STUDY: Survey finds a majority continuing hormone therapy

JOURNAL: Express Scripts

AUTHORS:

ABSTRACT: More than half of women taking hormone replacement therapy stuck with it last year despite reports that show it can raise the risk of heart disease, cancer and stroke, a new survey found.

---

COMMENTARY: Studies released over the summer indicated significant health risks associated with HRT, 36 percent of women stopped their treatments, the survey by pharmacy benefit manager Express Scripts found.

But 57 percent continued using HRT, the St. Louis-based company found. And even though the studies found no extra risk for women taking estrogen alone, 22.6 percent of those surveyed stopped taking an estrogen product, Express Scripts said.

For its report, Express Scripts surveyed a sample of 372,777 women who used HRT or osteoporosis drugs. The company compared use patterns last year before and after the announcement, and during similar periods in 2001.

The Food and Drug Administration strengthened warning labels on all women’s hormone replacement therapy products to take account of last year’s findings.

An estimated 10 million women were taking HRT at the time last year’s reports were released.

The risk to an individual woman is small, but accumulates when many women take the drugs over time. The FDA says the overall risks to women outweigh the benefits of the drugs, but recommends that each woman consult with her doctor about what to do.

The studies used only Wyeth’s PremPro and related products, but the FDA said there was no reason to believe that other HRT products would not have similar effects.

HRT was, until last year, widely prescribed to treat not only the immediate symptoms of menopause such as hot flashes, but also to prevent heart disease and osteoporosis.

STUDY: Study supports belief that diet is to blame for adolescent acne.

JOURNAL: Cordain, L. et al. Acne vulgaris: a disease of western civilization. Archives of Dermatology, 138, 123 - 321, (2002).

AUTHORS: Cordain

ABSTRACT: US scientists are throwing a lifeline to acne-ridden adolescents. A controversial new study suggests that avoiding a sugary Western diet could help to treat the teenage scourge.

---

COMMENTARY: Anecdotal evidence has long linked chocolate and chips to pubescent spots, but scientists have never proved the connection. Then anthropologist Kim Hill at the University of New Mexico in Albuquerque stumbled on a remote community in Paraguay, who eat manioc (cassava), peanuts and meat. "I've travelled to remote tribes all over South America and I've never seen acne," Hill says. Teenagers in a second community of remote islanders, in Papua New Guinea, are also spotless, it turns out.

Genetics cannot explain the perfect skin of the two unrelated groups, maintains team leader Loren Cordain of Colorado State University. He blames today's refined foods, such as bread, rice and cakes, for the pimples suffered by 95% of westernized teenagers."The theory makes sense," comments acne expert Alan Shalita of State University of New York.

Yet it flies in the face of 1970s and 1980s studies that failed to find a link between diet and spots. Based on these, most dermatologists have "pooh-poohed" the idea, says Shalita.Skin researcher Richard Bojar of the University of Leeds, UK remains unconvinced. The non-westernised groups might also get more beneficial sun or exercise, he points out. "There's not much data and a lot of hypothesis," he says. "They need to go on and test it."

STUDY:

JOURNAL: Am J Cardiol 2002;90:1150-1153.

AUTHORS: Dr. Momiyama

ABSTRACT: New research from Japan suggests that green tea use may reduce the risk of myocardial infarction (MI). Although study subjects who drank one or more cups of green tea were no less likely to have coronary artery disease (CAD) than were those who did not drink green tea, they were much less likely to have an MI.

---

COMMENTARY: "We found...that MI was less prevalent in green tea drinkers, suggesting that regular green tea intake may be playing a protective role against the development of MI in Japanese," study coauthor Dr. Yukihiko Momiyama, of the National Defense Medical College in Saitama.

The study involved 393 patients who underwent angiography to rule out CAD. Many of the participants had risk factors for CAD, including hypertension, high cholesterol and diabetes.

Dr. Momiyama's team did not detect a link between the number of cups of green tea a person drank each day and the risk or severity of CAD. However, those who drank at least one cup of green tea per day were 42% less likely to have a MI than people who did not drink green tea.

