursday was J&J executive Colleen Goggins, who oversaw the consumer division of the company’s McNeil Healthcare unit during the recalls.

At the May hearing, Goggins told lawmakers she had no knowledge of instructions to contractors involved in the phantom recall to not tell store employees what they were doing. In her testimony Thursday, Goggins acknowledged that the company wrote those instructions.

“Based on what I have learned since May, I believe that McNeil should have handled things differently,” Goggins said.

Goggins will retire in March, Johnson & Johnson announced this month.

Ralph’s Note – If all the product did was not dissolve correctly….Then why the incredible secrecy, and deception? I’m sorry.. First the FDA and J&J admit being dishonest….Then they issue this weak press release. Yes the FDA may not of had the authoity to issue a recall…BUT IT IS THEIR JOB TO AT LEAST INFORM THE PUBLIC.. Now that all the recalled tablets have been secretly REMOVED AS EVIDENCE….How will we ever know the TRUTH. Whatever Tablets remain, need to go to an independent testing facility…. WHY are no lot numbers mentioned in this article? They are probably still sitting in medicine cabinets across the country….

Public release date: 1-Oct-2010

Vitamin D levels lower in African-Americans

MIAMI — African-American women had lower vitamin D levels than white women, and vitamin D deficiency was associated with a greater likelihood for aggressive breast cancer, according to data presented at the Third AACR Conference on the Science of Cancer Health Disparities.

“We know that darker skin pigmentation acts somewhat as a block to producing vitamin D when exposed to sunlight, which is the primary source of vitamin D in most people,” said Susan Steck, Ph.D., M.P.H., associate professor of epidemiology at the University of South Carolina.

Steck and colleagues observed 107 women who were all diagnosed with breast cancer in the previous five years. Sixty of these women were African-American, while the remaining 47 were white.

All women donated a blood sample, and vitamin D status was determined using circulating 25 hydroxyvitamin D levels as a marker. The mean serum concentration of vitamin D was 29.8 ng/ml in white women and 19.3 ng/ml in African-American women.

Researchers defined vitamin D deficiency as a serum concentration less than 20 ng/ml, and found this to be the case in 60 percent of African-American women compared with 15 percent of white women. Serum levels were lowest among patients with triple-negative breast cancer, and aggressive disease was eight times more likely among patients with vitamin D deficiency.

Steck said the findings of this study provide a foundation for a possible prevention strategy, but further research would be required.

Public release date: 1-Oct-2010

Vigorous exercise reduces breast cancer risk in African-American women

MIAMI — Vigorous exercise of more than two hours per week reduces the risk of developing breast cancer in postmenopausal African-American women by 64 percent, compared to women of the same race who do not exercise, according to researchers at Georgetown Lombardi Comprehensive Cancer Center.

Results were presented at the Third AACR Conference on The Science of Cancer Health Disparities, held Sept. 30 to Oct. 3, 2010.

“People often want to know what they can do to reduce their risk of disease, and we have found that just two or more hours of vigorous activity per week can made a difference in one’s risk of developing breast cancer,” said the lead researcher Vanessa Sheppard, Ph.D., a cancer control scientist and assistant professor in the department of oncology at the Lombardi Comprehensive Cancer Center.

In this study, more than two hours of aerobics, running or similar activity over the span of a week counted as vigorous activity.

“We also know from other studies that being physically active can have benefits in other diseases that occur at high rates in African-American women, such as diabetes and hypertension,” Sheppard said. “Four out of five African-American women are either overweight or obese, and disease control is a particularly important issue for them.”

Evidence showing exercise reduces breast cancer risk has been inconsistent, and there are few that look specifically at African-American women, Sheppard said. The issue is important, she added, because breast cancer has some important differences in this community. Whereas more white women are diagnosed with breast cancer, African-American women have a higher risk of developing premenopausal breast cancer than white women do, and comparatively more African-American women develop the most aggressive form of the disease, known as triple-negative breast cancer.

The researchers identified 97 recently diagnosed African-American breast cancer patients in the Washington, D.C., area and matched them with 102 African-American women without breast cancer. Participants filled out a questionnaire about exercise routines; the responses were analyzed and compared.

