Women who work out regularly should consider taking it easy in the week before their period is due - as they could be at greater risk of injury, say scientists.
Researchers found that the nerve fibres around their knee muscles fired more often during this week than earlier in their menstrual cycle.
They said this difference in firing rate could affect the stability of the joint, potentially making it more susceptible to injury.
Sportswomen typically suffer from more knee injuries than their male counterparts, especially in sports such as football that involve knee twisting and turning. Previous studies found women were also more likely to experience ligament tears and chronic pain.
Researchers set out to see if hormone levels could be part of the problem, by affecting muscle-controlling nerves.
Working with female volunteers aged between 19 and 35, the team from the University of Texas-Austin and University of North Carolina, charted their menstrual cycles by taking body temperature measurements every morning.
It is possible to track where a woman is on her menstrual cycle because body temperature increases slightly after ovulation and dips to pre-ovulation temperatures just before the start of a new cycle. Hormonal levels also fluctuate during the cycle, with progesterone and estrogen levels falling in the final week before menstruation.
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The scientists also measured the women's motor activity in their knees at five different points during the study. They inserted a fine wire electrode into two knee muscles and took readings as the women performed simple knee extensions.
The results from the seven women revealed that the rate of nerve firing in these muscles jumped in the third week of the menstrual cycle, known as the 'late luteal phase'.
Research leader Professor Matthew Tenan, from the University of Texas-Austin, said: 'Our results suggest that muscle activation patterns are altered by the menstrual cycle.
'These alterations could lead to changes in rates of injury.'
He said further investigation was now needed to see whether these results coincide with a difference in knee injury rates at different points in the menstrual cycle.
The study was presented at The Integrative Biology of Exercise conference held in Colorado.
Read more: http://www.dailymail.co.uk/health/article-2218520/Why-jogging-week-period-damage-knees.html#ixzz29WqmIoKo
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Tuesday, October 16, 2012
Sunday, July 22, 2012
12 Ways to Fight Stress and Help Your Heart
Relax! You can help your heart by learning how to
de-stress, chill out, and let it go. Here are 12 ways to get yourself
closer to the Zen zone.
Can stress hurt your heart?
By Amanda GardnerThe evidence is piling up that the answer is—yes, stress is bad for your ticker.
“There are studies to show that stress is comparable to other risk factors that we traditionally think of as major, like hypertension, poor diet, and lack of exercise,” says Kathi Heffner, PhD, assistant professor of psychiatry at the Rochester Center for Mind-Body Research at the University of Rochester Medical Center in New York.
Here are 12 steps you can take to fight stress and protect your heart.
1. Focus on relaxation
Stress-reduction techniques and exercises such as yoga, meditation, and tai chi have been shown to lower stress hormones and bolster immune function, says Heffner.In one study, people who practiced yoga regularly experienced a decrease in some of their body’s inflammatory responses. Inflammation is emerging as a key culprit in heart disease, among many other chronic conditions.
"Dedicating a certain time of the day to focus on your body and on actually relaxing, (not) caring about the other things that are going on your day, is very useful," says John Simmons Jr., MD, assistant professor of family medicine at Texas A&M Health Science Center College of Medicine in Bryan.
2. Connect with friends
Spending too much time on your own can affect not only your mental health but your heart health as well. This holds true whether or not you’ve been actually diagnosed with heart disease.According to one study, women in particular were more prone to angina, a heart-disease-related chest pain, and other problems if they had little social support when they were recovering from a heart attack.
So get out and about. However, make sure you’re connecting with true friends. “If you have a lot of friends but they’re all mean to you, that won’t be beneficial,” Heffner says. And that’s backed up by research.
3. Forget perfect
We all know that the type A personality—the one constantly striving for perfection—seems more prone to heart disease. But what it really boils down to, says Heffner, is hostility. "Hostility has been shown to be the key ingredient in what used to be termed the type A personality," she says. "Hostility is behavior that's fueled by anger toward other people." Research suggests that hostility may be a better predictor of heart disease than things like high blood pressure and being overweight.So play nice and think nice thoughts about the future, as optimism has also been shown to protect the heart.
4. Don’t hold grudges
Nursing a grudge isn't going to help in the heart-health department. Research suggests that people experience more psychological stress and higher heart rates when they hold grudges than when they grant forgiveness."You would be amazed at how strongly they can take root in your psyche and how long they can gnaw at you. Getting that monkey off your back psychologically is very important, and allows you to move on and quit perseverating," Dr. Simmons says.
So be quick to forgive. This is also likely to lead to better social relationships, another boost for the heart, Heffner says.
5. Lighten up
Laughter can burn up to 20% more calories than keeping that poker face, according to a 2005 study, which monitored adults while they watched funny and not-so-funny film clips.And fewer calories, as we all know, mean a better chance of staying slim, which is one of the best ways to protect your heart for the long-term. Mirth also increased heart rate and, in a 2010 study in the American Journal of Cardiology, was shown to improve vascular function. So laugh a little or, better yet, a lot. The first study found that the more you laugh, the more calories you use up and the harder your heart works.
6. Don’t drink (too much) alcohol
Having too many drinks can raise triglycerides and blood pressure and even lead to heart failure. However, moderate drinking may actually ward off heart disease. Moderate means no more than one drink a day for women and two for men.If you don’t drink, this isn't a reason to start, according to Dr. Simmons. "But if you have always enjoyed a glass of wine and want reassurance, it's perfectly fine," he says.
7. Cut the caffeine
Caffeine can quickly raise your fight-or-flight response and all the attendant stress hormones, explains Dr. Simmons.Elevated stress hormones contribute to inflammation. So cut down on your coffee or tea habit. And even your diet soda habit. Preliminary studies have linked diet sodas to an increased risk of diabetes, a major risk factor for heart disease.
8. Limit emotional involvement
Not with people! But avoid getting too emotionally invested in things that don’t matter that much.For example, researchers recently linked football team losses with a greater risk of heart attack. In Los Angeles County, deaths from heart attacks and just deaths in general (mostly in elderly people) spiked after the Pittsburgh Steelers routed the Los Angeles Rams 31-19 in the 1980 Super Bowl. But when the Rams pounced the Washington Redskins 38-9 in 1984, deaths in the county declined. So don’t sweat the small stuff and remember that it's all small stuff.
9. Eat right
Eating a balanced diet—low in red meat and processed foods, high in fruits and vegetables, poultry, fish, and whole grains—will not only keep your weight down but also have a more direct effect on the heart’s functioning: It keeps your blood sugar stable throughout the day so you can avoid destructive peaks and valleys. "Eating a more balanced diet with complex carbs means you’re going to be stable throughout the day," Dr. Simmons says. "You're not going to have a carb high, then a drop down. Your mood isn’t going to fluctuate."Healthy eating can help prevent or delay diabetes, a major risk factor for heart trouble.
10. Seek help for depression
Depression can increase the risk of heart disease and may shorten life span. If you’re depressed, medication, psychotherapy or cognitive behavioral therapy, and other treatments may help. The Cleveland Clinic recommends antidepressants known as selective serotonin reuptake inhibitors (SSRIs, such as Prozac and Zoloft) because they don’t raise blood pressure.But ask your doctor if this is the best drug for your depression and make sure you know about any interactions.
11. Get some sleep
So many people in our sleep-deprived culture just aren’t getting enough z’s, or enough of the right kind of rest. An average of six to eight hours of sleep is recommended, according to Dr. Simmons.However, quality of sleep is key. Sleep apnea—a condition in which you wake up periodically due to interrupted breathing—has been linked with cardiovascular disease.
People who awake in the middle of the night from sleep apnea are unable to complete normal sleep cycles, a time when the body naturally lowers hormone levels and blood pressure. This can lead to hypertension and heart disease.
12. Exercise more
Want a cure-all? Try aerobic exercises like running, walking, swimming, and even dancing. These activities help you feel better, lower your risk for diabetes, and make your heart stronger, a trifecta of health benefits. Exercise can also help depression.Study after study has shown the benefits of physical activity, even active housework or gardening. The reason? It pumps your heart, moving blood all around the body.
The American Heart Association recommends exercising aerobically at least 30 minutes all or most days of the week. But talk to your doctor before hitting the track.
Source : http://www.health.com
Read More ...
Do Stressful Jobs Fuel Heart Attacks?
By Amanda Gardner
Getty Images
After a bad day at work, do you ever complain to your friends that
your high-pressure job or demanding boss is giving you a heart attack?
It’s just a figure of speech, but you might actually be on to something.
According to a new study of more than 22,000 female doctors and
nurses, being in a stressful work situation increases a woman’s risk of
heart attacks and related problems, possibly because the stress
contributes to high blood pressure and other hazards.
Women who reported high levels of job strain were two-thirds more
likely to have a heart attack during a 10-year period compared with
women in easygoing jobs, the study found. Women in high-strain jobs were
also 41% more likely to require a heart procedure such as bypass
surgery.
Job strain isn’t exactly the same as job stress. When researchers
talk about job strain, they’re referring to a specific type of
psychological stress that’s “basically a combination of how demanding
one’s job is and how much control one has over one’s job,” says Michelle
Albert, M.D., the senior author of the study.
Challenging, fast-paced jobs aren’t necessarily straining.
High-strain jobs are very demanding, yet they also involve little
control or authority (picture working 12-hour days while being
micromanaged). Low-strain jobs, on the other hand, feature relatively
few demands and high levels of day-to-day control.
Chronic stress can lead to anxiety and depression, both of which have
been linked to heart disease. In this study, though, anxiety and
depression—along with other risk factors, such as smoking and body mass
index—contributed only slightly to the relationship between job strain
and heart attacks, suggesting that other factors were at play.
One likely explanation, Albert says, is that job strain leads to
over-activation of the body’s stress system, including the release of
stress hormones. This can lead to higher blood pressure, insulin
resistance, and other processes that damage the blood vessels and heart.
“Stress is normal, except when it overpowers our body’s ability to
adapt to the stressor—and that’s what we’re talking about here,” says
Albert, a Harvard Medical School professor and cardiologist at Brigham
& Women’s Hospital, in Boston.
Albert and her colleagues were somewhat surprised to find that women
with high-demand, high-control jobs had elevated heart risk, too. This
type of job—managerial positions, for instance—aren’t considered
high-strain, so it could be that they breed a different kind of stress.
