Stressed Out Pregnancy May Yield Asthma-Prone Baby

Last Updated: 2008-05-19 12:28:36 -0400 (Reuters Health)

By Megan Rauscher

NEW YORK (Reuters Health) - Babies born to mothers who are stressed out during pregnancy appear to be increased risk for asthma and allergies, according to a study presented over the weekend at a medical conference in Toronto.

Stress is like a pollutant that, when "breathed" into the body, may influence not only a mother's immune system, but her unborn baby's as well, Dr. Rosalind Wright, of Brigham and Women's Hospital and Harvard Medical School noted in comments to Reuters Health.

"There is a lot of evidence to support the notion that negative experiences that cause stress get into the body and disrupt immune function," Wright said. This is why people are more likely to catch colds or the flu when they're stressed. And, according to Wright's research, mother's stress during pregnancy can also influence her baby's developing immune system.

Dust mites, pollen, molds, tobacco smoke and other substances in the environment are other identified important factors for asthma and allergies. However, those do not fully explain rising rates of asthma seen in the past, or why there's more asthma in inner city and lower income populations.

This motivated Wright's team to consider stress as another important factor. In a study involving about 1,000 families, they measured pregnant women's stress levels by asking questions covering money and housing problems, relationships and other issues. They also tested the level of dust mite allergens in their homes while pregnant.

The researchers measured levels of IgE -- antibodies involved in an allergic response - in umbilical cord blood. Among 387 babies tested thus far, levels were increased among those whose mothers suffered higher level stress compared to mothers with less stress. This was true even when the exposure to dust mites during pregnancy was relatively low.

This suggests that mother's stress during pregnancy magnified the effect of dust exposure on the child's immune system, making it more reactive, Wright explained.

Chronic stress can lead to increased levels of cortisol and adrenalin in the body, both of which interact with the functioning of the immune system, she further explained. "If mom is under chronic stress these changes may be more persistent and can even be transmitted to the baby," Wright said.

"So when the baby is now exposed to increased cortisol from the mother, for example, this may change the way their immune system develops and make them more likely to produce IgE, a potential marker of allergic reactivity, when also exposed to lower levels of dust than would normally stimulate the immune system," Wright added.

Pregnant women need to "try to reduce stress as it may affect their own health as well as their baby," she said.

The children in this study are being followed up to see how many of them develop asthma.

The findings were presented Sunday at the American Thoracic Society's 2008 International Conference in Toronto by Wright's colleague, Dr. Junenette Peters, a postdoctoral fellow at the Harvard School of Public Health.

 

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Prenatal Fish Intake Benefits Kids' Brains

Last Updated: 2008-05-27 11:00:44 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Three-year-olds whose mothers ate more fish while pregnant with them score better on several tests of cognitive function than their peers whose mothers avoided seafood, a new study shows.

However, the researchers also found that the amount of mercury in a woman's body rose with the amount of fish she had consumed -- and that children exposed to more mercury performed worse on these tests. Based on the findings, they say, it's possible fish could have even greater brain benefits for babies if mothers-to-be consumed seafood with lower mercury levels.

"Recommendations for fish consumption during pregnancy should take into account the nutritional benefits of fish as well as the potential harms from mercury exposure," Dr. Emily Oken of Harvard Medical School in Boston and her colleagues write in the May 15 issue of the American Journal of Epidemiology.

Advisories on mercury contamination of certain types of large, long-lived fish -- including tuna and swordfish -- have raised concerns about seafood consumption during pregnancy, Oken and her team note. On the other hand, fish are also the chief dietary source of omega-3 fatty acids, substances key to early brain development, they add.

To better understand the risks and benefits of fish consumption, Oken and her team surveyed 341 mothers about their intake of fish during the second trimester of pregnancy, and then had their children complete a battery of tests of cognitive function at 3 years of age.

On average, women reported eating 1.5 servings of fish each week while they were pregnant. The amount of mercury the women had in their red blood cells was directly related to the amount of fish they ate. Children's test scores rose with the amount of fish their mothers had consumed, but those whose mothers had more mercury in their bodies performed less well on the tests.

Accounting for the effects of mercury exposure strengthened the effect of fish intake, and vice versa, the researchers found. Benefits were strongest for children whose mothers ate more than two servings a week.

"Our finding that the benefit of fish intake is strengthened with adjustment for mercury levels suggests that if mercury contamination were not present, the cognitive benefits of fish would be greater," Oken and her team explain. "Maternal consumption of fish lower in mercury and reduced environmental mercury contamination would allow for stronger benefits of fish intake."

SOURCE: American Journal of Epidemiology, May 15, 2008.

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Omega-3 Fatty Acid May Guard Against Repeat Stroke

Last Updated: 2008-07-03 14:00:15 -0400 (Reuters Health)

By Scott Baltic

NEW YORK (Reuters Health) - Eicosapentaenoic acid, or EPA -- the essential omega-3 polyunsaturated fatty acid abundant in oily fish -- may help protect stroke patients from suffering a second stroke, a Japanese study shows.

In a study of people with high cholesterol who were taking a low dose of a cholesterol-lowering "statin," researchers found that adding EPA did not reduce the occurrence of a first stroke but did lower recurrence rates in those with a history of stroke.

The finding, published in the journal Stroke, stems from a large study of patients with elevated cholesterol levels who were randomly assigned to a low dose of pravastatin or simvastatin daily alone or with 1800 milligrams daily of EPA for roughly 5 years.

Of the 9,326 patients in the EPA group, 485 had a history of stroke, as compared with 457 of the 9,319 patients in the no-EPA group.

Dr. Kortaro Tanaka of Toyama University Hospital and colleagues found that rates of first stroke were 1.3 percent and 1.5 percent in the EPA and no-EPA groups -- a nonsignificant difference.

However, there were far fewer second strokes in the EPA group. The recurrent stroke rates were 6.8 percent in the EPA group versus 10.5 percent in the no-EPA group -- a significant difference.

Tanaka and colleagues say it is noteworthy that even among Japanese individuals, who have relatively high blood concentrations of EPA, "further increases in EPA concentration may lead to prevention of recurrence of stroke."

The researchers note that because this trial used purified EPA instead of the fish oil used in previous studies, the preventive effects on stroke can be attributed to EPA.

The exact mechanism remains unclear, however, because EPA has a variety of beneficial effects in the body including lowering cholesterol and inflammation as well as production of platelets, a blood component that promotes the formation of blood clots. It may also guard against heart rhythm disturbances.

Based on the many studies of fish consumption in the US and Europe, Tanaka told Reuters Health, "the beneficial effects of EPA which became clear from our study can be applied to other nationalities."

SOURCE: Stroke, July 2008.

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Low Vitamin D Linked to Sudden Cardiac Death

Last Updated: 2008-11-17 12:00:32 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Vitamin D deficiency is associated with heart dysfunction, sudden cardiac death, and death due to heart failure, German researchers report.

An association between vitamin D deficiency and heart trouble is physiologically plausible, the researchers note. For example, vitamin D is known to affect contractility of the heart.

Dr. Stefan Pilz, from the University of Heidelberg, and colleagues assessed vitamin D levels in 3,299 Caucasian patients who were referred for a test used to look for clogged heart arteries called coronary angiography from 1997 to 2000. The subjects were then followed for 7.7 years.

During follow-up, 116 patients died from heart failure and 188 from sudden cardiac death, Pilz and colleagues report.

In analyses taking into factors that might influence the results, they found that severe vitamin D deficiency, compared with optimal vitamin D levels, was associated with nearly a three-fold increased risk of death from heart failure and about a five-fold increased risk of sudden cardiac death.

"These data strongly indicate that the maintenance of an optimal vitamin D status may be a promising approach for the prevention and/or therapy of (heart) diseases, warranting confirmation in interventional trials with vitamin D supplementation," the researchers conclude.

SOURCE: Journal of Clinical Endocrinology and Metabolism October, 2008.

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Frequent Weight Loss May Weaken Men's Bones

Last Updated: 2008-05-06 13:25:29 -0400 (Reuters Health)

By Anne Harding

NEW YORK (Reuters Health) - Weight cycling in adulthood may lead to fragile bones later in life, according to a new study of 4,601 men followed for 28 years.

The more frequently men slimmed down and regained weight between the ages of 25 and 50, the more likely they were to suffer a fractured forearm after age 50, Dr. Anne Johanne Sogaard of the Norwegian Institute of Public Health in Oslo and colleagues found.

Weight cycling could increase skeletal fragility by causing microscopic damage to bone structure, or it could also boost men's fall risk by weakening muscles, Sogaard noted in emailed comments to Reuters Health.

Sogaard and her team had previously found that among the group of men initially examined in 1972-1973 and then later in 2000, those who had lost weight more frequently, and lost more weight with each slimming bout, were more likely to develop metabolic syndrome and diabetes.

In the current study, in the American Journal of Epidemiology, the researchers investigated whether weight cycling was related to the risk of forearm fracture, "an early and sensitive marker of male skeletal fragility."

Among men who reported no weight loss episodes before age 50, about 17-18 percent suffered forearm fractures. The rate was 35-43 percent among men who had lost weight four or more times, depending to some extent on the amount lost.

After accounting for other factors, losing weight four or more times before the age of 50 nearly tripled the risk of forearm fracture after 50.