Women who exercised vigorously for more than two hours a week in the past year had a 64 percent reduced risk of breast cancer compared to women who did not exercise. Women who engaged in moderate exercise, like walking, had a 17 percent reduced risk, compared to women who were sedentary.

After evaluating those who were pre- and postmenopausal, they found that vigorous exercise only significantly benefitted postmenopausal women — they had a 62 percent reduction in risk.

“I was surprised that we did not find a significant effect in premenopausal women, but it may be because we need a larger sample,” Sheppard said.

However, when the researchers examined the effect of total physical activity, which combined walking with vigorous activity of two or more hours per week, they saw significant gains for both premenopausal and postmenopausal women.

“We suggest that our findings, while promising, should be interpreted with caution. This is a pilot study and a larger, more rigorous study is needed to precisely quantify the effect of exercise on development of breast cancer. I think it is fair to conclude that if African American women exercise they can help take charge of their health,” said Sheppard.

Public release date: 1-Oct-2010

Think saturated fat contributes to heart disease? Think again

Leading scientists re-examine the role of saturated fat in the diet

(Rosemont, IL) Oct. 1 – For the past three decades, saturated fat has been considered a major culprit of cardiovascular disease (CVD) and as a result dietary advice persists in recommending reduced consumption of this macronutrient. However, new evidence shows that saturated fat intake has only a very limited impact on CVD risk — causing many to rethink the “saturated fat is bad” paradigm.

A series of research articles published in the October issue of Lipids provides a snapshot of recent advances in saturated fat and health research, based on science presented at the 100th American Oil Chemists’ Society (AOCS) annual meeting in Orlando, Florida (May 2009). During a symposium entitled “Saturated Fats and Health: Facts and Feelings,” world-renowned scientists specializing in fat research analyzed the evidence between saturated fat intake and health, and overall agreed upon the need to reduce over-simplification when it came to saturated fat dietary advice.

“The relationship between dietary intake of fats and health is intricate, and variations in factors such as human genetics, life stage and lifestyles can lead to different responses to saturated fat intake,” said J. Bruce German, PhD, professor and chemist in the Department of Food Science and Technology, University of California at Davis. “Although diets inordinately high in fat and saturated fat are associated with increased cardiovascular disease risk in some individuals, assuming that saturated fat at any intake level is harmful is an over-simplification and not supported by scientific evidence.”

Professor Philippe Legrand of Agrocampus-INRA in France confirmed this by discussing various roles that different saturated fatty acids play in the body. His main conclusion was that saturated fats can no longer be considered a single group in terms of structure, metabolism and cellular function, and recommendations that group them together with regard to health effects need to be updated.

Effect of Saturated Fat Replacement on CVD Risk

Results from a research review conducted by Dariush Mozaffarian, MD, MPH, Department of Epidemiology and Nutrition at Harvard University School of Public Health, found that the effects of saturated fat intake on CVD risk depend upon simultaneous changes in other nutrients. For example, replacing saturated fat with mono-unsaturated fat yielded uncertain effects on CVD risk, while replacing saturated fat with carbohydrates was found to be ineffective and even harmful especially when refined carbohydrates such as starches or sugars were used in place of fat . Replacing saturated fat with polyunsaturated fat gave a small reduction in CVD risk, but even with optimal replacement the magnitude of the benefit was very small. According to Mozaffarian it would be far better to focus on dietary factors giving much larger benefits for CVD health, such as increasing intake of seafood/omega-3 fatty acids, whole grains, fruits and vegetables, and decreasing intake of trans fats and sodium.

”Carbohydrate intake has been intimately linked to metabolic syndrome, which is a combination of risk factors that can increase CVD risk,” said Jeff Volek, PhD, RD, Department of Kinesiology, University of Connecticut. His research showed that very low carbohydrate diets can favorably impact a broad spectrum of metabolic syndrome and cardiovascular risk factors, even in the presence of high saturated fat intake and in the absence of weight loss.

