[np-related]

The same week, I noticed a large feature in Esquire magazine that revolved around an outfit in Burlington, Ont., known as the Masters Men’s Clinic, which, according to the article, is run by a gynecologist who bills himself as an expert on male hormone replacement. (Normally, male hormones would be the domain of an endocrinologist. A gynecologist typically specializes in women’s health.) But the really strange thing about the article was its cheerleading tone. “What do these doctors think the various compounds can accomplish?” posed Craig Davidson, the Canadian writer of the Esquire piece. “Very simply, a life that is good to the end.”

It’s not difficult to discern why male hormone replacement is becoming a hot topic. Male baby boomers are getting older, and as they age, they’re looking for ways to stave off Father Time. Men tend to experience testosterone levels that fall over time. That decrease has in the last several years received a name:andropause. The medically significant term, which refers to abnormally low levels of testosterone in men with clinical symptoms, is male hypogonadism. The medical professionals who hope to make money treating “testosterone deficiency” are billing the phenomenon as the male counterpart to menopause, the transition that happens in a woman’s life some time after the age of 45, when the female body stops making estrogen and progesterone. (In women, hormone levels drop quickly, whereas in men, it is more of a gradual decline.)

The problem? As a 2010 New England Journal of Medicine editorial concluded, the symptoms of hypogonadism — decreases in sexual function, muscle mass and strength, increased fatigue and depressed mood — are remarkably similar to the normal effects of aging. “Therefore, it is frequently unclear in caring for individual older patients whether the diagnosis of hypogonadism is appropriate and whether testosterone administration might be helpful or might instead cause adverse effects,” noted William Bremner, the writer of the editorial. In plainer language? Who is to say whether the patient is suffering from the malady of testosterone deficiency — or just plain old age?

Doctors such as myself are now seeing early adopters with normal hormone levels who seek testosterone-replacement therapy as a way to stave off the effects of aging. In all likelihood, Masters Men’s Clinic is benefitting from interest from a similar demographic — as is Cenegenics, the anti-aging system marketed with photos of septuagenarian strongman Dr. Jeffry Life of Las Vegas.

If you’re a doctor speaking with a patient, male hormone therapy represents a bit of a dilemma. Academics have shown that it does have short-term effects that will be alluring for many middle-aged guys. “Many studies involving limited numbers of men have shown that the administration of testosterone results in improved muscle mass and strength, increased bone mass, and other positive effects,” Bremner noted in the New England Journal of Medicine.

But if you’re asking my opinion, it’s a short-term fix. And it’s controversial, too. In 2010, the Endocrine Society recommended limiting a diagnosis of testosterone deficiency only to “men with consistent symptoms and signs and unequivocally low serum testosterone levels” — in other words, healthy older men with normal, age-related declines in testosterone levels should not receive the therapy.

Worse, some of these advertised “therapies” espouse the advantages of bio-identical hormones — chemically derived synthetic molecules, some of which haven’t yet been adequately studied. The New England Journal editorial references a testosterone study conducted on 209 men aged 65 or older. Bremner notes: “The testosterone group showed greater leg and arm strength … but also had higher rates of cardiovascular adverse effects” — so much higher that an ethics committee prematurely halted the study. Other doctors wonder if hormone therapy increases the patient’s likelihood of developing subclinical prostate cancer. Why treat someone who is “normal” and asymptomatic?

There’s a whole movement out there tapping into our society’s psyche of aging, catering to men who want to stay young by manipulating hormones. Do these men live longer? I haven’t seen any evidence that they do. Do they feel stronger, more active and happier? Perhaps for a short period of time. But they also place themselves at the risk of a whole host of side effects that amount to the body’s premature burnout. And who knows at this point about long-term effects?

Until I see hard scientific evidence that the therapy is safe for healthy men over the long-term, I would advise consuming the rhetoric about testosterone-replacement therapy with a healthy dose of skepticism. And as for my ultra-healthy patient, Larry, I told him I could test his testosterone.

“But it’s going to be normal,” I said. “And if you want someone to prescribe you with testosterone, you’re going to have to find another doctor.” If Larry lives longer, it’s going to be because of good genes and a healthy lifestyle. There is no shortcut to the fountain of youth.

–Dr. James Aw is the medical director of the Medcan Clinic in Toronto. For more information, visit medcan.com.

A small but growing number of teens and even younger children who think they were born the wrong sex are getting support from parents and from doctors who give them sex-changing treatments, according to reports in the medical journal Pediatrics.

It’s an issue that raises ethical questions, and some experts urge caution in treating children with pubertyblocking drugs and hormones. An 8-year-old second-grader in Los Angeles is a typical patient. Born a girl, the child announced at 18 months, “I a boy” and has stuck with that belief. The family was shocked but now refers to the child as a boy and is watching for the first signs of puberty to begin treatment, his mother told The Associated Press.

As for our part — notwithstanding anything — other than perhaps mental, moral, ethical, spiritual, behavioral, and psychological abuse we wonder, as should the Department of Social Services and other associated agencies, just who is raising whom? It is apparent that our culture is fading so quickly and dare I say this…that political correctness is out of control. How much does a child know at 18 months? We’re not sure if there is a definitive answer; subsequently, we will offer our own — not nearly as much as anyone of us do — whilst this particular situation looks as though this child is going to have issues for life.

Pediatricians need to know these kids exist and deserve treatment, said Dr. Norman Spack, author of one of three reports published Monday and director of one of the nation’s first gender identity medical clinics, at Children’s Hospital Boston.

It’s an issue that raises ethical questions, and some experts urge caution in treating children with puberty-blocking drugs and hormones.

An 8-year-old second-grader in Los Angeles is a typical patient. Born a girl, the child announced at 18 months, “I a boy” and has stuck with that belief. The family was shocked but now refers to the child as a boy and is watching for the first signs of puberty to begin treatment, his mother told The Associated Press.

Pediatricians need to know these kids exist and deserve treatment, said Dr. Norman Spack, author of one of three reports published Monday and director of one of the nation’s first gender identity medical clinics, at Children’s Hospital Boston.

“If you open the doors, these are the kids who come. They’re out there. They’re in your practices,” Spack said in an interview.

Switching gender roles and occasionally pretending to be the opposite sex is common in young children. But these kids are different. They feel certain they were born with the wrong bodies.

Some are labeled with “gender identity disorder,” a psychiatric diagnosis. But Spack is among doctors who think that’s a misnomer. Emerging research suggests they may have brain differences more similar to the opposite sex.

Spack said by some estimates, 1 in 10,000 children have the condition.

Offering sex-changing treatment to kids younger than 18 raises ethical concerns, and their parents’ motives need to be closely examined, said Dr. Margaret Moon, a member of the American Academy of Pediatrics’ bioethics committee. She was not involved in any of the reports.

Some kids may get a psychiatric diagnosis when they are just hugely uncomfortable with narrowly defined gender roles; or some may be gay and are coerced into treatment by parents more comfortable with a sex change than having a homosexual child, said Moon, who teaches at the Johns Hopkins Berman Institute of Bioethics.

It’s harmful “to have an irreversible treatment too early,” Moon said.

Doctors who provide the treatment say withholding it would be more harmful.

These children sometimes resort to self-mutilation to try to change their anatomy; the other two journal reports note that some face verbal and physical abuse and are prone to stress, depression and suicide attempts. Spack said those problems typically disappear in kids who’ve had treatment and are allowed to live as the opposite sex.

Guidelines from the Endocrine Society endorse transgender hormone treatment but say it should not be given before puberty begins. At that point, the guidelines recommend puberty-blocking drugs until age 16, then lifelong sex-changing hormones with monitoring for potential health risks. Mental health professionals should be involved in the process, the guidelines say. The group’s members are doctors who treat hormonal conditions.

Those guidelines, along with YouTube videos by sex-changing teens and other media attention, have helped raise awareness about treatment and led more families to seek help, Spack said.

His report details a fourfold increase in patients at the Boston hospital. His Gender Management Service clinic, which opened at the hospital in 2007, averages about 19 patients each year, compared with about four per year treated for gender issues at the hospital in the late 1990s.

The report details 97 girls and boys treated between 1998 and 2010; the youngest was 4 years old. Kids that young and their families get psychological counseling and are monitored until the first signs of puberty emerge, usually around age 11 or 12. Then children are given puberty-blocking drugs, in monthly $1,000 injections or implants imbedded in the arm.

In another Pediatrics report, a Texas doctor says he’s also provided sex-changing treatment to an increasing number of children; so has a clinic at Children’s Hospital Los Angeles where the 8-year-old is a patient.

The drugs used by the clinics are approved for delaying puberty in kids who start maturing too soon. The drugs’ effects are reversible, and Spack said they’ve caused no complications in his patients. The idea is to give these children time to mature emotionally and make sure they want to proceed with a permanent sex change. Only 1 of the 97 opted out of permanent treatment, Spack said.

Kids will more easily pass as the opposite gender, and require less drastic treatment later, if drug treatment starts early, Spack said. For example, boys switching to girls will develop breasts and girls transitioning to boys will be flat-chested if puberty is blocked and sex-hormones started soon enough, Spack said.

Sex hormones, especially in high doses when used long-term, can have serious side effects, including blood clots and cancer. Spack said he uses low, safer doses but that patients should be monitored.

Gender-reassignment surgery, which may include removing or creating penises, is only done by a handful of U.S. doctors, on patients at least 18 years old, Spack said. His clinic has worked with local surgeons who’ve done breast removal surgery on girls at age 16, but that surgery can be relatively minor, or avoided, if puberty is halted in time, he said.

The mother of the Los Angeles 8-year-old says he’s eager to begin treatment.

When the child was told he could get shots to block breast development, “he was so excited,” the mother said.

He also knows he’ll eventually be taking testosterone shots for life but surgery right now is uncertain.

The child attends a public school where classmates don’t know he is biologically a girl. For that reason, his mother requested anonymity.

She said she explained about having a girl’s anatomy but he rejected that, refused to wear dresses, and has insisted on using a boy’s name since preschool.

The mother first thought it was a phase, then that her child might be a lesbian, and sought a therapist’s help to confirm her suspicion. That’s when she first heard the term “gender identity disorder” and learned it’s often not something kids outgrow.

Accepting his identity has been difficult for both parents, the woman said. Private schools refused to enroll him as a boy, and the family’s pediatrician refused to go along with their request to treat him like a boy. They found a physician who would, Dr. Jo Olson, medical director of a transgender clinic at Children’s Hospital Los Angeles.

Olson said the journal reports should help persuade more doctors to offer these kids sex-changing treatment or refer them to specialists who will.

“It would be so nice to move this out of the world of mental health, and into the medical world,” Olson said.

(© Copyright 2011 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)

Wylie W. Vale, Jr, PhD
1941 – 2012

Wiley W. Vale, Jr, PhD, a renowned and beloved Salk Institute and UC San Diego scientist whose pioneering work identified key brain hormones and growth factors, died on January 6 at the age of 70.

Vale was Professor and Helen McLoraine Chair in Molecular Neurobiology and Head of the Clayton Foundation Laboratories for Peptide Biology at the Salk Institute for Biological Studies.

He was highly regarded as the global authority on peptide hormones and growth factors that provide communication between the brain and endocrine system. Vale and his collaborators identified the central switchboard, a group of neuropeptides and their receptors that mediate the body’s responses to stress and stress-related disorders.

Among these neuropeptides is corticotropin releasing factor (CRF), characterized by Vale and colleagues in 1981. The work has had far-reaching effects in medical research and clinical medicine.

At UCSD, Vale held an adjunct professorship in the Division of Endocrinology and Metabolism. He contributed for many years as a researcher and educator in the School of Medicine and the Neurobiology Section of the Division of Biological Sciences.

“This is a great loss for those of us at UCSD who knew and worked with Wylie, and a great loss for endocrine science,” said Wolfgang H. Dillmann, MD, Helen M. Ranney Professor and Chair of the Department of Medicine.

“Wylie and his group of peptide chemists and neuroendocrinologists trained several PhD students in the Biomedical Sciences and Neurosciences graduate programs who have taken leadership positions in research and academia,” said Palmer Taylor, PhD.

Taylor is Sandra and Monroe Trout Professor of Pharmacology, founding Dean of the Skaggs School of Pharmacy and Pharmaceutical Sciences, and Associate Vice Chancellor for Health Sciences.

Vale’s coworkers and friends in the School of Medicine included numerous faculty members in the departments of reproductive medicine, neurosciences, psychiatry and surgery.

In 2004, Vale and colleagues at UCSD established the firmest link between a family of hormones that helps the body adapt to stress and possible new treatments for congestive heart failure.

Vale discovered that the hormone urocortin-2 has a positive impact on heart function, and the hormone was shown to significantly enhance heart muscle contractions. | Read the abstract of the study report in PNAS

In that effort, Vale collaborated with Drs. Kirk Peterson, Kenneth Chien and coworkers at the Seaweed Canyon Cardiovascular Physiology Laboratory and the Institute for Molecular Medicine.

Kirk L. Peterson, MD, FACP, FACC, the Edith and William M. Perlman Professor of Clinical Cardiology, is Director of the Sulpizio Cardiovascular Center, Director of the Seaweed Canyon Physiology Laboratory and professor emeritus in cardiology.

Kenneth Chien, MD, PhD, is professor emeritus in cardiology and former director of the Institute for Molecular Medicine.

Vale was a member of the National Academy of Sciences, the American Academy of Arts and Sciences, and the Institute of Medicine. In 1992-1993, he served as president of the Endocrine Society.

He co-founded two biotechnology companies, Neurocrine Biosciences and Acceleron Pharma, Inc.

The Vale family and the Endocrine Society have placed tribute pages on the Web where remembrances can be entered and viewed. Vale family tribute | Endocrine Society tribute

For more about Dr. Vale and his work, please see the Salk Institute press release.

