Archives for: May 2003
STUDY: Breast Best
ABSTRACT: The longer white infants from low-income families are breast-fed, the less likely they will be overweight as young children.
COMMENTARY: The study of more than 177,000 children from low-income families who visited U.S. public health clinics between 1988 and 1992 found that formula-fed infants and babies breast-fed for less than a month were more likely to develop weight problems by age 4 than infants breast-fed for longer periods.
However, the correlation between breast-feeding duration and healthier weight was limited to whites in the study, and did not apply to Hispanics or blacks, who made up nearly one-third of the participants.
U.S. obesity rates among children and adults have been climbing, with Hispanics and blacks the most likely to be overweight.
The report, which was published in the journal Pediatrics, speculated that different dietary habits among low-income Hispanics and blacks overwhelmed breast-feeding's benefits.
Among the possible reasons behind the correlation are that breast-fed children seem to be better able to self-regulate their eating at mealtimes compared to formula-fed children, the report said. Breast-fed babies likely exert more control over when to stop suckling, while babies fed formula might be urged to finish off a bottle or were left wanting more.
Breast-fed children also have been found to make an easier dietary transition to vegetables than formula-fed children, wrote study author Laurence Grummer-Strawn of the U.S. Centers for Disease Control and Prevention in Atlanta.
And compared to breast milk, formula provokes a greater insulin response that may lead to early deposits of body fat.
Breast-feeding is known to provide valuable nutrients and to strengthen the bond between mother and child. The American Academy of Pediatrics, which publishes Pediatrics, recommends mothers breast-feed for at least a year, and the World Health Organization recommends two years.
In 2001, only 69.5 percent of new American mothers said they had ever breast-fed their newborns and just 32 percent were still breast-feeding at six months. Low-income mothers were the least likely to breast-feed.
In the study, less than one-third of the children were ever breast-fed, and only 6 percent were breast-fed for more than six months.
Among whites, 14.5 percent of infants who had never breast-fed became overweight, compared to 7 percent of those breast-fed at least a year. The proportion of overweight Hispanic children in the study ranged from 22 percent to 29 percent, and among blacks between 13 percent and 19 percent, with duration of breast-feeding having little impact.
JOURNAL: Gastroenterology 0204
ABSTRACT: So-called "good bacteria" in the intestines, which may help people with inflammatory bowel disease, allergies and some forms of cancer, work even when they're inactive.
COMMENTARY: Called probiotics, they are bacterial organisms that contribute to the health and balance of the intestinal tract. Recent studies have proven the health benefit of these bacteria.
The effectiveness of probiotics has been attributed to their live, metabolic activity. But active probiotics are used in only a small number of food products, such as yogurt. Active probiotics are unsuitable for most food products because they induce fermentation, which changes the taste, texture and freshness of food on an hourly basis.
This new study, by researchers at the University of California, San Diego School of Medicine and the Shaare Zedak Medical Center in Jerusalem, found probiotics contain immune system-stimulating DNA that makes them just as effective when they're inactive.
The finding offers the potential to use inactivated probiotics in a variety of food products.
The study also outlines a method to determine and select which probiotic bacteria provide the most benefit for people with inflammatory bowel disease.
JOURNAL: Fertil Steril. 2004;81:93-98
AUTHORS: Giancarlo Balercia
ABSTRACT: Exogenous administration of coenzyme Q10 (CoQ10) may play a positive role in the treatment of infertile men with idiopathic asthenozoospermia, according to results of an open, uncontrolled pilot study.
COMMENTARY: "The positive effect of exogenous administration could be explained on the basis of the well-known involvement of CoQ10 in mitochondrial bioenergetics and of its widely recognized antioxidant properties," write Giancarlo Balercia, MD, and colleagues, from the University of Ancona in Italy.
Investigators selected 22 patients (mean age, 31 years; range, 25-39 years) with idiopathic asthenozoospermia. Subjects had a clinical history of primary intertility of at least three years. In addition to medical screening, researchers measured subjects' testicular volume using Prader's orchidometer.