People who want to make sure their bones stay strong when they lose weight should always be sure to exercise as well as diet, Sogaard said. "We know that weight-bearing activities, weight-training and exercise with varied loadings (e.g. squash, badminton, tennis) are favorable for muscles (and) balance, as well as bones."

Also, Sogaard noted, people who lose weight and then regain it often wind up weighing more than they did before they started trying to slim down. "If you want to lose weight, the crucial thing is to be serious (and) realistic regarding how much, and determined to change life-style," she said -- not just jump on a casual diet.

SOURCE: American Journal of Epidemiology, April 15, 2008.

 

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Youngsters Often Miss Diet and Exercise Marks

Last Updated: 2009-01-19 10:00:39 -0400 (Reuters Health)

By Joene Hendry

NEW YORK (Reuters Health) - According to their parents, pre-school children have somewhat better diets than school-age children, but both groups fall short when it comes to getting recommended amounts of exercise.

Dr. Hollie A. Raynor, of the University of Tennessee in Knoxville, and co-investigators, assessed parents' reports of their children's diet and activity levels. Of 174 boys and girls, about half (49 percent) were preschoolers (2 to 5.9 years old) and 51 percent were school-age children (6 to 12.9 years).

Parental reports of physical activity levels showed just 51 percent of kids, aged 2 to 12 years old, participated in sweat-inducing play or exercise for the recommended minimum of 60 minutes on most days, they report in the Journal of Nutrition Education and Behavior.

Overall, 47 percent of the school-age kids were at risk for or were overweight, compared with 22 percent of the pre-school age kids, the investigators found.

They also found that fewer pre-school kids ate salty and sweet snacks daily -- 14 and 16 percent, respectively. Conversely, reports showed nearly double this intake among school-age kids -- about 26 percent ate salty and nearly 30 percent ate sweet snacks daily.

On average, parents' reported pre-school children ate minimum recommended daily servings of low fat dairy products, but school-age children did not.

Moreover, while kids, regardless of age, minimally met recommended vegetable intake of 1 to 2.5 cups daily, and generally ate the recommended 1 to 1.5 cups of fruit daily, parents reported nearly 74 percent of the children ate fast food at least once a week.

In this study, parents' perspectives, as a whole, suggest "children's eating and leisure-time behaviors are not close to meeting current recommendations," Raynor said.

As unhealthy eating and activity habits tend to increase as children age, Raynor and colleagues surmise, it may be necessary to assist parents of young children establish healthy lifestyle habits before their kids' start school.

SOURCE: Journal of Nutrition Education and Behavior, January/February 2009

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Vitamins Block Post-Meal Grogginess in Diabetics

Last Updated: 2008-07-03 13:13:15 -0400 (Reuters Health)

By Anne Harding

NEW YORK (Reuters Health) - Fatty meals may cloud the brains of people with type 2 diabetes, but antioxidant vitamins can help clear the fog, Canadian researchers demonstrated in a study they conducted.

The findings suggest, the researchers say, that memory impairment after heavy meals in type 2 diabetics is related to oxidative damage.

The findings shouldn't be interpreted to mean that people can avoid the harmful consequences of fatty foods and "bad carbs" by popping vitamin pills, Dr. Carol Greenwood of the University of Toronto, who was involved in the study, told Reuters Health.

In the study, Greenwood and colleague Michael Herman Chui had 16 men and women with type 2 diabetes who were 50 and older eat three different meals at three separate weekly sessions: a Danish, cheddar cheese and yogurt with whipped cream; water only; or the same meal plus 1000 milligrams of vitamin C and 800 international units of vitamin E.

They found that people performed worse on tests of verbal recall and working memory 105 minutes after eating the high fat meal. But when they took vitamins with the meal, they did just as well on the tests as they did after drinking water.

The cognitive effects observed in the study were subtle, but large enough to impair performance, Greenwood said in an interview. "It kind of makes the 50-year-old brain more like the 75-year-old brain," she explained. And these effects could accumulate to cause lasting damage, according to the researcher.

Greenwood said studies are planned using brain imaging to look at what exactly happens in the brain of diabetes patients after a heavy meal.

SOURCE: Nutrition Research, July 2008.

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Heavily Marketed Kids' Cereals Are Least Healthy

Last Updated: 2008-04-23 11:48:24 -0400 (Reuters Health)

By Anne Harding

NEW YORK (Reuters Health) - Breakfast cereals for children are less healthy than cereals meant for adults, and those marketed the most aggressively to kids have the worst nutritional quality, according to a new analysis of 161 brands.

"The cereal the parent is eating him or herself is probably better than what they're feeding their child," Dr. Marlene B. Schwartz of Yale University in New Haven, Connecticut, the lead researcher on the study, told Reuters Health.

Schwartz and her colleagues also found that health claims made for kids' cereals were often misleading. Cereals sold as "low fat" or "low sugar" were not lower in calories, as parents might assume, and while brands touted as "whole grain" did have more fiber, they had just as much salt, sugar and fat as other brands and the same calorie content.

The food industry and public health authorities are both encouraging children to eat breakfast, especially ready-to-eat cereals, the researchers note in their report in the Journal of the American Dietetic Association. To compare the nutritional quality of cereals targeted to children and those marketed to adults, Schwartz and her team looked at 161 cereals, 46 percent of which were marketed to children. A cereal was put in this category if it had a character on the box, toys or games inside, or the company's Web site listed the brand as a children's cereal.

Children's cereals had more sugar, sodium, carbohydrate and calories per gram than non-children's cereals, and less protein and fiber. Sugar accounted for more than one-third of the weight of children's cereals, on average, compared to less than one-quarter of the adult cereals. Thirty-four percent of the kids' cereals met nutrition standards for foods sold in schools, compared to 56 percent of the non-children's cereals, Schwartz and her colleagues report.

Parents hoping to choose healthy cereals for their kids should look for brands containing 4 grams of sugar per serving (about one teaspoon) or less, Schwartz advised, and should aim for 4 grams of fiber per bowl of cereal.

As a psychologist, Schwartz says, she urges parents who want to ban heavily marketed cereals from their homes to stick to their guns. "My advice to parents of young children is you've got to just make a decision and stick with it because if you give in once, you're going to regret it. It's just going to make your kid nag you even more."

SOURCE: Journal of the American Dietetic Association, April 2006.

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"Good" Bacteria May Ease Hay Fever Symptoms: Study

Last Updated: 2008-06-03 9:59:55 -0400 (Reuters Health)

LONDON (Reuters) - A probiotic drink a day may help keep hay fever away, British researchers said on Tuesday.

A small study showed that probiotic, or "good" bacteria in a daily drink can change the immune system's response to grass pollen, a common cause of allergies, and balance antibodies in a way that may provide relief to people with the condition.

"These data show that probiotic supplements modulate immune responses...and may have the potential to alleviate the severity of symptoms," Claudio Nicoletti and colleagues at the Institute of Food Research in Norwich, Britain, reported in the journal Clinical and Experimental Allergy.

Probiotics contain live microorganisms, so-called good bacteria that colonize the intestine. They are sold as supplements but are also found naturally in many fermented foods, including yogurt and certain juices.

Humans normally carry several pounds of bacteria in their intestines and they are key to digestion, immune system function and possibly play other beneficial roles. They can also out-compete "bad" bacteria that may cause disease.

"The probiotic strain we tested changed the way the body's immune cells respond to grass pollen," added Kamal Ivory, a researcher who worked on the study.

In the study volunteers with a history of seasonal allergies drank a daily milk drink with or without Lactobacillus casei -- a bacteria widely studied for its beneficial properties -- over a five-month period.

The researchers took blood samples before the grass pollen season, at its peak and after the end of season. They found that people who had been drinking the probiotic drink had lower levels of an antibody that help produce allergy symptoms.

At the same, these people also had higher levels of a different antibody, called IgG that may play a protective role against allergic reactions.

These changes may reduce the severity of symptoms, something the researchers said they plan to test further. They also cautioned that the findings came from a small study and more work was needed.

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Why Metagenics Cont. - Quality Difference

Doctors and patients have thousands of nutritional products to choose from—with a wide variation in quality and price. We focus on improving people's health—not just selling pills.

Our top priority is to make products that work. Because no matter how much you pay for a product, it's too expensive if it doesn't work.

It's rare for a professional nutritional product company to devote the scientific staff, labs, equipment, time, resources, and strict procedures necessary to achieve true quality status.

We can't imagine it any other way—people's health may depend on it.

We Measure Up to All 5 Quality Standards—and Beyond.

We're the only nutritional company selling to health care professionals that strictly adheres to the 5 most identifiable standards for quality.

1. GMP-certified manufacturing—the ultimate quality marker. If it's on the label, it's in the bottle—guaranteed. Our manufacturing facility is certified for good manufacturing practices (GMP) by the Natural Products Association (NPA), National Sanitation Foundation (NSF), and the Therapeutic Goods Administration of Australia (TGA) to ensure the highest quality standards.

It's a sure way to know you're getting exactly what you pay for. No other professional supplement company has all 3 of these certifications. Many don't even have one.