It can be lonely at the top, and women who find themselves with a lot
of responsibility and authority may be more isolated, Albert says.
Feelings of loneliness and a lack of social support have both been shown
in previous studies to contribute to a higher risk of heart disease.
Interestingly, worrying about losing your job—a common source of
work-related stress—wasn’t linked at all with heart disease in the
study. But that could just be a quirk of the study population, and may
not be true across all industries.
“The group of women studied here are health care professionals,”
Albert says. “In the current economic climate, health care jobs tend to
be a little bit more stable.”
The findings may not apply to everyone, in other words, and they
don’t necessarily capture the myriad other sources of stress that can
affect health, such as owing money or losing a loved one. All that
remains to be worked out in future research.
“We live in an environment where you just don’t have one type of
stressor,” Albert says. “You have multiple types of stress, so there’s a
great need to look at the joint impact of different stressors on
cardiovascular disease.”
Women with high-stress jobs may be more likely to have a heart attack
(CBS News) Stress at work may have an adverse effect on your heart health if you're a woman.
A
new study shows that women who have high-stress jobs are 67 percent
more likely to have a heart attack and 38 percent more likely to have
any kind of cardiovascular event than women who have more low-stress
jobs.
Elevated job strain, a form of psychological stress, has long term
cardiovascular health effects in women and could suggest the need for
health care providers to incorporate assessment of and identification of
useful interventions that minimize the effects of job strain," Dr.
Michelle A. Albert, of Brigham and Women's Hospital and Harvard Medical
School,wrote in the study.
The study, published in the July 18 issue of PLoS ONE,
looked at more than 22,000 women working in the health care industry in
the United States who were part of the Women's Health Study. Their
average age was 57, and the women were predominantly white.
Women's
jobs were divided into four categories: low strain (low demand, high
control); passive (low demand, low control); active (high demand, high
control) and high strain (high demand, low control). The women were
monitored for the number of heart attacks, strokes, heart procedures and
deaths that occurred after a 10-year follow-up period.
"High strain is defined as high demand and low control," Albert told WebMD, using as an example a factory job in which a worker is pressured to produce.
While
the researchers found higher rates of heart problems among women with
high-strain jobs, they did not find any increased long-term
cardiovascular risk in women who reported job insecurity. Women with
active strain jobs, such as managers, were also shown to have this
increased risk.
Depression and anxiety, which are risk
factors for heart disease, were found only to slightly contribute to the
link between stress and heart problems in women. Albert told Health.com
that job stress may lead to over-activation of the body's stress
system, releasing stress hormones which may lead to higher blood
pressure, insulin resistance and other processes that may damage the
heart's blood vessels.
She told CBS station WBZ in Boston
that it's important for women to recognize when stress is taking a
toll, whether it's chest pains, frequent headaches or feeling overly
"worked up."
She recommends to maintain a healthy lifestyle, women
should increase their physical activity, lean on social support and
make sure they have time to allow themselves to de-stress.
"You're not going to get rid of stress," said Dr. Albert. "Stress is a normal part of life."
Friday, July 20, 2012
12 tips for healthy hair: get the shine, movement and softness you desire—fast and easy—with our expert advice from top pros
by Kathy Miller Kramer
Hair is the ultimate accessory; it can add to (or detract from)
your overall look instantly. Keeping it in healthy condition is the most
important thing you can do to help it look and feel fabulous. And,
while it seems easy, this isn't as simple as minimizing chemical
treatments or slathering on a weekly deep conditioner. While these can
make your strands softer and less split-end-prone, what really matters
is the daily handling; this is what creates the most stress--and
potential damage--to your tresses. To help your locks look their best,
we asked top experts from around the country for their advice on how to
baby your mane every single day. So whether your concern is dullness,
damage, frizz or fragility, we have the answers to ease even the
toughest hair-care woes. Read on for tips to achieve
run-your-fingers-through-it hair.
1 Steer clear of plastic-bristle brushes. "The proper bristles
are key," says stylist Edward Tricomi of the Warren-Tricomi Salon in New
York City. "A combination of natural boar bristles on either a round or
flat brush are best for dry hair, while soft, rubber-toothed
wide-paneled brushes are best for damp hair." Our favorite brushes
include the Mason Pearson Boar Bristle brush ($78.50; zitomer.com) and
Aveda's Wooden Paddle Brush ($17; aveda.com).
2 Brush before shampooing. A few gentle strokes on dry hair
will help remove product buildup and scalp flakes, as well as stimulate
the scalp and promote blood flow (which delivers nutrients like oxygen)
to hair follicles. For a smoother slide, try Clairol Herbal Essences Let
It Loose Detangling Spray ($3; at drugstores).
3 Know your water. If your hair looks dull or is hard to style,
the problem could be your tap water. According to Minneapolis-based
Gordon Nelson, international creative director for Regis Salons, well
water contains natural minerals (called "hard water") that can leave
hair lusterless and hard to manage and can impart a brassy, orange hue.
Soft water, on the other hand, has fewer damaging minerals. (Ask your
local water department if your water is soft or hard, or try using
Robert Craig's No More Bad Hair Days Kit, $20; robertcraig.com; with
strips to test your water.) To rid hair of mineral buildup, suds up
every week with a clarifying shampoo. We like Frederic Fekkai Apple
Cider Clarifying Shampoo and Clean Conditioner ($18.50 each; saks.com).
4 Mist your ends with water before home coloring. The ends of
your hair are more porous and, as a result, absorb more pigment. "Wet
hair doesn't absorb color as readily as dry hair," explains Renee
Patronik, a consulting colorist for L'Oreal in New York.
5 Trim your troubles. As the ends of your hair get older and
damaged by rough handling, they become prone to splitting, Nelson says.
Get regular trims, at least 1/2 inch every four to eight weeks. "Hair
grows (on average) half an inch per month, so trim to maintain healthy
ends," says stylist Stephen Knoll of the Stephen Knoll Salon in New
York.
6 Use color-protective products. Chemical treatments like color
can damage hair because the chemicals have to penetrate the outer layer
of the hair (or cuticle) to allow the hue to be absorbed, explains
stylist Rodolfo Valentin of Rodolfo Valentin Atelier for Hair in New
York. Color-protective products are specially designed to minimize
dryness, keep color true and prevent damage. "They typically have more
nourishing ingredients, strip less color and are less abusive," Knoll
explains. We love L'Oreal VIVE Color Care Shampoo and Conditioner ($3.69
each; at drugstores) and Matrix Biolage Color Care Shampoo ($10) and
Conditioner ($11; matrix.com for salon locations).
7 Give wet hair extra TLC. It stretches and snaps more easily
than dry hair does, so be extra-gentle with it. "Use a wide-tooth
plastic comb while hair is wet; then, once it's towel-dried, switch to a
good brush," says Jon Patrick, color director of the Mete Turkmen Hair
Salon Plus in New York. And avoid wooden combs; wood can have
microscopic divots that snag hairs. Instead try the Jilbere de Paris
plastic shower comb ($1.49; sally beauty.com for store locations).
8 Deep condition once every two weeks. "These treatments
penetrate the hair shaft and strengthen strands," says Patrick, who adds
that using heat (from a blow-dryer) can intensify deep conditioning, as
the heat causes the cuticle to open and the ingredients to penetrate.
For nourishing results, try Kerastase Masquintense ($36;
877-748-8357 for salons), available for fine or thick hair; Neutrogena
Triple Moisture Sheer Hydration Leave-In Foam ($7; at drugstores); or
Ellin Lavar Textures ReconstructMasque ($25; ellinlavar.com).
9 Try an ionic dryer. Ions are atoms with a positive or
negative charge. These particular hair-dryers bathe your hair in
negative ions, which help break up water molecules faster and cancel out
hair-damaging positive ions, Valentin explains. Plus, your hair-drying
time is cut in half. We love the Bio Ionic Super-Hydrator Pro Dryer
($165; bioionic.com for salon locations).
10 Just use your dryer's nozzle, urges stylist Frank Galasso of
Frank.Studio in Santa Monica, Calif. It's the best way to help prevent
frizz because it concentrates the airflow on sections. "Without a nozzle
the dryer's grill gets very hot; if your hair gets too close to it, it
will cause damage and/or breakage," explains stylist Mark Garrison of
the Mark Garrison Salon in New York.
For curls, use a diffuser attachment to gently surround your
hair with air. Try Vidal Sassoon Ceramic Finger Diffuser ($8; hotus.com
for store locations). Follow up with John Frieda's Frizz-Ease Secret
Weapon Flawless Finishing Creme ($6; at drugstores) to smooth strands.
11 Give textured or relaxed hair a break. African-American hair
tends to be coarse due to a lack of natural oils (more so if chemically
processed), says New York-based celebrity hairstylist Ellin Lavar.
Lavar suggests opting for gentle color choices like semipermanent or
vegetable color. Spacing processing treatments at least two weeks apart,
with weekly conditioning treatments in between for shine maintenance,
helps.
12 Use the right accessories. Kim Vo, a stylist at West
Hollywood's B2V Salon, suggests putting hair in soft braids or twists
and using claw clips rather than barrettes, which can pull hair. Other
options: gentle Goody Ouchless elastic bands ($3 for 14; at drugstores)
and L. Erickson Grab 'N Go Pony O's ($12 for three; franceluxe.com).
RELATED ARTICLE: POINT & CLICK FOR HEALTHY HAIR
For great styling advice that doesn't sacrifice hair health,
check out the Dove Styling Tool, a tip-filled interactive guide created
with the help of top celebrity stylist Eva Scrivo. It's organized
according to the look you're trying to achieve. Find it at
dove.com/unstick_your_style.
RELATED ARTICLE
BAN BAD-HAIR DAYS We're giving 50 lucky Shape readers the
chance to try Robert Craig's No More Bad Hair Days Kit (a $20 value!).
The kit includes 12 water test strips, three shampoos for different
water types (soft, moderately hard and extremely hard) and a leave-in
conditioner. Visit Shape.com/RobertCraig from Oct. 18 to Nov. 14 for
your chance to win. Good luck!
KATHY MILLER KRAMER is a New York City-based freelance writer. Additional reporting by CARLY CARDELLINO.