Eligiblity criteria included (1) sperm count greater than 20 x 106/mL, sperm motility (forward motility, class a and b, according to World Health Organization [WHO] 1999 criteria) less than 50% at two distinct sperm analyses, and normal sperm morphology greater than 50%; (2) seminal white blood cells (WBCs) less than 1 x 106/mL, negative sperm culture, and Chlamydia and Mycoplasma ureoliticum detection; (3) normal serum levels of gonadotropins, T, E2, and PRL; (4) absence of infectious genital diseases, anatomical abnormalities of the genital tract including varicocele, and antispermatozoa antibodies (Ab); (5) absence of systemic diseases or treatment with other drugs during the three months before enrollment in the present study; and (6) absence of smoking, alcohol, drug addiction, or occupational chemical exposure.
Researchers employed hysterosalpingography to rule out abnormal fallopian tube anatomy in female partners. Ovulation was also deemed normal.
Patients underwent oral administration of CoQ10, 200 mg/day twice daily for six months. Researchers performed clinical examination, semen analysis including computer-assisted sperm analysis (CASA), and CoQ10 and phosphatidylcholine assays at baseline, after six months of therapy, and six months after termination (washout).
After treatment, CoQ10 levels increased in seminal plasma; the mean value rising significantly from 42.0 ± 5.1 ng/mL at baseline to 127.1 ± 1.9 ng/mL after six months of CoQ10 administration (P < .005). Researchers also detected a significant increase of CoQ10 content in sperm cells (from 3.1 ± 0.4 to 6.5 ± 0.3 ng/106 cells; P < .05).
Phosphatidylcholine levels increased significantly both in seminal plasma and sperm cells after treatment (from 1.49 ± 0.50 to 5.84 ± 1.15 µm; P < .05; and from 6.83 ± 0.98 to 9.67 ± 1.23 nmol/106 cells; P < .05, respectively)
Forward (class a+b) motility of sperm cells went from 9.13% ± 2.50% to 16.34% ± 3.43% after six months (P < .05). Investigators also found a significant increase of curvilinear velocity (VCL) (from 26.31 ± 1.50 to 46.43 ± 2.28 µm/second; P < .05) and straight progressive velocity (VSL) (from 15.20 ± 1.30 to 20.40 ± -2.17 µm/second; P < .05) after treatment.
Using the Cramer's index of association, the investigators found a positive dependence among the relative variations, baseline and after treatment, of seminal plasma or intracellular CoQ10 content and of VCL and VSL kinetic parameters (Cramer's V = 0.4637, 0.3818, 0.3467, and 0.5148, respectively). After six months of washout, the investigators found a significant reduction in sperm forward motility (from 16.34% µ 3.43% to 9.50% µ 2.28%; P < .001).
CoQ10 oral administration was well tolerated. Three couples (13.6%) achieved spontaneous pregnancy within three months of discontinuation of therapy.
"The data of the present study show a significant improvement of sperm cell kinetic features after 6 months of administration of CoQ10, on the basis of both manual and computer- assisted evaluation," write Dr. Balercia and colleagues.
"Furthermore, our results are the first to demonstrate that exogenous administration of CoQ10 leads to increased levels in seminal plasma and in sperm cells."
STUDY: Survey of bodymeasurements reveals skyrocketing obesity rates in kids and adults
JOURNAL: Journal of the American Medical Association
AUTHORS: Cynthia Ogden
ABSTRACT: Americans are even fatter than they think they are, with nearly a third of all adults — almost 59 million people — rated obese in a disturbing new government survey based on actual body measurements.
COMMENTARY: One in five Americans, or 19.8 percent, had considered themselves obese in a 2000 survey based on people’s own assessments of their girth.
The new 1999-2000 survey puts the real number at 31 percent — a doubling over the past two decades. The new number is considered more reliable since people consistently underestimate their weight. The number of those considered overweight but not yet obese increased during the past 20 years from 56 percent to 65 percent. An accompanying survey found the number of overweight children has tripled over the same period.