Kiran Musunuru, MD, PhD, MPH. Cardiovascular Research Center and Center for Human Genetic Research, Massachusetts General Hospital, focused on the role of carbohydrates and fats on atherogenic dyslipidemia – a new marker for CVD risk often seen in patients with obesity, metabolic syndrome, insulin resistance and type 2 diabetes. He showed that low-carbohydrate diets appear to have beneficial lipoprotein effects in individuals with atherogenic dyslipidemia, compared to high-carbohydrate diets, whereas the content of saturated fat in the diet has no significant effect.

Full-Fat Dairy: An Unnecessary Target?

As long as saturated fat targets remain firmly rooted in dietary advice, nutrient-rich foods that contribute saturated fat to the diet, like full-fat dairy products, will continue to be unduly criticized regardless of their health benefits.

A recent meta-analysis of epidemiological and intervention studies of milk fat conducted by Peter Elwood, DSc, MD, FRCP, FFPHM, DUniv, Hon DSc, Honorary Professor at the School of Medicine, Cardiff University, found that milk and dairy consumption actually was associated with a decrease in CVD risk .

“It is clear that we have barely scratched the surface in our understanding about the biological effects of saturated fatty acids,” said Cindy Schweitzer, PhD, Technical Director, Global Dairy Platform. “Scientific meetings where researchers from different disciplines within the field of nutrition share information are extremely important to identify both the gaps in our knowledge and the studies that are needed to answer the important questions about diet and health.”

All of these recent research advances add to the growing body of science re-assessing the role of saturated fat in the diet. Whether it’s nutrient replacement or better understanding the role certain foods can play in CVD risk, saturated fat is definitely not be as bad as once thought.

Public release date: 4-Oct-2010

Sleep loss limits fat loss

Cutting back on sleep reduces the benefits of dieting, according to a study published October 5, 2010, in the Annals of Internal Medicine.

When dieters in the study got a full night’s sleep, they lost the same amount of weight as when they slept less. When dieters got adequate sleep, however, more than half of the weight they lost was fat. When they cut back on their sleep, only one-fourth of their weight loss came from fat.

They also felt hungrier. When sleep was restricted, dieters produced higher levels of ghrelin, a hormone that triggers hunger and reduces energy expenditure.

“If your goal is to lose fat, skipping sleep is like poking sticks in your bicycle wheels,” said study director Plamen Penev, MD, PhD, assistant professor of medicine at the University of Chicago. “Cutting back on sleep, a behavior that is ubiquitous in modern society, appears to compromise efforts to lose fat through dieting. In our study it reduced fat loss by 55 percent.”

The study, performed at the University of Chicago’s General Clinical Resource Center, followed 10 overweight but healthy volunteers aged 35 to 49 with a body mass index ranging from 25, considered overweight, to 32, considered obese. Participants were placed on an individualized, balanced diet, with calories restricted to 90 percent of what each person needed to maintain his or her weight without exercise.

Each participant was studied twice: once for 14 days in the laboratory with an 8.5-hour period set aside for sleep, and once for 14 days with only 5.5 hours for sleep. They spent their waking hours engaged in home- or office-like work or leisure activities.

During the two-week, 8.5-hours-in-bed phase, volunteers slept an average of 7 hours and 25 minutes each night. In the 5.5-hour phase, they slept 5 hours and 14 minutes, or more than two hours less. The number of calories they consumed, about 1,450 per day, was kept the same.

The volunteers lost an average of 6.6 pounds during each 14-day session. During weeks with adequate sleep, they lost 3.1 pounds of fat and 3.3 pounds of fat-free body mass, mostly protein. During the short-sleep weeks, participants lost an average of 1.3 pounds of fat and 5.3 pounds of fat-free mass.

Getting adequate sleep also helped control the dieters’ hunger. Average levels of ghrelin did not change when dieters spent 8.5 hours in bed. When they spent 5.5 hours in bed, their ghrelin levels rose over two weeks from 75 ng/L to 84 ng/L.

Higher ghrelin levels have been shown to “reduce energy expenditure, stimulate hunger and food intake, promote retention of fat, and increase hepatic glucose production to support the availability of fuel to glucose dependent tissues,” the authors note. “In our experiment, sleep restriction was accompanied by a similar pattern of increased hunger and … reduced oxidation of fat.”