COPYRIGHT 2005 Weider Publications
Tuesday, July 17, 2012
The sour truth about apple cider vinegar - evaluation of therapeutic use
by Beth Fontenot
Apple cider vinegar is an old folk remedy claimed to be beneficial in treating a long list of ailments. Proponents say that it can cure arthritis,
guard against osteoporosis, lower blood pressure and cholesterol,
prevent cancer, destroy infection, assist in digestion and weight
control, maintain memory, and protect the mind from aging.
Vinegar is said to have been used for medical ailments for at
least 10,000 years. The Babylonians first converted wine into vinegar in
5000 BCE using date palms, grapes, and figs, and believed vinegar had
exceptional healing properties. Hippocrates is said to have used vinegar
as an antibiotic. Samurai warriors supposedly used a vinegar tonic for
strength and power. During the U.S. Civil War, soldiers used vinegar to
prevent gastric upset and as a treatment for various ailments including
pneumonia and scurvy. It was used to treat wounds during World War I.
The name vinegar comes from a French word meaning "sour wine."
It is produced by the action of yeast and bacteria on grains or fruit
juices. Vinegars take their name from the material used to make the
vinegar, i.e., apple cider vinegar comes from apples, wine vinegar comes
from grapes.
Apple cider vinegar is made by crushing apples and squeezing
out the liquid. Sugar and yeast are added to the liquid to start the
fermentation process, which turns the sugars into alcohol. In a second
fermentation process, the alcohol is converted by acetic acid-forming
bacteria into vinegar. Acetic acid gives vinegar its sour taste.
"Mother of vinegar" is a term used to refer to the mass of
scum that forms on top of cider when alcohol turns into vinegar, or to
the cloudy substance that sometimes develops in stored vinegar. It is
actually bacteria and yeast cells that have died.
Folk Claims
In 1958 Dr. D. C. Jarvis, a "noted Vermont country doctor," wrote
a book entitled Folk Medicine in which he extolled the virtues of
vinegar. He claimed that Vermonters knew how to cure migraine headaches,
diabetes, chronic fatigue, arthritis, and a variety of other ailments.
They used apple cider vinegar.
Among Dr. Jarvis's
many tenets about apple cider vinegar was his advice to pregnant women
to drink an apple cider vinegar tonic daily to assure that the infant is
born with "an excellent chemical pattern with which to meet its new
environment." He recommended the same tonic for those suffering from
arthritis. Believing that apple cider vinegar would destroy bacteria in
the digestive tract, he advised those with GI problems to consume a
tonic with each meal. He also declared that the regular consumption of
an apple cider vinegar tonic would make body fat disappear because the
vinegar would cause the fat to be burned instead of stored.
His book quickly sold 500,000 copies and is still in print.
Apple cider vinegar is still promoted as one of the chief "natural"
remedies for arthritis.
Those who believe that apple cider vinegar has miraculous
properties attribute its powers to an abundance of nutrients in the
liquid. One company's sales pitch states, "Each golden drop is a natural
storehouse of vitamins and minerals." Marketers point to the trace
minerals, bacteria,. and enzymes present in their product as the
ingredients that give apple cider vinegar its curative characteristics.
Another company suggests that their apple cider vinegar is superior
because it contains pectin, beta-carotene, and potassium in addition to
enzymes and amino acids. Apple cider vinegar is also said to contain an
abundance of complex carbohydrates and dietary fiber. Dr. Jarvis
believed that the healing properties of apple cider vinegar were due in
large part to its rich potassium content.
Some New Twists
Apple cider vinegar is sold today by "health food" companies and
others who claim it has remedial properties. The claims are similar to
those in the past, but some have taken on a modem twist based on more
recent medical research.
Marketers contend that the beta-carotene in apple cider
vinegar destroys free radicals in the body which are involved in the
aging and mutation of tissues and in destroying the immune system. Apple
cider vinegar's beta-carotene is said to be in a "natural, easy to
digest form."
Its use as a remedy for arthritis is based on the notion that
acid crystals harden in the joints and tissues which cause the joints to
become stiff and the tissues to harden. These acid crystals also cause
the body to age prematurely, so the ads state. Apple cider vinegar is
supposed is put these acid crystals in solution so they can be flushed
from the body.
Producers also claim that apple cider vinegar can lower
cholesterol and blood pressure. These assertions are based on the
assumption that people naturally crave acids when eating animal proteins
in order to lessen the thickening influence of "heavy proteins and
fat." Apple cider vinegar supposedly thins the blood so it can
circulate. more freely. Thick blood, they say, puts a strain on the
heart and up goes the blood pressure. Another source states that the
pectin present in apple cider vinegar works its way through the
digestive system, binding to cholesterol and removing it from the body.
Apple cider vinegar is also available in tablet form. One
brand is merchandised as a "digestive aid for vegetarians." The
manufacturer of this product alleges that the tablets help acidify the
stomach and help digest protein. Another tablet, which contains apple
cider vinegar as one of its components, is sold as a fiber supplement
and supposedly assists in weight loss. Still other companies add herbs
to their apple cider vinegar "so people see relief from even more
ailments."
The rubbery mass of goo called the mother of vinegar" is
reputed to have magical healing properties as well. Nibbling on a bit of
this moldy slime every day is purported to prevent most infectious
diseases and keep germs and parasites from invading the body.
One company's advertisement for organic, raw, unfiltered,
unheated, unpasteurized apple cider vinegar is particularly alarming.
This company's ad maintains that "there is nothing in this wonderful
natural apple cider vinegar that can in any way harm your body!"
Apparently, they have never heard of the danger of E. coli 0157:H7 in
unpasteurized fruit juices. Normally vinegar is too acidic to support
bacteria. However, should the acidity weaken (pH reaching 4.6 or
higher), then pathogens will survive and grow.
Jogging in a Jug
In 1985, Jack McWilliams, an Alabama farmer, concocted a potion
he called "Jogging in a Jug." It consisted of apple cider vinegar
combined with a variety of fruit juices to give it a more appealing
taste.
Acetic acid, claimed McWilliams, was lacking in the modem
diet, and this deficiency was the root cause of many health problems. He
claimed that the potion had cured his arthritis and heart disease, and
it could reduce the risk of cancer in the internal organs. McWilliams
marketed his product through the media, receiving extensive coverage in
small community newspapers and broadcast outlets. He reportedly sold $9
million worth of his potion in one year.
The FDA, however, did not look kindly on Mr. McWilliams's
vinegar product and its advertised claims. The federal government
seized the product in 1994 due to the unproven health claims.
In 1995, thousands of bottles of the potion were ordered
destroyed because the product was considered an unapproved new drug due
to the claims made by the producer. Subsequently, Mr. McWilliams's
company, Third Option Laboratories, Inc., paid the Federal Trade
Commission a $480,000 fine to settle charges of false advertising.
"Jogging in a Jug" is still on the market today with a new label that
meets FDA guidelines.
The Real Story
There is no scientific evidence that apple cider vinegar has any
medicinal properties. While the folksy anecdotes from those who claim to
have benefited from apple cider vinegar tonics may be amusing to read,
they are simply that -- anecdotes.
Apple cider vinegar is anything but a storehouse of nutrients.
A nutritional analysis of one tablespoon (more than the one or two
teaspoons suggested to make a tonic) reveals that the golden liquid
contains less than a ram of carbohydrate: minuscule amounts of calcium,
iron, magnesium, sodium. copper, manganese, and phosphorus; and a mere
15 mg of potassium. The fiber, vitamin, and amino acid content is zero.
The Arthritis Foundation calls vinegar a harmless, but unproven, arthritis remedy. It points out that arthritis symptoms come and go, and that a person using an unproven remedy may think a remedy worked simply because they used it at a time when symptoms were going into natural remission. Such is undoubtedly the case for many of the "cures" connected to vinegar.
Beth Fontenot is a nutrition consultant and freelance nutrition writer in Lake Charles, LA. She serves on the adjunct faculty at both McNeese State University in Lake Charles and Lamar University in Qrange, TX.
COPYRIGHT 1997 Prometheus Books, Inc.
COPYRIGHT 2004 Gale Group
Wednesday, July 11, 2012
Working women more likely to put on weight 'as they put office needs over their health'
- Scientists claimed career-driven women are inclined to foresake healthy home-cooked food and exercise less
Dr Au said: 'Longer work hours may reduce the time spent preparing home-cooked meals'
Women who work more than 35 hours every week are more likely to put on weight, according to a new scientific study.
Research found career-driven women are inclined to foresake healthy home-cooked food, exercise and sleeping for the office. As a result, many are at risk of piling on the pounds.
The study also found that women who work more than 49 hours a wek are much more likely to drink and smoke.
The findings were revealed in a study into how employment status and the number of hours worked affects weight.
The
research, led by Dr Nicole Au, from the Centre for Health and Economics
at Monash University, Melbourne, analysed 9,276 women aged 45-50 over
two years.
Findings showed 55 per cent put on weight in that time - with the average women gaining 1.5 per cent of her initial weight.
Some were also reported to have experienced ‘extreme’ amounts of weight gain.
And those most likely to experience the problem were working more than 35 hours a week.
Dr Au put the findings down to women spending less time maintaining their health and fitness levels.
She said: 'This study
highlights the increasing number of women entering the workforce and the
effects on their ability to maintain a healthy weight.
'Longer
work hours may reduce the time spent preparing home-cooked meals,
exercising and sleeping which are risk factors for obesity.
'Policies
that assist women who work long hours to reduce the time costs of
sustaining a healthy diet and their physical activity routine may have
positive benefits.'
The
research, published in the International Journal of Obesity, also found
women working more than 49 hours were more likely to smoke and drink
alcohol.
As many as 65 per cent were drinking to ‘risky’ levels and 36 per cent did not do any form of exercise.
Lucy
Green, an office manager from London, said she’d found herself losing
control of her weight as a result of long working hours.
The 41-year-old said: 'I start work at 8am and don’t usually finish until 7pm.
'As a result, I’ve had to put my exercise regime on the back burner because I just don’t have the energy to go to the gym.
'Unfortunately, it’s really starting to take it’s toll on my figure.
'The office is always full of junk food like cakes and biscuits and I find myself eating them all too often.
