Category: Prior Clinic Blog
JOURNAL: Ann Intern Med 2003;138.
AUTHORS: Dr. Bent
ABSTRACT: Compared with other herbal products, ephedra is far more likely to cause adverse effects.
COMMENTARY: Based on an analysis of reports to the American Association of Poison Control Centers, Dr. Stephen Bent and his colleagues discovered that products with ephedra accounted for 64% of the herb-related adverse reactions in 2001.
This finding is remarkable, the authors note, given that less than 1% of herbal products sold that year contained ephedra.
Although awareness of the potential dangers of ephedra is growing among consumers, many still purchase ephedra-containing products.
Using data from case reports alone, it has been difficult to definitively link ephedra with various adverse effects, Dr. Bent said. But the finding that ephedra is linked to far more side effects than other herbs adds support to the theory that the substance can be dangerous, he said.
How ephedra stacked up against other products varied from herb to herb, Dr. Bent and his colleagues note -- but in all cases, it outnumbered other products in adverse reactions.
Overall, there were 1178 adverse reactions reported for ephedra, compared with 28 for ginkgo biloba, 31 for St. John's wort and 69 for Echinacea, among others.
My Comment is that Ephedra has always been the whipping boy of the herbal industry. Used properly I have never had a problem with it. It is the abuse of it that causes the issue.
Like everything else I don't see alcohol or tobacco being banned and these two items cause far greater adverse outcomes.
STUDY: . A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen.
JOURNAL: Phytomedicine 2000; 7(2): 85-89.
AUTHORS: Spasov AA, Wikman GK, Mandrikov VB, et al.
ABSTRACT: A placebo-controlled, Russian clinical study showed that an extract of Rhodiola rosea enhanced physical fitness, improved neuro-motor test responses, reduced mental fatigue, and improved general well being in a group of healthy foreign medical students undergoing a stressful exam period.
COMMENTARY: The 40 study participants, all Indian men between the ages of 17 and 19, were randomly assigned to take either placebo or Rhodiola extract at a dose of 50 mg twice daily.
The most significant differences between groups were seen in physical fitness, mental fatigue, neuro-motor tests, and well being; no significant differences were observed in results of correction tests or tapping speed tests.
No adverse events were reported. As the dose of Rhodiola employed in this study was lower than that used in previous studies, the researchers concluded, "...the study drug gave significant results compared to the placebo group but that the dose level probably was suboptimal."
According to the authors, the majority of earlier studies on the anti-fatigue and performance-enhancing effects of Rhodiola utilized single doses more than three times higher than the dose used in their study.
When used in psychiatric practice for the treatment of asthenic syndromes (weakness and debility), doses 15 times as high are used for periods of one to two months.
STUDY: Women who most often ate a Western diet were 46% more likely to develop colon cancer
JOURNAL: Arch Intern Med 2003;163:309-314.
ABSTRACT: Women who routinely consume a diet high in red meats, fats, and refined grains are at increased risk for colon cancer.
COMMENTARY: Although the notion that consumption of a "Western diet" may promote colon cancer is not novel, several reports have failed to establish an association, the authors point out.
For example, in a study of more than 60,000 women reported last year, consumption of a Western diet was not tied to an increased risk of colorectal cancer.
In the current study, women who most often ate a Western diet were 46% more likely to develop colon cancer than their peers who rarely consumed such a diet. In contrast, consumption of a Western diet was not tied to an increased risk of rectal cancer.
The findings are based on a study of 76,402 women who participated in the Nurses' Health Study and were questioned about their dietary habits in 1984, 1986, 1990, and 1994. The women ranged in age from 38 to 63 years and none had a history of cancer in 1984.
The women were classified according to how well their diet matched a Western diet pattern as well as a "prudent" pattern, defined as a diet high in fruits, vegetables, fish, poultry, and whole grains.
During the 12-year follow-up period, 445 cases of colon cancer and 101 cases of rectal cancer were observed, the authors note.
Compared with low adherence to a prudent diet, strict adherence to this dietary pattern was associated with a 29% reduction in the risk of colon cancer. Still, this association failed to reach statistical significance.
"We found that a diet high in red and processed meats, refined grains, and other characteristics of the Western pattern was associated with a higher risk of colon cancer in women," the researchers state. "Our study provides further evidence that switching from a typical Western diet to a more prudent diet may reduce that risk of colon cancer," they add.
STUDY: Take your Probiotics
JOURNAL: Am J Clin Nutr. 2003;77:517-520
AUTHORS: Ulrich Gluck
ABSTRACT: A probiotic drink reduces nasal carriage of potentially pathogenic bacteria (PP better than yogurt does.
COMMENTARY: "As a bacterial reservoir, the nose may harbor PPB: Staphylococcus aureus, Streptococcus pneumoniae, beta-hemolytic streptococci, and Haemophilus influenzae," write Ulrich Gluck, from the Swiss National Accident Insurance Institute in Lucerne, Switzerland, and colleagues.
"In patients carrying PPB, antiseptic regimens could be crucial for infection control after major operations on or injuries of the head, nasal sinuses, or lungs. Such regimens may also be important for diabetic patients and persons receiving hemodialysis, in intensive care units, or with impaired immunity due to various other causes."