“The problem keeps getting worse,” said Health and Human Services Secretary Tommy Thompson. “This has profound health implications.”
Cynthia Ogden, one of the authors of the studies from the National Center for Health Statistics, said increases in portion sizes, eating out more frequently and an inactive population were all to blame for the problem.
The measurement-based survey of young people found that 15 percent of youngsters ages 6 to 19 were seriously overweight. That is nearly 9 million youths and triple the number in a similar assessment from 1980. Even toddlers were affected, with more than 10 percent of children ages 2 through 5 seriously overweight, compared with 7.2 percent in 1994.
The studies published The Journal of the American Medical Association found that the biggest weight gains have been seen in people over the age of 60, black and Mexican-American teens and black women.
Obesity increases the risk for a number of serious ailments, including diabetes, heart disease, strokes, high blood pressure and some types of cancer.
Obesity is defined as having a body-mass index of 30 or above. The index is a formula in which a person’s body weight is divided by height squared. A BMI between 25 and 30 is considered overweight.
STUDY: Coenzyme Q-10 prevents nerve cell death
JOURNAL: Archives of Neurology
AUTHORS: Dr. Clifford Shults
ABSTRACT: A small but promising study found that the over-the-counter dietary supplement coenzyme Q-10, or CoQ10, may slow the progression of Parkinson’s disease.
COMMENTARY: Existing treatments may ease symptoms of the degenerative brain disorder but are not believed to affect the underlying disease process. The new study found evidence that the naturally occurring compound CoQ10 may help stop the nerve cell death that characterizes Parkinson’s.
The study involved just 80 people. Half ate maple-nut flavored wafers containing various CoQ10 doses, half took a placebo for up to 16 months. By the study’s end, the 23 patients on the highest daily doses had 44 percent less decline in mental function, movement and ability to perform daily living tasks than the placebo group.
Research has suggested that energy-supplying structures inside cells called mitochondria may be impaired in Parkinson’s disease. CoQ10, a compound made in the body, is believed to help mitochondria function.
Patients studied had early-stage Parkinson’s and took a placebo or CoQ10 in doses of 300 milligrams, 600 mgs or 1,200 mgs daily. Their symptoms were evaluated for up to 16 months. By the eighth month, the 23 patients on the highest dose showed significantly less impairment than the others.
The results indicate that follow-up research at perhaps even higher doses should proceed “pretty aggressively,” said Dr. Bernard Ravina of the National Institute of Neurological Disorders and Stroke, which funded the study.
STUDY: Tobacco harmful in any form
JOURNAL: J Epidemiol Community Health 2002;56:702-706.
AUTHORS: Dr. Eva Prescott
ABSTRACT: Even smokers who consume as little as 3 to 5 grams of tobacco per day and those who do not inhale are placing themselves at increased risk for myocardial infarction (MI) and death, according to a report published in the Journal of Epidemiology and Community Health.
COMMENTARY: The current findings dispel the myth held by many smokers that consumption of few cigarettes or smoking without inhalation is not hazardous to their health.
Women appear to be particularly vulnerable to the harmful effects of such smoking habits. The authors believe this is because women are more prone to respiratory disease than men and because smoking alters the natural balance of the cardioprotective hormone estrogen.
The current study involved 6505 women and 5644 men who were drawn from the general population of Copenhagen in 1976. At enrollment, the subjects were surveyed regarding their current and past smoking habits. The subjects were followed until 1998 to determine the occurrence of first MI as well as all cause mortality.
For study purposes, smoking one cigarette was equated to 1 gram of tobacco consumption, one cheroot to 3 grams, and one cigar to 5 grams of tobacco.
Women who consumed 3 to 5 grams of tobacco per day were more than twice as likely as women who never smoked to experience an MI, the authors note. In addition, such women were 86% more likely to die during the study period than were those who never smoked.
Among men, similar increased risks were noted when the use of 6 to 9 grams of tobacco per day was compared with non-use.