Health Technology Research Synopsis

122nd Issue Date 10FEB2012

Compiled By Ralph Turchiano

www.vit.bz

www.youtube.com/vhfilm

Editors Top Five:

1.      Honey could be effective at treating and preventing wound infections

2.      A silver bullet to beat cancer?

3.      Lower levels of sunlight link to allergy and eczema

4.      Pneumonia wonder drug: Zinc saves lives

5.      Study to determine whether fish oil can help prevent psychiatric disorders

In This Issue:

1.    A glass of milk a day could benefit your brain

2.    Biological time-keeper linked to diabetes

3.    Honey could be effective at treating and preventing wound infections

4.    Women taking indigestion drugs at increased risk of hip fracture after menopause

5.    Are diet soft drinks bad for you?

6.    Societal control of sugar essential to ease public health burden

7.    Need an excuse to get a massage? Study shows it reduces inflammation following strenuous exercise

8.    Decaffeinated coffee preserves memory function by improving brain energy metabolism

9.    How antipsychotic medications cause metabolic side effects such as obesity and diabetes

10. Potatoes lower blood pressure in people with obesity and hypertension without increasing weight

11. Vigorous exercise linked to gene activity in prostate

12. Young children exposed to anesthesia multiple times show elevated rates of ADHD

13. Websites advertising cholesterol-lowering drugs of poor quality

14. A silver bullet to beat cancer?

15. EARTH: Dangerous dust

16. Coffee consumption reduces fibrosis risk in those with fatty liver disease

17. Breastfeeding and lung function at school age: Does maternal asthma modify the effect?

18. Lower levels of sunlight link to allergy and eczema

19. Vitamin D deficiency in geriatric patients

20. Regular use of vitamin and mineral supplements could reduce the risk of colon cancer

21. Administration of meningococcal vaccine with other routine infant vaccines appears effective

22. Pneumonia wonder drug: Zinc saves lives

23. Vitamin D deficiency high among trauma patients

24. Drinking large amounts of soft drinks associated with asthma and COPD

25. Fasting weakens cancer in mice

26. Halting bone-building osteoporosis drug use cuts risk for additional atypical femur fracture in half

27. NIH study links high levels of cadmium, lead in blood to pregnancy delay

28. Antidepressant use linked with less patient satisfaction after hip replacement

29. Study to determine whether fish oil can help prevent psychiatric disorders

30. Scientists sound alarm over threat of untreatable gonorrhea in United States

31. Seizures in patients with pork tapeworm caused by Substance P

32. Obesity is associated with altered brain function

33. U.S. workers are ‘giving away the store,’ costing firms billions

34. Phosphate additives pose a risk to health

35. Curry spice component may help slow prostate tumor growth

New research finds milk drinkers scored better on memory and brain function tests

Pouring at least one glass of milk each day could not only boost your intake of much-needed key nutrients, but it could also positively impact your brain and mental performance, according to a recent study in the International Dairy Journal.1 Researchers found that adults with higher intakes of milk and milk products scored significantly higher on memory and other brain function tests than those who drank little to no milk. Milk drinkers were five times less likely to “fail” the test, compared to non milk drinkers.

Researchers at the University of Maine put more than 900 men and women ages 23 to 98 through a series of brain tests – including visual-spatial, verbal and working memory tests – and tracked the milk consumption habits of the participants. In the series of eight different measures of mental performance, regardless of age and through all tests, those who drank at least one glass of milk each day had an advantage. The highest scores for all eight outcomes were observed for those with the highest intakes of milk and milk products compared to those with low and infrequent milk intakes. The benefits persisted even after controlling for other factors that can affect brain health, including cardiovascular health and other lifestyle and diet factors. In fact, milk drinkers tended to have healthier diets overall, but there was something about milk intake specifically that offered the brain health advantage, according to the researchers.

In addition to the many established health benefits of milk from bone health to cardiovascular health, the potential to stave off mental decline may represent a novel benefit with great potential to impact the aging population. While more research is needed, the scientists suggest some of milk’s nutrients may have a direct effect on brain function and that “easily implemented lifestyle changes that individuals can make present an opportunity to slow or prevent neuropsychological dysfunction.”

New and emerging brain health benefits are just one more reason to start each day with lowfat or fat free milk. Whether in a latte, in a smoothie, on your favorite cereal, or straight from the glass, milk at breakfast can be a key part of a healthy breakfast that help sets you up for a successful day. The 2010 Dietary Guidelines for Americans recommend three glasses of lowfat or fat free milk daily for adults and each 8-ounce glass contains nine essential nutrients Americans need, including calcium and vitamin D.

Researchers in Lille and Paris demonstrated that mutations in the melatonin receptor gene (melatonin or the “hormone of darkness” induces sleep) lead to an almost sevenfold increase in the risk of developing diabetes. This research, which was published in Nature Genetics on 29 January 2012, could contributed to the development of new drugs for the treatment or prevention of this metabolic disease.

Type 2 diabetes is characterised by excess blood glucose and increased resistance to insulin. It is the most common form of the disease and affects 300 million people in the world, including 3 million in France. This figure should double in the next few years, driven by the obesity epidemic and the disappearance of ancestral lifestyles. It is known that genetic factors, combined with a high-fat, high-sugar diet and lack of exercise, can also contribute to the onset of the disease. Furthermore, several studies have shown that sleeping disorders that affect the duration and quality of sleep are also high risk factors. Shift workers, for example, are at greater risk of developing the disease. No previous research has described any mechanism linking the biological clock to diabetes.

The researchers focused their attention on the receptor of a hormone called melatonin, which is produced by the pineal gland as light fades. Melatonin, also known as the hormone of darkness, can be seen as a biological “time-keeper”, synchronising biological rhythms with nightfall. The teams sequenced the MT2 gene, which encodes its receptor, in 7600 diabetics and persons with normal glycaemia. They found 40 rare mutations that modify the protein structure of the melatonin receptor, 14 of which made the receptor in question non-functional. The team went on to demonstrate that the risk of developing diabetes is nearly seven times higher in people affected by such mutations, which make them melatonin-insensitive.

It is known that the production of insulin, the hormone responsible for controlling blood glucose levels, drops at night to prevent any risk of hypoglycaemia. Insulin production starts up again, however, to avoid excess blood glucose during the day, which is when most people eat.

This study could lead to new drugs aimed at preventing or treating diabetes. Researchers could, for example, adjust MT2 receptor activity to control the metabolic pathways associated with it . The work also highlights the importance of genome sequencing as a means of personalising treatment for diabetic patients. There are many genetic causes for diabetes and the therapeutic approach needs to be adapted to the metabolic pathways concerned by each patient’s particular disorder.

Manuka honey could help clear chronic wound infections and even prevent them from developing in the first place, according to a new study published in Microbiology. The findings provide further evidence for the clinical use of manuka honey to treat bacterial infections in the face of growing antibiotic resistance.

Streptococcus pyogenes is a normal skin bacterium that is frequently associated with chronic (non-healing) wounds. Bacteria that infect wounds can clump together forming ‘biofilms’, which form a barrier to drugs and promotes chronic infection. Researchers at Cardiff Metropolitan University have shown that manuka honey can not only destroy fully-formed S. pyogenes biofilms in vitro but also prevent the bacteria initially binding to components of wound tissue.

Honey has long been acknowledged for its antimicrobial properties. Traditional remedies containing honey were used in the topical treatment of wounds by diverse ancient civilisations. Manuka honey is derived from nectar collected by honey bees foraging on the manuka tree found growing in New Zealand and parts of Australia. It is included in modern licensed wound-care products around the world. Manuka honey has been reported to inhibit more than 80 species of bacteria, yet the antimicrobial properties of honey have not yet been fully exploited by modern medicine as its mechanisms of action are not fully understood.

Wounds that are infected with S. pyogenes often fail to respond to treatment. This is largely due to the development of biofilms which may be difficult for antibiotics to penetrate – in addition to problems of antibiotic resistance. The results of the study showed that very small concentrations of honey prevented the start of biofilm development and that treating established biofilms grown in Petri dishes with honey for 2 hours killed up to 85% of bacteria within them.

The Cardiff team are working towards providing molecular explanations for the antibacterial action of honey. The latest study reveals that honey can disrupt the interaction between S. pyogenes and the human protein fibronectin, which is displayed on the surface of damaged cells. “Molecules on the surface of the bacteria latch onto human fibronectin, anchoring the bacteria to the cell. This allows infection to proceed and biofilms to develop,” explained Dr Sarah Maddocks who led the study. “We found that honey reduced the expression of these bacterial surface proteins, inhibiting binding to human fibronectin, therefore making biofilm formation less likely. This is a feasible mechanism by which manuka honey minimizes the initiation of acute wound infections and also the establishment of chronic infections.

Ongoing work in Dr Maddocks’ lab is investigating other wound-associated bacteria including Pseudomonas aeruginosa and meticillin-resistant Staphylococcus aureus (MRSA). Manuka honey has also been shown to be effective at killing these bacteria. “There is an urgent need to find innovative and effective ways of controlling wound infections that are unlikely to contribute to increased antimicrobial resistance. No instances of honey-resistant bacteria have been reported to date, or seem likely,” said Dr Maddocks. “Applying antibacterial agents directly to the skin to clear bacteria from wounds is cheaper than systemic antibiotics and may well complement antibiotic therapy in the future. This is significant as chronic wounds account for up to 4% of health care expenses in the developed world.”

Research: A prospective study of proton pump inhibitor use and risk of hip fracture in relation to dietary and lifestyle factors

Post-menopausal women are 35% more likely to suffer hip fracture if they take indigestion drugs, known as proton pump inhibitors (PPIs), a figure which increases to 50% if they are also current or former smokers, suggests a study published today on bmj.com.

PPIs are one of the most common medicines used worldwide and are often used to treat heartburn and acid reflex. They can, however, inhibit the absorption of calcium, which leads to the increased risk of fractures.

Authors from the Massachusetts General Hospital have looked at the association between PPIs and hip fractures in just under 80,000 post-menopausal women over an eight year period from 2000 to 2008. They suggest that women with a prolonged use of these drugs and who smoke could be up to 50% more likely to suffer from hip fractures compared to women who do not smoke or take these drugs.

Several studies have already been carried out in response to the growing concerns between the long-term use of PPIs and the risk of hip fractures, but these studies have been met with significant limitations. In May 2010, the Food and Drug Administration issued a warning of hip fractures and taking PPIs, but concluded that more data was needed for a full analysis.

Several factors including menopausal status, body weight, time spent carrying out physical activity, smoking status, alcohol consumption and calcium supplement usage were all taken into account. Calcium intake from food included in each participant’s diet was also analysed. Low and moderate traumas relating to fracture (including falling on ice, falling off a chair) were recorded, whereas high traumas (including skiing accidents or falling down the stairs) were not included.

Results show that out of 79,899 post-menopausal women, there were 893 hip fractures in total over an eight year period, concluding that post-menopausal women were at a 35% increased risk. In absolute numbers, the risk of hip fracture among regular users of PPIs was 2.02 events per 1000 person years, compared with 1.51 events per 1000 person years among non-users of the drugs (a “person year” is the number of years of follow up multiplied by the number of people in the study).Women who were also current or former smokers were at an even higher risk of 50%. Correlation was also found between the length of time PPIs were taken and the risk of fractures.

Figures show that 6.7% of women were regularly using a PPI in 2000 which increased to 18.9% in 2008, which poses an increased risk of fractures associated with PPIs in the coming years. Because of this, the Food and Drug Administration wish to revise labelling on these drugs and the authors stress the importance of evaluating the need for long-term use of PPIs among those with a history of smoking. Finally, it was noted that the risk of hip fracture returned to a normal level two years after patients stopped taking PPIs.

New study finds potential link between daily consumption of diet soft drinks and risk of vascular events

Individuals who drink diet soft drinks on a daily basis may be at increased risk of suffering vascular events such as stroke, heart attack, and vascular death. This is according to a new study by Hannah Gardener and her colleagues from the University of Miami Miller School of Medicine and at Columbia University Medical Center. However, in contrast, they found that regular soft drink consumption and a more moderate intake of diet soft drinks do not appear to be linked to a higher risk of vascular events. The research¹ appears online in the Journal of General Internal Medicine², published by Springer.

In the current climate of escalating obesity rates, artificially sweetened soft drinks are marketed as healthier alternatives to sugar-sweetened beverages, due to their lack of calories. However, the long-term health consequences of drinking diet soft drinks remain unclear.

Gardener and team examined the relationship between both diet and regular soft drink consumption and risk of stroke, myocardial infarction (or heart attack), and vascular death. Data were analyzed from 2,564 participants in the NIH-funded Northern Manhattan Study, which was designed to determine stroke incidence, risk factors and prognosis in a multi-ethnic urban population. The researchers looked at how often individuals drank soft drinks – diet and regular – and the number of vascular events that occurred over a ten-year period.

They found that those who drank diet soft drinks daily were 43 percent more likely to have suffered a vascular event than those who drank none, after taking into account pre-existing vascular conditions such as metabolic syndrome, diabetes and high blood pressure. Light diet soft drink users, i.e. those who drank between one a month and six a week, and those who chose regular soft drinks were not more likely to suffer vascular events.

Gardener concludes: “Our results suggest a potential association between daily diet soft drink consumption and vascular outcomes. However, the mechanisms by which soft drinks may affect vascular events are unclear. There is a need for further research before any conclusions can be drawn regarding the potential health consequences of diet soft drink consumption.”

References

1. Gardener H et al (2012). Diet soft drink consumption is associated with an increased risk of vascular events in the Northern Manhattan Study. Journal of General Internal Medicine. DOI 10.1007/s11606-011-1968-2

2. The Journal of General Internal Medicine is the official journal of the Society of General Internal Medicine.

Sugar should be controlled like alcohol and tobacco to protect public health, according to a team of UCSF researchers, who maintain in a new report that sugar is fueling a global obesity pandemic, contributing to 35 million deaths annually worldwide from non-communicable diseases like diabetes, heart disease and cancer.

Non-communicable diseases now pose a greater health burden worldwide than infectious diseases, according to the United Nations. In the United States, 75 percent of health care dollars are spent treating these diseases and their associated disabilities.

In the Feb. 2 issue of Nature, Robert Lustig MD, Laura Schmidt PhD, MSW, MPH, and Claire Brindis, DPH, colleagues at the University of California, San Francisco (UCSF), argue that sugar’s potential for abuse, coupled with its toxicity and pervasiveness in the Western diet make it a primary culprit of this worldwide health crisis.

This partnership of scientists trained in endocrinology, sociology and public health took a new look at the accumulating scientific evidence on sugar. Such interdisciplinary liaisons underscore the power of academic health sciences institutions like UCSF.

Sugar, they argue, is far from just “empty calories” that make people fat. At the levels consumed by most Americans, sugar changes metabolism, raises blood pressure, critically alters the signaling of hormones and causes significant damage to the liver – the least understood of sugar’s damages. These health hazards largely mirror the effects of drinking too much alcohol, which they point out in their commentary is the distillation of sugar.

Worldwide consumption of sugar has tripled during the past 50 years and is viewed as a key cause of the obesity epidemic. But obesity, Lustig, Schmidt and Brindis argue, may just be a marker for the damage caused by the toxic effects of too much sugar. This would help explain why 40 percent of people with metabolic syndrome—the key metabolic changes that lead to diabetes, heart disease and cancer—are not clinically obese.

“As long as the public thinks that sugar is just ‘empty calories,’ we have no chance in solving this,” said Lustig, a professor of pediatrics, in the division of endocrinology at the UCSF Benioff Children’s Hospital and director of the Weight Assessment for Teen and Child Health (WATCH) Program at UCSF.

“There are good calories and bad calories, just as there are good fats and bad fats, good amino acids and bad amino acids, good carbohydrates and bad carbohydrates,” Lustig said. “But sugar is toxic beyond its calories.”