'I’m
putting on weight because I’m not taking time to work off the extra
calories, so I’m going to have to make a special effort to start doing
exercise again soon.'
Read more:
Wednesday, May 9, 2012
Blood test for missing or damaged DNA could provide hint of a prostate cancer relapse
By Sophie Borland
A blood test for men with prostate cancer could detect if the illness is likely to be life-threatening, claim scientists.
At present it is extremely difficult for doctors to know whether a patient’s tumour is slow-growing - and harmless - or if it is deadly.
This means that thousands of men have to endure agonising surgery, chemotherapy or radiotherapy to remove tumours that may never have caused a problem.
Breakthrough: Researchers believe they've found a blood test that can determine the likelihood of prostate cancer returning
It could also determine whether the tumour is likely to return after surgery - which would warrant the patient having additional chemotherapy or radiotherapy.
The method involves testing the blood for a genetic abnormality - called the copy number variation, or CNV - that determines how quickly the cancer will spread.
Researchers at the University of Pittsburgh in the U.S, looked at the blood samples and records of 238 prostate cancer patients over a period of ten years.
They compared the levels of CNV with how the disease had progressed, as established from their medical records.
Hard cell: The method involves testing the blood for a genetic abnormality - called the copy number variation, or CNV
In 81 per cent of cases it was able to determine whether it would return after treatment.
The scientists - whose work is published in the American Journal of Pathology - also tested patients’ tissue close to the tumours for levels of CNV and this showed similar success rates.
It is likely to be several years before the academics are able to develop a blood test to predict the speed prostate cancer will spread.
But lead researcher Dr Jian-Hua Luo, from the University of Pittsburgh School of Medicine, said in future it could prove to be ‘a more efficient and accurate way to predict the behaviour of prostate cancer.
‘For a patient diagnosed with prostate cancer, CNV analysis done on blood or normal tissues would eliminate the need for additional invasive procedures to decide a treatment mode.
‘For a patient already having a radical prostatectomy (surgery), CNV analysis on the tumour or blood sample may help to decide whether additional treatment is warranted to prevent relapse.’
New figures last week showed that 40,000 men are now being diagnosed with prostate cancer every year.
This increase is mainly due to greater use of the Prostate Specific Antigen (PSA) test, which measures levels of a chemical that is high when tumours are present.
But although the test has been credited with detecting some deadly cancer cases earlier, there are concerns it often causes ‘false alarms’.
And this month another group of American researchers claimed that surgery to remove prostate cancer is often ineffective.
A study involving 731 patients found that those who had operations were only 3 per cent more likely still to be alive 12 years later compared to those who didn’t have treatment.
Persistent cough 'could be warning sign of lung cancer': Stars who lost relatives to disease launch awareness campaign
By Claire Bates
Just one in 10 people realise that a persistent cough could be a key symptom of lung cancer, according to statistics released by the Government as it launches a campaign to raise awareness about the disease.
Despite the condition killing more people than any other form of cancer in England, very few people are aware a cough lasting three weeks is a sign of a potential sufferer.
An advertising drive backed by actor Ricky Gervais and TV presenter Jenny Frost will be launched tomorrow in a bid to raise awareness about the issue and improve earlier diagnosis in England.
Actor Ricky Gervais and singer Jenny Frost are
both backing the Government's 'Be Clear on Cancer' campaign, after both
lost a parent to lung cancer
Health Minister Paul Burstow said: 'Lung cancer is the biggest cancer killer in this country but worryingly many people don't know the signs and symptoms that could save their lives.
'The earlier lung cancer is diagnosed, the better the chance of survival.
'The message from this campaign is simple; if you have a persistent cough for three weeks or more, visit your GP.'
Lung cancer affects 33,000 people every year in England with the majority of cases occurring in people over the age of 55.
When diagnosed at its earliest stage, as many as 80 per cent of people are alive five years after diagnosis compared with only seven per cent diagnosed at a late stage.
Manchester United captain Sir Alex Ferguson lost
both his mother and father to lung cancer, while Lynda Bellingham lost
her sister
He told the Manchester Evening News: 'My father was 66 when he died and my mother was only 64. Dad was diagnosed with lung cancer only a week after he retired and within 12 months it had killed him.
'Then my mum, who had smoked all her life, was diagnosed with lung cancer as well and she passed away a few years after my dad.'
Actor Ricky Gervais, who lost his mother to lung cancer when she was 74, said the condition was 'devastating'.
'It's a horrible, horrible disease,' he said.
Singer Jenny Frost cancelled her wedding in 2010 after her mother Rita succumbed to lung cancer.
Other celebrity supporters include actor Robert Powell, author Tony Parsons and actress Terry Dwyer who lost their fathers and Dragon Duncan Bannatyne who lost his mother. I'm A Celebrity star Stephanie Powers and writer Cassandra Jardine battled the disease themselves.
Campaign backers: Sir Alex Ferguson, Stephanie
Powers, Tony Parsons and (bottom row) Linda Robson, Mark Lawrenson and
Cassandra Jardine
Professor Sir Mike Richards, National Cancer Director for England, said: 'It is vital that cancer patients get treated quickly so they have the best chance of surviving. We have made early diagnosis central to our Cancer Outcomes Strategy.
'Earlier diagnosis of Lung Cancer combined with the best treatments could help save an additional 1,300 lives a year.'
Paula Chadwick, chief executive of the Roy Castle Lung Cancer Foundation, added: 'We really hope people will begin to associate a persistent cough as a symptom of lung cancer, the way they associate a lump as a symptom of breast or testicular cancer.'
Supporters: Ricky Gervais, Robert Powell, Nikesh
Shukla, Lynda Bellingham with (bottom row left to right) Duncan
Bannatyne,Tricia Penrose, Jenny Frost and Terri Dwyer
One in six cancers are caused by preventable infections
By Daily Mail Reporter
'Application
of existing public-health methods for infection prevention, such as
vaccination, safer injection practice, or antimicrobial treatments,
could have a substantial effect on future burden of cancer worldwide.'
Two types of the human papilloma virus (HPV) cause around 70 per cent of all cervical cancers
One in six cancers are caused by preventable infections, research shows.
Infections cause around two million cancer cases a year, with 80 per cent of these effecting the developing world.
Infections cause around two million cancer cases a year, with 80 per cent of these effecting the developing world.
Of
7.5 million cancer deaths worldwide in 2008, 1.5 million were down to
treatable or preventable infections, reports the Lancet Oncology.
Catherine
de Martel and Martyn Plummer from the International Agency for Research
on Cancer in France said: 'Infections with certain viruses, bacteria,
and parasites are one of the biggest and preventable causes of cancer
worldwide.
'Application
of existing public-health methods for infection prevention, such as
vaccination, safer injection practice, or antimicrobial treatments,
could have a substantial effect on future burden of cancer worldwide.'
For
the study the team estimated the proportion of cancers that could be
attributed to infection globally and in eight regions by calculating the
population attributable fractions (PAF) - the proportion of new cancers
in a population that could have been prevented by an intervention.
They
calculated that around 16 per cent of all cancers worldwide in 2008
were infection-related, with the fraction of cancers related to
infection about three times higher in developing than in developed
countries.
The fraction
of infection-related cancers varied widely between regions, from 3.3
per cent in Australia and New Zealand to 32.7 per cent in sub-Saharan
Africa.
Dr de Martel
said: 'Many infection-related cancers are preventable, particularly
those associated with human papillomaviruses (HPV), Helicobacter pylori,
and hepatitis B (HBV) and C viruses (HCV).'
Since September 2008 there has been a national programme to vaccinate girls aged 12 to 13 against the human papilloma virus
Cervical cancer accounted for around
half of the infection-related burden of cancer in women, and in men
liver and gastric cancers accounted for more than 80 per cent.
Dr
de Martel concluded: 'The 2011 UN high-level meeting on
non-communicable diseases highlighted the growing global agenda for
prevention and control of non-communicable diseases.
'But
although cancer is considered a major non-communicable disease, a
sizable proportion of its causation is infectious and simple
non-communicable disease paradigms will not be sufficient.'
In
an accompanying Comment, Goodarz Danaei from Harvard School of Public
Medicine, Boston, said: 'Their estimates show the potential for
preventive and therapeutic programmes in less developed countries to
significantly reduce the global burden of cancer and the vast
disparities across regions and countries.
'Since
effective and relatively low-cost vaccines for HPV and HBV are
available, increasing coverage should be a priority for health systems
in high-burden countries.'
Less Inflammatory Bowel Disease Seen in Southern Latitudes
Women living in the southern latitudes of the United States have
significantly lower rates of Inflammatory Bowel Disease (IBD) than those
living in the country's northern regions, according to new research
published online January 11, 2012, in Gut.
Similar trends have been reported in Europe in the past; however, this is the first study to evaluate the role of latitude on IBD incidence in the United States.
To investigate the issue, Hamed Khalili, MD, from the Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, and colleagues evaluated data on 175,912 women enrolled in the Nurses' Health Study I (NHS) in 1976, and in the NHS II in 1989.
The data included information on the women's state of residence at birth, at age 15 years, and at age 30 years. The states were categorized as being in the northern, middle, or southern tiers of each of the 4 time zones (eastern, central, mountain, and pacific).
Follow-up data taken in 2003 identified 257 cases of Crohn's disease and 313 cases of ulcerative colitis among the women, with the incidence of each disease increasing significantly according to increased latitude (P trend < .01).
The residence at age 30 years showed the strongest association with risk for Inflammatory Bowel Disease.
The multivariate-adjusted hazard ratio for women residing in southern latitudes compared with those residing at northern latitudes at age 30 years was 0.48 (95% confidence interval, 0.30 - 0.77) for Crohn's disease and 0.62 (95% confidence interval, 0.42 - 0.90) for ulcerative colitis. The multivariate analysis was adjusted for age, body mass index, ancestry (Southern European, Scandinavian, other white, nonwhite), smoking, and oral contraceptive and hormone therapy use.
"In two large prospective cohorts of US women, the incidence of [ulcerative colitis and Crohn's disease] was significantly lower among women who resided in the southern latitudes, particularly in later life (age 30 years), than in those residing in the northern latitudes," Dr. Khalili and colleagues write.
"These results were consistent even after accounting for differences in self-reported ancestry and smoking, suggesting that other environmental or lifestyle factors correlated with geographical variation may mediate these associations."