The tightly controlled circumstances of this study may actually have masked some of sleep’s benefits for dieters, suggested Penev. Study subjects did not have access to extra calories. This may have helped dieters to “stick with their lower-calorie meal plans despite increased hunger in the presence of sleep restriction,” he said.

The message for people trying to lose weight is clear, Penev said. “For the first time, we have evidence that the amount of sleep makes a big difference on the results of dietary interventions. One should not ignore the way they sleep when going on a diet. Obtaining adequate sleep may enhance the beneficial effects of a diet. Not getting enough sleep could defeat the desired effects.”

Public release date: 4-Oct-2010

Walnuts, walnut oil, improve reaction to stress

A diet rich in walnuts and walnut oil may prepare the body to deal better with stress, according to a team of Penn State researchers who looked at how these foods, which contain polyunsaturated fats, influence blood pressure at rest and under stress.

Previous studies have shown that omega-3 fatty acids — like the alpha linolenic acid found in walnuts and flax seeds — can reduce low density lipoproteins (LDL) — bad cholesterol. These foods may also reduce c-reactive protein and other markers of inflammation.

“People who show an exaggerated biological response to stress are at higher risk of heart disease,” said Sheila G. West, associate professor of biobehavioral health. “We wanted to find out if omega 3-fatty acids from plant sources would blunt cardiovascular responses to stress.”

The researchers studied 22 healthy adults with elevated LDL cholesterol. All meals and snacks were provided during three diet periods of six weeks each.

The researchers found that including walnuts and walnut oil in the diet lowered both resting blood pressure and blood pressure responses to stress in the laboratory. Participants gave a speech or immersed their foot in cold water as a stressor. Adding flax seed oil to the walnut diet did not further lower blood pressure. They report their findings in the current issue of the Journal of the American College of Nutrition.

“This is the first study to show that walnuts and walnut oil reduce blood pressure during stress,” said West. “This is important because we can’t avoid all of the stressors in our daily lives. This study shows that a dietary change could help our bodies better respond to stress.”

A subset of the participants also underwent a vascular ultrasound in order to measure artery dilation. Results showed that adding flax oil to the walnut diet significantly improved this test of vascular health. The flax plus walnuts diet also lowered c-reactive protein, indicating an anti-inflammatory effect. According to West, that could also reduce risk of cardiovascular disease.

The researchers used a randomized, crossover study design. Tests were conducted at the end of each six-week diet, and every participant consumed each of the three diets in random order, with a one-week break between. Diets included an “average” American diet – a diet without nuts that reflects what the typical person in the U.S. consumes each day. The second diet included 1.3 ounces of walnuts and a tablespoon of walnut oil substituted for some of the fat and protein in the average American diet. The third diet included walnuts, walnut oil and 1.5 tablespoons of flaxseed oil. The three diets were matched for calories and were specifically designed for each participant so that no weight loss or gain occurred. The walnuts, walnut oil, and flax oil were either mixed into the food in such offerings as muffins or salad dressing or eaten as a snack. About 18 walnut halves or 9 walnuts make up the average serving used by the researchers.

After each diet, the participants underwent two stress tests. In the first test, they received a topic; and they were given two minutes to prepare a three-minute speech, which they presented while being videotaped. The second stressor was a standard physical test of stress consisting of submerging one foot in ice-cold water. Throughout these tests, the researchers took blood pressure readings from the participants.

Results showed that average diastolic blood pressure — the “bottom number” or the pressure in the arteries when the heart is resting — was significantly reduced during the diets containing walnuts and walnut oil.

Walnuts are a rich source of fiber, antioxidants, and unsaturated fatty acids, particularly alpha linolenic acid, an omega-3 fatty acid, and these compounds could be responsible for the beneficial effects on blood pressure. Flax oil is a more concentrated source of omega-3 fatty acids than walnut oil, but this study did not test whether flax oil alone could blunt cardiovascular responses to stress.