Limiting the consumption of sugar has challenges beyond educating people about its potential toxicity. “We recognize that there are cultural and celebratory aspects of sugar,” said Brindis, director of UCSF’s Philip R. Lee Institute for Health Policy Studies. “Changing these patterns is very complicated”

According to Brindis, effective interventions can’t rely solely on individual change, but instead on environmental and community-wide solutions, similar to what has occurred with alcohol and tobacco, that increase the likelihood of success.

The authors argue for society to shift away from high sugar consumption, the public must be better informed about the emerging science on sugar.

“There is an enormous gap between what we know from science and what we practice in reality,” said Schmidt, professor of health policy at UCSF’s Philip R. Lee Institute for Health Policy Studies (IHPS) and co-chair of UCSF’s Clinical and Translational Science Institute’s (CTSI) Community Engagement and Health Policy Program, which focuses on alcohol and addiction research.

“In order to move the health needle, this issue needs to be recognized as a fundamental concern at the global level,” she said.

The paper was made possible with funding from UCSF’s Clinical and Translational Science Institute, UCSF’s National Institutes of Health-funded program that helps accelerate clinical and translational research through interdisciplinary, interprofessional and transdisciplinary work.

Many of the interventions that have reduced alcohol and tobacco consumption can be models for addressing the sugar problem, such as levying special sales taxes, controlling access, and tightening licensing requirements on vending machines and snack bars that sell high sugar products in schools and workplaces.

“We’re not talking prohibition,” Schmidt said. “We’re not advocating a major imposition of the government into people’s lives. We’re talking about gentle ways to make sugar consumption slightly less convenient, thereby moving people away from the concentrated dose. What we want is to actually increase people’s choices by making foods that aren’t loaded with sugar comparatively easier and cheaper to get.”

Genetic analysis also shows massage promotes growth of new mitochondria

Most athletes can testify to the pain-relieving, recovery-promoting effects of massage. Now there’s a scientific basis that supports booking a session with a massage therapist: On the cellular level massage reduces inflammation and promotes the growth of new mitochondria in skeletal muscle. The research, involving scientists from the Buck Institute for Research on Aging and McMaster University in Hamilton Ontario appears in the February 1st online edition of Science Translational Medicine.

The study involved the genetic analysis of muscle biopsies taken from the quadriceps of eleven young males after they had exercised to exhaustion on a stationary bicycle. One of their legs was randomly chosen to be massaged. Biopsies were taken from both legs prior to the exercise, immediately after 10 minutes of massage treatment and after a 2.5 hour period of recovery.

Buck Institute faculty Simon Melov, PhD, was responsible for the genetic analysis of the tissue samples. “Our research showed that massage dampened the expression of inflammatory cytokines in the muscle cells and promoted biogenesis of mitochondria, which are the energy-producing units in the cells,” said Melov. He added that the pain reduction associated with massage may involve the same mechanism as those targeted by conventional anti-inflammatory drugs. “There’s general agreement that massage feels good, now we have a scientific basis for the experience,” said Melov.

Study participants were recruited at McMaster University in Hamilton, Ontario, Canada. Lead author Mark Tarnopolsky, MD, PhD, from the Department of Pediatrics and Medicine said the research provides much needed validation for a practice that is growing in popularity. “The potential benefits of massage could be useful to a broad spectrum of individuals including the elderly, those suffering from musculoskeletal injuries and patients with chronic inflammatory disease,” said Tarnopolsky. “This study provides evidence that manipulative therapies, such as massage, may be justifiable in medical practice.”

About 18 million individuals undergo massage therapy annually in the U.S., making it the fifth most widely used form of complementary and alternative medicine. Despite several reports that long-term massage therapy reduces chronic pain and improves range of motion in clinical trials, the biological effects of massage on skeletal tissue have remained unclear.

Researchers from Mount Sinai School of Medicine have discovered that decaffeinated coffee may improve brain energy metabolism associated with type 2 diabetes. This brain dysfunction is a known risk factor for dementia and other neurodegenerative disorders like Alzheimer’s disease. The research is published online in Nutritional Neuroscience.

A research group led by Giulio Maria Pasinetti, MD, PhD, Professor of Neurology, and Psychiatry, at Mount Sinai School of Medicine, explored whether dietary supplementation with a standardized decaffeinated coffee preparation prior to diabetes onset might improve insulin resistance and glucose utilization in mice with diet-induced type 2 diabetes. The researchers administered the supplement for five months, and evaluated the brain’s genetic response in the mice. They found that the brain was able to more effectively metabolize glucose and use it for cellular energy in the brain. Glucose utilization in the brain is reduced in people with type 2 diabetes, which can often result in neurocognitive problems.

“Impaired energy metabolism in the brain is known to be tightly correlated with cognitive decline during aging and in subjects at high risk for developing neurodegenerative disorders,” said Dr. Pasinetti. “This is the first evidence showing the potential benefits of decaffeinated coffee preparations for both preventing and treating cognitive decline caused by type 2 diabetes, aging, and/or neurodegenerative disorders.”

Coffee intake is not recommended for everybody due to the fact that it is associated with cardiovascular health risks such as elevated blood cholesterol and blood pressure, both of which lead to an increased risk for heart disease, stroke, and premature death. These negative effects have primarily been attributed to the high caffeine content of coffee. Nonetheless, these novel findings are evidence that some of the non-caffeine components in coffee provide health benefits in mice. Dr. Pasinetti hopes to explore the preventive role of decaffeinated coffee delivered as a dietary supplement in humans.

“In light of recent evidence suggesting that cognitive impairment associated with Alzheimer’s disease and other age-related neurodegenerative disorders may be traced back to neuropathological conditions initiated several decades before disease onset, developing preventive treatments for such disorders is critical,” he said.

Sanford-Burnham study suggests that many antipsychotics affect metabolism because they activate the TGFbeta pathway — a finding that could lead to safer therapeutics for bipolar disorder and schizophrenia patients

LA JOLLA, Calif. — In 2008, roughly 14.3 million Americans were taking antipsychotics—typically prescribed for bipolar disorder, schizophrenia, or a number of other behavioral disorders—making them among the most prescribed drugs in the U.S. Almost all of these medications are known to cause the metabolic side effects of obesity and diabetes, leaving patients with a difficult choice between improving their mental health and damaging their physical health. In a paper published January 31 in the journal Molecular Psychiatry, researchers at Sanford-Burnham Medical Research Institute (Sanford-Burnham) reveal how antipsychotic drugs interfere with normal metabolism by activating a protein called SMAD3, an important part of the transforming growth factor beta (TGFbeta) pathway.

The TGFbeta pathway is a cellular mechanism that regulates many biological processes, including cell growth, inflammation, and insulin signaling. In this study, all antipsychotics that cause metabolic side effects activated SMAD3, while antipsychotics free from these side effects did not. What’s more, SMAD3 activation by antipsychotics was completely independent from their neurological effects, raising the possibility that antipsychotics could be designed that retain beneficial therapeutic effects in the brain, but lack the negative metabolic side effects.

“We now believe that many antipsychotics cause obesity and diabetes because they trigger the TGFbeta pathway. Of all the drugs we tested, the only two that didn’t activate the pathway were the ones that are known not to cause metabolic side effects,” said Fred Levine, M.D., Ph.D., director of the Sanford Children’s Health Research Center at Sanford-Burnham and senior author of the study.

In a previous study aimed at developing new insights into diabetes, Dr. Levine and his team used Sanford-Burnham’s high-throughput screening capabilities to search a collection of known drugs for those that alter the body’s ability to generate insulin, the pancreatic hormone that helps regulate glucose. That’s when they first noticed that many antipsychotics alter the activity of the insulin gene. In this current study, the researchers set out to connect the dots between antipsychotics and insulin. In doing so, experiments in laboratory cell-lines showed that antipsychotics known to cause metabolic side effects also activated the TGFbeta pathway—a mechanism that controls many cellular functions, including the production of insulin—while the drugs without these side effects did not.

Wondering whether their initial laboratory observations were relevant to the human experience, the researchers reanalyzed previously published gene expression patterns in brain tissue from schizophrenic patients treated with antipsychotics. What they found supported their earlier findings—TGFbeta signaling was activated only in those patients receiving antipsychotic treatment. Looking further, they found that the extent to which each antipsychotic drug activated the TGFbeta pathway in human brains correlated very closely with the extent to which those same drugs activated SMAD3 and affected the insulin promoter in their cell culture experiments.

The TGFbeta pathway also plays an important role in metabolic disease in people who don’t take antipsychotic medications. “It’s known that people who have elevated TGFbeta levels are more prone to diabetes. So having a dysregulated TGFbeta pathway—whether caused by antipsychotics or through some other mechanism—is clearly a very bad thing,” said Dr. Levine. “The fact that antipsychotics activate this pathway should be a big concern to pharmaceutical companies. We hope this new information will lead to the development of improved drugs.”

Journal of Agricultural and Food Chemistry

The first study to check the effects of eating potatoes on blood pressure in humans has concluded that two small helpings of purple potatoes (Purple Majesty) a day decreases blood pressure by about 4 percent without causing weight gain. In a report in the ACS’ Journal of Agricultural and Food Chemistry, the researchers say that decrease, although seemingly small, is sufficient to potentially reduce the risk of several forms of heart disease.

Joe Vinson and colleagues point out that people in the U.S. eat more potatoes than any other vegetable. Purple-skinned potatoes, a boutique variety increasingly available in food stores, are noted for having high levels of healthful antioxidant compounds. And in Korea, purple potatoes are renowned in folk medicine as a way to lose weight. Vinson’s team thus decided to investigate the effects of eating 6-8 small microwaved purple potatoes twice a day on 18 volunteers, most of whom were overweight with high blood pressure. The volunteers ate potatoes or no potatoes for four weeks, and then switched to the opposite regimen for another four weeks while researchers monitored systolic and diastolic blood pressure (the higher and lower numbers in a blood pressure reading like 120/80), body weight and other health indicators.

Average diastolic blood pressure dropped by 4.3 percent and systolic pressure decreased by 3.5 percent. The majority of subjects took anti-hypertensive drugs and still had a reduction in blood pressure. None of the study participants gained weight. Vinson said that other studies have identified substances in potatoes with effects in the body similar to those of the well-known ACE-inhibitor medications, a mainstay for treating high blood pressure. But he suspects that the effects may be due to other substances in potatoes. The scientists do not know yet whether ordinary white potatoes have the same beneficial effects.

UCSF discovery sheds light on how robust exercise may lower the risk of prostate cancer progression

Scientists at the University of California, San Francisco (UCSF) have identified nearly 200 genes in the healthy prostate tissue of men with low-grade prostate cancer that may help explain how physical activity improves survival from the disease.

The study compared the activity of some 20,000 genes in healthy prostate tissue biopsied from several dozen patients.

The finding builds on two studies last year by UCSF and Harvard School of Public Health that showed brisk walking or vigorous exercise such as jogging for three or more hours a week was linked to a lowered risk of prostate cancer progression and death after diagnosis. Those earlier studies, however, offered no explanation as to why.

In the current work, to be presented Friday, February 3, 2012 at an American Society of Clinical Oncology (ASCO) meeting in San Francisco, the UCSF team teased out a molecular profile of 184 genes whose expression in the prostate gland is linked to vigorous exercise.

Understanding how the activity of these genes is impacted by vigorous exercise and how this might translate to a lowered risk of prostate cancer progression may help reveal new ways to manage the disease, said the senior author of the study, June Chan, ScD, the Steven and Christine Burd-Safeway Distinguished Professor at UCSF.

“Vigorous physical activity may provide clinical benefits for men diagnosed with earlier stage prostate cancer,” she said. “The finding suggests some interesting leads on mechanisms by which physical activity may protect against prostate cancer progression.”

Prostate cancer is one of the most commonly diagnosed cancers in the United States. More than 217,000 U.S. men are diagnosed with the disease, and some 32,000 men die from prostate cancer, each year, according to the National Cancer Institute.

The analysis involved examining the levels of expression, or activity, of the same 20,000 genes in 70 men. This information was correlated with the exercise patterns the men reported on questionnaires.

The study revealed 109 genes were “up-regulated,” or more active, and 75 were “down-regulated” or less active, among the men who exercised vigorously for at least three hours a week compared to those who exercised less. Among the genes that exhibited greater expression were a number that already are thought to help thwart cancer progression, including the well-known “tumor suppressor” genes BRCA1 and BRCA2, as well as genes involved in cell cycle and DNA repair. The authors are continuing to analyze the data, including investigating pathways that were down-regulated by vigorous physical activity.

The team plans to follow this small, preliminary study with an investigation in a larger population of men. In another future study, they plan to examine the effects of physical activity among men who already have experienced cancer recurrence. Further research on these genes, said Chan, may help to determine how exercise contributes to improved cancer survivorship, and suggest novel strategies for prevention.

ROCHESTER, Minn. — Mayo Clinic researchers have found that multiple exposures to anesthesia at a young age are associated with higher rates of attention-deficit/hyperactivity disorder (ADHD).

Children exposed to two or more anesthetics before age 3 had more than double the incidence of ADHD than children who had no exposure, says David Warner, M.D., a Mayo Clinic pediatric anesthesiologist and investigator on the observational study.

The findings are published in the Feb. 2 edition of Mayo Clinic Proceedings.

When basic science studies in the medical literature began to suggest anesthesia used in surgery causes changes in the brains of young animals, Dr. Warner and a group of researchers at Mayo Clinic took note.

“Those studies piqued our interest,” Dr. Warner says. “We were skeptical that the findings in animals would correlate with kids, but it appears that it does.”

The study utilized results of an existing epidemiological study that looked at educational records of children born between 1976 and 1982 in Rochester, Minn., and determined those who developed some form of learning disability or ADHD.

Among 341 cases of ADHD in those younger than 19, researchers traced medical records in the Rochester Epidemiology Project, a decades-long database of all patient care in Olmsted County, Minn., looking for exposure to anesthesia and surgery before age 3.

Children who had no exposure to anesthesia and surgery had ADHD at a rate of 7.3 percent. The rate after a single exposure to anesthesia and surgery was approximately the same. For children who had two or more exposures to anesthesia and surgery, the rate of ADHD was 17.9 percent, even after researchers adjusted for other factors, including gestational age, sex, birth weight and comorbid health conditions.

The results of the study, however, do not definitively mean that anesthesia causes ADHD, Dr. Warner says.

“This is an observational study,” he says. “A wide range of other factors might be responsible for the higher frequency of ADHD in children with multiple exposures. The findings certainly do suggest that further investigation into this area is warranted, and investigators at Mayo Clinic and elsewhere are actively pursuing these studies.”

A new study published in the journal Pharmacoepidemiology & Drug Safety reveals that internet sites selling prescription statins directly to consumers are widespread, and that most websites advertising statins for sale to the general public contain very poor levels of information relevant to safe use of the medicine and side effects.