2. Pure ingredients—identity tested on multiple levels. We accept nothing less than the best we can find. We quarantine each raw material then test each thoroughly to support quality, safety, and efficacy. On formulas requiring especially sensitive or perishable ingredients, we conduct additional testing—above and beyond the testing required of us by the Food and Drug Administration current good manufacturing practices, or cGMPs. A batch of each final product is then tested again for purity as an added safety measure and confirmation of quality.

Our attention to detail here is unmatched in our industry.

3. Safety-reviewed ingredients—we won't create a formula without them. We don't even think of using an ingredient in a formula without a thorough literature search on its predicted safety in use as a nutritional supplement.

We have an onsite research staff and medical information center with access to thousands of peer-reviewed scientific publications. We review published studies and articles on every new natural ingredient we consider using in our products.

It's an added assurance for products you can trust.

4. Human clinical evaluations—the surest way to show effectiveness. The best way to test effectiveness and safety of a nutritional product is to see how it works with real patients. The Functional Medicine Research Center℠ (FMRC)—the clinical research arm of Metagenics—is an on-site clinic staffed by medical professionals who recommend our nutritional approaches and monitor their success. The FMRC also conducts clinical trials that have been published in respected peer-reviewed journals.

No other company in our market segment can offer this kind of first-hand knowledge that can only be achieved a clinical setting.

5. Scientific staff and facilities—the best in our business. Not every professional nutrition company has its own staff of dedicated medical and technical professionals. We have one of the largest in-house scientific staffs—MDs, PhDs, and others—in our industry segment.

Plus we have some of the industry's most progressive research facilities and labs, such as our MetaProteomics labs for testing the effects of nutrients on proteins and genetic expression.

It's easy to see why so many health care professionals and their patients rely on our products.

Added Measures to Maximize Effectiveness & Value

Going above and beyond is just routine for us. Here are just a few more examples:

Appropriate ingredient form & dose—so you can be sure. Our goal is to use highly absorbable nutrient forms so the body has a greater chance of using it the way it should to promote health. This is particularly important with certain key nutrients that may be poorly absorbed, or for people who have absorption concerns. And the dosages we recommend are based on scientific research that document effectiveness and predicted safety when used as intended.

The right delivery form—to meet the demands of patients and appropriate to the ingredients. We don't have a "one form fits all" policy. Not every ingredient should be made into a tablet or a capsule. So the ingredients often decide the delivery form for each product—tablet, chewable, liquid, capsule, softgel, soft chew, bar, or powder.

And a product can't work if people won't take it. So we also consider what people prefer. That's why we offer many of our products in a variety of forms and flavors.

Tablets made for ultimate performance—for better results. Nobody pays more attention to tablets than we do. Our tableting technology makes sure they disintegrate within a short time, to release ingredients for optimal absorption.

And we don't stop testing even after we create the final formula. Every product batch is tested to make sure our high tablet standards are met.

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Why Metagenics?

Patient Health—It's Our Greatest Concern

We've built a reputation on nutraceuticals and medical foods that meet the high expectations of health care professionals worldwide. But what we care about most is serving the best interests of the patients who use our products and services with a goal of improving health and reversing chronic illness.

The Industry Leader in Quality & Efficacy

We don't compromise on safety, efficacy, or quality—to make sure that we deliver the best results possible. Time after time. Bottle after bottle. We carefully monitor all products to assure purity and safety, from formulation and ingredient selection all the way to the final product.

Research & Innovation Ahead of the Curve

We offer more than just products. Our strong focus on research keeps us on the leading edge of the current evolution in personalized medicine. Our in-house team of highly regarded clinicians and scientists is actively developing breakthroughs in nutrient modulation of gene expression to help us create even more effective health care solutions.

Educational Programs with Renowned Experts

We offer more educational support for health care professionals than anyone else in our field—keeping them in touch with the latest research and nutritional approaches to help manage today’s most common illnesses. With our renowned in-house experts, including Dr. Jeffrey Bland and many other opinion leaders, we provide education through seminars, workshops, webinars, symposiums, and other venues.

Discover the Difference

See why more health care professionals and patients select Metagenics over many other professional brands. You'll be glad you did.

 

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Probiotics Aid in Weight Loss After Gastric Bypass Surgery

Last Updated: 2008-05-22 13:26:39 -0400 (Reuters Health)

By Martha Kerr

SAN DIEGO (Reuters Health) - In a study at Stanford University, patients who took probiotics after Roux en Y gastric bypass surgery (RNYGB) lost more weight than RNYGB patients who did not.

These findings were presented Tuesday during Digestive Disease Week 2008 by Dr. John M. Morton, during a session on the management of patients with obesity.

"We have better treatments for crack cocaine addiction than we do for obesity," Dr. Morton asserted, "but there has been a real revolution with bariatric surgery. It provides strikingly durable weight loss...As a result, blood pressures will normalize...We have seen diabetes cure rates of 82%, and this can occur within weeks of surgery."

The trial involved 44 patients who underwent endoscopic RNYGB and were randomized to receive either 2.4 billion lactobacilli daily or no probiotic therapy for six months. Quality of life, hydrogen (H2) breath tests, vitamin B12 levels and weight were measured before surgery and at three and six months afterward.

At six months, the probiotic group had lower H2 breath tests, lower fasting insulin, lipoprotein A and triglyceride levels, and higher HDL cholesterol levels compared with controls, although the differences were not statistically significant. There was, however, a significantly greater improvement in quality of life in patients taking probiotics compared to controls.

"What was surprising was that probiotic patients lost more weight after surgery," Dr. Morton told Reuters Health. The study group lost 70% of their excess weight at six months compared with a loss of 66% of excess weight in controls.

He added, "This suggests that the cause of the weight increase may be bacterial...and may help explain the observation that fat people have fat friends...Some of it may be environmental and related to social factors, but it may also be related to high bacteria levels in some way."

"We know that probiotics have to be live cultures and you have to [ingest] a minimum of two billion colonies a day," Dr. Morton said. "We don't know exactly which probiotic organisms are best and how much to recommended...The populations vary. They are different in the gut flora in different patient types."

At the very least, probiotics are safe, Dr. Morton said. "There doesn't seem to be any downside to taking them," he commented.

 

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Apolipoprotein Ratio Better Than Cholesterol Ratios as Indicator of MI Risk

Last Updated: 2008-07-17 18:30:13 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The ratio of apolipoprotein B100 (ApoB) to apolipoprotein A1 (ApoA1) is superior to cholesterol ratios for estimating risk of acute myocardial infarction, the INTERHEART study investigators report in the July 19 issue of The Lancet.

The ApoB/ApoA1 ratio is an index of the proatherogenic and antiatherogenic lipoproteins in plasma, Dr. Matthew J. McQueen, at McMaster University in Hamilton, Ontario, Canada, and co-authors explain.

The study team obtained non-fasting blood samples from 9345 patients with a first acute MI and 12,120 age- and sex-matched controls from 52 countries, representing all major ethnic groups. Concentrations of plasma lipids, lipoproteins, and apolipoproteins were measured using standard assays.

The population-attributable risk of MI was substantially higher for the ApoB/ApoA1 ratio (54%) than for the ratio of total cholesterol/HDL cholesterol (TC/HDL, 32%, p < 0.001).

The odds ratio associated with a one standard-deviation change in the ratio of ApoB/ApoA1 (1.59) was also higher than that for TC/HDL (1.17, p < 0.001).

ApoB/ApoA1 was superior to cholesterol ratios for estimation of the risk of acute MI "in all ethnic groups, in both sexes, and at all ages, and it should be introduced into worldwide clinical practice," Dr. McQueen's group maintains.

As they note, "The clinical measurement of apolipoproteins is standardized, simple, inexpensive, and can be done with samples obtained from non-fasting individuals."

They also point out that their recommendation is in line with the recent joint Consensus Statement by the American Diabetes Association and the American College of Cardiology, that "ApoB should be the final test of adequacy of any LDL cholesterol-lowering treatment."

In an editorial, Dr. Lars Lind from University Hospital in Uppsala, Sweden, remarks that "the most important task is to ascertain that lipids are evaluated at all."

"Physicians and patients have taken decades to learn to measure lipids and treat hyperlipidaemia," he notes, predicting that "it will be a demanding but not impossible task of education to substitute traditional lipid measurements by the possibly somewhat better apolipoproteins."

Lancet 2008;372:185-186,224-233.

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Exercise ECG Identifies Heart Problems in Prospective Athletes

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - Exercise 12-lead electrocardiography (ECG) is useful in identifying cardiac abnormalities in individuals who are seeking to participate in competitive sports, new research shows. Whether disqualification of these athletes helps prevent cardiovascular events will require further study.

The study is the "first to investigate, in a large population of sports participants, a complete cardiovascular preparticipation screening that included both baseline and exercise electrocardiograms," lead author Dr. Francesco Sofi from the University of Florence, Italy, told Reuters Health.

As reported in the October 17th Online First issue of the British Medical Journal, Dr. Sofi's team analyzed data from 30,065 prospective athletes to assess the clinical usefulness of preparticipation cardiovascular screening.

Resting ECG identified 6% of subjects as having cardiac abnormalities, while exercise ECG identified 4.9%. More than 80% of the abnormalities seen with resting ECG involved relatively benign ECG changes.

The authors report that 1227 athletes with normal findings on resting ECG showed abnormalities on exercise ECG.