“These results are in agreement with several recent studies showing that walnuts can reduce cholesterol and blood pressure,” noted West. “This work suggests that blood pressure is also reduced when a person is exposed to stress in their daily life.”

Public release date: 4-Oct-2010

Surprise: Scientists discover that inflammation helps to heal wounds

New research in the FASEB Journal suggests that muscle inflammation after acute muscle injury is essential to muscle repair by means of insulin-like growth factor-1

A new research study published in The FASEB Journal (http://www.fasebj.org) may change how sports injuries involving muscle tissue are treated, as well as how much patient monitoring is necessary when potent anti-inflammatory drugs are prescribed for a long time. That’s because the study shows for the first time that inflammation actually helps to heal damaged muscle tissue, turning conventional wisdom on its head that inflammation must be largely controlled to encourage healing. These findings could lead to new therapies for acute muscle injuries caused by trauma, chemicals, infections, freeze damage, and exposure to medications which cause muscle damage as a side effect. In addition, these findings suggest that existing and future therapies used to combat inflammation should be closely examined to ensure that the benefits of inflammation are not eliminated.

“We hope that our findings stimulate further research to dissect different roles played by tissue inflammation in clinical settings, so we can utilize the positive effects and control the negative effects of tissue inflammation,” said Lan Zhou, M.D., Ph.D., a researcher involved in the work from the Neuroinflammation Research Center/Department of Neurosciences/Lerner Research Institute at the Cleveland Clinic in Ohio.

Zhou and colleagues found that the presence of inflammatory cells (macrophages) in acute muscle injury produce a high level of a growth factor called insulin-like growth factor-1 (IGF-1) which significantly increases the rate of muscle regeneration. The research report shows that muscle inflammatory cells produce the highest levels of IGF-1, which improves muscle injury repair. To reach this conclusion, the researchers studied two groups of mice. The first group of mice was genetically altered so they could not mount inflammatory responses to acute injury. The second group of mice was normal. Each group experienced muscle injury induced by barium chloride. The muscle injury in the first group of mice did not heal, but in the second group, their bodies repaired the injury. Further analysis showed that macrophages within injured muscles in the second group of mice produced a high level of IGF-1, leading to significantly improved muscle repair.

“For wounds to heal we need controlled inflammation, not too much, and not too little,” said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal, “It’s been known for a long time that excess anti-inflammatory medication, such as cortisone, slows wound healing. This study goes a long way to telling us why: insulin-like growth factor and other materials released by inflammatory cells helps wound to heal.”

Public release date: 5-Oct-2010

Amino acid supplement makes mice live longer

When mice are given drinking water laced with a special concoction of amino acids, they live longer than your average mouse, according to a new report in the October issue of Cell Metabolism, a Cell Press publication. The key ingredients in the supplemental mixture are so-called branched-chain amino acids, which account for 3 of the 20 amino acids (specifically leucine, isoleucine, and valine) that are the building blocks of proteins.

“This is the first demonstration that an amino acid mixture can increase survival in mice,” said Enzo Nisoli of Milan University in Italy, noting that researchers last year showed that leucine, isoleucine, and valine extend the life span of single-celled yeast.

In the new study, the researchers gave middle-aged, male mice extra branched-chain amino acids (BCAA) in their drinking water. The animals were otherwise healthy and eating standard mouse chow.

Animals that were given the extra amino acids over a period of months lived longer, with a median life span of 869 days compared to 774 days for untreated control animals, the researchers report. That’s an increase of 12 percent.

Those survival gains were accompanied by an increase in mitochondria in cardiac and skeletal muscles. Mitochondria are the cellular components responsible for powering cells. The supplement-fed mice also showed increased activity of SIRT1, a well-known longevity gene, and of the defense system that combats free radicals. They therefore showed fewer signs of oxidative damage.

The benefits of the amino acid supplements appear similar to those earlier ascribed to calorie restriction, Nisoli said.

Treated animals also showed improvements in their exercise endurance and in motor coordination, the researchers report. (It is important to note that the animals in the current study were all male, Nisoli said. They plan to test the effects in females in future studies.)