Researchers led by Professor David Brown, School of Pharmacy and Biomedical Sciences, University of Portsmouth, simulated a customer search and evaluation of 184 retrieved sites using evaluation tools focusing on quality and safe medicine use.

Results showed that a potential purchaser of statins is likely to encounter websites from a wide geographical base of generally poor quality.

General contraindications were absent in 92.4% of sites and contraindicated medicines were absent in 47.3%. Key warnings on the appearance of symptoms associated with myopathy, liver disease, hypersensitivity and pancreatitis were absent in 37, 48.4, 91.3, and 96.2% of sites respectively.

Most websites presented a chaotic and incomplete list of known side effects; just 13 (7.1%) presented a list compatible with current prescribing information. Only two thirds (65.8%) attempted to describe any side effects in lay language.

“Websites offering statins for sale contain little information on the safety of these drugs, which are intended as prescription only medicines” Brown notes. “There is an inherent danger in patients seeking to self-medicate in this way without consulting a healthcare professional and being appraised of ways to use the medicine safely.”

The internet is awash with stories of how silver can be used to treat cancer. Now, lab tests have shown that it is as effective as the leading chemotherapy drug – and may have fewer side-effects.

Results from the study at the University of Leeds, published in Dalton Transactions, show that particular silver compounds are as toxic to cancer cells as the platinum-based drug Cisplatin, which is widely used to treat a range of cancers.

But the crucial difference is that silver is thought to be much less toxic to healthy human cells, and in some cases, can be beneficial. Silver is currently used for its antiseptic and antibiotic properties, in bandages, wound dressings and water purification filters in the third world.

Nausea and vomiting, kidney damage and an increased risk of infection are common side effects of Cisplatin which is used to treat cancer of the lungs, breast, bladder, testicles, head and neck, ovaries and lymph nodes.

Dr Charlotte Willans who is leading the study said: “As many are unfortunately aware, chemotherapy can be a very gruelling experience for the patient. Finding effective, yet non-toxic drugs is an ongoing problem, but these preliminary results are an important step in solving it.”

“Our research has looked at the structure which surrounds a central silver atom. This ‘shrubbery’ is what determines how reactive it is and what it will interact with. Our research has used different types of these ligands to see which is the most effective against cancer cells,” adds Dr Willans.

The research, still the first phase of drug development, involved exposing breast and colon cancer cells with different silver-based chemicals for six day periods. It has been shown that ligands which are co-ordinately bonded to the central silver atom through two sites are more effective than those coordinated through only one site. This may be due to the release of silver being much slower and make these compounds more effective over a longer period of time.

A major barrier to the continued development of these compounds is a lack of understanding of how they work. Over the next 12 months, research will focus on investigating how the compounds damage cancerous cells and what effects they have on healthy cells. This will establish whether these silver complexes are in fact less toxic to ordinary human tissue, and will help to design and develop the next-generation of chemotherapy drugs. This work is been carried out in collaboration with Dr. Roger Phillips at the University of Bradford and is funded by Yorkshire Cancer Research.

Alexandria, VA – What would you do if you found out that the roads you drive on could cause cancer? This is the reality that residents face in Dunn County, North Dakota. For roughly 30 years, gravel containing the potentially carcinogenic mineral erionite was spread on nearly 500 kilometers of roads, playgrounds, parking lots, and even flower beds throughout Dunn County.

Concerns about erionite were first unveiled in Central Anatolia, Turkey, where an epidemic of mesothelioma — a normally rare cancer of the smooth lining of the chest, lungs, heart and abdomen — was responsible for up to 50 percent of the deaths in some villages. Although it is found in 12 states, erionite remains an unregulated mineral in the U.S. because it has not been used commercially and was previously thought that, unlike asbestos, human exposure was extremely limited. However, new evidence of its prevalence and dangers is coming to light, and scientists are beginning to wonder whether we should be worried. Find out more at http://www.earthmagazine.org/article/dangerous-dust-erionite-asbestos-mineral-causing-cancer-epidemic-turkey-found-least-13.

Increased coffee intake significantly decreases risk in nonalcoholic steatohepatitis patients

Caffeine consumption has long been associated with decreased risk of liver disease and reduced fibrosis in patients with chronic liver disease. Now, newly published research confirms that coffee caffeine consumption reduces the risk of advanced fibrosis in those with nonalcoholic fatty liver disease (NAFLD). Findings published in the February issue of Hepatology, a journal of the American Association for the Study of Liver Diseases, show that increased coffee intake, specifically among patients with nonalcoholic steatohepatitis (NASH), decreases risk of hepatic fibrosis.

The steady increase in rates of diabetes, obesity, and metabolic syndrome over the past 20 years has given rise to greater prevalence of NAFLD. In fact, experts now believe NAFLD is the leading cause of chronic liver disease in the U.S., surpassing both hepatitis B and C. The majority of patients will have isolated fatty liver which has a very low likelihood of developing progressive liver disease. However, a subset of patients will have NASH, which is characterized by inflammation of the liver, destruction of liver cells, and possibly scarring of the liver. Progression to cirrhosis (advanced scarring of the liver) may occur in about 10-11% of NASH patients over a 15 year period, although this is highly variable.

To enhance understanding of the correlation between coffee consumption and the prevalence and severity of NAFLD, a team led by Dr. Stephen Harrison, Lieutenant Colonel, U.S. Army at Brooke Army Medical Center in Fort Sam Houston, Texas surveyed participants from a previous NAFLD study as well as NASH patients treated at the center’s hepatology clinic. The 306 participants were asked about caffeine coffee consumption and categorized into four groups: patients with no sign of fibrosis on ultrasound (control), steatosis, NASH stage 0-1, and NASH stage 2-4.

Researchers found that the average milligrams in total caffeine consumption per day in the control, steatosis, Nash 0-1, and Nash 2-4 groups was 307, 229, 351 and 252; average milligrams of coffee intake per day was 228, 160, 255, and 152, respectively. There was a significant difference in caffeine consumption between patients in the steatosis group compared to those with NASH stage 0-1. Coffee consumption was significantly greater for patients with NASH stage 0-1, with 58% of caffeine intake from regular coffee, than with NASH stage 2-4 patients at only 36% of caffeine consumption from regular coffee.

Multiple analyses showed a negative correlation between coffee consumption and risk of hepatic fibrosis. “Our study is the first to demonstrate a histopatholgic relationship between fatty liver disease and estimated coffee intake,” concludes Dr. Harrison. “Patients with NASH may benefit from moderate coffee consumption that decreases risk of advanced fibrosis. Further prospective research should examine the amount of coffee intake on clinical outcomes.”

Breastfeeding is associated with improved lung function at school age, particularly in children of asthmatic mothers, according to a new study from researchers in Switzerland and the UK.

“In our cohort of school age children, breastfeeding was associated with modest improvement in forced mid-expiratory flow (FEF50) in our whole group and with improvements in forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1) only in the children of asthmatic mothers,” said Claudia E. Kuehni, MD, MSc, professor at the Institute of Social and Preventive Medicine at the University of Bern. “In contrast, some earlier studies have suggested that breastfeeding might be harmful in the offspring of mothers with asthma.”

The findings were published online ahead of print publication in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

The researchers analyzed data from a nested sample of 1458 children from the Leicestershire cohort studies, born between 1993 and 1997 in the UK. They assessed duration of breastfeeding, other exposures and respiratorysymptoms by repeated questionnaires. Post-bronchodilator FVC, FEV1, peak expiratory flow rates (PEF), FEF50 and skinprick tests were measured at age 12.

In the entire sample of children, FEF50was significantly higher in breastfed children compared with those who were not breastfed, increasing by 0.130 L/sec (P=.048) in those breastfed for 4-6 months and 0.164 L/sec (P=.041) in those breastfed for more than six months. These effects were larger among children of mothers with asthma, with increases of 0.375 L/sec (P=.015) in those breastfed for 4-6 months and 0.468 L/sec (P=.009) in those breastfed for more than six months. Significant improvements in FVC and FEV1with breastfeeding were seen only in the children of asthmatic mothers. Adjustments for respiratory infections in infancy and asthma and atopy in childhood did not change the results of these analyses.

The study had several limitations, including a modest response rate of the original cohort for laboratory examinations and the use of self-report for determining duration of breastfeeding, maternal asthma and infections during infancy.

“We observed modest improvements in lung function in breastfed children in our cohort, including the children of mothers with asthma. Furthermore, our data suggest that rather than acting by reducing respiratory infections, asthma or allergy, breastfeeding might have a direct effect on lung growth,” said Dr. Kuehni. “This study supports a strong recommendation for breastfeeding in all children, including those with asthmatic mothers.”

Sunshine may help to prevent allergies and eczema

Increased exposure to sunlight may reduce the risk of both food allergies and eczema in children, according to a new scientific study published this week.

Researchers from the European Centre for Environment & Human Health, along with several Australian institutions, have found that children living in areas with lower levels of sunlight are at greater risk of developing food allergies and the skin condition eczema, compared to those in areas with higher UV.

The research team used data from a study of Australian children and analysed how rates of food allergy, eczema and asthma varied throughout the country. As well as finding a link between latitude and allergies to peanut and egg, the results showed that on average children in the south of the country are twice as likely to develop eczema as those in the north.

The report builds upon existing evidence that suggests exposure to the sun may play a role in rising levels of food allergy and eczema. Sunlight is important because it provides our body with the fuel to create vitamin D in the skin, and locations closer to the equator typically receive higher levels of sunshine. Australia is a particularly good place for this type of study as it spans nearly 3000 miles from north to south, with a large variation in climate, day length and sun strength – from Queensland in the north to Tasmania in the south.

Dr Nick Osborne, who led the research, believes these findings provide us with an important insight into the prevalence of food allergies and eczema, which appear to be on the increase. Dr Osborne also cautioned that exposure to sunlight can vary for a host of reasons beyond latitude, such as local climate variations and behaviours, and these factors will also need to be considered.

He said “This investigation has further underlined the association between food allergies, eczema and where you live. We’re now hoping to study these effects at a much finer scale and examine which factors such as temperature, infectious disease or vitamin D are the main drivers of this relationship. As always, care has to be taken we are not exposed to too much sunlight, increasing the risk of skin cancer.”

The great majority of geriatric patients in a German rehabilitation hospital were found to have vitamin D deficiency. Stefan Schilling presents his study results in this week’s issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2012; 109[3]: 33-8).

In order to establish the vitamin D status in geriatric patients in Germany, the researchers measured 25-OH vitamin D in 1578 patients in the geriatric rehabilitation hospital in Trier after they had been examined on admission.

Insufficiently high concentrations were found in 89% of patients, and 67% had severe vitamin D deficiency. Vitamin D affects the calcium and bone metabolism, and it is also attributed with numerous other effects. A sufficiently high concentration of vitamin D, and its effects on the muscles, seems to help reduce the risk of falls and thus of fractures.

Older people seek exposure to the sun less often than young people; the risk of skin cancer is another reason for restricting sun exposure. In contrast to the fluctuations in vitamin D levels between the summer and winter halves of the year that is observed in young people, the old patients in this study (average age 82) did not display any seasonal fluctuations.

According to the recommendations of the Institute of Medicine, daily supplementation with 800 IU of vitamin D is therefore advisable in people older than 70.

Ottawa, Ontario –Could the use of vitamin and mineral supplements in a regular diet help to reduce the risk of colon cancer and protect against carcinogens? A study published in the Canadian Journal of Physiology and Pharmacology (CJPP) found that rats given regular multivitamin and mineral supplements showed a significantly lower risk of developing colon cancer when they were exposed to carcinogens.

“It has been unclear whether multivitamin supplementation to cancer patients is helpful, has no effect, or is even detrimental during therapy,” commented Dr. Grant Pierce, Editor of CJPP. “This study is important because it gives some direction to cancer patients in desperate need of guidance on the value of multivitamins and minerals administered during cancer.”

The authors studied rats that were fed a high-fat diet (20% fat) over a 32 week period. The rats were divided into 6 groups, which were exposed to different combinations of supplements and carcinogens; the colon carcinogenisis induced in the study rats has characteristics that mimic human colon cancer. Rats fed a high-fat plus low-fibre diet and exposed to carcinogens developed pre-cancerous lesions; whereas, rats undergoing similar treatment, but provided with daily multivitamin and mineral supplements, showed a significant (84%) reduction in the formation of pre-cancerous lesions and did not develop tumours.

The authors conclude that “multivitamin and mineral supplements synergistically contribute to the cancer chemopreventative potential, and hence, regular supplements of multivitamins and minerals could reduce the risk of colon cancer.”

The study “Multivitamin and mineral supplementation in 1,2-dimethylhydrazine induced experimental colon carcinogenesis and evaluation of free radical status, antioxidant potential, and incidence of ACF” appears in the January issue of CJPP.

IMMUNOLOGY: How a stomach-colonizing bacterium protects against asthma

The bacterium Helicobacter pylori can be found colonizing the stomach lining of almost half the world’s population. Although persistent infection with Helicobacter pylori increases an individual’s risk of developing stomach cancer, it also decreases their risk of developing asthma. A team of researchers led by Anne Müller, at the University of Zürich, Switzerland, has now identified a cellular mechanism by which persistent infection with Helicobacter pylori protects mice from developing allergic asthma. Specifically, they found that Helicobacter pylori modulated immune cells known as dendritic cells such that they did not activate an aggressive immune response but instead activated what is known as a tolerogenic immune response. Although this tolerogenic immune response enabled Helicobacter pylori to persist, it also prevented the onset of unwanted immune responses to allergens (that is, it protected against allergic asthma).

As noted by Kouji Matsushima and Shigenori Nagai, in an accompanying commentary, these data provide new mechanistic insight into the intriguing link between the recent sharp rise in the industrialized world in the number of people with asthma and the simultaneous decrease in exposure to microbes, including Helicobacter pylori.

TITLE: DC-derived IL-18 drives Treg differentiation, murine Helicobacter pylori–specific immune tolerance, and asthma protection

CHICAGO – Administration of routine infant immunizations with a vaccine for serogroup B Neisseria meningitidis, a bacterium that is a cause of serious disease such as sepsis and meningitis, was effective against meningococcal strains and produced minimal interference with the response to the routine vaccinations, according to a study in the February 8 issue of JAMA.

Certain serogroup B Neisseria meningitidis (MenB) vaccines proved effective in clinical trials and controlled a clonal MenB outbreak in New Zealand; however, the high strain specificity of these vaccines limited their usefulness, especially in infants and young children, according to background information in the article.