All told, 196 subjects (0.6%) were considered ineligible for participation in competitive sports, including 159 who were disqualified for cardiac reasons. Nearly 80% of the latter group had important cardiac abnormalities that were only seen on exercise ECG.

On regression analysis, age over 30 years was identified as a significant predictor of disqualification due to cardiac abnormalities on exercise testing.

In an accompanying clinical review, Dr. Sanjay Sharma, from King's College Hospital, London, and colleagues discuss the epidemiology, objectives, methods, psychological impact, and costs of preparticipation screening for cardiac abnormalities in young athletes.

The authors conclude that "preparticipation screening using health questionnaires and physical examination only has poor sensitivity whereas elaborate screening programs are cost prohibitive." This leaves 12-lead ECG testing, which is useful in preventing sudden cardiac death from channelopathies and cardiomyopathies, but not due to coronary disease, they note.

Unfortunately, "implementation of preparticipation screening is currently hampered by the lack of resources and infrastructure and cannot be regarded as cost effective in most countries," Dr. Sharma's team concludes.

BMJ Online First 2008.

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Warm Up to Winter Activities

December 15, 2000 -- As the snow piles up, North Americans are running down their winter activity lists. Skiing, skating, sledding and leisurely walks in the snow are just some of the more popular pursuits.

But while having fun should be first and foremost in your mind, avoiding health risks should be second. Trudging through snow, braving icy sidewalks, battling bitter winds, climbing snow banks and hitting the ski hills can wreak havoc on your body -- especially if you're out of shape.

That's why the American Chiropractic Association (ACA) is warning people about flurries of winter activity. The ACA says sprains, tears and painful muscle spasms are just some of the injuries outdoor enthusiasts experience in the winter, and these are more likely to occur in people who aren't used to physical exertion.

The cold makes everyone more vulnerable to injuries, says ACA spokesperson Dr. Jerome McAndrews, because the body's muscles and blood vessels contract to conserve heat, lowering blood supply and reducing muscle capacity. This can weaken muscles and even trigger joint pain.

That's why bundling up is important. But besides wearing thermal underwear and a parka, people can prevent the cold from causing injuries by properly preparing their body with warm-ups and stretches. "The warm-up becomes important to get the blood back out to the extremities and to get those blood vessels dilated again," says McAndrews. "In the winter it is always good for someone who is going to engage in skiing or even walking to stretch out a little bit."

If you don't exercise regularly, McAndrews says warm-ups and stretches are even more important. "If those muscles are not in condition or toned up, the impact on them can be unbalanced and you could be in for some trouble."

For pain-free fun, different activities demand different precautions. Here are some of the ACA's tips for people who enjoy winter's most popular pleasures:

Skiers should know squat: Before hitting the slopes, you should do 10 to 15 squats. Stand with your legs about shoulder-width apart, slowly lower your buttocks as if you were sitting down, return to a standing position and repeat the process without a break until you complete the set.

Lunge for the goal: Before that pick-up ice hockey game or family skate, try doing a few lunges. Take a moderately deep step forward and let your back knee come down to the floor while your shoulders remain aligned over your hips. Come back to a standing position and repeat the process with the other foot. Continue, switching feet after each lunge, until your leg muscles are loose and warm.

Pull sleds, not muscles: To prevent injuries that can occur while you're sitting or kneeling on a sled and bouncing downhill, do knee-to-chest stretches before your ride. While lying on your back, pull your knees to your chest and hold them there for about 30 seconds.

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Fast Food Eaters Risk Liver Damage, Weight Gain

Last Updated: 2008-02-14 15:34:01 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Too much fast food and too little exercise can wreak havoc on the liver, according to results of a small Swedish study.

In the study, 18 trim, healthy adult volunteers who restricted their levels of physical activity to no more than 5,000 steps a day and ate at least two fast food meals every day for 4 weeks showed clear signs of liver damage. They also put on weight.

Another group of volunteers, who were matched to members of the first group by age and sex, maintained a normal diet and did not develop signs of liver damage or gain weight.

Dr. Fredrik H. Nystrom of University Hospital of Linkoping, Sweden and colleagues report their results in the medical journal Gut.

They designed their "fast food challenge" study to see what impact doubling the number of calories eaten daily and increasing body weight by 10 and 15 percent would have on liver health.

At the end of the 4 weeks, the fast food eaters had put on an average of 6.5 kilograms (14.3 pounds). Five increased their weight by 15 percent, and 1 person put on an extra 12 kilograms (26.4 pounds) in just 2 weeks.

Moreover, after just 1 week on the fast food diet, blood tests showed sharp increases in a liver enzyme called alanine aminotransferase (ALT). ALT levels more than quadrupled over the 4-week study period.

Doctors often use increases in ALT and other liver enzymes to diagnose liver disease before symptoms develop. In 11 fast food dieters, ALT rose to levels suggestive of liver damage.

The ALT increases were linked to weight gain and higher sugar and carbohydrate intake.

Too much fat in the liver is another sign of damage. Only one fast food eater developed "fatty liver," but test results from the other participants showed a steep rise in fat content in their liver cells, which is associated with insulin resistance, a precursor to diabetes.

None of these changes were seen among the comparison group who maintained their normal diet.

SOURCE: Gut, February 2008.

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Does Mold Make You Sick? Doctors Seek Answers

Last Updated: 2008-10-28 15:15:27 -0400 (Reuters Health)

By Maggie Fox

WASHINGTON (Reuters) - Fungus expert Joan Bennett did not believe in so-called toxic mold -- the cause of "sick building syndrome" and many lawsuits -- until her New Orleans home was flooded during Hurricane Katrina in 2005.

When she got a whiff of the foul air that the black goo had created in her home, she decided to change her research focus and try to find out how and if the fungi that took over most of the flooded homes on the Gulf Coast might make people ill.

"The overwhelming obnoxiousness of the odor and of the enveloping air made me start to believe in something that I had never believed in before -- sick building syndrome," Bennett, of Rutgers University in New Jersey, told a news conference.

But it has been more difficult than she thought.

Bennett believes that molds could potentially cause illness in certain susceptible people via volatile organic compounds -- gassy versions of chemicals produced as the organisms metabolize food.

She has been unable to show this in the lab so far. But she told a joint meeting of the American Society for Microbiology and the Infectious Diseases Society of America.

She has tested various molds on the laboratory roundworm C. elegans. "Sometimes the worm swims away and sometimes the worm does nothing and sometimes the worm eats the fungus," Bennett said.

"I am actually looking for something that has never been discovered by methods that have never been worked out."

Yet hundreds of lawsuits have been filed -- and some won -- by people claiming mold in their homes or workplaces has made them ill.

Dr. David Denning of the University of Manchester in Britain said it is plausible that molds and fungi would emit volatile organic compounds.

GENETIC SENSITIVITY

If these can be found, they could form the basis of diagnosing fungal illness as well -- perhaps using a breath test. People with fungal infections of the lungs, such as aspergillosis, would release these chemicals when they breathed.

"A certain group of severe asthmatics -- about a million people -- are sensitive to a number of different fungi," Denning told the news conference. These include Aspergillis and Candida.

"This is almost certainly a genetic issue," he added. "If you have (a) predisposition (to asthma), you probably have an additional predisposition to fungal sensitization."

Dr. David Goldman, a pediatrician in the Bronx, New York, said asthma rates in his borough are disproportionately high, and he blames in part Cryptococcus neoformins, a microbe found in pigeon droppings that causes disease in immune-compromised people.

"We believe this fungus contributes to asthma by modulating the immune response," Goldman told the news conference.

Both Goldman and Denning said treating patients with antifungal drugs such as itraconozole and fluconazole helped relieve the symptoms of patients with severe asthma. This supports evidence that fungi are contributing to symptoms.

All three experts agreed it would likely take a combination of factors -- including a person genetically susceptible to molds and unusual fungal activity -- to cause any disease.

"It is probably a relatively temporary disease, not a life-threatening disease," Denning said.

"As we sit here we are probably breathing in hundreds of spores," Bennett added. "Usually we only get sick if our immune systems are compromised or if we have this genetic susceptibility to allergy."

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'Low Glycemic' Diet Helpful in Diabetic Youth

Last Updated: 2008-04-24 15:19:04 -0400 (Reuters Health)

NEW YORK (Reuters Health) - In children and adolescents with type 1, or insulin-dependent, diabetes, consumption of a low glycemic index diet may improve blood sugar control, according to results of a National Institutes of Health-sponsored study.

Glycemic index, or GI, refers to how rapidly a food causes blood sugar to rise. High-GI foods, like white bread and potatoes, tend to spur a quick surge in blood sugar, while low-GI foods, such as lentils, soybeans, yogurt and many high-fiber grains, create a more gradual increase in blood sugar.

Dr. Tonja R. Nansel of the National Institute of Child Health and Human Development and colleagues tested the effects of high GI and low GI meals on blood sugar levels using continuous blood sugar monitoring in 20 type 1 diabetics who were between the ages of 7 and 16 years.

The findings, reported in the journal Diabetes Care, suggest that a low GI diet can improve blood sugar control "to a clinically meaningful degree above that obtained by careful carbohydrate counting and contemporary insulin regimens," Nansel noted in comments to Reuters Health.

"When consuming the low GI diet, blood glucose (sugar) levels were in the target range 66 percent of the time compared to 47 percent of the time when consuming the high GI diet," she explained. "This difference was statistically significant."