The authors hypothesize that the main explanation for the reductions in southern latitudes is related to greater levels of sun exposure and to the higher levels of plasma vitamin D that are associated with ultraviolet (UV) radiation.
"UV radiation is the greatest environmental determinant of plasma vitamin D and there is substantial experimental data supporting a role for vitamin D in the innate immunity and regulation of inflammatory response," the authors write.
"The role of vitamin D in the pathogenesis of IBD is further supported by the observation that animal models of colitis have more severe inflammation in vitamin D receptor knock out animals or animals deficient in 1,25(OH)2 vitamin D."
In addition, UV radiation is associated with regulation of T cells, as well as the production of interleukin (IL) 4 and IL-10, and the inhibition of IL-12, which suppresses the inflammatory response, they note.
Bincy P. Abraham, MD, an assistant professor of medicine in the Inflammatory Bowel Disease Program at Baylor College of Medicine in Houston, Texas, said that vitamin D, or a lack thereof, has been recognized as a potential risk factor for IBD, but its role is not entirely understood.
"Theoretically, vitamin D can play a role in inflammation: low levels may contribute to inflammation, and thus can be explained by the general north–south gradient of inflammatory bowel disease we have seen historically in the US, as well as Europe," Dr. Abraham told Medscape Medical News.
"However, knowing the vitamin D levels in both groups of patients is important in order to clarify this," added Dr. Abraham, who was not involved in the study. "This is because there could be other confounders — other environmental causes that we do not know about."
In her own research on Inflammatory Bowel Disease, Dr. Abraham found high levels of abnormal bone density among patients with IBD and vitamin D deficiency, but that research was also inconclusive regarding the vitamin's influence.
"It was difficult for us to determine a correlation of IBD disease activity and vitamin D levels due to too many confounding variables," she said, noting that, among potential variables, there is even a theory that refrigeration of food may increase the risk for Inflammatory Bowel Disease.
"My general sense is that [a correlation with vitamin D] is quite possible," Dr. Abraham concludes. "We may need to do additional, larger-scale studies of vitamin D levels and their association in contributing to the development of Inflammatory Bowel Disease."
The study received support from the National Institutes of Health and the Broad Medical Research Program of the Broad Foundation. The authors included a clinical investigator for the Damon Runyon Cancer Research Foundation, and one author is supported by a career development award from the IBD Working Group and the Crohn's and Colitis Foundation of America. Dr. Abraham has disclosed no relevant financial relationships.
Similar trends have been reported in Europe in the past; however, this is the first study to evaluate the role of latitude on IBD incidence in the United States.
To investigate the issue, Hamed Khalili, MD, from the Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, and colleagues evaluated data on 175,912 women enrolled in the Nurses' Health Study I (NHS) in 1976, and in the NHS II in 1989.
The data included information on the women's state of residence at birth, at age 15 years, and at age 30 years. The states were categorized as being in the northern, middle, or southern tiers of each of the 4 time zones (eastern, central, mountain, and pacific).
Follow-up data taken in 2003 identified 257 cases of Crohn's disease and 313 cases of ulcerative colitis among the women, with the incidence of each disease increasing significantly according to increased latitude (P trend < .01).
The residence at age 30 years showed the strongest association with risk for Inflammatory Bowel Disease.
The multivariate-adjusted hazard ratio for women residing in southern latitudes compared with those residing at northern latitudes at age 30 years was 0.48 (95% confidence interval, 0.30 - 0.77) for Crohn's disease and 0.62 (95% confidence interval, 0.42 - 0.90) for ulcerative colitis. The multivariate analysis was adjusted for age, body mass index, ancestry (Southern European, Scandinavian, other white, nonwhite), smoking, and oral contraceptive and hormone therapy use.
"In two large prospective cohorts of US women, the incidence of [ulcerative colitis and Crohn's disease] was significantly lower among women who resided in the southern latitudes, particularly in later life (age 30 years), than in those residing in the northern latitudes," Dr. Khalili and colleagues write.
"These results were consistent even after accounting for differences in self-reported ancestry and smoking, suggesting that other environmental or lifestyle factors correlated with geographical variation may mediate these associations."
The authors hypothesize that the main explanation for the reductions in southern latitudes is related to greater levels of sun exposure and to the higher levels of plasma vitamin D that are associated with ultraviolet (UV) radiation.
"UV radiation is the greatest environmental determinant of plasma vitamin D and there is substantial experimental data supporting a role for vitamin D in the innate immunity and regulation of inflammatory response," the authors write.
"The role of vitamin D in the pathogenesis of IBD is further supported by the observation that animal models of colitis have more severe inflammation in vitamin D receptor knock out animals or animals deficient in 1,25(OH)2 vitamin D."
In addition, UV radiation is associated with regulation of T cells, as well as the production of interleukin (IL) 4 and IL-10, and the inhibition of IL-12, which suppresses the inflammatory response, they note.
Bincy P. Abraham, MD, an assistant professor of medicine in the Inflammatory Bowel Disease Program at Baylor College of Medicine in Houston, Texas, said that vitamin D, or a lack thereof, has been recognized as a potential risk factor for IBD, but its role is not entirely understood.
"Theoretically, vitamin D can play a role in inflammation: low levels may contribute to inflammation, and thus can be explained by the general north–south gradient of inflammatory bowel disease we have seen historically in the US, as well as Europe," Dr. Abraham told Medscape Medical News.
"However, knowing the vitamin D levels in both groups of patients is important in order to clarify this," added Dr. Abraham, who was not involved in the study. "This is because there could be other confounders — other environmental causes that we do not know about."
In her own research on Inflammatory Bowel Disease, Dr. Abraham found high levels of abnormal bone density among patients with IBD and vitamin D deficiency, but that research was also inconclusive regarding the vitamin's influence.
"It was difficult for us to determine a correlation of IBD disease activity and vitamin D levels due to too many confounding variables," she said, noting that, among potential variables, there is even a theory that refrigeration of food may increase the risk for Inflammatory Bowel Disease.
"My general sense is that [a correlation with vitamin D] is quite possible," Dr. Abraham concludes. "We may need to do additional, larger-scale studies of vitamin D levels and their association in contributing to the development of Inflammatory Bowel Disease."
The study received support from the National Institutes of Health and the Broad Medical Research Program of the Broad Foundation. The authors included a clinical investigator for the Damon Runyon Cancer Research Foundation, and one author is supported by a career development award from the IBD Working Group and the Crohn's and Colitis Foundation of America. Dr. Abraham has disclosed no relevant financial relationships.
Fecal Calprotectin Helps Spot Pediatric Inflammatory Bowel Disease
By David Douglas
NEW YORK (Reuters Health) Mar 16 - High fecal calprotectin (FC) levels identify children who need endoscopic exams for inflammatory bowel disease (IBD), UK researchers say.
FC is "far superior to commonly utilized blood parameters such as C-reactive protein and white cell count" as a marker of IBD, they reported online February 28th in The American Journal of Gastroenterology.
"This study robustly identifies fecal calprotectin as not only an important biomarker during the treatment of pediatric inflammatory bowel disease but also during the initial investigation of children with suspected disease," Iead author Dr. Paul Henderson told Reuters Health by email.
Dr. Henderson of the University of Edinburgh and colleagues reviewed data on 190 volunteers who had FC testing, including 91 with IBD and 99 controls.
In their own practice, the researchers use a cutoff of 200 mcg/g to define high levels.
In the study, the median FC at diagnosis in the IBD group was 1,265 mcg/g, compared to only 65 mcg/g in controls. In the patient group, values were similar whether with Crohn's disease, ulcerative colitis and unclassified Inflammatory Bowel Disease.
"Our work demonstrates that disease location and type do not influence FC at diagnosis and that FC performs far better than commonly used blood tests," Dr. Henderson said.
Senior author Dr. David C. Wilson added, "(FC) has indeed become our standard of care -- although no single test will be 100% correct in diagnostic terms, it is much superior to any (or a combination of all) commonly used blood 'inflammatory markers.'"
"A negative test is very helpful," he said, "and reduces the number of children in our practice going to invasive testing with GI endoscopy and biopsies; by contrast, a test showing more than 200 mcg/g strengthens our suspicion of Inflammatory Bowel Disease and will expedite further investigation, unless the clinical scenario has markedly improved."
Further studies are now required, but Dr. Wilson pointed out that "because it has become our standard of care, we are not placed to perform the definitive trial with blinded calprotectin usage and evaluation of suspected gut inflammation of children and young people generating robust data on reduction (or not) or need for GI endoscopy and biopsies."
In the meantime, he and his colleagues predict, someday "the routine use of FC in the pediatric setting should significantly enhance our ability to more accurately screen children for Inflammatory Bowel Disease."
NEW YORK (Reuters Health) Mar 16 - High fecal calprotectin (FC) levels identify children who need endoscopic exams for inflammatory bowel disease (IBD), UK researchers say.
FC is "far superior to commonly utilized blood parameters such as C-reactive protein and white cell count" as a marker of IBD, they reported online February 28th in The American Journal of Gastroenterology.
"This study robustly identifies fecal calprotectin as not only an important biomarker during the treatment of pediatric inflammatory bowel disease but also during the initial investigation of children with suspected disease," Iead author Dr. Paul Henderson told Reuters Health by email.
Dr. Henderson of the University of Edinburgh and colleagues reviewed data on 190 volunteers who had FC testing, including 91 with IBD and 99 controls.
In their own practice, the researchers use a cutoff of 200 mcg/g to define high levels.
In the study, the median FC at diagnosis in the IBD group was 1,265 mcg/g, compared to only 65 mcg/g in controls. In the patient group, values were similar whether with Crohn's disease, ulcerative colitis and unclassified Inflammatory Bowel Disease.
"Our work demonstrates that disease location and type do not influence FC at diagnosis and that FC performs far better than commonly used blood tests," Dr. Henderson said.
Senior author Dr. David C. Wilson added, "(FC) has indeed become our standard of care -- although no single test will be 100% correct in diagnostic terms, it is much superior to any (or a combination of all) commonly used blood 'inflammatory markers.'"
"A negative test is very helpful," he said, "and reduces the number of children in our practice going to invasive testing with GI endoscopy and biopsies; by contrast, a test showing more than 200 mcg/g strengthens our suspicion of Inflammatory Bowel Disease and will expedite further investigation, unless the clinical scenario has markedly improved."