Nicoletta Gossger, M.D., of the University of Oxford, United Kingdom, and colleagues assessed the immunogenicity (the ability to produce an immune response) and reactogenicity (producing adverse reactions) of a vaccine developed to provide broader protection, a multicomponent serogroup B meningococcal vaccine (4CMenB), in a large group of infants, given in 2 different schedules, with or separately from routine vaccines. The multicenter, randomized controlled study included 1,885 infants enrolled at age 2 months from August 2008 to July 2010 in Europe. Participants were randomized to receive (1) 4CMenB at 2, 4, and 6 months with routine vaccines (7-valent pneumococcal and combined diphtheria, tetanus, acellular pertussis, inactivated polio, hepatitis B, Haemophilus influenzae type b vaccines); (2) 4CMenB at 2, 4, and 6 months and routine vaccines at 3, 5, and 7 months; (3) 4CMenB with routine vaccines at 2, 3, and 4 months; or (4) routine vaccines alone at 2, 3, and 4 months. The primary outcome the researchers measured was the percentage of participants with human complement serum bactericidal activity (hSBA) titer (concentration) of 1:5 or greater against 3 MenB strains specific for vaccine antigens (NZ98/254, 44/76-SL, and 5/99).

After immunization with 4CMenB and routine vaccines together at either 2, 4, and 6 or 2, 3, and 4 months, 99 percent or more of participants had hSBA titers of 1:5 or greater for strains 44/76-SL and 5/99. For NZ98/254, this proportion was 79 percent for vaccination at 2, 4, and 6 months with routine vaccines, 86.1 percent for vaccination at 2, 4, and 6 months without routine vaccines, and 81.7 percent for vaccination at 2,3, and 4 months with routine vaccines. The predefined criteria of a sufficient immune response was met for all three strains.

Responses to routine vaccines given with 4CMenB were noninferior (outcome not worse than treatment compared to) to routine vaccines alone for all antigens, except for the responses to pertactin (a pertussis antigen) and the pneumococcal vaccine serotype 6B.

“Fever was seen following 26 percent to 41 percent of 4CMenB doses when administered alone, compared with 23 percent to 36 percent after routine vaccines given alone and 51 percent to 61 percent after 4CMenB and routine vaccines administered together,” the authors write.

“In conclusion, 4CMenB was immunogenic, generally well tolerated, and showed minimal interference with routine vaccines in the first year of life. The flexibility in schedule allows it to be incorporated into a range of country-specific immunization schedules and for primary immunization to be completed in early infancy. If licensed, the decisions regarding vaccine introduction will require detailed assessment of potential vaccine coverage at a regional level and monitoring after implementation to determine the accuracy of such predictions. Nevertheless, this vaccine could potentially provide improved protection for infants against meningococcal disease beyond the protection provided by currently licensed vaccines.”

(JAMA. 2012;307[6]:573-582. Available pre-embargo to the media at www.jamamedia.org)

Editor’s Note: This study was funded by Novartis Vaccines and Diagnostics. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, etc.

Ralph’s Note: Over 50% Chance your child will get immediately sick from the vaccination. That seems acceptable to the company.

Respiratory tract infections, including pneumonia, are the most common cause of death in children under the age of five. In a study looking at children given standard antibiotic therapy, new research published in BioMed Central’s open access journal BMC Medicine shows how zinc supplements drastically improved children’s chances of surviving the infection. The increase in survival due to zinc (on top of antibiotics) was even greater for HIV infected children.

In a double-blind, randomized, placebo-controlled trial, 350 children, aged from six months to five years old, were treated with standard antibiotic therapy at Mulago Hospital. Half the children were given zinc and the other half a placebo.

The researchers from Makerere University found that while there was no difference between zinc and placebo in the time it took to recover from the infection (measured by time it took to return to a normal temperature, reparatory rate and oxygen saturation) the risk of death between the groups was very different. 4% of the children taking zinc died compared to 12% of the children without zinc. This means that an extra eight out of 100 children could have been saved by taking zinc. Among the HIV infected children this rose to 26 out of every 100.

Prof James Tumwine explained, “Zinc is known to bolster the immune system and zinc deficiency is rife all over the developed, and developing, world. In Uganda, where this study was performed, zinc deficiency in some areas can be as high as 70%. We would only need to give 13 of these children with pneumonia zinc on top of their antibiotics to save one life. This equates to about 4 USD – a small price to pay.”

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Notes to Editors

1. Zinc adjunct therapy reduces case fatality in severe childhood pneumonia: a randomized double blind placebo-controlled trial Maheswari G Srinivasan, Grace Ndeezi, Cordelia Katureebe Mboijana, Sarah Kiguli, Gabriel S Bimenya, Victoria Nankabirwa and James K Tumwine BMC Medicine (in press)

New research presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) found that 77 percent of trauma patients had deficient or insufficient levels of vitamin D.

Researchers have linked a lack of vitamin D with muscle weakness, bone fractures, and the inability of bones to fully heal. In a new study, investigators sought to determine the prevalence of vitamin D deficiency among orthopaedic trauma patients.

Investigators reviewed the medical records of 1,830 adult (ages 18 and older) patients at a university Level 1 trauma center from Jan. 1, 2009 to Sept. 30, 2010. Participants with vitamin D levels below 20 ng/mL were categorized as “deficient,” and those with levels between 20 and 32 ng/mL, “insufficient” (levels between 40 and 70 ng/mL are considered “healthy.”)

Thirty-nine percent of all patients were vitamin D deficient, and another 38.4 percent had insufficient levels of vitamin D. Patients ages 18 to 25 had the lowest levels of vitamin D deficiency and insufficiency of any age group, and yet 29 percent were deficient, and 54.7 percent, insufficient.

“Vitamin D deficiency affects patients of all ages and is more prevalent than we thought it was,” said Brett D. Crist, MD, lead investigator and co-director of the Orthopaedic Trauma Service, Department of Orthopaedic Surgery, University of Missouri. The findings are important “as vitamin D deficiency has been linked to increased incidences of fracture nonunions (bone breaks that fail to heal).”

With the new data showing that a significant number of patients have deficient or insufficient levels of vitamin D, physicians should consider treating fracture patients with a supplement to ensure optimal outcome, said Dr. Crist, who provides vitamin D and calcium supplements to all trauma patients in his care, except to those patients for whom higher levels of calcium are not recommended.

“Although we’ve gone to treating most patients with weekly high dose vitamin D, in addition to daily vitamin D and calcium, monitoring vitamin D levels can be done to diagnose and monitor levels,” said Dr. Crist. Vitamin D deficiency is “easy to manage,” and “can prevent future fractures and improve healing of current fractures.”

It is extremely difficult to naturally obtain enough vitamin D. An adult needs at least 1,000 International Units (IU) of vitamin D (10 glasses of milk and one fish meal each day), and a child, 400 to 800 IUs for good health, depending on age, weight and growth.

To ensure appropriate levels of vitamin D, a daily supplement is recommended for children and adults.

A new study published in the journal Respirology reveals that a high level of soft drink consumption is associated with asthma and/or chronic obstructive pulmonary disease (COPD).

Led by Zumin Shi, MD, PhD, of the University of Adelaide, researchers conducted computer assisted telephone interviewing among 16,907 participants aged 16 years and older in South Australia between March 2008 and June 2010 inquiring about soft drink consumption. Soft drinks comprised Coke, lemonade, flavored mineral water, Powerade, and Gatorade etc.

Results showed that one in ten adults drink more than half a liter of soft drink daily in South Australia. The amount of soft drink consumption is associated with an increased chance of asthma and/or COPD. There exists a dose-response relationship, which means the more soft drink one consumes, the higher the chance of having these diseases.

Overall, 13.3% of participants with asthma and 15.6% of those with COPD reported consuming more than half a liter of soft drink per day.

The odds ratio for asthma and COPD was 1.26 and 1.79, comparing those who consumed more than half a liter of soft drink per day with those who did not consume soft drinks.

Furthermore, smoking makes this relationship even worse, especially for COPD. Compared with those who did not smoke and consume soft drinks, those that consumed more than half a liter of soft drink per day and were current smokers had a 6.6-fold greater risk of COPD.

“Our study emphasizes the importance of healthy eating and drinking in the prevention of chronic diseases like asthma and COPD,” Zumin concludes.

New study finds that short fasting cycles can work as well as chemotherapy, and the 2 combined greatly improve survival

Man may not live by bread alone, but cancer in animals appears less resilient, judging by a study that found chemotherapy drugs work better when combined with cycles of short, severe fasting.

Even fasting on its own effectively treated a majority of cancers tested in animals, including cancers from human cells.

The study in Science Translational Medicine, part of the Science family of journals, found that five out of eight cancer types in mice responded to fasting alone: Just as with chemotherapy, fasting slowed the growth and spread of tumors.

And without exception, “the combination of fasting cycles plus chemotherapy was either more or much more effective than chemo alone,” said senior author Valter Longo, professor of gerontology and biological sciences at the University of Southern California.

For example, multiple cycles of fasting combined with chemotherapy cured 20 percent of mice with a highly aggressive type of children’s cancer that had spread throughout the organism and 40 percent of mice with a more limited spread of the same cancer.

No mice survived in either case if treated only with chemotherapy.

Only a clinical trial lasting several years can demonstrate whether humans would benefit from the same treatment, Longo cautioned.

Results from the first phase of a clinical trial with breast, urinary tract and ovarian cancer patients, conducted at the USC Norris Comprehensive Cancer Center and led by oncologists Tanya Dorff and David Quinn, in collaboration with Longo, have been submitted for presentation at the annual meeting of the American Society of Cancer Oncologists.

The first phase tests only the safety of a therapy, in this case whether patients can tolerate short-term fasts of two days before and one day after chemotherapy.

“We don’t know whether in humans it’s effective,” Longo said of fasting as a cancer therapy. “It should be off limits to patients, but a patient should be able to go to their oncologist and say, ‘What about fasting with chemotherapy or without if chemotherapy was not recommended or considered?”

In a case report study with self-reported data published in the journal Aging in 2010, 10 cancer patients who tried fasting cycles perceived fewer side effects from chemotherapy.

Longo stressed that fasting may not be safe for everyone. The clinical trial did not enroll patients who already had lost more than 10 percent of their normal weight or who had other risk factors, such as diabetes. Fasting also can cause a drop in blood pressure and headaches, which could make driving and other activities dangerous for some patients.

In mice, the study found that fasting cycles without chemotherapy could slow the growth of breast cancer, melanoma, glioma and human neuroblastoma. In several cases, the fasting cycles were as effective as chemotherapy.

Fasting also extended survival in mice bearing a human ovarian cancer. In the case of melanoma, the cancer cells became resistant to fasting alone after a single round, but the single cycle of fasting was as effective as chemotherapy in reducing the spread of cancer to other organs.

For all cancers tested, fasting combined with chemotherapy improved survival, slowed tumor growth and/or limited the spread of tumors.

As with any potential cancer treatment, fasting has its limits. The growth of large tumor masses was reduced by multiple fasting and chemotherapy cycles, but cancer-free survival could not be achieved. Longo speculated that cells inside a large tumor may be protected in some way or that the variety of mutations in a large mass may make it more adaptable.

But he noted that in most patients, oncologists have at least one chance to attack the cancer before it grows too large.

Longo and collaborators at the National Institute on Aging studied one type of breast cancer in detail to try to understand the effects of fasting.

While normal cells deprived of nutrients enter a dormant state similar to hibernation, the researchers saw that the cancer cells tried to make new proteins and took other steps to keep growing and dividing.

The result, Longo said, was a “cascade of events” that led to the creation of damaging free radical molecules, which broke down the cancer cells’ own DNA and caused their destruction.

“The cell is, in fact, committing cellular suicide. What we’re seeing is that the cancer cell tries to compensate for the lack of all these things missing in the blood after fasting. It may be trying to replace them, but it can’t,” Longo said.

The new study bookends research published in Proceedings of the National Academy of Sciences in 2008.

In that study, Longo’s team showed that fasting protected normal cells against chemotherapy, but did not address the effect on cancer cells. The study also focused only on a single cancer and chemotherapy drug.

The new study on a range of cancers and common chemotherapy drugs extends the 2008 results by showing that fasting not only fails to protect cancer cells, but makes them more vulnerable.

Longo called the effect “Differential Stress Sensitization” to reflect the change in vulnerability between normal and cancerous cells.

Longo’s interest in fasting and cancer grew from years of studies on the beneficial effects of fasting in yeast and other organisms. He showed 15 years ago that starved yeast cells enter a stress-resistant mode as they wait for better times.

By contrast, he said, the mutations in cancer cells come at a cost, such as a loss in adaptability to diverse environments. For example, Longo found that yeast genetically modified to resemble cancer cells become much more sensitive to several toxins.

“A way to beat cancer cells may not be to try to find drugs that kill them specifically but to confuse them by generating extreme environments, such as fasting that only normal cells can quickly respond to,” Longo said.

SAN FRANCISCO —There is growing evidence that supports an association between atypical fractures of the femur– a rare break of the thigh bone, typically without trauma – and the use of bisphosphonates, drugs proven to enhance bone density and reduce fracture incidence caused by osteoporosis. While the risk for suffering an atypical femur fracture while taking bisphosphonates is still very small – just 1 in 1,000 patients after six years of treatment – research presented today at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) found that discontinuing bisphosphonate use following an atypical femur fracture can significantly lower the risk for a subsequent atypical fracture.

Scientists believe that bisphosphonates may suppress the body’s natural process of remodeling — where old bone tissue is replaced with new, healthy tissue – in some patients, resulting in brittle bones susceptible to atypical fractures, especially in the femur.

Investigators reviewed femur fracture data from Jan. 1, 2007 until Dec. 31, 2009 in patients older than 45 enrolled in a large California HMO. There were 126 patients with an atypical femur fracture who reportedly took bisphosphonates prior to their bone break.

The incidence of a subsequent atypical femur fracture occurring in the other thigh was 53.9 percent in patients who continued bisphosphonates for three or more years after their first fracture, compared to 19.3 percent in patients who discontinued bisphosphonate use. Overall, subsequent atypical femur fractures were decreased by 65.6 percent when bisphosphonates were stopped within one year following the first fracture.

“The risk of a contralateral atypical femur fracture (on the opposite side) increases over time if the bisphosphonates are continued,” said lead investigator Richard Dell, MD, a researcher in the Department of Orthopaedics at Kaiser Permanente. “Based on these observations, we recommend discontinuing bisphosphonate use as soon as possible after the initial atypical femur fracture has occurred.”

Dr. Dell then recommends the ongoing evaluation of these patients, through X-ray or MRI, as they still are at risk for a subsequent, atypical femur fracture on the other femur.

If the patient is at high risk for other fractures, the study recommends use of an alternative osteoporosis medication.

Higher blood levels of cadmium in females, and higher blood levels of lead in males, delayed pregnancy in couples trying to become pregnant, according to a study by researchers at the National Institutes of Health and other academic research institutions.