The findings in older mice suggest that the supplementary mixture may be specifically beneficial for those who are elderly or ill. “It may not be useful in young people or body builders,” who are already in good condition, he said. But it might be a useful preventive strategy, he added, emphasizing that the mice they studied “were just aged, not sick.”

Nisoli emphasized that consuming amino acid supplements is different from consuming proteins containing those amino acids. That’s because they do not have to be digested, and can enter the bloodstream immediately. “They come with no energy cost.”

He suspects that BCAA nutritional supplements may prove to be particularly helpful for people with heart failure, the muscle-wasting condition known as sarcopenia, chronic obstructive pulmonary disease, or other conditions characterized by energy defects. In fact, there are already some small studies in human to support that idea and BCAA supplements are already available for purchase in several countries, including Italy.

The challenge, Nisoli says, will be convincing clinicians that these supplements might be a benefit to their patients. He says a large clinical trial is needed, but there is little incentive for companies to do such trials for dietary supplements as opposed to drugs.

Overall, Nisoli said the new work supports a “general philosophy of a nutritional approach to disease, aging, and problems of energy status.”

Public release date: 5-Oct-2010

Shortfalls in carotenoid ( Pro-Vitamin A )intake may impact women’s health

Newly released report finds younger women have greater ‘carotenoid gap’ in the diet than older women

GRAND RAPIDS, MICH., Oct. 5, 2010 – Only about a third of American women are meeting their fruit and vegetable intake recommendations, which means they are likely missing out on potentially important breast and ovarian health benefits (1). Along with vitamins, minerals and fiber, fruits and vegetables contain a type of phytonutrient called carotenoids, which research suggests help support women’s health including breast and ovarian health.

Based on a new report called America’s Phytonutrient Report: Women’s Health by Color, older women have total carotenoid intakes 20 percent greater than younger women after accounting for differences in caloric intake. Similar to the original America’s Phytonutrient Report: Quantifying the Gap which found that on average eight out of 10 American adults are falling short on phytonutrient consumption, the new report revealed a troubling shortfall, this time among women and carotenoids. America’s Phytonutrient Reports are released by The Nutrilite Health Institute, a worldwide collaboration of experts who are dedicated to helping people achieve optimal health – through research, education, and practical, personalized solutions. Nutrilite is the world’s leading brand of vitamin, mineral, and dietary supplements, based on 2008 sales.

Carotenoids are compounds that give fruits and vegetables their vibrant colors, which research suggests may offer breast, ovarian and other health benefits for women. Using NHANES energy-adjusted data to compare the diets of women 45 years and older with those younger, the report finds that many women of all ages lack carotenoid-rich foods in their diet, but the relative magnitude of the “carotenoid gap” is greater among women less than 45 years old as compared to older women.

“This points to a troubling phenomenon where younger women may be missing some of the benefits of consuming more carotenoid rich fruits and vegetables, and yet calorie for calorie, older women are eating more of these important nutrients,” said Keith Randolph, Ph.D., Technology Strategist for Nutrilite.

The Carotenoids by Color Category

This new report examined consumption of five different carotenoids across three phytonutrient color categories including alpha-carotene, beta-carotene and beta-cryptoxanthin in the yellow/orange category, lutein/zeaxanthin in the green category and lycopene in red. In every color category, older women consumed equal or greater amounts compared to younger women after adjusting for differences in caloric intake. Specifically, women age 45 and older consume:

•50 percent more beta-carotene;

•40 percent more alpha-carotene and lutein/zeaxanthin;

•and, 10 percent more beta-cryptoxanthin.

For lycopene, younger and older women consume comparable amounts.

Carotenoids Shown To Reduce Cancer Risk

A growing body of research suggests carotenoids may be associated with protective benefits against certain cancers. The research points to an apparent lowered risk for breast and ovarian cancers among women of all ages who increase their intake of fruits and vegetables rich in various carotenoids including lutein/zeaxanthin, lycopene, alpha-carotene, beta-carotene and beta-cryptoxanthin according to Randolph.

Top Food Sources

It turns out that a limited number of foods account for significant portions of carotenoid intakes, according to the new report. Following are the single largest food contributors in the diets of American women by color category of phytonutrient:

•Green Carotenoid: Lutein/Zeaxanthin

◦Spinach accounts for 33% of lutein/zeaxanthin intake among younger women and 31% among older.