Further studies are now required, but Dr. Wilson pointed out that "because it has become our standard of care, we are not placed to perform the definitive trial with blinded calprotectin usage and evaluation of suspected gut inflammation of children and young people generating robust data on reduction (or not) or need for GI endoscopy and biopsies."
In the meantime, he and his colleagues predict, someday "the routine use of FC in the pediatric setting should significantly enhance our ability to more accurately screen children for Inflammatory Bowel Disease."
Patients With IBD Fare Well on Their Travels
Patients with inflammatory bowel disease (IBD) who traveled to
developed countries had a higher rate of illness compared with other
travelers, but the rate of illness was the same for travel to developing
or tropical regions. Most travel-related illnesses among the patients
with IBD arose from sporadic flares of their disease, rather than
increased susceptibility to enteric infections, suggested study authors
Shomron Ben-Horin, MD, director of the IBD service, and coauthors from
the Sheba Medical Center and Sackler School of Medicine of Tel-Aviv
University in Tel Hashomer, Israel.
The research was published online November 3 and in the February print issue of Clinical Gastroenterology and Hepatology.
Compared with healthy control patients, the absolute increased risk for patients with IBD was small, and most episodes of illness that they experienced were mild, providing reassurance for many patients who want to travel.
Patients with IBD have often been advised to avoid travel, especially to developing countries, for fear of contracting infections or experiencing disease flares in regions with poor hygiene or potentially inadequate medical facilities. Self-imposed or physician-advised restrictions on travel can severely limit patients' quality of life or opportunities to do business abroad.
Because little data exist on the risk of travel for patients with Inflammatory Bowel Disease, the investigators performed a retrospective, case–control study comparing illnesses among patients with Inflammatory Bowel Disease (n = 222; 523 trips) and healthy control individuals (n = 224; 576 trips), using validated, structured questionnaires, interviews, and chart reviews. The questionnaires included items related to demographics, medical history (eg, travel clinic attendance, immunizations, and prophylactic and regular medications), details of all travel going back 5 years, and any illness during or within 3 months after any trips. The authors used the United Nations Human Developmental Index classification to identify developing and developed countries.
Individuals in the case group included individuals attending outpatient gastroenterology (GI) clinics at the medical center. Individuals in the control group included volunteers without known Inflammatory Bowel Disease who were drawn from hospital staff, their family members, and people escorting relatives undergoing endoscopies. The mean age of both groups was 37 years. Individuals in the control group received the same questionnaire as patients with IBD, but without IBD-specific items. The authors defined illness as any GI or non-GI episode.
Patients with Inflammatory Bowel Disease experienced illness in 15.1% of their trips compared with 10.9% of trips made by control patients (odds ratio [OR], 1.44; 95% confidence interval [CI], 1.01 - 2.0; P = .04). For both patients with IBD and control participants, enteric disease accounted for 92% of the episodes, most of which were mild to moderate and resolved within a few days, the authors report. Only 5 patients with IBD and 4 control participants required hospital admission for any reason while traveling.
Travel to developed countries accounted for most of the difference in illness between patients with IBD and control participants. For the 2 groups, the rates of illness were the same when they went to developing regions (17% vs 21% of trips, respectively; P = .24).
Their rates of illness when traveling to developing countries (17% of trips) was not statistically different from when they went to developed countries (13.9% of trips; P = .32). They did, however, experience an almost 2-fold increased risk when traveling to the tropics compared with developed countries (OR, 1.9; 95% CI, 1.1 - 3.3; P = .02).
Control individuals experienced much less illness in developed countries (3.3% of trips) compared with travel in developing regions (21.4% of trips; OR, 6.6; 95% CI, 3.2 - 12.2; P < .001). When they went to the tropics, however, their rates of illness increased 10-fold compared with travel in developed countries (33.3% vs 3%, respectively; OR, 13.6%; 95% CI, 6.7 - 27.6; P < .001) and were not statistically different from the rate of illness for patients with IBD (P = .18).
Factors Influencing Travel-Related Risk
It appeared that underlying IBD activity was an important determinant of travel-related disease activity. Multivariate analysis showed that risk increased if patients experienced frequent flares (OR, 1.9; 95% CI, 1.1 - 3.4; P = .02) or had prior IBD-related hospitalizations (OR, 3.5; 95% CI, 1.3 - 9.3; P = .01). Among patients with IBD, disease remission for at least 3 months before traveling reduced the risk for travel-related illness by 70% (OR, 0.3; 95% CI, 0.16 - 0.5; P < .001). Patients in remission had the same risk for illness during travel as did individuals in the control group (12% vs 10.9%; P = .5).
In the multivariate analysis, there was no independent effect of the use of immunomodulatory drugs during the trip on the risk for illness during travel (P = .5).
Because the length of the trip may affect the likelihood of illness, the investigators normalized the results per 10 days of travel and found a 7% risk per 10 days for individuals in the case group vs 5% per 10 days for individuals in the control group (OR, 1.4; 95% CI, 1.01 - 1.96; P = .04). When stratified by trip duration, there was no increased risk for patients with IBD traveling to developing or tropic areas, in line with the nonnormalized analyses.
Travelers with IBD experienced disease flares within 3 months of returning to Israel after 16% of their trips. The incidence of flares was higher if travelers had experienced an episode of illness during the trip than for uneventful trips (43% vs 11.6%, respectively; OR, 7.4; 95% CI, 4.2 - 12.9; P < .001). The authors note that almost half of the patients with illness during the trip and flares afterward felt that the flare was a direct continuation of the episode during the trip.
The authors caution that the retrospective nature of the study makes it susceptible to recall bias, and they emphasize that it was not sufficiently powered to detect differences in rare opportunistic infections that may affect immunocompromised patients. They also warned that live attenuated vaccines such as those against yellow fever are contraindicated in such patients. Another limitation of the study is that it involved travelers from a single, developed country, and therefore the results may not be generalizable to travelers with IBD from other developed or developing countries.
Charles Ericsson, MD, professor of medicine, head of clinical infectious diseases, and director of the travel medicine clinic at the University of Texas Medical School at Houston; founding editor-in-chief of the Journal of Travel Medicine; and past-president of the International Society of Travel Medicine, told Medscape Medical News that the study is retrospective, albeit case-controlled, "so that immediately calls into question recall bias when you're asking people to remember trips up to 5 years later. I'm taking any of the data with a bit of a grain of salt." He said most of the illnesses were reportedly mild, but people tend especially to remember more severe illnesses.
"The data are OK as far as they go, but I think you're left with enough uncertainties that I will refuse to use data like this to say that I'm not going to worry about somebody with IBD when they travel to a developing country" and not offer them chemoprophylaxis against travelers' diarrhea, Dr. Ericsson said. Even if the incidence is not different from control participants, "when they do get travelers' diarrhea, I think the impact on the subject is profound because they don't know whether it's a flare of their IBD" that requires treatment or not, "and I'd rather prevent that conundrum to begin with." He admits he's "a fan of chemoprophylaxis" in general, offering rifaximin to his high-risk travelers, which is active in the upper GI tract, and therefore a good prophylactic agent.
Another issue "that does bug me a little bit is the outcome measurement [of] any illness," he said. He would have preferred the authors to distinguish enteric conditions from other types of illness. "They allude to the fact that...92% of the outcomes were enteric disease," he noted. "Then why not just study that 92%, to keep it clean? You would have a study that would have focused on the most important issue."
Dr. Ericsson also wondered about the meaning of the finding that the patients with IBD experienced more illness when they went to developed countries compared with control patients (P < .001), but not when they visited developing ones (P = .2). "What they didn't control for is the likelihood, I would think, that anybody traveling from a developed to another developed country may well not have been on a vacation but, rather, traveling for business, and was stressed out, and that's a known precipitator for a flare of your IBD," he noted. And he speculated that "the IBD people in fact are concerned about going to a developing country and take extra precautions," such as chemoprophylaxis or watching out for food and beverages.
The finding that people with IBD had such a high level of problems in developed countries, but not in developing ones, implies that they experienced only a very small level of travelers' diarrhea in developing countries. "It doesn't sit well with me," Dr. Ericsson said. "I'm not quite sure how to interpret it. I'm worried that there's confounding issues going on of behavioral differences that were not assessed."
Also, with a reported mean trip length of 22 days for both patients with IBD and control participants, he found the incidence of illness quite low compared with previous reports of travelers' diarrhea, depending on trip length. The specific countries, areas of the countries, and purposes of the trips may have affected the outcomes.
In summary, Dr. Ericsson said the study is valid as it is presented, but "it's the interpretation of it that has to be taken with a bit of a grain of salt." He said the findings may lead him to advise a patient with IBD who has had many flares to find out where to get treatment while traveling, as their risk for illness is increased.
He said that going forward, he would like to see a properly designed prospective case–control study implemented that looks at a sufficient number of patients with IBD as they travel, which may avoid some of the problems of recall bias during such a long period of a retrospective study as this one.
Dr. Ben-Horin has received consultancy fees from Schering-Plough and Abbott Laboratories. The other authors and Dr. Ericsson have disclosed no relevant financial relationships.
The research was published online November 3 and in the February print issue of Clinical Gastroenterology and Hepatology.
Compared with healthy control patients, the absolute increased risk for patients with IBD was small, and most episodes of illness that they experienced were mild, providing reassurance for many patients who want to travel.
Patients with IBD have often been advised to avoid travel, especially to developing countries, for fear of contracting infections or experiencing disease flares in regions with poor hygiene or potentially inadequate medical facilities. Self-imposed or physician-advised restrictions on travel can severely limit patients' quality of life or opportunities to do business abroad.
Because little data exist on the risk of travel for patients with Inflammatory Bowel Disease, the investigators performed a retrospective, case–control study comparing illnesses among patients with Inflammatory Bowel Disease (n = 222; 523 trips) and healthy control individuals (n = 224; 576 trips), using validated, structured questionnaires, interviews, and chart reviews. The questionnaires included items related to demographics, medical history (eg, travel clinic attendance, immunizations, and prophylactic and regular medications), details of all travel going back 5 years, and any illness during or within 3 months after any trips. The authors used the United Nations Human Developmental Index classification to identify developing and developed countries.