Cigarette smoke is the most common source of exposure to cadmium,, a toxic metal found in the earth’s crust, which is used in batteries, pigments, metal coatings and plastics. Smokers are estimated to have twice the levels of cadmium as do non-smokers. Exposure also occurs in workplaces where cadmium-containing products are made, and from the air near industrial facilities that emit cadmium. Airborne cadmium particles can travel long distances before settling on the ground or water. Soil levels of cadmium vary with location. Fish, plants, and animals absorb cadmium from the environment, and all foods contain at least low levels of the metal.

Lead, a toxic metal also found in the earth’s crust, is used in a variety of products, such as ceramics, pipes, and batteries. Common sources of lead exposure in the United States include lead-based paint in older homes, lead-glazed pottery, contaminated soil, and contaminated drinking water.

Exposure to these metals is known to have a number of effects on human health, but the effects on human fertility have not been extensively studied, especially when studying both partners of a couple.

The study was published online in Chemosphere. The study’s principal investigator was Germaine M. Buck Louis, Ph.D., director of the Division of Epidemiology, Statistics, and Prevention Research at the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Other authors of the study were from the NICHD, the Texas A&M Health Science Center School of Rural Public Health, College Station; The Ohio State University College of Medicine, Columbus; The EMMES Corp. in Rockville, Md.; the National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta; and the Rollins School of Public Health at Emory University, Atlanta.

“Our results indicate that men and women planning to have children should minimize their exposure to lead and cadmium,” Dr. Buck Louis said. “They can reduce cadmium exposure by avoiding cigarettes or by quitting if they are current smokers, especially if they intend to become pregnant in the future. Similarly, they can take steps to reduce their exposure to lead based paints, which may occur in older housing, including during periods of home renovation.”

To conduct the study, the researchers enrolled 501 couples from four counties in Michigan and 12 counties in Texas, from 2005 to 2009. The women ranged from 18 to 44 years of age, and the men were over 18. Couples provided blood samples for the analysis of three heavy metals. Women kept journals to record their monthly menstrual cycles and the results of home pregnancy tests. The couples were followed until pregnancy or for up to one year of trying.

The researchers ranked the study participants on the basis of their blood levels of lead and cadmium. The researchers also measured the participants’ blood mercury levels, but found they were not associated with the length of time couples required to become pregnant. Nearly every study participant had some exposure to these common metals, although blood levels of the metals varied across participants.

Researchers calculated the probability that a couple would achieve pregnancy by levels of blood cadmium and lead with a statistical measure called the fecundability odds ratio. The measure estimates couples’ probability of pregnancy each cycle, by their blood concentration of metals. A ratio less than one suggests a longer time to pregnancy, while a ratio greater than one suggests a shorter time to pregnancy. Females’ blood cadmium concentration was associated with a ratio below 1 (0.78), which means that the probability of pregnancy was reduced by 22 percent with each increase in the level of cadmium. Males’ blood lead exposure also was associated with a ratio below 1 (0.85) with increasing levels, or about a 15 percent reduction in the probability of pregnancy for each increase in the level of blood lead concentrations.

The researchers also calculated a fecundability odds ratio based on both partners’ combined lead, cadmium and mercury concentrations. The researchers found a ratio of 0.82 for male lead exposure, representing approximately a 28 percent reduction in the probability of pregnancy for each menstrual cycle, with increasing male blood lead concentration.

“The findings highlight the importance of assessing couples’ exposure jointly, in a single, combined measure,” Dr. Buck Louis said. “Males matter, because couples’ chances of becoming pregnant each cycle were reduced with increasing blood lead concentrations in men.”

Understanding a patient’s mental health status before hip replacement surgery may improve education and care

SAN FRANCISCO – Patients taking antidepressants up to three years prior to undergoing a total hip replacement (THR) were more likely to report greater pain before and after surgery and less satisfaction with their procedure, according to new research presented today at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

In the study, 1,657 patients (13 percent of the study population) used antidepressants up to three years before surgery.

The patients were surveyed before and one year after the THR. The investigators found that a patient’s mental health status, assessed by the use of antidepressants before surgery, was a significant factor in predicting outcomes, as well as gender (men are more likely to report lower outcomes), advanced age and co-morbidity (other joint diseases or conditions which affect walking).

According to the investigators, a patient’s mental health status should be assessed prior to surgery and taken into consideration during post-operative care.

MANHASSET, NY – Researchers at Zucker Hillside Hospital’s Recognition and Prevention (RAP) Program who have worked with teenagers at risk for serious mental illness for the past decade are now studying the effectiveness of Omega 3 fatty acids (fish oil) for treating psychiatric symptoms. This new study is a National Institute of Mental Health-funded randomized double-blind trial that was designed to test whether Omega-3 fatty acids improve clinical symptoms, and help adolescents and young adults (ages 12 to 25) who are at elevated risk for severe psychiatric disorders function better in school, work and other social environments.

“Of the 300 adolescents who have participated in the RAP Program, most have shown substantial improvement,” noted Barbara Cornblatt, Ph.D., director of the Recognition and Prevention (RAP) Program and investigator at The Feinstein Institute for Medical Research. “If this study continues to show success, Omega 3 could offer a natural alternative to the range of medications and therapies now offered to RAP participants. Ultimately, the goal of the RAP Program is to intervene and prevent illness before symptoms get worse.”

Omega 3 fatty acids are critical for normal brain function and they have been increasingly studied as potential treatments for medical and psychiatric disorders. The RAP Program study will randomly assign participants to either Omega 3 supplementation or to a placebo, and will compare the groups on key measures of symptoms and functioning after six months. Participants in both groups will be monitored closely on a monthly basis and compensation will be provided. All supplements are offered free of charge.

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About the Recognition and Prevention (RAP) Program

The RAP Program is considered a leading research and treatment program in the field of early intervention and prevention of serious mental illness. The RAP Program has also joined with other early intervention research groups to form the eight-site North American Prodrome Longitudinal Study (NAPLS), a major international study consortium conducting cutting edge research with at-risk adolescents and young adults. The Omega 3 fatty acid trial will be conducted at all eight sites in order to evaluate the possibility that fish oil, widely available in health food stores, will provide protection against emerging symptoms of illness.

For more information on the RAP Program research and clinical studies, including the Omega 3 study, call 718-470-8115 or visit the RAP website at www.rapprogram.org.

Trends in other countries and emerging cephalosporin resistance signal likelihood of treatment failures

Researchers are continuing to sound the alarm on the growing threat of multi-drug resistant gonorrhea in the United States, according to a Perspective commentary in the Feb. 9 issue of the New England Journal of Medicine.

In July 2011, the U.S. Centers for Disease Control and Prevention released “Cephalosporin Susceptibility Among Neisseria gonorrhoeae Isolates – United States, 2000-2010,” which signaled the potential for resistance to the cephalosporins, the last line of defense for treating gonorrhea.

The Feb. 9 New England Journal of Medicine‘s piece, “The Emerging Threat of Untreatable Gonococcal Infection,” by Gail A. Bolan, director of the Division of STD Prevention at the Centers for Disease Control and Prevention in Atlanta, P. Frederick Sparling, professor emeritus at the University of North Carolina, Chapel Hill, and Judith N. Wasserheit, professor and vice chair of the Department of Global Health at the University of Washington in Seattle, issues an urgent call to action to halt the continued increases in drug-resistant gonorrhea.

“It is time to sound the alarm,” said co-author Wasserheit. “Though there is no evidence yet of treatment failures in the United States, trends in decreased susceptibility coupled with a history of emerging resistance and reported treatment failures in other countries point to a likelihood of failures on the horizon and a need for urgent action.”

According to the article, gonorrhea is the second most commonly reported communicable disease in the United States, with an estimated incidence of more than 600,000 cases annually. It disproportionately affects some populations such as minorities who are marginalized because of race, ethnic group or sexual orientation.

Scientists note that Neisseria gonorrhoeae has always readily developed resistance to antimicrobial agents: it became resistant to sulfanilamide in the 1940s, penicillins and tetracyclines in the 1980s, and fluoroquinolones by 2007. The treatment options recommended by the CDC are now limited to third-generation cephalosporins.

But the effectiveness of cephalosporins for treating gonorrhea has been decreasing rapidly. Through CDC’s Gonococcal Isolate Surveillance Project , researchers are seeing a 17-fold increase in elevated minimum inhibitory concentrations (MICs) — a measure of drug susceptibility. MICs for oral cefixime went from 0.1 percent in 2006 to 1.7 percent in the first six months of 2011.

In the past, when the prevalence of antimicrobial resistance in the Gonococcal Isolate Surveillance Project exceeded 5 percent, national treatment recommendations were changed to focus on other effective drugs. But currently, there are no other drugs.

The most prominent increases in drug susceptibility to gonorrhea continue to be among men who have sex with men, and in the West, according to the authors. They wrote that these geographic and demographic patterns are worrisome because they mirror those observed during the emergence of fluoroquinolone-resistant N. gonorrhoeae.

Scientists are calling on a collective effort from physicians, drug companies, and health care providers to help stop the emergence and spread of resistant gonorrhea.

“Investing in rebuilding our defenses against gonococcal infections now, with involvement of the health care, public health, and research communities, is paramount if we are to control the spread and reduce the consequences of cephalosporin-resistant strains,” the scientists wrote.

HOUSTON — (Feb. 9, 2012) – A neuropeptide called Substance P is the cause of seizures in patients with brains infected by the pork tapeworm (Taenia solium), said Baylor College of Medicine researchers in a report that appears online in the open access journal PLoS Pathogens.

“Neurocysticercosis or the tapeworm parasitic infection in the brain, is the major cause of acquired seizures,” said Dr. Prema Robinson, assistant professor of medicine – infectious diseases, and corresponding author of the report. “It is particularly important to understand the source of these seizures in order to develop ways to treat and prevent them.”

Substance P is a neuropeptide (a small protein-like molecule involved in neuron-to-neuron communication.) It is produced by neurons, endothelial cells (the cells that line blood vessels) and cells involved in host defense. Discovered in the 1930s, it has long been recognized as a pain transmitter. However, in recent years, it has also been found to play a role in many other functions.

Robinson realized that Substance P is involved in inflammation and wondered if it might be involved in seizure activity.

Robinson and her colleagues – including one from Tufts Medical Center in Boston – found Substance P in autopsies of the brains of patients who had the tapeworm infection. They did not find Substance P in uninfected brains.

“As long as the parasite is alive, nothing happens,” said Robinson. However, once the worm dies, the body responds with chemicals that recruit immune system cells to the site of infection, causing inflammation. Her studies showed that the cells that produce Substance P are found mainly in areas of inflammation near the dead worms.

Animals injected with Substance P alone or with extracts from the areas of inflammation (granulomas) near the worms in infected mice suffered severe seizures, she said.

When the rodents received the drug that blocks the Substance P receptor, they did not have seizures, she said.

In addition, mice that lacked the Substance P receptor did not have seizures even when injected with the extracts of granulomas from infected mice. In addition, granuloma extracts from mice that lacked the cells that make Substance P did not induce seizures.

These findings have implications for people, who often suffer seizures during treatment for the tapeworm infection, she said. As the worms die, inflammatory cells rush to the scene and the seizures begin. There are medications known to block the receptor for Substance P. These medications may prove to be the most effective means of treating and preventing seizures in these patients.

Robinson plans to look at the role Substance P may play in other diseases associated with seizures such as cancer and tuberculosis.

In most western countries the annual increase in the prevalence and the severity of obesity is currently substantial. Although obesity typically results simply from excessive energy intake, it is currently unclear why some people are prone to overeating and gaining weight.

Because the central nervous system is intimately involved in processing of hunger signals and controlling food intake, it is possible that the cause of weight gain and obesity might be in the brain.

Researchers at the University of Turku and Aalto University have now found new evidence for the role of the brain in obesity. The researchers measured the functioning brain circuits involved in with multiple brain imaging methods.

The results revealed that in obese versus lean individuals, brain glucose metabolism was significantly higher in the brain’s striatal regions, which are involved in processing of rewards. Moreover, obese individual’s reward system responded more vigorously to food pictures, whereas responses in the frontal cortical regions involved in cognitive control were dampened.

“The results suggest that obese individuals’ brains might constantly generate signals that promote eating even when the body would not require additional energy uptake,” says Adjunct Professor Lauri Nummenmaa from the University of Turku.

“The results highlight the role of the brain in obesity and weight gaining. The results have major implications on the current models of obesity, but also on development of pharmacological and psychological treatments of obesity,” Nummenmaa says.

The participants were morbidly obese individuals and lean, healthy controls. Their brain glucose metabolism was measured with positron emission tomography during conditions in which the body was satiated in terms of insulin signalling. Brain responses to pictures of foods were measured with functional magnetic resonance imaging.

The research is funded by the Academy of Finland, Turku University Hospital, University of Turku, Åbo Akademi University and Aalto University.

The results were published on January 27th, 2012 in scientific journal PLoS ONE.

Clay Voorhees, assistant professor of marketing

EAST LANSING, Mich. — Nearly 70 percent of the nation’s service employees give away free goods and services – from hamburgers to cable TV – costing companies billions of dollars a year, according to a groundbreaking study.

Clay Voorhees, study co-author and marketing expert at Michigan State University, said one of the best ways to combat this illegal practice – called “sweethearting” – is through better screening of job candidates.

“Our results show that by adding a few screening questions that focus on the potential employee’s risk-taking, ethics and need for social acceptance, employers could identify ‘bad apples’ up front and simply avoid hiring them,” Voorhees said. “In the long run, this approach would address the issue.”

In the short term, Voorhees said, education and training are needed about the ramifications of sweethearting and how it damages a firm. “Simply reminding individuals of their ethical obligations can greatly reduce deviant behavior,” he said.

The study, which will appear in an upcoming issue of the Journal of Marketing, is the first to look at sweethearting specifically. Voorhees, assistant professor of marketing, co-authored the study with Michael Brady and Michael Brusco of Florida State University.

In the United States, employee theft costs firms about $200 billion a year – 40 percent of which stems from sweethearting, according to previous research.

Voorhees and colleagues surveyed nearly 800 service employees and customers in restaurants, hotels, car washes, cable television installation and repair companies, tanning salons and other retailers and service providers.

Some 67 percent of respondents said they had participated in sweethearting in the past two months. Many employees surveyed said they were motivated by the prospect of receiving better tips and similar sweetheart deals at the customer’s place of business (“tit-for-tat”).

“I was surprised by how pervasive this behavior was across a wide range of service industries,” Voorhees said. “I fully expected to see this behavior in bars and restaurants, but I was surprised at how prevalent it was in industries like retail, sports and recreation, and even with insurance claims.”

Excessive consumption of phosphate is damaging to health. Therefore, food that contains phosphate additives should be labeled, as recommended by Eberhard Ritz and coauthors in their article in the current issue of Deutsches Ärzteblatt International [Dtsch Arztebl Int 2012; (109 (4): 49-55].