When consuming the low GI diet, study subjects also demonstrated significantly lower daytime average blood sugar levels compared to the high GI diet and fewer blood sugar excursions.

"It is plausible" based on the results of this study, Nansel said, "that a low glycemic index diet may reduce the dose of insulin required while improving blood sugar control.

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SOURCE: Diabetes Care April, 2008.

Nutritional Strategies in the Prevention of Osteoporosis: A Summary

By Neil Hirschenbein, M.D., Ph.D., C.C.N.
The statistics are alarming: in the U.S. today, approximately 10 million men and women have osteoporosis and another 18 million have osteopenia (low bone mass). Osteoporosis literally means "porous bone," and is characterized by bone fragility and an increased susceptibility to bone fractures.1,2 An estimated 1 in 2 women and 1 in 8 men over age 50 will suffer a bone fracture due to osteoporosis in their lifetime. Although osteoporosis can develop at any age, the risk factors increase with age in both men and women.

Osteoporosis is called "the silent disease" because it is generally a symptomless process resulting from a gradual loss of bone mass. Without proper risk assessment, osteoporosis can go undetected until bones become so brittle that even the slightest trauma causes a bone fracture.1,2 Fortunately, experts agree that this type of suffering may be preventable. Studies show that lifetime maintenance of adequate nutrient intake, including calcium and other nutrients important to bone health, along with regular exercise and a healthy lifestyle may reduce the risk of developing osteoporosis.3-5

What are the Risk Factors?
Many risk factors contribute to the development of osteoporosis.1,3,4,6 Some of these include dietary and lifestyle factors such as nutrient deficiencies (e.g., calcium, magnesium, vitamin D), high protein intake, lack of exercise, smoking, excessive alcohol or caffeine consumption, and prolonged use of certain medications (e.g., corticosteroids, antacids). Other risk factors include Caucasian or Asian ethnicity; a thin, small-bone frame; and a family history of osteoporosis.

The Importance of Prevention
The key to preventing osteoporosis is to achieve optimal bone mass during the first three decades of life and maintain it throughout the aging process.7,8 The more bone mass acquired by age 35, the less likely it will decrease to a level at which osteoporosis develops later in life.3 An optimal intake of calcium not only helps to achieve a greater peak bone mass, but also reduces the rate of age-related bone loss.3,9-15

Calcium: What are the Recommendations?
The Reference Daily Intake (RDI) provides recommendations for daily nutrient intakes considered to adequately meet the needs of most healthy individuals in the U.S. The current RDI for calcium is 1,000 mg per day, which is lower than many health experts recommend.7,16-18,20 Unfortunately, reliable statistics show that an alarming 65% of the U.S. population consumes even less than the RDI for calcium.21

The ability to absorb calcium declines with age in both men and women.2 Consequently, there is a need to address factors that affect calcium absorption, particularly when dealing with the elderly population. For instance, large quantities of dietary fiber, certain medications, and nutrient deficiencies (e.g., vitamin D, magnesium) can interfere with calcium absorption. Hypochlorhydria, a condition of low gastric acid production, can also hinder calcium absorption and is quite common in the elderly. Patients encountering any of these factors may need to make dietary adjustments and be sure they are consuming forms of calcium that are easily absorbed.

Other Powerful Bone-Supportive Nutrients
Vitamin D—Vitamin D plays an essential role in maintaining optimal bone mass by acting primarily to assist calcium absorption.22 Vitamin D deficiency is common among the elderly population, owing to less efficient absorption, reduced sun exposure, and reduced intake.22-24 Studies show that supplementation with 400-800 IU per day of vitamin D effectively reverses vitamin D deficiency in the elderly.25-28

Magnesium—There is growing evidence that magnesium is required to properly utilize calcium, and experts agree that adequate calcium intake may not ensure normal bone mass if magnesium levels are low.29,30 In addition, an excessively high calcium intake combined with a low magnesium intake may further intensify magnesium deficiency.31 Because of the effect of magnesium in calcium utilization, magnesium deficiency may be implicated as a risk factor for osteoporosis.32,33

Trace Minerals—Despite the fact that they are only required in small amounts, studies suggest that trace minerals including zinc, manganese, fluoride, boron, and silicon are no less important to bone health than other minerals. For instance, in a 2-year clinical study, postmenopausal women who increased their intake of both calcium and trace minerals experienced an increase in bone mass.34 Conversely, women who increased their intakes of calcium alone or trace minerals alone experienced bone loss, suggesting that the combined nutritional regimen is far more effective.

Ipriflavone—This derivative of naturally occurring isoflavones has a positive effect on bone metabolism. Numerous studies have shown that ipriflavone reduces bone loss in postmenopausal women with osteopenia or established osteoporosis.35-40 One study evaluating the effects of ipriflavone combined with vitamin D showed that the combined nutritional therapy was more effective in reducing bone loss than either therapy alone.41

Comprehensive Bone Nourishment: MCHC
Microcrystalline hydroxyapatite concentrate (MCHC) is a whole bone extract, complete with all the minerals and organic factors in the same proportions naturally found in healthy bone. It is an excellent source of absorbable calcium, a full spectrum of minerals, and other nutrients essential to bone health.42-48

MCHC also contains the proteins found in healthy bone, including growth factors and collagen.48 Recently, scientists have focused attention on the actions of growth factors in stimulating bone growth. Experts have postulated that the presence of growth factors in MCHC may be one reason why it is so effective in maximizing bone strength.

Studies have repeatedly confirmed the effectiveness of MCHC in maximizing bone mass, and suggest that MCHC is more effective than calcium carbonate and calcium gluconate. In a study comparing the effects of MCHC and calcium carbonate supplementation in postmenopausal osteoporosis, MCHC nearly halted bone loss, while calcium carbonate only slowed bone loss by approximately 50%.49,50

There is a great variation in the quality of MCHC products. The source and processing procedures of bone extract is of utmost importance in determining the quality and effectiveness of MCHC. A high-grade source of MCHC would come from New Zealand and is free of pesticide and heavy metal contamination. MCHC should not be processed with high-heat or excess grinding, which destroys the beneficial organic factors and protein content.51,52

Conclusion
Experts agree that lifetime maintenance of adequate nutrient intake including calcium and other important nutrients, along with regular exercise and a healthy lifestyle, is essential to reducing the risk of osteoporosis.3-5 Studies show that MCHC is an excellent source of absorbable calcium and other nutrients essential to bone health, has a positive effect in maximizing bone mass, and is more effective than commonly used forms of calcium.42-46

References
Dempster DW, Lindsay R. Pathogenesis of osteoporosis. Lancet 1993;341:797-801.
Weaver CM. Calcium bioavailability and its relation to osteoporosis. Soc Exp Biol Med 1992;200:157-60.
Arnaud CD, Sanchez SD. The role of calcium in osteoporosis. Annu Rev Nutr 1990;10:397-414.
Notelovitz M. Osteoporosis: screening, prevention, and management. Fertil Steril 1993;59:707-25.
Lindsay R. Prevention and treatment of osteoporosis. Lancet 1993;341:801-05.
Riggs BL, Melton LJ. Involutional osteoporosis. N Eng J Med 1986;314:1676-86.
Matkovic V, Fontana D, Tominac C, et al. Factors that influence peak bone mass formation: a study of calcium balance and the inheritance of bone mass in adolescent females. Am J Clin Nutr 1990;52:878-88.
WHO Study Group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Report of a WHO Study Group. WHO Technical Report Series 843, Geneva: World Health Organization, 1994:1-29.
Chan G, Hess M, Hollis J, et al. Bone mineral status in childhood accidental fractures. Am J Dis Child 1984;138:569-70.
Chan G. The effect of dietary calcium supplementation on pubertal girls’ growth and bone mineral status. Clin Res 1992;40:60A.
Johnston C, Miller JZ, Slemenda CW, et al. Calcium supplementation and increases in bone mineral density in children. N Engl J Med 1992;327:82-87.
Lloyd T, Andon MB, Rollings N, et al. Calcium supplementation and bone mineral density in adolescent girls. JAMA 1993;270:841-44.
Recker RR. Bone gain in young adult women. JAMA 1992;268:2403-08.
Reid IR, Ames RW, Evans MC, et al. Effect of calcium supplementation on bone loss in postmenopausal women. N Engl J Med 1993;328:460-64.
Dawson-Hughes B, Dallal GE, Krall EA, et al. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med 1990;323:878-83.
Heaney RP. Thinking straight about calcium. N Eng J Med 1993; 328:503-05.
Andon MB, Lloyd T, Matkovic V. Supplementation trials with calcium citrate malate: evidence in favor of increasing the calcium RDA during childhood and adolescence. J Nutr 1994;124(8 Suppl):1412S-17S.
Prince R. The calcium controversy revisited: implications of new data. Med J Aust 1993;159:404-07.
Smith EL, Gilligan C, Smith PE, et al. Calcium supplementation and bone loss in middle-aged women. Am J Clin Nutr 1989;50:833-42.
Weaver CM. Age related calcium requirements due to changes in absorption and utilization. J Nutr 1994;124(8 Suppl):1418S-25S.
U.S. Department of Agriculture, Agricultural Research Service. Data tables: USDA’s 1994-96 Continuing Survey of Food Intakes by Individuals. Retrieved May 10, 2002, from http://www.barc.usda.gov/bhnrc/foodsurvey/home.htm
Melton LJ. Hip fractures: a worldwide problem today and tomorrow. Bone 1993;14(1 Suppl):S1-S8.
Holick MF. Vitamin D and bone health. J Nutr 1996;126(4 Suppl):1159S-64S.
Dawson-Hughes B. Calcium and vitamin D nutritional needs of elderly women. J Nutr 1996;126(4 Suppl):1165S-67S.
Ooms ME, Roos JC, Bezemer PD, et al. Prevention of bone loss by vitamin D supplementation in elderly women: a randomized double-blind trial. J Clin Endocrinol Metab 1995;80:1052-58.
Mezquita-Raya P, Munoz-Torres M, Luna JD, et al. Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women. Bone Miner Res 2001;16(8):1408-15.
Gennari C. Calcium and vitamin D nutrition and bone disease of the elderly. Public Health Nut 2001;4(2B):547-49.
Dawson-Hughes B, Harris SS, Krall EA, et al. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 1997;337:670-76.
Wallach S. Effects of magnesium on skeletal metabolism. J Am Coll Nutr 1989;8:457A.
Fatemi S, Ryzen E, Flores J, et al. Effect of experimental human magnesium depletion on parathyroid hormone secretion and 1,25-dihydroxyvitamin D metabolism. J Clin Endocrinol Metab 1991;73:1067-72.
Abraham GE. The importance of magnesium in the management of primary postmenopausal osteoporosis. J Nutr Med 1991;2(2):1-25.
Abbott LG, Rude RK. Clinical manifestations of magnesium deficiency. Miner Electrolyte Metab 1993;19(4-5):314-22.