Individuals in the case group included individuals attending outpatient gastroenterology (GI) clinics at the medical center. Individuals in the control group included volunteers without known Inflammatory Bowel Disease who were drawn from hospital staff, their family members, and people escorting relatives undergoing endoscopies. The mean age of both groups was 37 years. Individuals in the control group received the same questionnaire as patients with IBD, but without IBD-specific items. The authors defined illness as any GI or non-GI episode.
Patients with Inflammatory Bowel Disease experienced illness in 15.1% of their trips compared with 10.9% of trips made by control patients (odds ratio [OR], 1.44; 95% confidence interval [CI], 1.01 - 2.0; P = .04). For both patients with IBD and control participants, enteric disease accounted for 92% of the episodes, most of which were mild to moderate and resolved within a few days, the authors report. Only 5 patients with IBD and 4 control participants required hospital admission for any reason while traveling.
Travel to developed countries accounted for most of the difference in illness between patients with IBD and control participants. For the 2 groups, the rates of illness were the same when they went to developing regions (17% vs 21% of trips, respectively; P = .24).
Their rates of illness when traveling to developing countries (17% of trips) was not statistically different from when they went to developed countries (13.9% of trips; P = .32). They did, however, experience an almost 2-fold increased risk when traveling to the tropics compared with developed countries (OR, 1.9; 95% CI, 1.1 - 3.3; P = .02).
Control individuals experienced much less illness in developed countries (3.3% of trips) compared with travel in developing regions (21.4% of trips; OR, 6.6; 95% CI, 3.2 - 12.2; P < .001). When they went to the tropics, however, their rates of illness increased 10-fold compared with travel in developed countries (33.3% vs 3%, respectively; OR, 13.6%; 95% CI, 6.7 - 27.6; P < .001) and were not statistically different from the rate of illness for patients with IBD (P = .18).
Factors Influencing Travel-Related Risk
It appeared that underlying IBD activity was an important determinant of travel-related disease activity. Multivariate analysis showed that risk increased if patients experienced frequent flares (OR, 1.9; 95% CI, 1.1 - 3.4; P = .02) or had prior IBD-related hospitalizations (OR, 3.5; 95% CI, 1.3 - 9.3; P = .01). Among patients with IBD, disease remission for at least 3 months before traveling reduced the risk for travel-related illness by 70% (OR, 0.3; 95% CI, 0.16 - 0.5; P < .001). Patients in remission had the same risk for illness during travel as did individuals in the control group (12% vs 10.9%; P = .5).
In the multivariate analysis, there was no independent effect of the use of immunomodulatory drugs during the trip on the risk for illness during travel (P = .5).
Because the length of the trip may affect the likelihood of illness, the investigators normalized the results per 10 days of travel and found a 7% risk per 10 days for individuals in the case group vs 5% per 10 days for individuals in the control group (OR, 1.4; 95% CI, 1.01 - 1.96; P = .04). When stratified by trip duration, there was no increased risk for patients with IBD traveling to developing or tropic areas, in line with the nonnormalized analyses.
Travelers with IBD experienced disease flares within 3 months of returning to Israel after 16% of their trips. The incidence of flares was higher if travelers had experienced an episode of illness during the trip than for uneventful trips (43% vs 11.6%, respectively; OR, 7.4; 95% CI, 4.2 - 12.9; P < .001). The authors note that almost half of the patients with illness during the trip and flares afterward felt that the flare was a direct continuation of the episode during the trip.
The authors caution that the retrospective nature of the study makes it susceptible to recall bias, and they emphasize that it was not sufficiently powered to detect differences in rare opportunistic infections that may affect immunocompromised patients. They also warned that live attenuated vaccines such as those against yellow fever are contraindicated in such patients. Another limitation of the study is that it involved travelers from a single, developed country, and therefore the results may not be generalizable to travelers with IBD from other developed or developing countries.
Charles Ericsson, MD, professor of medicine, head of clinical infectious diseases, and director of the travel medicine clinic at the University of Texas Medical School at Houston; founding editor-in-chief of the Journal of Travel Medicine; and past-president of the International Society of Travel Medicine, told Medscape Medical News that the study is retrospective, albeit case-controlled, "so that immediately calls into question recall bias when you're asking people to remember trips up to 5 years later. I'm taking any of the data with a bit of a grain of salt." He said most of the illnesses were reportedly mild, but people tend especially to remember more severe illnesses.
"The data are OK as far as they go, but I think you're left with enough uncertainties that I will refuse to use data like this to say that I'm not going to worry about somebody with IBD when they travel to a developing country" and not offer them chemoprophylaxis against travelers' diarrhea, Dr. Ericsson said. Even if the incidence is not different from control participants, "when they do get travelers' diarrhea, I think the impact on the subject is profound because they don't know whether it's a flare of their IBD" that requires treatment or not, "and I'd rather prevent that conundrum to begin with." He admits he's "a fan of chemoprophylaxis" in general, offering rifaximin to his high-risk travelers, which is active in the upper GI tract, and therefore a good prophylactic agent.
Another issue "that does bug me a little bit is the outcome measurement [of] any illness," he said. He would have preferred the authors to distinguish enteric conditions from other types of illness. "They allude to the fact that...92% of the outcomes were enteric disease," he noted. "Then why not just study that 92%, to keep it clean? You would have a study that would have focused on the most important issue."
Dr. Ericsson also wondered about the meaning of the finding that the patients with IBD experienced more illness when they went to developed countries compared with control patients (P < .001), but not when they visited developing ones (P = .2). "What they didn't control for is the likelihood, I would think, that anybody traveling from a developed to another developed country may well not have been on a vacation but, rather, traveling for business, and was stressed out, and that's a known precipitator for a flare of your IBD," he noted. And he speculated that "the IBD people in fact are concerned about going to a developing country and take extra precautions," such as chemoprophylaxis or watching out for food and beverages.
The finding that people with IBD had such a high level of problems in developed countries, but not in developing ones, implies that they experienced only a very small level of travelers' diarrhea in developing countries. "It doesn't sit well with me," Dr. Ericsson said. "I'm not quite sure how to interpret it. I'm worried that there's confounding issues going on of behavioral differences that were not assessed."
Also, with a reported mean trip length of 22 days for both patients with IBD and control participants, he found the incidence of illness quite low compared with previous reports of travelers' diarrhea, depending on trip length. The specific countries, areas of the countries, and purposes of the trips may have affected the outcomes.
In summary, Dr. Ericsson said the study is valid as it is presented, but "it's the interpretation of it that has to be taken with a bit of a grain of salt." He said the findings may lead him to advise a patient with IBD who has had many flares to find out where to get treatment while traveling, as their risk for illness is increased.
He said that going forward, he would like to see a properly designed prospective case–control study implemented that looks at a sufficient number of patients with IBD as they travel, which may avoid some of the problems of recall bias during such a long period of a retrospective study as this one.
Dr. Ben-Horin has received consultancy fees from Schering-Plough and Abbott Laboratories. The other authors and Dr. Ericsson have disclosed no relevant financial relationships.
Fecal Calprotectin Helps Spot Pediatric IBD
By David Douglas
NEW YORK (Reuters Health) Mar 16 - High fecal calprotectin (FC) levels identify children who need endoscopic exams for inflammatory bowel disease (IBD), UK researchers say.
FC is "far superior to commonly utilized blood parameters such as C-reactive protein and white cell count" as a marker of IBD, they reported online February 28th in The American Journal of Gastroenterology.
"This study robustly identifies fecal calprotectin as not only an important biomarker during the treatment of pediatric inflammatory bowel disease but also during the initial investigation of children with suspected disease," Iead author Dr. Paul Henderson told Reuters Health by email.
Dr. Henderson of the University of Edinburgh and colleagues reviewed data on 190 volunteers who had FC testing, including 91 with IBD and 99 controls.
In their own practice, the researchers use a cutoff of 200 mcg/g to define high levels.
In the study, the median FC at diagnosis in the IBD group was 1,265 mcg/g, compared to only 65 mcg/g in controls. In the patient group, values were similar whether with Crohn's disease, ulcerative colitis and unclassified Inflammatory Bowel Disease.
"Our work demonstrates that disease location and type do not influence FC at diagnosis and that FC performs far better than commonly used blood tests," Dr. Henderson said.
Senior author Dr. David C. Wilson added, "(FC) has indeed become our standard of care -- although no single test will be 100% correct in diagnostic terms, it is much superior to any (or a combination of all) commonly used blood 'inflammatory markers.'"
"A negative test is very helpful," he said, "and reduces the number of children in our practice going to invasive testing with GI endoscopy and biopsies; by contrast, a test showing more than 200 mcg/g strengthens our suspicion of Inflammatory Bowel Disease and will expedite further investigation, unless the clinical scenario has markedly improved."
Further studies are now required, but Dr. Wilson pointed out that "because it has become our standard of care, we are not placed to perform the definitive trial with blinded calprotectin usage and evaluation of suspected gut inflammation of children and young people generating robust data on reduction (or not) or need for GI endoscopy and biopsies."
In the meantime, he and his colleagues predict, someday "the routine use of FC in the pediatric setting should significantly enhance our ability to more accurately screen children for Inflammatory Bowel Disease."
NEW YORK (Reuters Health) Mar 16 - High fecal calprotectin (FC) levels identify children who need endoscopic exams for inflammatory bowel disease (IBD), UK researchers say.
FC is "far superior to commonly utilized blood parameters such as C-reactive protein and white cell count" as a marker of IBD, they reported online February 28th in The American Journal of Gastroenterology.
"This study robustly identifies fecal calprotectin as not only an important biomarker during the treatment of pediatric inflammatory bowel disease but also during the initial investigation of children with suspected disease," Iead author Dr. Paul Henderson told Reuters Health by email.
Dr. Henderson of the University of Edinburgh and colleagues reviewed data on 190 volunteers who had FC testing, including 91 with IBD and 99 controls.
In their own practice, the researchers use a cutoff of 200 mcg/g to define high levels.
In the study, the median FC at diagnosis in the IBD group was 1,265 mcg/g, compared to only 65 mcg/g in controls. In the patient group, values were similar whether with Crohn's disease, ulcerative colitis and unclassified Inflammatory Bowel Disease.