For many years, researchers have been trying to determine why CAD is less common in Japan than in the West. Although there are probably many factors that explain the difference, some scientists suspect that use of green tea--a common beverage in Japan--may protect against CAD.

Green tea is known to contain high levels of flavonoids, compounds that have been shown to neutralize free radicals. By protecting against oxidative damage, flavonoids may decrease the risk of CAD and stroke, the researchers explain.

Several reports have found that people who consume high levels of flavonoids are less likely to die from CAD; and another study linked high flavonoid consumption to a reduced risk of MI.

STUDY:

JOURNAL:

AUTHORS: Dr. Karl Citek

ABSTRACT: Sunglasses in all price ranges appear to maintain their ability to protect wearers from harmful ultraviolet rays after a season of cleaning, new research shows.

---

COMMENTARY: Researchers based at Pacific University in Forest Grove, Oregon, found that subjecting six pairs of non-prescription sunglasses to nine months of cleaning--either using soap and face tissues or a lens cleaner and soft cloths--did not diminish the ability of the sunglasses to shield wearers from harmful UV rays.

However, the researchers did discover that not all of the glasses protect wearers to begin with: one less expensive pair let through more than the minimum allowable amount of UVB, the most harmful form of ultraviolet light.

The limits of UV absorption are set by the American National Standards Institute, a nonprofit organization that coordinates a system of voluntary standards in the US.

While these results suggest that UV protection can last through cleaning, consumers should still be careful to buy sunglasses that start out with enough UV protection, study author Researchers based at Pacific University in Forest Grove, Oregon, found that subjecting six pairs of non-prescription sunglasses to nine months of cleaning--either using soap and face tissues or a lens cleaner and soft cloths--did not diminish the ability of the sunglasses to shield wearers from harmful UV rays.

However, the researchers did discover that not all of the glasses protect wearers to begin with: one less expensive pair let through more than the minimum allowable amount of UVB, the most harmful form of ultraviolet light.

The limits of UV absorption are set by the American National Standards Institute, a nonprofit organization that coordinates a system of voluntary standards in the US.

While these results suggest that UV protection can last through cleaning, consumers should still be careful to buy sunglasses that start out with enough UV protection.

"To ensure that non-prescription sun eyewear has adequate UV protection, we recommend that consumers purchase recognizable brand name eyewear from reputable stores and optical shops, and not from roadside stands," Citek said.

UV rays have been shown to cause eye diseases such as cataracts, a gradual clouding of the lens of the eye, and have been implicated in the development of age-related eye damage known as macular degeneration.

STUDY:

JOURNAL: American Journal of Epidemiology 2002;156:824-831.

AUTHORS: Dr. Chisato Nagata

ABSTRACT: A new study from Japan provides additional evidence for the health benefits of a diet rich in fish oil and soy products.

---

COMMENTARY: According to the report, men and women who consumed the highest levels of soy were least likely to die of any cause during the study. Omega-3 fatty acids found in fish oil and fatty fish such as salmon and mackerel were also associated with a lower risk of death among women, but not men.

Fish and soy are staples of the diet in Japan, which has the highest reported life expectancy in the world, note researchers in a recent issue of the American Journal of Epidemiology.

Numerous studies have demonstrated that dietary soy, which contains plant estrogens known as phytoestrogens, may inhibit some forms of cancer and lower the risk of heart disease. Fish oil is associated with reduced levels of inflammation in the body, reduced clotting and improved blood cholesterol levels.

But the relationship between these compounds and longevity is not clear. To investigate, researchers from Gifu University in Japan reviewed food records of nearly 30,000 Japanese adults. About 2,000 died over the 7-year course of the study.

An analysis of diet records revealed that adults who were in the top 25% based on their consumption of soy foods were less likely to die during the study than their peers who consumed the least soy. Omega-3 fatty acids were associated with a lower risk of dying from all causes among women but not among men.

More research is needed on the relationship between these compounds and specific diseases such as cancer, stroke and heart disease.