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Advanced Nutrition Publications ©2002

Probiotics Help Distance Runners Stay Healthy

Last Updated: 2008-02-19 12:23:13 -0400 (Reuters Health)

By Anne Harding

NEW YORK (Reuters Health) - Endurance runners' strenuous training can erode their immunity and make them more vulnerable to catching colds, but a daily dose of "good" bacteria could bring their immune systems back up to speed, Australian researchers have shown.

These bacteria, known as probiotics, are found in fermented dairy foods like yogurt, and are also available as dietary supplements.

"There is emerging evidence that probiotic supplementation can improve the health of a wide range of individuals including infants, athletes, people in highly active and/or stressful jobs, and in the general population," Dr. David Pyne of the Australian Institute of Sport in Canberra, one of the study's authors, told Reuters Health.

To investigate whether the supplements help endurance athletes stay healthy, Pyne and his team randomized 20 healthy elite distance runners to take a capsule containing Lactobacillus fermentum or a placebo every day during their four-month winter training session. The athletes ran about 100 kilometers (62 miles) per week, on average.

As the researchers report in the British Journal of Sports Medicine, runners who took probiotics averaged 30 days of respiratory symptoms during the course of the study, compared to 72 days for those on placebo.

Probiotic treatment also doubled levels of interferon gamma, a substance secreted by T cells that plays a key role in fighting viral infections.

"Probiotics primarily work by providing good bacteria in the gut to maintain a healthy balance in the digestive tract and stimulating the immune system," Pyne noted. "In effect, probiotics top up the beneficial bacteria in the gut to improve the balance between good and bad bacteria." This better balance may improve mucosal immunity, or the ability of cells in the body's mucous membranes to fight off infection, throughout the body, he added.

While probiotics clearly benefit a wide range of individuals, including recreational athletes as well as elite competitors, they can't replace "a healthy, well-balanced diet, regular exercise, and good hygiene," Pyne said. To get the most out of probiotic supplements and foods, which can degrade over time, "consumers should purchase products and supplements from reputable manufacturers and ensure that use-by-dates are adhered to," he added.

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SOURCE: British Journal of Sports Medicine, February 13, 2008.

Workplace Programmes Can Improve Health - Study

Last Updated: 2008-05-19 12:16:17 -0400 (Reuters Health)

GENEVA (Reuters) - Workplace programmes targeting physical inactivity and unhealthy dietary habits are effective in mitigating the impact of obesity, diabetes and heart disease, according to a study published on Monday.

Deaths from non-communicable diseases such as heart disease, stroke, cancer and diabetes are forecast to rise 17 percent in 2005-2015, said the joint study by business thinktank the World Economic Forum and the U.N.'s World Health Organisation (WHO).

The impact of these deaths and health problems on the economies of different countries is dramatic, with China forecast to lose $557.7 billion in the period, Russia $303.2 billion and India $236.6 billion, it said.

"Enhancing employee productivity, improving corporate image and moderating medical care costs are some of the arguments that might foster senior management to initiate and invest in WHP (workplace health promotion) programmes," it said.

Unhealthy diets and excessive energy intake, physical inactivity and tobacco use are major risk factors for non-communicable diseases, it said.

In 2005 about 35 million people died of non-communicable diseases such as heart disease, stroke, cancer and diabetes, accounting for 60 percent of all deaths worldwide, it said.

This is projected to rise to 47 million deaths a year in the next 25 years, the study said.

Around 80 percent of these deaths occur in low and middle-income countries that also have to deal with infectious diseases, poor maternal and perinatal conditions and nutritional deficiencies, it said.

Successful workplace programmes are linked to business objectives, enjoy strong management support, involve staff from the start and are adapted to social norms, it said.

The study cited scientific evidence that healthy diet and adequate physical activity - at least 30 minutes of moderate activity at least five days a week - help prevent non-communicable disease.

The study, based on programmes in rich countries mainly in Europe and North America, said further research was needed, especially for poor countries.

The study was presented as the WHO's annual World Health Assembly opened in Geneva. Business leaders attending the launch urged the 193-member state forum to tackle the causes of chronic disease in the workplace. (For the report click on: www.weforum.org/en/initiatives/Wellness/index.htm)

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Creatine Supplements Help Muscle Disorders

NEW YORK, (Reuters Health) - Creatine, an amino acid supplement popular among athletes, may help to build muscle and increase muscle strength in patients with muscular dystrophy and other neuromuscular disorders, a study suggests.

People with these muscle disorders had a small increase in handgrip, ankle, and knee strength after taking creatine daily for 10 to 12 days, according to the report in the journal Neurology. The study included 21 people with various types of neuromuscular disorders including muscular dystrophy, which cause muscle atrophy (wasting) and loss of strength.

"The treatment appears to be well tolerated in the short term," report Dr. Mark Tarnopolsky and Joan Martin, of McMaster University Medical Center in Ontario, Canada. But the researchers caution that more studies need to be conducted to determine if creatine continues to have a benefit over a longer period of time.

The subjects consumed either a placebo ("dummy" pill) or 10 grams of creatine daily for 5 days followed by 5 grams of creatine daily for 5 to 7 days.

After an 11-day rest period, the subjects taking a placebo repeated the trial with creatine and those taking creatine were switched to placebo, with none of the people knowing which kind of pill they were taking.

The study showed that patients gained weight during the study. This increase affected the "lean body compartment," that is, muscle rather than fat. "This could be a great benefit for patients with neuromuscular diseases, where muscle atrophy is common," Tarnopolsky said in a statement.

There was a greater increase in handgrip and ankle strength in those taking creatine compared with placebo, the researchers report. For example, knee strength increased by 11% in those taking creatine, but only 2.3% in placebo users.

"It's possible that this added strength could be enough to help someone who's having trouble eating to bring the spoon up to their mouth," said Tarnopolsky in a statement issued by the American Academy of Neurology. "Or maybe for someone who is on the verge of going into a wheelchair, it may buy them an extra few weeks or months. Clearly, we need larger studies to address these potential benefits."

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Spices May Lessen Consequences of High Blood Sugar

Last Updated: 2008-08-14 14:00:36 -0400 (Reuters Health)

By Amy Norton

NEW YORK (Reuters Health) - People with diabetes may want to start spicing up their diets, if new lab research findings prove true in humans.

In test-tube experiments, researchers at the University of Georgia, Athens, found that extracts of various herbs and spices -- such as cinnamon, cloves, sage and rosemary -- inhibited a damaging process that can result from high blood sugar levels.

When blood sugar is high, as is chronically the case in diabetes, it can lead to the formation of substances known as AGE compounds. These compounds, in turn, cause inflammation and tissue damage, which can contribute to the clogged arteries and heart disease commonly associated with diabetes.

But, at least in the in the lab dish, numerous herbs and spices appear to block the chemical process that creates AGE compounds, according to the new findings, published in the Journal of Medicinal Food.

Whether this holds true in humans is not yet known. And even it does, well-seasoned food will not take the place of good blood sugar control for people with diabetes, according to Dr. James L. Hargrove, an associate professor of foods and nutrition at the University of Georgia and principal investigator.

But, he told Reuters Health, "there are reasons to be excited about work that will be done over the next few years."

In the meantime, it will not harm anyone to add more herbs and spices to their meals, Hargrove noted -- especially if they take the place of salt.

The anti-AGE benefits of herbs and spices seem to come from plant antioxidants called phenols, which were present in high concentrations in many of the products Hargrove and his colleagues studied -- all of which were dried varieties that the researchers bought at a local supermarket.