The risk of MI and all-cause mortality was also increased in female smokers who did not inhale. However, for men, only the all-cause mortality risk was significantly increased relative to non-smoking.
The type of tobacco product used significantly influenced the mortality risk. Specifically, cigarette smokers were more likely to die during the study period than were smokers of other tobacco products.
Although from a toxicology point of view it is not surprising that the dose-response relation between smoking and morbidity does not have a lower threshold limit, from a public health point of view it is important to recognize the increased risk associated with even a low consumption of tobacco.
Bottom line is try your best not to smoke!!!!!!!
STUDY: Early treatment to reduce pressure in the eye can slow the progression of glaucoma.
JOURNAL: Archives of Ophthalmology 2002;120:1268-1279
AUTHORS: Dr. Anders Heijl
ABSTRACT: Early treatment to reduce pressure in the eye can slow the progression of glaucoma, according to a new study.
COMMENTARY: The study is the first "definite proof" that lowering intraocular pressure early in glaucoma can slow the deterioration caused by the disease.
But he cautioned that the encouraging results of the study "do not mean that all glaucoma patients should receive maximum treatment." He noted that since glaucoma did not progress for several years in some patients who did not receive treatment, it is "reasonable" to delay treatment in some low-risk patients "and instead follow them closely as long they show no worsening of their disease."
Glaucoma was less likely to progress in patients who underwent treatment, and when the disease did advance, it did so later than in untreated patients. During the study, glaucoma progressed in 45% of treated patients compared with 62% of untreated patients. On average, progression occurred 18 months later in the treatment group than in the control group.
Even though the study demonstrated the benefits of early treatment, Heijl noted that "disease progression rates vary very much between individual patients. Treatment and follow-up must therefore be tailored to the needs of the individual patient." He said that newly diagnosed patients should probably be followed for signs of progression more closely than is common today.
Talk over your treatment options with you doctor.
STUDY: Weight Loss Improves Outcome
JOURNAL: American Journal of Clinical Nutrition (2002;75(Suppl):339S).
ABSTRACT: Overweight people infected with the hepatitis C virus (HCV) may be able to limit or even reverse virus-caused liver damage by losing weight, according to recent study in the American Journal of Clinical Nutrition.
COMMENTARY: The Centers for Disease Control and Prevention estimate almost four million Americans have been infected with HCV, and that 75 to 85% of these people will develop a chronic infection due to the virus.
Hepatitis C is most often contracted through blood transfusions, intravenous drug use (sharing needles), or through other blood exposure. While most people with chronic HCV have no symptoms, infection with this virus can cause long-term liver damage and rarely is associated with liver cancer.
Men and those who consume more than 10 grams (one-third of an ounce) of alcohol per day appear to be at higher risk of developing more severe liver disease.
The success rate for conventional antiviral treatment is less than 50%, with many people experiencing only temporary remission. Common medications prescribed for HCV include alpha-interferon (Roferon A®) and ribavirin (Rebetol®, Rebetron®), which may be given for six months to one year. These treatments are expensive and have many debilitating side effects.
Researchers put 19 overweight people with HCV on a 12-week diet and exercise program, with a goal of losing about 1 pound per week. At the conclusion of the study, average weight loss was approximately 13 pounds. In addition, several markers of liver health improved, including a decrease in liver enzymes (higher numbers suggest more liver damage) and a reduction in the amount of scar tissue and fat in the liver.
These changes indicate a decrease in the severity of the liver disease. Those who continued on the weight loss program for another 12 months had sustained improvement in the health of their liver.
A surprising finding is that these improvements occurred even though the virus was not eradicated from the body. This study therefore suggests that overweight individuals may be able to improve the health of their liver, even if they continue to suffer from chronic hepatitis C.
It is important to note that going on a diet is not a substitute for medical treatment for hepatitis C, but rather an additional approach to help improve liver function. Please consult a physician or nutritionist before starting any diet or exercise program.
STUDY: Photodynamic Therapy
JOURNAL: Journal of Urology 2002;168:1427-1432.