•Red Carotenoid: Lycopene

◦Tomatoes (and tomato products) account for 93% of lycopene intake among younger women and 89% among older.

•Yellow/Orange Carotenoid: Alpha-carotene

◦Carrots account for 76% of alpha-carotene intake among younger women and 73% among older.

•Yellow/Orange Carotenoid: Beta-carotene

◦Carrots account for 33% of beta-carotene intake among younger women and 30% among older.

•Yellow/Orange Carotenoid: Beta-cryptoxanthin

◦Oranges (and orange juice) account for 61% of beta-cryptoxanthin intake among younger women and 60% among older.

Powering Up Produce

Choosing to increase the amount of the fruit and vegetables richest in carotenoids is important for long-term preventative health among women. While foods like spinach, tomatoes and carrots are certainly part of a healthy diet, there are opportunities for women to choose a wider variety of produce. For example, while carrots are among the top food sources of alpha and beta-carotenes, cooked pumpkin is also a concentrated food source of not only those carotenes, but of beta-cryptoxanthin. However, based on the current data analysis, cooked pumpkin accounts for less than 3% of total intake of these carotenoids among American women.

“It’s concerning that so many American women lack a variety of carotenoid-rich foods in their regular diets,” says Amy Hendel, Nutrilite’s Phytonutrient Coach. “By selecting the most carotenoid-rich produce choices, women can purposefully increase their carotenoid and phytonutrient intakes which can impact health significantly as they age.”

Hendel, a registered physician assistant and health/wellness expert, offers these easy substitutions to “power up” your plate and add new flavors to your meal plan:

•Green: A serving of cooked kale provides triple the amount of lutein/zeaxanthin as a serving of raw spinach.

•Red: A serving of guava delivers more than one and a half times the lycopene in a raw tomato.

•Yellow/Orange:

◦A serving of sweet potatoes has nearly double the beta-carotene as a serving of carrots.

◦A serving of carrots delivers four times the amount of alpha-carotene as a serving of winter squash.

◦A serving of fresh papaya has roughly 10 times the beta-cryptoxanthin found in an orange.

Hendel adds, a good goal for most individuals is to consume 10 servings of fruits and vegetables daily, with an emphasis on quality, not just quantity. If this proves challenging, consider a natural, plant-based dietary supplement which includes phytonutrients such as carotenoids.

“Just remember, small changes in the diet each day can add up to powerful changes over time. Older women may eat more carotenoids, but women of all ages are falling short. Diet is a lifetime of exposure and best we teach younger women how to eat right, up those carotenoids, and exercise more from the beginning,” says Hendel.

Public release date: 5-Oct-2010

Low Testosterone Linked to Alzheimer’s Disease

SLU Geriatrician Collaborates on Year-Long Study of Chinese Older Men

ST. LOUIS — Low levels of the male sex hormone, testosterone, in older men is associated with the onset of Alzheimer’s disease, according to research by a team that includes a Saint Louis University scientist.

John Morley, M.D.

“Having low testosterone may make you more vulnerable to Alzheimer’s disease,” said John E. Morley, M.D., director of the division of geriatric medicine at Saint Louis University and a study co-investigator. “The take-home message is we should pay more attention to low testosterone, particularly in people who have memory problems or other signs of cognitive impairment.”

The study was published electronically prior to its print publication in the Journal of Alzheimer’s Disease and led by Leung-Wing Chu, M.D., who is chief of the division of geriatric medicine at Queen Mary Hospital at the University of Hong Kong.

Researchers studied 153 Chinese men who were recruited from social centers. They were at least 55 years and older, lived in the community and didn’t have dementia. Of those men, 47 had mild cognitive impairment – or problems with clear thinking and memory loss.

Within a year, 10 men who all were part of the cognitively impaired group developed probable Alzheimer’s disease. These men also had low testosterone in their body tissues; elevated levels of the ApoE 4 (apolipoprotein E) protein, which is correlated with a higher risk of Alzheimer’s disease; and high blood pressure.