When they examined each seasoning's phenol content, cinnamon, cloves and ground Jamaican allspice came out on top; those spices also showed the greatest potential for blocking the formation of AGE compounds. The most potent herbs included sage, marjoram, tarragon and rosemary.

Herbs and spices, Hargrove said, are the most concentrated sources of antioxidants in the diet. He noted that cinnamon, for example, has 50 to 100 times more "antioxidant power" per unit weight than fresh berries do.

According to Hargrove, some of the most "intriguing" research into herbs and spices has shown that components of the plants not only serve as antioxidants by themselves, but also act on our body cells to regulate their antioxidant defenses.

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SOURCE: Journal of Medicinal Food, June 2008.

Olive Leaf Extract May Help Lower Blood Pressure

Last Updated: 2008-09-03 15:07:51 -0400 (Reuters Health)

By Amy Norton

NEW YORK (Reuters Health) - A supplement containing olive leaf extract may help lower blood pressure and cholesterol in people on the brink of developing high blood pressure, a new study suggests.

The leaves of the olive tree have been used for medicinal purposes since ancient times, and modern lab research suggests that olive leaf extracts have antibacterial, anti-inflammatory and antioxidant actions. There is also evidence that the extracts have properties that could lower blood pressure.

The current study, published in the journal Phytotherapy Research, included 20 sets of identical twins with "borderline" hypertension -- blood pressure that is above the optimal level of 120/80, but below the cutoff of 140/90 used to diagnose high blood pressure.

One member of each twin pair was given tablets containing olive leaf extract, while the other received no supplements but did get lifestyle advice on lowering blood pressure -- the standard approach to managing borderline hypertension.

Half of the supplement users took 500 mg of olive leaf extract per day, and the other half took 1,000 mg.

After eight weeks, the study found, supplement users on the higher dose showed a substantial dip in their blood pressure overall -- from an average of 137/80 to 126/76. They also saw their average level of "bad" LDL cholesterol fall.

In contrast, the twins who received no supplements showed no significant change in their blood pressure and a smaller improvement in cholesterol, according to the researchers, led by Tania Perrinjaquet-Moccetti, a molecular biologist with Frutarom Switzerland Ltd. in Wadenswil.

The company makes the olive leaf extract used in the study, a product called Benolea.

The benefits seen in this study can be attributed to the various "bioactive components" of the olive leaf, Perrinjaquet-Moccetti told Reuters Health. The most significant of these, she noted, is a compound called oleuropein.

Research shows that oleuropein acts as an antioxidant and can help relax and dilate the blood vessels.

However, Perrinjaquet-Moccetti added, no single ingredient of the olive leaf extract accounts for its blood pressure benefits.

Olive leaf extracts are available over the counter, but people with high blood pressure, or any medical condition, are generally advised to consult their doctor before self-prescribing a supplement.

Perrinjaquet-Moccetti said it "would be wise" for patients to mention any supplement use to their doctor, especially if they are taking any medications. Herbal supplements have the potential to interact with drugs, which could interfere with the medication's effectiveness or create side effects.

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SOURCE: Phytotherapy Research, September 2008.

Healthy Habits Key to Longer Life for Men

Last Updated: 2008-02-11 16:00:26 -0400 (Reuters Health)

By Anne Harding

NEW YORK (Reuters Health) - Elderly men can improve their chances of having an even longer and healthier life by quitting smoking, controlling their weight, getting their blood pressure and blood glucose under control and exercising regularly, a study shows.

But making such changes is, of course, easier said than done, Dr. Laurel B. Yates of Brigham and Women's Hospital, the study's lead author, admitted in an interview with Reuters Health. "Lifestyle factors are the hardest things to do -- it's much easier to take a pill," she said. Nevertheless, she added, the rewards will include not only longer life but healthier, well-functioning years at the end of that life.

While a healthy lifestyle is understood to lead to a healthier life, the issue of whether pursuing healthy habits matters as much among older people has been controversial, Yates noted. To investigate, she and her team followed a group of 2,357 men participating in the Physicians' Health Study to determine which factors were associated with living to age 90. The men, whose average age was 72 at the study's outset, were followed for 25 years.

Forty-one percent of the men lived to be 90 or older. Smokers were half as likely as non-smokers to reach their 90th birthdays, while being diabetic, obese, or having high blood pressure also boosted mortality. Men who exercised regularly were 28 percent less likely to die during the study.

At age 70, men who didn't smoke, weren't obese, had normal blood pressure, were free from diabetes and exercised regularly had a 54 percent chance of living for at least another 20 years. But among 70-year-olds who smoked, were obese, had hypertension and diabetes, and were sedentary, just 4 percent reached age 90.

The longer-lived men also had better physical function and mental well-being as they aged, and developed heart disease or cancer years later than their shorter-lived peers.

"It does seem that, yes, there is something a person can do to increase the probability that he will have increased life span and good years at the end of that time," Yates said. It's likely, she added, that the same would hold true for women.

"This study suggests that adherence to sound medical management and lifestyle management pays enormous dividends in life extension and probably substantial reductions of aggregate medical care costs," Dr. William J. Hall of the University of Rochester School of Medicine & Dentistry in Rochester, New York, writes in an editorial published with the study.

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SOURCE: Archives of Internal Medicine, February 11, 2008.

Baby Boomers' Bodies Hit by Years of Wear and Tear

Last Updated: 2008-05-30 14:23:50 -0400 (Reuters Health)

By Megan Rauscher

NEW YORK (Reuters Health) - Doctors who specialize in disorders of the skeletal system and associated muscles, joints and ligaments are being kept busy these days, as increasing numbers of baby boomer athletes and exercise enthusiasts hit middle age and beyond.

"We are seeing a number of overuse or 'wear and tear' injuries in the foot, ankle, knees, hip, shoulders and elbows, in baby boomers," Dr. Jeffrey A. Ross, a foot and ankle podiatrist from Baylor College of Medicine, Houston, told Reuters Health. "Baby boomers suffer injuries over a period of time and a lot has to do with biomechanics, poor flexibility, wear and tear, and pounding on hard surfaces" that come with sports like running, tennis, step aerobics and basketball, Ross added.

As people age, Ross believes it's worth considering alternative activities that put less stress on joints. "It is really important that people continue to be physically active, but they need to think logically about how to remain active as they age," he said.

Ross spoke about overuse injuries in baby boomers at the annual meeting of the American College of Sports Medicine underway in Indianapolis. "We need to be rational and logical without hurting ourselves and developing overuse injuries that can really become debilitating as we get older," Ross told Reuters Health.

For example, he suggests aging marathoners cut back on distance and think about cross-training instead. "Probably when you start getting into your 40s and 50s, the half marathon is a great alternative. Or, if you did two or three marathons a year, cut it back to one a year or opt for 10K or 5K runs," Ross said.

A marathon runner himself, Ross fully admits that some marathoners will have a tough time cutting back on their runs. "Having run 25 marathons, it was hard for me to cut back. Psychologically, a lot of runners don't want to hear that and they continue even against the advice of their doctors," Ross said.

Ross is also concerned about the alarming rise in sports-related injuries suffered by children and adolescents who overdo it on the playing field. "Today, injuries occur in kids who do sports like soccer, baseball, and ballet year-round, without taking a break. What happens to them 20 to 30 years later, after suffering an injury as a teenager? It's a concern," Ross said.

For more articles on Health, Wellness & Nutrition, please visit www.abdproducts.com.

Baby Boomers' Bodies Hit by Years of Wear and Tear

Last Updated: 2008-05-30 14:23:50 -0400 (Reuters Health)

By Megan Rauscher

NEW YORK (Reuters Health) - Doctors who specialize in disorders of the skeletal system and associated muscles, joints and ligaments are being kept busy these days, as increasing numbers of baby boomer athletes and exercise enthusiasts hit middle age and beyond.

"We are seeing a number of overuse or 'wear and tear' injuries in the foot, ankle, knees, hip, shoulders and elbows, in baby boomers," Dr. Jeffrey A. Ross, a foot and ankle podiatrist from Baylor College of Medicine, Houston, told Reuters Health. "Baby boomers suffer injuries over a period of time and a lot has to do with biomechanics, poor flexibility, wear and tear, and pounding on hard surfaces" that come with sports like running, tennis, step aerobics and basketball, Ross added.

As people age, Ross believes it's worth considering alternative activities that put less stress on joints. "It is really important that people continue to be physically active, but they need to think logically about how to remain active as they age," he said.

Ross spoke about overuse injuries in baby boomers at the annual meeting of the American College of Sports Medicine underway in Indianapolis. "We need to be rational and logical without hurting ourselves and developing overuse injuries that can really become debilitating as we get older," Ross told Reuters Health.

For example, he suggests aging marathoners cut back on distance and think about cross-training instead. "Probably when you start getting into your 40s and 50s, the half marathon is a great alternative. Or, if you did two or three marathons a year, cut it back to one a year or opt for 10K or 5K runs," Ross said.

A marathon runner himself, Ross fully admits that some marathoners will have a tough time cutting back on their runs. "Having run 25 marathons, it was hard for me to cut back. Psychologically, a lot of runners don't want to hear that and they continue even against the advice of their doctors," Ross said.

Ross is also concerned about the alarming rise in sports-related injuries suffered by children and adolescents who overdo it on the playing field. "Today, injuries occur in kids who do sports like soccer, baseball, and ballet year-round, without taking a break. What happens to them 20 to 30 years later, after suffering an injury as a teenager? It's a concern," Ross said.

