It’s ANOTHER Power Packed Month of July in the topics of Nutrigenomics, Health, and Drug Updates….

Remember…skimming and taking more of what you like and leaving the rest…is fine! 🙂

Highlights in Nutrigenomics include:

1. Environmental factors related to cancer

2. How various supplements modulate risk factors for disease (notice the power of garlic in cancer and inflammation!)

Highlights in Health include:

1. Stress Impact on Health

2. Power of Group Healing

3. Lead levels

Highlights in Drug Updates include:

1. Actos and Bladder Cancer

2. Are Bisphosphates really helpful long-term for bone health (and what nutrition is!)

3. The business of drugs

Now, the major headline this week:

A summary of updated practices and guidelines related to over-screening.

Medscape reports:

Medscape: I’d like to go through the recommendations and talk about some of the evidence backing each one up. The first one was not to perform imaging for low back pain within the first 6 weeks unless red flags are present. Why was that number 1?

Dr. Stream: The idea was that these recommendations would be for everyday common practices in family medicine for which there was a solid research basis. If we highlighted rare or esoteric conditions, we wouldn’t have an opportunity to make a big impact.

Low back pain is among the top complaints for seeing a primary care physician, and it is a misunderstanding among patients that imaging studies somehow contribute to better treatment.

Medscape: The second recommendation is to avoid prescribing an antibiotic for acute to moderate sinusitis, unless symptoms last longer than 7 days or symptoms get worse. Overprescribing of antibiotics seems to be chronic. I know we’ve been reading about that for years.

Dr. Stream: Well, from the standpoint of the patient, they might say, “Gee, I’m sick. Give me anything that will make me better.” Physicians often know that’s not right, but it’s sometimes easier to say, “Okay, here’s your prescription,” rather than respond, “I know you’re miserable. However, the vast majority of these infections are viral, which are self-limited and not caused by bacteria, and they won’t be benefited by antibiotic therapy.”[4,5] But this takes longer, so we need to educate both patients and physicians to say, “This antibiotic isn’t going to help.”

We certainly know that unnecessary use of antibiotics can involve serious side effects. Unnecessary use also contributes to the problem of antibiotic resistance. So I’ll often tell patients, “An antibiotic isn’t going to help you this time. And if we give it to you now when you don’t need it, it may not work when you do.”

Medscape: The third recommendation is not to screen for osteoporosis in women younger than 65 years, or men younger than 70 years with no risk factors.

Dr. Stream: In everyday practice, many physicians and patients believe that when women reach menopausal age, osteoporosis screening is medically indicated. However, the evidence-based evaluation done by the US Preventive Services Task Force (USPSTF) says no, it should start at age 65 years.[6] And again, the little-known complex aspect of screening is not just whether the problem is identified, but it is also whether you can actually help somebody with that information.

What’s the harm versus benefit of screening when it comes to a treatment decision? With osteoporosis screening, we’re seeing more about the safety issue with bisphosphonates. If I screen somebody at age 55 years and they’ve got borderline osteoporosis, and I put them on therapy and they have a complication, did I help them or not? It’s difficult to know, because treating the bone density isn’t the target goal. It’s preventing fractures. So that’s the challenge.

However, to take a couple of steps backward, there are always going to be exceptions for any of these recommendations, including those we’ve already talked about, when the patient and doctor should both ask, “In general this recommendation is true, but is my situation an exception?” For the osteoporosis screening, if people have a strong family history — or if they’ve had medical treatment, such as long-term steroid therapy — then they would be in a risk group where screening earlier may be necessary.

Medscape: So, the fourth one: Don’t order annual ECGs or any other cardiac screening for low-risk patients without symptoms.

Dr. Stream: We don’t think of an ECG as a very invasive test, and it’s not. The issue here, as in other screening tests, is one of false-positive results.[7-9] If you have a well person with no symptoms who has an ECG that shows problems, what is the likelihood that this is a real problem or a false-positive finding?

The point is, we see lots of false-positive results. The whole strategy of screening is to pick a target population whose chance of having a true abnormality is high enough that they benefit from screening. This is why we don’t do mammograms on 25-year-old women. The radiation exposure is more likely to harm them than that we’re going to find something that will help them

Medscape: And the last recommendation: Don’t perform Papanicolaou (Pap) smears on women younger than 21 years or who have had hysterectomy for noncancer disease.

Dr. Stream: There are 2 separate things here. Not performing Pap smears in women younger than 21 years is a relatively new change and comes from multiple sources, including the USPSTF.[10,11] We used to tell women that they should have their first Pap smear at age 18 years or when they became sexually active. Then the age became 21 years or when you became sexually active. The current recommendation is not to do the test before age 21 years, regardless of being sexually active.