Ritz et al. selectively review the literature on the subject, which documents the fact that ex-cessive phosphate consumption elevates mortality in patients with renal disease. Recent stud-ies have also shown that phosphate apparently damages blood vessels and induces aging pro-cesses. Free phosphate (the type found in food additives) is entirely resorbed in the gastroin-testinal tract. Persons with renal disease have been found to have a markedly elevated serum phosphate concentration.

Phosphate additives are present in many types of fast food, which are eaten mainly by persons of lower socioeconomic status. It seems likely that excessive phosphate consumption is linked to the increased prevalence of cardiovascular diseases in the general population.

The authors conclude that physicians and the public need to be educated about the role of phosphate additives as a risk factor for disease.

Data supports use of curcumin in combination with androgen deprivation therapy to reduce castrate-resistant prostate cancer cell and tumor growth

PHILADELPHIA—Curcumin, an active component of the Indian curry spice turmeric, may help slow down tumor growth in castration-resistant prostate cancer patients on androgen deprivation therapy (ADT), a study from researchers at Jefferson’s Kimmel Cancer Center suggests.

Reporting in a recent issue of Cancer Research, Karen Knudsen, Ph.D., a Professor of Cancer Biology, Urology and Radiation Oncology at Thomas Jefferson University, and colleagues observed in a pre-clinical study that curcumin suppresses two known nuclear receptor activators, p300 and CPB (or CREB1-binding protein), which have been shown to work against ADT.

ADT aims to inhibit the androgen receptor—an important male hormone in the development and progression of prostate cancer—in patients. But a major mechanism of therapeutic failure and progression to advanced disease is inappropriate reactivation of this receptor. Sophisticated tumor cells, with the help of p300 and CPB, sometimes bypass the therapy.

Thus, development of novel targets that act in concert with the therapy would be of benefit to patients with castration-resistant prostate cancer.

For the study, prostate cancer cells were subjected to hormone deprivation in the presence and absence of curcumin with “physiologically attainable’ doses. (Previous studies, which found similar results, included doses that were not realistic.)

Curcumin augments the results of ADT, and reduced cell number compared to ADT alone, the researchers found. Moreover, the spice was found to be a potent inhibitor of both cell cycle and survival in prostate cancer cells.

To help support their findings, the researchers also investigated curcumin in mice, which were castrated to mimic ADT. They were randomized into two cohorts: curcumin and control. Tumor growth and mass were significantly reduced in the mice with curcumin, the researchers report.

These data demonstrate for the first time that curcumin not only hampers the transition of ADT-sensitive disease to castration-resistance, but is also effective in blocking the growth of established castrate-resistant prostate tumors.

“This study sets the stage for further development of curcumin as a novel agent to target androgen receptor signaling,” said Dr. Knudsen. “It also has implications beyond prostate cancer since p300 and CBP are important in other malignancies, like breast cancer. In tumors where these play an important function, curcumin may prove to be a promising therapeutic agent.”




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These reports are done with the appreciation of all the Doctors, Scientist, and other

Medical Researchers who sacrificed their time and effort. In order to give people the

ability to empower themselves. Without the base aspirations for fame, or fortune. Just honorable people, doing honorable things.

Higher testosterone levels were also associated with less loss of lower body strength.

Loss of muscle mass and strength contribute to frailty and are associated with accidental falls, mobility limitations and fractures.

Men lose more muscle mass and strength than women as they age, suggesting that sex steroids, and testosterone in particular, may contribute to body composition and physical function changes.

This study helps us better understand the relationship between testosterone levels and healthy aging in older men. The study showed that higher testosterone levels may help older men preserve muscle mass and delay frailty as they age.

“Our study finds that men, aged 65 years and older, with higher testosterone levels lost less muscle mass, especially in their arms and legs, than men this age who had lower testosterone levels,” said researchers from Kaiser Permanente Northwest in Portland, Oregon. They added “Men who had higher testosterone levels before they lost weight also lost less leg function and could stand up more easily from a chair than men who had lower testosterone levels before they lost weight.”

In this study, the researchers used data from 1,183 men aged 65 years or older and tested the hypothesis that higher baseline measures of sex steroids are associated with lesser declines in lean mass and maintenance of physical performance over an average follow-up of 4.5 years.

Body composition was measured using dual energy x-ray absorptiometry (DXA) scans and physical performance was measured through a series of exercises that assessed grip strength, lower extremity power, walking speed and the ability to rise from a chair without the use of arms.

“The amount of testosterone men have in their bodies may contribute to how much muscle and strength they lose as they get older,” they reported. “Our study adds evidence to the growing body of literature that suggest higher levels of endogenous testosterone may be favorably associated with some key components of healthy aging in men.”

The study included researchers from: Oregon Health & Science University in Portland; University of California, San Diego in La Jolla, CA; University of Pittsburgh in PA; and Stanford University in CA.

Story Source: The Endocrine Society.

Journal Reference: Higher Testosterone Levels Are Associated with Less Loss of Lean Body Mass in Older Men. Journal of Clinical

Endocrinology & Metabolism, 2011;

The Endocrine Society (2011, October 27). Older men with higher testosterone levels lose less muscle mass as they age.

This article is for informational and educational purposes only, and is not intended to provide medical advice, diagnosis or treatment. Contact your doctor or healthcare professional for medical and nutritional consultation.

Related articles

• Dairy foods may improve bone health during diet and exercise in overweight premenopausal women (eurekalert.org)
• The Anabolic Truth of Andropause (drkennethorbeck.com)
• Heart Disease Linked to Low Testosterone Levels in New Study (inquisitr.com)
• Study: Testosterone May Not Treat ED (webmd.com)

• The Penn Neuroendocrine Tumor Symposium on September 9 at the University of Pennsylvania
• The North American Neuroendocrine Tumor Society (NANETS) symposium, NET Diagnosis and Treatment:  A New Era – A New Direction, scheduled for October 20-22 in Minneapolis, Minnesota
• Ohio State’s Multidisciplinary Management of Neuroendocrine Cancers:  From Standard of Care to Cutting Edge Therapies on December 3 in Columbus, Ohio

The Penn Neuroendocrine Tumor Symposium is designed for endocrinologists, internists, oncologists, gastroenterologists, geneticists, nephrologists, pathologists, radiologists, specialists in nuclear medicine, physician assistants, nurses, nurse practitioners and other allied health professionals. Click here for a conference brochure.

NANETS’ symposium is designed for physicians and other health professionals from a variety of practice settings and levels including the specialties of oncology, endocrinology, surgery, pathology, internal medicine, gastroenterology, research, diagnostic radiology, interventional radiology, pulmonology, nuclear medicine, and primary care. Early registration is encouraged as enrollment is limited.

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The University of Texas M.D. Anderson Cancer Center and the North American Neuroendocrine Tumor Society (NANETS). Nursing continuing education contact hours will be provided. For more information, click here.

Ohio State’s Multidisciplinary Management of Neuroendocrine Cancers:  From Standard of Care to Cutting Edge Therapies is a review of state-of-the-art evidence-based information on the diagnosis and management of neuroendocrine cancers. This meeting will focus on the needs and practice gaps in physician practice to improve patient outcomes by promoting multidisciplinary teams to address clinical and patient issues. The December 3, 2011 meeting, to be held in Columbus, Ohio, is for specialists, primary care physicians, surgeons, radiologists, nurses and other healthcare professionals who diagnose and treat patients with cancer.  Click here for an agenda and more information.

There are also two CME opportunities through December 2011:  Redefining Therapeutic Paradigms for Advanced Gastroenteropancreatic Neuroendocrine Tumors, sponsored by Educational Concepts Group, LLC (click here for more information) and Endocrine Self-Assessment Tool – Multidisciplinary Approach to Management of Neuroendocrine Tumors, presented by The Endocrine Society (click here for more information).

Members of the medical community are encouraged to share other CME opportunities with the Carcinoid Cancer Foundation so these activities can be listed on the  Foundation’s website.  Please write to carcinoid@carcinoid.org or call 888-722-3132, Eastern time, if you would like to provide information for future listings.

Breakfast. It seems like forever since Mom told us breakfast is the most important meal of the day, but one study shows it’s actually true—she wasn’t just nagging us. Breakfast is a key component of weight management: A study presented at the 90th annual meeting of the Endocrine Society showed that  participants who consumed large breakfasts high in protein and carbohydrates followed by a low-carb, low-calorie diet for the rest of the day lost almost five times as much weight as the participants who followed a low-carb,  high-protein diet throughout the day. So what’s the big deal about breakfast? And what is a big breakfast anyway? It doesn’t seem like the lumberjack special at the local diner would do much to get the pounds off, so what should we be eating?

The study supported the idea that when we wake up in the morning, our bodies want food. You’ve burned through all the fuel from the previous day, and now your body’s ready to burn anything—even muscle—to get a jump-start on the day. And if you skip breakfast, muscle is indeed what your body will burn. Later in the day, your brain is still in starvation mode from breakfast (or lack thereof), so your body will store all the calories you eat as adipose tissue, or fat, to save up for the next day when you try to starve it again. This study also found that levels of serotonin, the chemical responsible for controlling cravings, were much higher in the morning, which is why breakfast is the meal so many of us are willing to skip. But if our bodies are left unfed, our serotonin levels drop, and our bodies’ craving for sweets begin to rise throughout the day.

But before you hit McDonald’s® for their 800-calorie Big Breakfast, or worse, their 1,150-calorie Deluxe Breakfast, or you swing by Denny’s® for a 740-calorie Grand Slam® or 950-calorie All-American Slam® with hash browns, keep in mind these weren’t the breakfasts the study participants consumed. The big-breakfast group had a 610-calorie breakfast as part of a 1,240-calorie day. Breakfasts included milk, lean meat, cheese, whole grains, a serving of healthy fat, and one ounce of chocolate or candy to defray the craving for sweets. The other group’s participants consumed 1,085 calories per day as part of a high-protein, low-carb diet; only 290 of their daily calories were consumed at breakfast. Both groups were on their respective diets for 8 months. The high-protein group lost an average of nine pounds, but the big-breakfast group lost an average of 40 pounds. And, perhaps not surprisingly, the big-breakfast group complained less about cravings and hunger.

The big-breakfast group’s breakfast consisted of 58 grams of carbs, 47 grams of protein, and 22 grams of fat. Study reviewers attribute some of the success of the big-breakfast group to the fact that the protein and healthy fats eaten kept the participants full and reduced cravings. They also said that nutritional requirements were well met and that there weren’t empty calories consumed, because the breakfasts included lots of whole grains, fruits, lean proteins, and healthy unsaturated fats. So bad news for the lumberjack-special devotees—a big plate of greasy hash browns, bacon, and biscuits with gravy isn’t going to get the job done, unless the job we’re discussing is clogging your arteries.

Here are some healthy big breakfasts, similar to the ones consumed by the study’s participantsm…all having approx 600 calories, 45 – 50g protein, and 50 – 60g carbs each:

Chicken and the Egg

2 large eggs, scrambled

2 slices whole wheat toast

1 boneless, skinless chicken breast, grilled

1 grapefruit

Oats ‘n’ Berries Breakfast

1 packet plain instant oatmeal, prepared, with 1 scoop Beachbody® Whey
Protein Powder

1 cup fresh blueberries

3 oz. roasted turkey breast

1 large hard-boiled egg

1 oz. dark chocolate

Two Egg Sandwiches

2 whole wheat English muffins, toasted

2 large poached eggs

2 slices low-fat Swiss cheese

2 slices Canadian bacon, grilled

Vegetarian Breakfast

1 cup cottage cheese (2% milk fat)

1 cup sliced peaches, canned in juice, not syrup

1 slice whole wheat toast

1/2 avocado

2 vegetarian sausage links, cooked

Pescetarian Breakfast

1 6-oz. can light tuna, canned in water, drained

2 Tbsp. mayonnaise (preferably olive oil or canola oil-based)

2 slices whole wheat toast

1 oz. dark chocolate

Image courtesy of Wikimedia Commons user Szakalová Edina

The eyes may be windows to the soul, but those darn wrinkles may be a window on bone health. In one of the more interesting studies presented at the annual meeting of the Endocrine Society, Dr. Lubna Pal revealed evidence of an association between bone density and skin wrinkling.

In postmenopausal women, the appearance of the skin might offer a glimpse at the skeletal well-being, a relationship not previously described,” she said in a press statement. “This information may allow the possibility of identifying postmenopausal women at fracture risk at a glance, without dependence on costly tests.”

Dr. Pal and her coinvestigators gave 114 postmenopausal women a score for face and neck wrinkles (based on the number of sites and depth). They also attempted to measure skin rigidity, using a durometer. Bone mineral density was measured with dual-energy x-ray absorptiometry (DXA). The researchers found a significant association between wrinkle severity and bone density, so that more severe wrinkling was associated with lower bone density.

It’s not as far-fetched as it sounds though. After all, skin and bone share some common building blocks — collagen. Changes in collagen with age may affect both skin and bone.

Of course, such a correspondence holds only for those who refrain from Botox, fillers, peels, and plastic surgery — all bets are off then.

—Kerri Wachter

Image courtesy of Flickr user WordRidden (CC)

For years, we’ve been hit over the head with messages about good fat and bad fat.  Let me rephrase that. For years, we’ve been hit over the head with messages about good and bad dietary fat.  It’s time for mono-unsaturated olive oil to make room for brown adipose tissue — good biologic fat.

Fat in the body — aka adipose tissue — appears to come in two colors — white and brown — and it may not entirely be inappropriate to think of these as bad and good fats respectively. I was able to listen in on a very interesting talk about brown adipose tissue today by Dr. Aaron M. Cypress  at Endo 2001 in Boston [OR11-6].

In short, brown adipose tissue is found primarily in the scapular region in humans and deposition of it seems to increase with increasing depth — findings that are based on surgical resection of this adipose tissue in 10 patients undergoing neck surgery.  In other words, more brown adipose tissue is found in the longus colli and carotid sheath than in the prevertebral, subplatysmal, and subcutaneous depots.

Brown adipose tissue can expend energy via thermogenesis, a process that is regulated by the tissue-specific mitochondrial inner-membrane protein uncoupling protein-1 (UCP1). In fact, the researchers looked specifically at oxygen consumption and found that compared with undifferentiated cells, adipocytes found in brown fat had basal and maximally stimulated oxygen consumption rates that were 3.5- and 6.5-fold higher, respectively.

So, it makes sense that more brown adipose tissue is found in thinner people. While it’s way too early to tell, the ability to produce more brown adipose tissue in the body could increase metabolism and maybe increase weight loss — of slacker white adipose tissue.

—Kerri Wachter

Fragile Annie writes a blog called, “It’s Time To Get Over How Fragile You Are.”  Isn’t that a great name?  She own’s her frailty, own’s that it has affected her life, and own’s what it’s time to do now.  All in a name and a title.