"Our work demonstrates that disease location and type do not influence FC at diagnosis and that FC performs far better than commonly used blood tests," Dr. Henderson said.
Senior author Dr. David C. Wilson added, "(FC) has indeed become our standard of care -- although no single test will be 100% correct in diagnostic terms, it is much superior to any (or a combination of all) commonly used blood 'inflammatory markers.'"
"A negative test is very helpful," he said, "and reduces the number of children in our practice going to invasive testing with GI endoscopy and biopsies; by contrast, a test showing more than 200 mcg/g strengthens our suspicion of Inflammatory Bowel Disease and will expedite further investigation, unless the clinical scenario has markedly improved."
Further studies are now required, but Dr. Wilson pointed out that "because it has become our standard of care, we are not placed to perform the definitive trial with blinded calprotectin usage and evaluation of suspected gut inflammation of children and young people generating robust data on reduction (or not) or need for GI endoscopy and biopsies."
In the meantime, he and his colleagues predict, someday "the routine use of FC in the pediatric setting should significantly enhance our ability to more accurately screen children for Inflammatory Bowel Disease."
Youths With IBD May Need Large Doses of Vitamin D
By Megan Brooks
NEW YORK (Reuters Health) Apr 17 - In children and adolescents with inflammatory bowel disease (IBD) and insufficient serum vitamin D levels, taking 2,000 IU of vitamin D3 every day for six weeks, or a 50,000-IU dose of vitamin D2 every week, were both more effective at raising serum 25OHD concentration than 2,000 IU/day of vitamin D2.
Dr. Helen Pappa from Children's Hospital Boston, who worked on the study, told Reuters Health: "This is the first study to compare efficacy of three widely used vitamin D repletion regimens in children with vitamin D insufficiency. Findings from the study suggest that large vitamin D doses are needed to treat vitamin D insufficiency in this population, and that body weight rather than absorption affects regimen success in this population."
Based on the results of this study, "doses of 2,000 IU of vitamin D2 per day for six weeks should not be used because they may be inadequate in treating vitamin D insufficiency in adolescents with IBD," she said.
Vitamin D insufficiency (25OHD <20 ng/mL) is common in children with IBD and its treatment has not been studied, Dr. Pappa and colleagues said in a report online March 28 in the Journal of Clinical Endocrinology and Metabolism.
They enrolled in their study 71 patients with Inflammatory Bowel Disease between 5 and 21 years old and serum 25OHD <20 ng/ml.
All participants took oral elemental calcium (1,200 mg for those aged 11 or older and 800 mg for those younger than age 11) plus one of three vitamin D regimens: 2,000 IU vitamin D2 daily (study arm A; control), 2,000 IU vitamin D3 daily (arm B) and 50,000 IU vitamin D2 once weekly (arm C).
Sixty-one subjects completed the trial and two withdrew due to adverse events. All regimens were well tolerated, the researchers say. Adverse events occurred in one third of subjects overall, with no differences between the three arms. Most common were nausea (n=6), increased thirst and loss of appetite (n=5 each) and pruritus (n=4),
After six weeks of treatment, the mean changes from baseline in serum 25OHD were 9.3, 16.4 and 25.4 ng/mL in arms A, B and C, respectively.
Arms B and C experienced statistically significantly greater mean changes than arm A (Bonferroni adjusted p=0.03 and p=0.0004, respectively). "Serum 25OHD concentration increased on average by 130% and 190% in arms B and C, respectively, compared with just 62% in arm A," the researchers report.
Both arms B and C were 95% successful in raising serum 25OHD levels above 20 ng/mL; however, 62% of subjects in arm B and 25% in arm C did achieve a serum 25OHD level above 32 ng/mL, the investigators report. They estimate that a cumulative dose of 400,000 IU of vitamin D2 or 220,000 IU of vitamin D3 "would be sufficient to achieve this level."
The researchers say further studies are needed to "define a specific target serum 25OHD concentration and the best regimen by which to achieve and maintain this in young patients with Inflammatory Bowel Disease."
They also found that subjects who failed treatment were heavier, which supports weight-adjusted vitamin D dosing.
No change in serum parathyroid hormone (PTH) concentration was observed in any of the treatment arms. The authors note that baseline PTH levels were lower than reference PTH values for healthy children of similar age in their geographic region.
"PTH response to treatment was blunted suggesting a relative hypoparathyroidism in this population," Dr. Pappa said. None of the study subjects experienced hypercalcemia, hyperphosphatemia, or serum 25OHD concentration above 68 ng/mL after treatment.
Wednesday, May 2, 2012
Stress levels and smoking: Why your dad's bad habits may have wrecked your genes
By
John Naish
For years, scientists and doctors
have blamed illnesses on our parents, showing how conditions such as
blindness and deafness can be passed down genetically, and bad lifestyle
habits can put babies at risk of heart defects.
But
medicine is increasingly pointing the finger specifically at fathers,
with studies showing how male genes and even men’s diets and stress
levels can create serious health problems for their offspring, including
diabetes, depression and obesity.
This latest finding is part of a larger picture
where scientists are starting to discover diseases passed from man to
boy through the Y chromosome
It seems that the Bible warning holds
true for health: the sins of the fathers really do plague their
children — and this effect may pass on to their grandchildren, too.
The
latest evidence in this newly emerging jigsaw comes from research that
shows a common genetic flaw may increase a son’s risk of heart disease
by 50 per cent.
Scientists
at Leicester University who analysed samples from more than 3,000 men
found that those with a common group of genetic traits (called
haplogroup I) had a 50 per cent higher risk of coronary artery disease
than men in other genetic groups.
This genetic flaw is at the
centre of male genetic identity; it’s carried in the Y chromosome,
responsible for determining that babies are born as boys (chromosomes
are found in all cells and carry our genetic blueprint) — so it’s passed
only from fathers to sons.
It
is thought that as yet unidentified genetic flaws in men’s immune
systems may cause chronic inflammation in their arteries, which can lead
to heart disease.
The
British Heart Foundation, which funded the study, said the findings
could lead to new tests and treatments for coronary problems.
And
while men can’t change their genes, they could benefit from learning if
they have inherited this danger, says research scientist Lisa Bloomer,
one of the study’s authors.
Indeed,
while there are no tests for this haplogroup yet, if your father and
uncles have had heart troubles, it is sensible to assume there is a
strong chance you may be affected.
‘You
can reduce your risk if you mitigate the effects of other dangers, such
as your weight, blood pressure and cholesterol levels,’ says Ms
Bloomer.
This latest
finding is part of a larger picture where scientists are starting to
discover diseases passed from man to boy through the Y chromosome.
‘It
has already been found genes on this chromosome can increase people’s
risk of being born with autism and for contracting HIV,’ says Ms
Bloomer.
‘We need to do more work to understand how these problems occur.’
Men can pass on addictive behaviours and stress-related depression
Scientists are also learning how the
bad effects of men’s lifestyle habits, such as their diet, stress
levels, weight and smoking, can be transmitted through the genes in
their sperm.
Just as disturbingly, it seems that men can pass on addictive behaviours and stress-related depression.
Here, it is not only sons who are affected but daughters, too, because
these problems are passed on through genes that are not on the Y sex
chromosome.
Early clues
to this have been found by Washington University researchers who
studied the sperm of a group of male heroin addicts.
The men’s sperm contained genes that had been changed from normal and would affect the development of any children they had.
These changes are called ‘epigenetic’ — alterations to a person’s genes that are caused by their lifestyle habits.
Significantly,
the researchers found epigenetic changes that boosted the activity of
OPRM1, a gene that controls how the body responds to its own
heroin-like feel-good hormones.
This change is believed to be a factor in making people more liable to develop addictions.
In a similar fashion, men may transmit stress-related diseases across generations.
Scientists
at New York’s Mount Sinai School of Medicine say lab experiments on
rats have found epigenetic changes in the semen of males who show signs
of stress and anxiety after being isolated or threatened.
Their
studies show that baby rats sired by these fathers show an increased
vulnerability to stress, and become anxious and depressed more quickly
than normal. They also have higher levels of stress hormones.
This
is despite the fact that their mothers showed no such problems,
according to the study published in the journal Biological Psychiatry.
This may offer one explanation as to why depression can run in families.
Even smoking when very young can affect men’s sperm — and surprisingly, this may make their sons prone to becoming overweight.
The
discovery was made using survey results from the Avon Longitudinal
Study of Parents and Children — an investigation into the health of
14,000 mothers and their children in the Bristol area.
It began in 1991 and is the most comprehensive study of its kind.
Professor
Marcus Pembrey, a clinical geneticist at the Institute of Child Health
in London, found men who smoked before puberty had sons who were fatter
by the age of nine, even when other lifestyle factors were taken into
account. There was no similar effect among women.
‘It
seems that before puberty, our genes are tuned to suit the environment
we are living in. It is these genetic changes that are passed down the
male line,’ says Professor Pembrey.
Perhaps the most important factor in determining a man’s legacy to his children comes from his dietary habits.
This takes us into a newly emerging field of science called nutri- epigenomics — the study of how food can alter our genes.
‘Rather
than “you are what you eat”, this science shows “you are what your dad
ate”,’ says Anne Ferguson-Smith, professor of developmental genetics
at Cambridge University.
She
points to research that showed fathers who eat high-fat diets and are
obese tend to have daughters with a high risk of developing diabetes.
These girls are born with low insulin levels and glucose intolerance — classic signs of the disease.
The research, published in the journal Nature, concluded that the problems seem to be transmitted through the father’s sperm.
Professor
Ferguson-Smith warns in the journal Cell Metabolism that these studies
show the problem of ill-health being passed from parents to children ‘is
not only just maternal territory.
The
father’s nutritional and metabolic status merits attention, too, if we
are to optimise the health of his children and grandchildren’.
Parents must understand that having healthy offspring is a joint enterprise if their babies are to inherit healthy genes.
This is most starkly illustrated by a study that found obese mothers produced sons at risk of being morbidly overweight.
These boys grew up to father daughters who, in turn, had an inherited tendency to be perilously overweight.
The
Biblical prediction turns out to be more complex than anyone thought:
the lifestyle sins of both parents can be visited on their children and
are passed on in ways we are only beginning to understand.
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