For three weeks, 209 volunteers consumed either 65 mL of a probiotic, fermented milk drink or 180 g of standard yogurt once daily. The probiotic contained Lactobacillus GG (ATCC 53103), Bifidobacterium sp B420, Lactobacillus acidophilus 145, and Streptococcus thermophilus. Microbial examination on days 1, 21, and 28 was blinded to the source of the samples.
In the group that consumed the probiotic drink, nasal PPB decreased by 19% from baseline (P < .001), primarily because of a decrease in gram-positive bacteria (P < .05). The group that consumed yogurt had no significant reduction in nasal PPB.
"An orally administered fermented milk product containing the probiotic bacterium Lactobacillus GG significantly reduces the occurrence of nasal colonization with PPB," the authors write.
"The mechanisms underlying this result may have involved stimulation of the B lymphocytes of the gut-associated lymphoid tissue, which may have migrated to the upper respiratory immune system."
The investigators suggest that the migrating GALT B lymphocytes (which produce serum immunoglobulin A subclass 2 rather than subclass 1) usually produced in nasal and bronchial lymphoid tissue, may help eliminate the PPB, which often produce SIgA1-specific proteases. They plan to test this hypothesis by measuring the concentrations of both SIgA1 and SIgA2 in nasal lavage samples before and after probiotic ingestion.
STUDY: Latest research suggests DNA even more to blame for weight
JOURNAL: Howard Hughes Medical Institute at The Rockefeller University in New York City
AUTHORS: Dr. Jeffrey Friedman
ABSTRACT: Despite all the public service announcements telling people how unhealthy it is to be fat, Americans just keep larding on the pounds. Studies have shown that as many as 60 percent of the U.S. population is overweight, while almost 30 percent is classified as obese. Some say the fast-food industry is to blame while others fault super-sized meal portions. But is it just a problem of unhealthy lifestyles or is there something else going on deep down in our cells?
COMMENTARY: Why the sudden change in weight-loss philosophy? It’s simple. Scientists have learned that while willpower is important, much of what, when and how much we eat is dependent on our genes. In addition, the urge to exercise may also be related to the DNA we inherit.
When it comes to losing weight, we’re fighting against a body regulatory system that has evolved over hundreds of thousands of years to keep us functioning no matter how sparse food becomes. And, scientists have been learning, this genetic influence is stronger in some people than others.
As a prime example of the role of genetics, researchers point to two groups of Pima Indians, one living in Arizona and the other in Mexico’s Sierra Madre Mountains. The Pimas in Arizona have long been known for high rates of obesity, diabetes (almost 50 percent suffer from this disease) and high cholesterol.
The Pimas in Mexico, where food is more sparse and manual labor more common, tend to be lean and have a much lower rate of diabetes than those in Arizona. But despite their healthier lifestyles, the Mexican Pimas still have higher rates of obesity and diabetes than the general population, a finding that leads researchers to point to genes as the culprit.
After studying groups like the Pimas, scientists have developed a theory known as “The Thrifty Gene Hypothesis.” This idea suggests that some of us are born with the Honda of metabolisms — we can go a long way with little fuel.
Other, more fortunate people — fortunate, that is, in times of plenty — have metabolisms that more closely resemble gas-guzzling SUVs. They burn fuel fast leaving bodies slim.
In 1994, when researchers discovered the chemical compound leptin, they thought they had come up with a cure for people with thrifty genes. Leptin is released by fat cells and the larger fat cells get, the more leptin they release.
Normally, when the brain gets a surge of leptin, it concludes that the body has a safe store of fat and sends out a message to dampen appetite.
But, much to their dismay, when scientists tried giving overweight people more leptin to see if it would kill appetite and cause weight loss, the experiments failed.
Most obese people already have high levels of leptin,” explains Dr. Jeffrey Friedman, an investigator with the Howard Hughes Medical Institute at The Rockefeller University in New York City. “But they seem to be insensitive to it.”
Friedman suspected that there might be a way to bypass leptin by looking at enzymes the hormone regulates. Last summer, he and his colleagues found an enzyme related to weight control called SCD-1 and studied the effects of the enzyme in mice genetically engineered to be deficient in it. These mice tended to stay thin, even though they ate more than normal mice, because they had faster metabolisms.
Apparently, the body needs SCD-1 in order to store fat and, without the enzyme, most fat is burned instead of being stashed away.
Another factor in determining whether someone will be heavy or not is the amount time they spend working out. But new research suggests that whether one chooses to become a couch potato may also be the result of their DNA.
Researchers looking at a gene labeled Nh1h2 found that mutations of the gene impacted the impulse to exercise. Mice with certain mutations of Nh1h2 tended to be lethargic.
“Basically, if you put a normal mouse in a cage with an exercise wheel, he’ll run,” explains Deborah Good, an assistant professor of vertebrate molecular genetics at the University of Massachusetts in Amherst.
“But the mutant ones, if you put them in a cage with a wheel, they’re not interested in running,” says Good. “There’s nothing physically wrong with them. They did as well or better in tests with forced exercise. They just don’t want to run.”
While genes may ultimately explain why some of us tend to be pudgy and others stay slim, research into one’s DNA won’t offer any practical help with weight loss for the time being, experts say.
“At present, we’re at least five years away from having any therapeutic applications based on genes,” says Thomas Wadden, director of the Weight and Eating Disorders Program.