For more information on Health, Wellness & Nutrition, please visit www.abdproducts.com.

Health Care Guidelines Issued For School Athletes

Last Updated: 2008-06-24 9:44:30 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Schools and other organizations that sponsor teen athletic programs should do more to ensure school-aged athletes stay healthy and injury-free, according to new guidelines.

The recommendations, issued by the National Athletic Trainers' Association (NATA) and 16 other professional organizations, call for high schools and groups that sponsor teen sports to set up "athletic health care teams."

The teams -- including a physician and an athletic trainer who is on-site during practice and competition -- should not only treat injuries but also have comprehensive plans for preventing them, according to the guidelines.

More than 7 million U.S. high school students participate in school sports -- with numerous benefits, NATA points out. Still, roughly 715,000 students suffer sports- or recreation-related injuries in schools each year, and many could be prevented.

"Appropriate medical care of athletes involves more than just basic emergency care during sporting events," Jon Almquist, chair of the task force that created the guidelines, said in a statement.

"To reduce injuries, organizations sponsoring athletic programs need to establish an athletic health care team that functions to ensure appropriate medical care is provided for all participants; this can go a long way in preventing minor injuries from becoming more significant time-loss injuries."

The task force recommendations, which are published in NATA's Journal of Athletic Training, state that yearly pre-season medical screening of all high school athletes is "essential" to spot teens who are at risk for injuries or more serious problems such as a heart defect.

Such pre-participation screening is required in schools, but it should be encouraged in community sports programs as well, according to the guidelines.

The recommendations also call on organizations to ensure that their facilities and equipment are safe and well-maintained; that there is always a qualified professional on site to take care of athletes' injuries or illnesses, and to oversee their recovery after an injury; and that they give athletes sound advice on nutrition and health.

Athletic health care teams should also try to spot potential "psychosocial" problems, such as eating disorder symptoms, and refer those teenagers for a proper diagnosis and treatment.

According to task force member Dr. Keith J. Loud, of Children's Hospital Medical Center in Akron, Ohio, the recommendations underscore the importance of preventing and treating problems that could eventually "sideline an athlete in a variety of ways throughout life."

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SOURCE: Journal of Athletic Training, July 2008.

Grape Seed Extract May Fight Alzheimer's

Last Updated: 2008-07-01 14:00:57 -0400 (Reuters Health)

By Anne Harding

NEW YORK (Reuters Health) - A red grape seed extract that packs the punch of red wine -- without the alcohol -- could help protect against memory loss due to Alzheimer's disease, research in mice suggests.

Rodents prone to developing Alzheimer's-like brain changes showed better cognitive function at 11 months of age -- when they would have been expected to already have some memory impairment -- if they were given the grape seed polyphenolic extract in their drinking water, Dr. Giulio Maria Pasinetti of the Mount Sinai School of Medicine and colleagues found.

Polyphenolic compounds are antioxidants naturally found in wine, tea, chocolate, and some fruits and vegetables. The mice in the study received levels of polyphenols equivalent to what a person would consume with a daily glass or two of red wine.

While the health benefits of moderate red wine consumption are fairly clear, Pasinetti noted in an interview, "moderate consumption of alcohol in the form of red wine might have potential complications for people with maybe metabolic disorders or cardiovascular disorders."

To sidestep the alcohol issue, Pasinetti and his team investigated whether an extract of red grape seeds sold as MegaNatural AZ by Polyphenolics, a Madera, California-based grape products supplier, might prevent the progress of the disease in mice. Polyphenolics helped fund the research.

Mice received an amount equivalent to 1 gram of polyphenolics daily for humans, or plain water. After five months of treatment, the grape seed extract-fed mice had 30 percent to 50 percent less clumping of amyloid-beta protein in their brains.

Amyloid-beta protein clumping is a key step in the formation of the plaques and tangles within the brain seen in Alzheimer's patients, Pasinetti told Reuters Health, so preventing it could conceivably help slow brain degeneration.

Animals treated with the extract also performed significantly better on a standard test of spatial learning memory than rodents who didn't receive it. But the extract did not improve maze performance in control mice, suggesting that it improved cognitive function in the Alzheimer's prone rodents by reducing brain damage due to plaque formation.

Pasinetti and his colleagues are now planning clinical trials to determine if MegaNatural AZ could prevent or even treat Alzheimer's in humans.

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SOURCE: The Journal of Neuroscience, June 18, 2008.

Obesity May Raise Headache Risk

Last Updated: 2008-12-09 13:54:58 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Being overweight or obese may increase the likelihood of having severe headaches and migraines, new study findings suggest. An increased prevalence of headache may be associated with being underweight as well.

In analyses of 7,601 adult men and women, Dr. Earl S. Ford and colleagues at the U.S. Centers for Disease Control and Prevention in Atlanta, report that being overweight or obese increased the likelihood of headache by 1.2- to nearly 1.4-times.

Ford's group investigated association between body mass index (BMI), the ratio between height and weight often used to determine the weight range an individual falls into, and headache among men and women, 20 years of age or older, who participated in the 1999 to 2002 National Health and Nutrition Examination Survey.

Overall, about 15 percent of the men and 28 percent of the women reported they had severe headaches or migraines during the previous 3 months, the researchers report in the medical journal Cephalalgia.

Nearly 35 percent of the study group were overweight (BMI between 25 and 30), another 30 percent were obese (BMI over 30), and 33 percent were in the normal weight range (BMI between 18.5 and 25).

In the underweight participants, just about 2 percent of the study population, Ford's group noted a two-fold higher prevalence of headache, but the limited number of underweight participants precluded further analysis.

After accounting for other factors potentially associated with increased headache risk such as gender, ethnicity, smoking, alcohol use, physical activity, diabetes and cholesterol levels, the overweight and obese subjects still had a greater headache frequency than did normal-weight participants.

"If obesity increases the risk for headaches, weight management might be a useful approach in headache management," Ford and colleagues suggest.

They also recommend further analyses to establish "whether obesity is causally related to the development of headaches."

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SOURCE: Cephalalgia, December 2008

Infant Feeding Patterns May Contribute to Celiac Disease Risk

Last Updated: 2008-10-01 17:28:46 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Differences in celiac disease risk between Swedish birth cohorts suggest that infant feeding patterns contribute to the disease, according to a new report by investigators in Sweden.

"The current study indicates both short- and long-term consequences of infant feeding on celiac disease risk, i.e., abrupt introduction of gluten without ongoing breastfeeding might contribute to increased celiac disease risk even later in childhood," Cecilia Olsson from Umea University told Reuters Health.

Olsson and colleagues analyzed celiac disease risk in birth cohorts before and after an epidemic of celiac disease in children under 2 years of age to explore the opportunity for primary prevention.

The start of the epidemic in 1984 coincided with implementation of national feeding recommendations for infants which postponed the introduction of gluten-containing foods from 4 to 6 months of age, the investigators explain in the September issue of Pediatrics.

The incidence of celiac disease more than tripled after adoption of the new feeding recommendations, the authors report. When the recommendations were changed again (suggesting introduction of gluten-containing foods in increasing amounts at 4 to 6 months of age, preferably while the infant was still breast-feeding), the incidence declined significantly but then increased again from 2000 to 2003, the last year of the study.

"Only longer follow-up monitoring will reveal whether the increase in incidence rates in children <2 years seen between 2000 and 2003 is an ongoing trend," the researchers note. "Only one half of the epidemic was explained by changes in infant feeding. Consequently, other, still unknown, environmental exposures contributed to the change in disease occurrence."

"Further studies are needed to explore the role of potentially contributing exposures operating during different parts of the life span," Olsson said. "The possible role of the increasing consumption of wheat-based food and processing of cereals and other foods should be given priority. If general dietary patterns can be identified as contributors to increased celiac disease risk, implementation of dietary guidelines and/or modification of food processing might have considerable public health effects."

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Pediatrics 2008;122:528-534.

Take 2 Steps to Get Cleaner, Leaner & Healthier

Before you lose the weight, lose the waste. Shedding unhealthy fat is a big step toward better health. However, you might consider getting “clean” first with a short metabolic detoxification regimen. It could make a difference in how you feel, and help you meet your body composition and health goals even faster.

A greater percentage of lean muscle benefits general health and well-being—and reduces your risk to diabetes and heart disease. But that unwanted fat stores environmental pollutants your body can't keep up with through normal elimination. Some research suggests that fat loss may increase circulating and stored pollutants, which could slow your metabolism by decreasing energy production and influencing multiple body functions. This may explain why some people reach a “plateau” and fail to make further progress in meeting their lean body goals. And why others develop symptoms associated with excess pollutants when they lose fat, dragging them down and making them feel worse...not better.

Clear the path for a cleaner, leaner you. Environmental overload has been suggested as an important consideration before starting any body composition program. A brief “detox” (often 10 days or less) provides scientifically tested nutrients to support your body's metabolic detoxification process—to help it catch up with any overload and keep you feeling good. It may also help remove obstacles that stand in your way of getting leaner and healthier.
Can a short metabolic detoxification regimen and body composition program help you? Please contact my office to set up an appointment. We'll help you get cleaner, leaner, and healthier!
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