When I was in psychotherapy, talking on about injustices suffered, my feelings, the rightness of my condition – my therapist said, “It’s time to grow up Sana.”  I still feel the punch in my stomach and the quiet immediately following.  I couldn’t breath for a bit.  Just nodded my head.  ”Ok.”  …I said, “Ok” a few times.  I don’t remember much else of what he told me but I don’t think I’ll ever forget that.  He’d be satisfied with his work with me if he knew.

After all, it’s not such a small thing to grow up, or “get over” our frailty.  It’s not such a small thing to see our need.  It’s not so little to act on it.  These are things that champions do.  These are things any coach, parent, therapist, teacher would be proud to be a part of.  These are the things that make the difference between falling victim to your history, or claiming the rights to your now and to your future.

Think about what is upsetting you the most.  What seems to keep at you and trip you and keep you back and keep you right where it left you last?  It’s time to grow up.

Self-Care Tip #106 – In Fragile Annie’s own words, ”It’s time to get over how fragile you are.”  Be a friend to yourself.

Question:  What has knocked your breath out in a good way, sending you off towards growth?  Please tell me your story.

Related Articles

• Fragile (current.com)

Maybe it’s just me, but it feels like the environmental health train picked up some extraordinary speed in 2009. Starting with the National Academy of Science’s report “Science and Decisions: Advancing Risk Assessment,” which makes recommendations to address the current limitations of risk assessment; moving to the appointments of Dr. Lisa Jackson as the new EPA Administrator and Dr. Linda Birnbaum as the new Director of NIEHS; then to the seminal publication of The Endocrine Society’s statement on the health implications of endocrine disrupting chemicals (EDCs) (and the subsequent resolution on EDCs passed by the American Medical Association); the publication of the “Common Agenda for Health and the Environment‘” by the Lowell Center for Sustainability with input from hundreds of colleagues, offering principles for implementing concrete steps towards a healthier future; Nicholas Kristof’s compelling series of New York Times op-eds focused on EDCs; Administrator Jackson’s consistent message that we must ensure children’s health is at the center of every regulatory and policy decision; the significant push to prioritize the health of vulnerable populations in the climate change discussions; and the increasing momentum on chemical policy reform on state and national levels – to name just a few noteworthy events over the course of the year.

I also want to acknowledge that many of you, our CHE partners, played pivotal roles in these and other remarkable actions and publications this year – often behind the scenes and in understated ways, but with no less potency. And of course, what we see manifesting today is built on decades of courageous and tenacious efforts of those on the front lines of science and on the fence lines of communities.

So what is next? I believe the burgeoning science and reflective discussions in CHE and elsewhere are encouraging us more and more to figure out how to move not only one train faster down a track, but to understand how myriad tracks interact and loop back and join together at different times and in different modalities – in short, to apply complexity theory to ecological health in concrete, effective terms. Taking a systems approach would entail finding meaningful ways to address the fact that, as Michael Lerner, co-founder and Vice Chair of CHE, summarized in a recent e-mail to the CHE Science listserv, “a high number of different endogenous and exogenous factors in and around the human organism encounter different inherited genetic dispositions and different patterns of gene expression so that different people reach the ‘final common pathways’ of different diseases for different combinations of reasons.” We are seeing this in the scientific literature on metabolic syndrome, autism, Alzheimer’s and many other conditions. The task at hand then is to press for restructuring our regulatory system, our food system, our health care system, and our economic system to make health, justice and sustainability the highest priorities — in fact, to make those inalienable rights of current and future generations. Daunting, yes. Impossible, no.

We each are engaged in various aspects of this dynamic system, and we each need to stay focused on our part to ensure its success. At the same time, we need to consistently review our efforts in relationship to the whole. This is nothing new. It just gets harder to do as our understanding of the variables and complexity grows. That said, if we bring our intelligence, creativity and wisdom to our collective conversations and initiatives, we can and will make healthier choices based on the best available science. That is what CHE is all about. In 2010, we invite you to continue to contribute your expertise and insights to our common work.  

Warmest wishes for the holidays and a healthier-than-ever New Year.

The American Medical Association (AMA) took an unprecedented action yesterday: It unanimously passed a resolution calling for new policies to decrease public exposure to endocrine disrupting chemicals (EDCs) [read more] based on the Endocrine Society’s seminal scientific statement on EDCs published last summer [read the statement]. Both The Endocrine Society Statement and the AMA’s resolution mark an historical turning point for mainstream medical associations. For the first time, tens of thousands of prestigious health professionals are saying in no uncertain terms:

• We have enough science to undertake proactive health measures.
• The risk to public health is too great to wait any longer. 
• We need to act now to implement health protective policies and regulations.

Many CHE partners were involved in catalyzing this remarkable action. We now would like to encourage other health-related professional societies to adopt similar resolutons to signal to national leaders and policymakers that fundamental chemical policy reform can no longer be side-lined. In fact, chemical policy reform is not only integral to health care reform, as I suggested in last month’s CHE e-newsletter, but to climate change as well. EPA Administrator Jackson made this point on Monday in her remarks at the American Public Health Association conference. She announced greenhouse gas emission standards for automobiles, a first for the EPA, saying the limits would mean “less harmful pollution that sends people to the hospital with asthma, heart disease, and any number of other conditions.”

In this context, what if we prioritized these same health-focused principles in climate change decisions across the board? That is, in essence, what CHE organizational partners, the Health and Environmental Alliance (HEAL) and Health Care Without Harm (HCWH), are calling for in a new campaign entitled “Prescription for a Healthy Planet.” To date, protecting public health has been essentially left out of the conversation in international talks on climate change. At the upcoming Copenhagen summit in December, however, we have an opportunity to ensure that children’s health and that of other vulnerable populations are prioritized. As stated in the “Prescription”, “a fair and binding international agreement in Copenhagen means: less global warming, less illness, lower healthcare costs, better health for the world population and a healthier planet.” This sounds promising. But right now very little research and discussion has focused on climate change and health.

What we do know is that children will be the most impacted by climate change. Nine percent of American children already suffer from asthma and those attacks will become more numerous and severe with increased air pollution and ozone levels – and of course, the number of children affected in developing countries, where there may be even less regulation on pollutants, will likely be far higher. In addition, we will be faced with increased exposures to industrial chemicals as recently outlined by the World Health Organization. For example, with more extreme storms and floods, there will be greater runoff of chemicals used in urban and agricultural areas into surface and ground waters. With increased drought, non-volatile chemicals and toxic metals will concentrate and rapidly enter groundwater supplies through parched soil when rain finally comes. In addition, global warming will release chemicals currently trapped in glacial ice, and changing weather patterns will move persistent chemicals through water and air streams in ways previously unanticipated. And this doesn’t even begin to describe other concerns about increased infectious diseases and the challenges of whole populations migrating elsewhere because of rising sea water and less fertile land.

All of this is to say that the AMA and myriad other health professional societies in the US and abroad are essential to figuring out solutions to this thorny nexus of pressing public health issues, namely: chemical policy reform, health care reform and the impact of climate change on human health. Through ongoing efforts to translate the best available science for lay audiences and to incubate strategic health-focused initiatives, I have no doubt CHE partners can continue to change the landscape in which these major decisions – decisions affecting all of us and future generations – are made.

Most of us have heard of Michael Pollan’s ‘An Eater’s Manifesto’: “Eat food. Not too much. Mostly plants.” Excellent advice for those of us who are fortunate enough to have a variety of food choices. The challenge of course is that our current industrialized food system (and related sectors such as advertising) encourages us to eat lots of food-like substances and high on the food chain—and for many in inner cities, finding a fresh vegetable, much less an organic one, can be as rare as gold.

In addition to these challenges, hormone disruptors (also known as endocrine disrupting chemicals) are found in everything from the feed given to animals to the pesticides sprayed on crops to the plastic additives in packaging—all of which we end up ingesting. These chemicals are now associated with a range of health concerns, including obesity, diabetes, certain cancers, neurological disorders and reproductive health problems, as the Endocrine Society described in their recent consensus statement. And then there are issues such as the use of antibiotics in food, the importation of foods that aren’t required to meet US standards, and food-borne viruses like e.coli.

The good news is that organizations on national, state and local levels are beginning to press for a health-based food system. For example, the American Medical Association (AMA) recently adopted a policy resolution “in support of practices and policies within health care systems that promote and model a healthy and ecologically sustainable food system.” In addition, the Institute of Medicine (IOM) and The National Research Council (NRC) released a report last week that emphasized the need for local governments to create environments in which people make healthful lifestyle decisions. The statement calls for municipalities to “discourage fast-food restaurants near schools and playgrounds through zoning, provide tax incentives for groceries in underserved areas, and create nutritional standards for government-run after-school programs.” In addition, myriad groups across the country are promoting Community Supported Agriculture (CSAs) and working with local school districts to develop “farm to school” initiatives that would help local farmers as well as improve the quality of the food served in schools.

The question is whether these actions are enough to shift the economy towards a sustainable, health-based food system given the deeply intertwined and diverse set of players involved in the production and marketing of food. In an ecological or systems biology model, all the interacting factors work in concert, each as a complement to the other and each supporting the system as a whole. Right now at the federal level, the Department of Agriculture doesn’t collaborate with the Food and Drug Administration which doesn’t work with Environmental Protection Agency nor the Department of Housing and Urban Development nor the Department of Transportation, and so on—at times, in fact, some of these agencies even work at odds. Then on the local level, public health departments rarely work with school districts or planning commissions, certainly not in regards to the availability of high quality food.

This of course means we need to coordinate these efforts more effectively on every level if we are to improve the health of current and future generations. If you are interested in learning more about these issues and what we can do to address then, please join us on our next CHE Partner call entitled Food Matters: The Impact of Food Systems on Public Health to be held on September 22, 2009.

BPA, a synthetic estrogen, is used in the manufacture of polycarbonate water bottles and other food packaging; baby bottles; the epoxy resin lining of cans; and PVC water pipes. The National Institutes of Health has found that it can leach into food and beverages; a May [2009] report from researchers from the Harvard School of Public Health showed that hard-plastic drinking bottles containing BPA leach “notable amounts of the controversial chemical into people’s bodies,” The Boston Globe reported May 22, 2009.

Studies, including those presented at The Endocrine Society’s annual meeting June 10-13 in Washington, have reported that exposure to BPA and other EDCs affect male and female development, prostate cancer, thyroid disease and cardiovascular disease.

[...] The Endocrine Society said, “Results from animal models, human clinical observations and epidemiological studies converge to implicate EDCs as a significant concern to public health.”

During the society’s 91^st Annual Meeting, several studies were presented that show BPA can affect the hearts of women and can permanently damage the DNA of mice, UPIand ScienceDaily recently reported. Scientists also reported during the meeting that human exposure to BPA may be much higher than the recommended safe daily dose, entering the human body from a variety of sources, UPI reported June 11, 2009.

The Endocrine Society is urging humans to avoid using products that are known to contain BPA and other EDCs, according to its statement. It also stated the Society’s intent to actively engage “in lobbying for regulation seeking to decrease human exposure to the many endocrine-disrupting agents.”

New US Food and Drug Administration (FDA) Commissioner Dr. Margaret Hamburg said this month that the agency is reexamining its position about the safety of BPA in food containers. [In] December [2008], the FDA agreed to continue to its review of BPA in food contact applications, while maintaining the position that the chemical is safe. That decision followed a finding in October [2008] by a panel of FDA scientific advisors that FDA’s draft safety assessment of the chemical in food contact applications was inadequate. In August 2008, the FDA said that the public was not at risk from BPA, as WaterTech Online® reported.

The American Chemical Council (ACC) June 10 released a statement in response to the recent Endocrine Society research. In its statement, the ACC said: “These brief presentations on unpublished research are difficult to assess for significance to human health, since they have not been peer-reviewed or published in scientific literature and few details are available in conference abstracts. Bypassing the scientific process in favor of sensational press releases is a scare tactic that will not promote public health.”

Health Canada, the Canadian national health agency, said it has no safety concerns about the presence of the plastic-hardening chemical bisphenol A (BPA) in 18.5-liter (5-gallon) polycarbonate drinking water bottles, according to a recent report on the Health Canada Web site.

“The levels of BPA in these containers were very low and pose no safety concerns,” Health Canada reported, citing findings of a study by its Bureau of Chemical Safety entitled “Survey of Bisphenol A in Bottled Water Products.”

In April 2009, scientists at Goethe University found that polyethylene terephthalate, or PET, plastics, of which individual bottled water containers commonly are made, may contain hormone-disrupting chemicals that leach into the water, Discovery News reported. According to researchers, it now appears that some as-yet-unidentified chemicals in PET plastics have the potential to interfere with estrogen and other reproductive hormones in the same manner that BPA and phthalates are suspected of doing.

Source: WaterTech Online, 12 Jun 2009 ; WaterTechn Online, 16 Jul 2009 ; WaterTech Online, 28 Apr 2009

The most interesting aspect of this research was the discovery that regardless of environment (ie, raised by an anxious mouse or non-anxious mouse), the offspring of the “anxious” mice still experienced a delay of puberty when raised by a controlled non-anxious mother.

Here’s a snippet of the press release:

Women have an increased rate of anxiety during pregnancy and for 2 years after giving birth, said the study’s lead author, Caroline Larsen, PhD, a postdoctoral fellow at the University of Otago in Dunedin, New Zealand.

“Postpartum anxiety disorders are poorly understood and difficult to treat,” Larsen said. “There is growing evidence that untreated anxiety disorder during pregnancy may contribute to premature birth and also can have major and lasting adverse effects on the infant’s development and behavior.”

Prolactin is a hormone that may protect against anxiety. Recently Larsen and her co-workers found that mice with induced low levels of prolactin in early pregnancy displayed substantial anxiety after they gave birth. Because the researchers also noted that daughters of the anxious mothers had delayed onset of puberty, they conducted the current study to learn what causes this late physical transition to sexual maturation.

Daughters of female mice made anxious by low prolactin were raised either by their birth mother or by a mouse who was not anxious (control mother). Another group consisted of daughters of nonanxious mice, and these mice were raised by either a control mother or an anxious mother. There were at least six mice in each of the four groups. The researchers determined onset of puberty by examining when the vagina opened and noting the time of first estrus (equivalent to the first menstrual cycle in humans).

“Remarkably, puberty was still delayed even if the daughters of anxious mothers were raised by nonanxious mice,” Larsen said. “And delayed puberty also occurred in daughters born to nonanxious mothers who were raised by anxious mothers.”

This result demonstrates that hormonal changes in early pregnancy, as well as changes in maternal behavior caused by these hormone changes, can alter brain development in the offspring and delay puberty, she explained. Larsen believes that their work, with further study, may translate to people.

“Finding the hormonal mechanisms that trigger the timing of puberty in mice may help identify potential targets for the prevention and treatment of delayed or early puberty in humans,” she said.

Late puberty in humans is linked to shortened height and psychological problems that can persist into adulthood.