AUTHORS: Timothy R. Nathan
ABSTRACT: Researchers may have added prostate cancer to the list of cancers that can benefit from photodynamic therapy (PDT), which combines drugs and light to treat cancer and other conditions.
COMMENTARY: Timothy R. Nathan of the University College London Hospital in the UK and his colleagues report that most patients treated with PDT, whose prostate cancer had returned following radiation treatment, appear to benefit from the new therapy.
Specifically, the authors report, more than half of treated patients experienced a decrease in their blood levels of PSA, a protein produced by the prostate gland that is often elevated in the presence of prostate cancer. In addition, more than one third of PDT-treated men showed no trace of cancer from a post-treatment biopsy.
Photodynamic therapy is a new option that could be suitable for organ confined prostate cancer recurrence after radiotherapy. These results suggest that photodynamic therapy merits further investigation.
PDT is a two-step therapy that is already being used to treat head and neck cancers, especially esophageal cancers. The first step is to give the patient a light-activated drug such as Photofrin, which tends to collect in tumors. The drug makes the abnormal tissue particularly sensitive to light. The second step is to shine a laser light on the drug-saturated tumors for a brief period of time. There are several PDT drugs available, and each is activated by different wavelengths of light.
Recent reports have suggested that PDT may also help treat cancers of the pancreas, lung and breast.
During the current study, Nathan and his team administered PDT to 14 men. All patients had prostate cancer that had returned following treatment with radiation, as indicated by an increase in PSA and results from a biopsy.
After the procedure, the researchers noted that PSA levels decreased in 9 patients, reaching undetectable levels in 2 patients. Biopsies of 5 patients showed that they were tumor-free. Scans showed that PDT had destroyed up to 91% of the prostate tissue.
A few of the patients experienced side effects after the treatment, Nathan and his team note. Four of the men reported stress incontinence, meaning they leaked urine as a result of laughing, coughing, sneezing or exercise, which began to gradually improve over time. Seven of the participants were able to have intercourse before PDT, and 4 reported a decrease in their abilities after receiving light therapy. This side effect did not appear to diminish over time, the authors report in the October issue of the Journal of Urology.
Complications were no worse among the patients than among studies of patients given surgery or cryotherapy to treat prostate tumors that had returned after treatment. And, the researchers note, complications could be reduced by dosage adjustment.
STUDY: Probiotics reduce duration of diarrheas
JOURNAL: Pediatr Infect Dis J 2002;21:411-419
AUTHORS: Dr. Vibeke Rosenfeldt
ABSTRACT: Oral bacteriotherapy with Lactobacillus rhamnosus and L. reuteri reduces the duration of diarrhea in children with mild gastroenteritis and in those with more severe disease requiring hospitalization, Danish researchers report.
COMMENTARY: The investigators conducted placebo-controlled trials in a cohort of 69 children, ages 6 to 36 months, who were hospitalized for diarrhea, and in a second group of 43 children, ages 9 to 44 months, who were attending day-care centers.
More than half the subjects in both groups were infected with rotavirus. Other pathogens isolated were Campylobacter jejuni, Salmonella typhimurium and Clostridium difficile.
By day 5 after treatment began, three of the 30 probiotic-treated hospitalized children still had loose stools, versus 13 of the 39 children given placebo (p=0.03).
Results were similar in the outpatient cohort. Probiotic-treated children spent 1.6 days in the hospital, on average, versus 2.6 days for the patients given placebo (p=0.02).
The effect of treatment was most pronounced when treatment was initiated within the first 60 hours of illness. Time to recovery was 79 to 80 hours in the early intervention treatment groups and 130 to 139 hours in the early intervention placebo groups.
L. rhamnosus had been chosen because of its ability to extensively adhere to intestinal epithelium. L. reuteri was selected because of its antimicrobial activity.
Based on comparison of their results with those of previous studies, the researchers believe that dual therapy is unnecessary, and that the ability to colonize the mucosa is the more important of the two characteristics.