“It’s a very exciting study because we’ve shown that a low level of testosterone is one of the risk factors for Alzheimer’s disease,” Morley said.

The findings corroborate findings in previous studies of older Caucasian men that show low testosterone is associated with impaired thinking and Alzheimer’s disease. They suggest that testosterone may have a protective value against Alzheimer’s disease.

The next step, Morley said, is to conduct a large-scale study that investigates the use of testosterone in preventing Alzheimer’s disease. Morley and his co-authors advocate studying the effectiveness of testosterone replacement in older men who have both mild memory problems and low testosterone in staving off Alzheimer’s disease.

Public release date: 6-Oct-2010

Vitamin D deficiency rampant in patients undergoing orthopedic surgery, damaging patient recovery

Doctors provide strategy to improve outcomes

Almost 50 percent of patients undergoing orthopedic surgery have vitamin D deficiency that should be corrected before surgery to improve patient outcomes, based on a study by researchers at Hospital for Special Surgery (HSS) in New York City. Vitamin D is essential for bone healing and muscle function and is critical for a patient’s recovery. The study appears in the October issue of The Journal of Bone and Joint Surgery.

“In the perfect world, test levels, fix and then operate,” said Joseph Lane, M.D., professor of Orthopedic Surgery and chief of the Metabolic Bone Disease Service at HSS, who led the study. “If you put people on 2,000-4,000 [milligrams] of vitamin D based on what their deficient value was, you can usually get them corrected in four to six weeks, which is when you are really going to need the vitamin D. If you are really aggressive right before surgery, you can correct deficient levels quickly, but you have to correct it, measure it, and then act on it.”

According to Dr. Lane, bone remodeling or bone tissue formation, a part of the healing process, occurs about two to four weeks after surgery. This is the critical stage when your body needs vitamin D.

For their study, investigators conducted a retrospective chart review of 723 patients who were scheduled for orthopedic surgery between January 2007 and March 2008 at HSS. They examined the vitamin D levels, which had been measured in all patients before their surgery, and found that 43 percent had insufficient vitamin D and 40 percent had deficient levels.

Vitamin D inadequacy was defined as

The highest levels of deficiency were seen in patients in the trauma service, where 66 percent of patients had insufficient levels and 52 percent had deficient levels. Of the patients undergoing foot and ankle surgery, 34 percent had inadequate levels and of patients undergoing hand surgery, 40 percent had insufficient levels.

In the Sports Medicine Service, 52.3 percent had insufficient levels and of these, one-third of these or 17 percent of the total had deficient levels. “We frequently see stress fractures in the Sports Medicine Service and if you want to heal, you have to fix the calcium and vitamin D,” Dr. Lane said.

In the Arthroplasty Service, which conducts hip and knee replacements, 38 percent had inadequate levels and 48 percent had deficient levels. “With arthroplasty, there is a certain number of patients that when you put in the prothesis, it breaks the bone adjacent to the protheses, which can really debilitate patients.” This could be prevented or minimized by rectifying vitamin D levels. Dr. Lane also explained that they now perform procedures where they grow a bone into a prosthesis without using cement. “In those people, it would be an advantage to have adequate vitamin D, because it matures the bone as it grows in, it is really healing into the prosthesis,” he said.

“The take home message is that low vitamin D has an implication in terms of muscle and fracture healing, it occurs in about 50 percent of people coming in for orthopedic surgery, and it is eminently correctable,” Dr. Lane said. “We recommend that people undergoing a procedure that involves the bone or the muscle should correct their vitamin D if they want to have an earlier faster, better, result. What we are saying is ‘wake up guys, smell the coffee; half of your patients have a problem, measure it, and if they are low, then fix it.'”

In recent years, vitamin D deficiency has been recognized as a common phenomenon and is caused by many factors. It is difficult to get from foods, except, for example, cod liver oil and fish. Until recently, the recommended daily allowance was set too low so foods were not supplemented with adequate doses. And third, while people can absorb vitamin D from sunlight, people these days often work long hours and often use sunscreen that impedes vitamin D intake.

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