What has been found is that Pap smear abnormalities in women of any age are usually related to human papillomavirus (HPV) infection and are more likely to clear on their own than to require treatment.

Carol Peckham; Glen Stream, MD, MBI. Questionable Practices From AAFP: An Interview With Glen Stream. Medscape. June 13, 2012. http://www.medscape.com/viewarticle/765167?src=ptalk

NUTRIGENOMICS

Lee BJ, Huang YC, Chen SJ, Lin PT.Effects of coenzyme Q10 supplementation on inflammatory markers (high-sensitivity C-reactive protein, interleukin-6, and homocysteine) in patients with coronary artery disease.Nutrition. 2012 Feb 16. [Epub ahead of print]

Plasma coenzyme Q10 was inversely correlated with hs-CRP (r = -0.20, P = 0.07) and IL-6 (r = -0.25, P = 0.03) at baseline. After supplementation, plasma coenzyme Q10 was significantly correlated with malondialdehyde (r = -0.35, P < 0.01) and superoxide dismutase activities (r = 0.52, P < 0.01). However, there was no correlation between coenzyme Q10 and homocysteine.CONCLUSION: Coenzyme Q10 supplementation at a dosage of 150 mg appears to decrease the inflammatory marker IL-6 in patients with CAD. 

Cancer Risk and Vegetables (Vanderbilt University)

A study by Vanderbilt-Ingram Cancer Center and Shanghai Center for Disease Control and Prevention investigators reveals that breast cancer survivors who eat more cruciferous vegetables may have improved survival. The study of women in China was presented by postdoctoral fellow Sarah J. Nechuta, Ph.D., M.P.H., at the American Association for Cancer Research Annual Meeting in Chicago, Ill.-McMilin. Eating cruciferous vegetables may improve breast cancer survival. April 3, 2012

Garlic and Leukemia (Leuk Res)

The apoptosis inducing activity of ajoene is via the mitochondria-dependent caspase cascade through a significant reduction of the anti-apoptotic bcl-2 that results in release of cytochrome c and the activation of caspase-3. Since acute myeloid leukaemia (AML) is a heterogeneous malignant disease in which disease progression at the level of CD34-positive cells has a major impact on resistance to chemotherapy and relapse and the inability to undergo apoptosis is a crucial mechanism of multi-drug resistance in AML patients. The recent findings of the potent enhancing activity of ajoene on chemotherapy-induced apoptosis in CD34-positive resistant human myeloid leukaemia cells suggest a novel promising role for the treatment of refractory and/or relapsed AML patients as well as elderly AML patients. Further studies are warranted to evaluate similar enhancing effect for ajoene in blast cells from AML patients in primary cultures before its introduction in pilot clinical study. (Hassan HT.. Ajoene (natural garlic compound): a new anti-leukaemia agent for AML therapy. Leuk Res2004 Jul;28(7):667-71.PMID:15158086.)
Around 2 million cancer cases each year are caused by infectious agents. Application of existing public health methods for infection prevention, such as vaccination, safer injection practice, or antimicrobial treatments, could have a substantial effect on the future burden of cancer worldwide.
-Martel, et al. The Lancet Oncology, Volume 13, Issue 6, Pages 607 – 615. June 2012. (Online May 2012). doi:10.1016/S1470-2045(12)70137-7.

Previous studies have linked low oxygen levels in cells as a contributing factor in cancer development, but not as the driving force for cancer growth. High incidence rates of cancer around the world cannot be explained by chance genetic mutations alone, Xu said. He added that bioinformatics, which melds biology and computational science, has allowed researchers to see cancer in a new light. Gene-level mutations may give cancer cells a competitive edge over healthy cells, but the proposed new cancer growth model does not require the presence of common malfunctions such as a sudden proliferation of oncogenes, precursors to cancer cells.

“Cancer drugs try to get to the root — at the molecular level — of a particular mutation, but the cancer often bypasses it,” Xu said. “So we think that possibly genetic mutations may not be the main driver of cancer.”

Much of cancer research so far has focused on designing drug treatments that counteract genetic mutations associated with a particular type of cancer. In their study, the researchers analyzed data downloaded from the Stanford Microarray Database via a software program to detect abnormal gene expression patterns in seven cancers: breast, kidney, liver, lung, ovary, pancreatic and stomach. The online database allows scientists to examine information from microarray chips, which are small glass slides containing large amounts of gene material.

Xu relied on the gene HIF1A as a biomarker of the amount of molecular oxygen in a cell. All seven cancers showed increasing amounts of HIF1A, indicating decreasing oxygen levels in the cancer cells.

Low oxygen levels in a cell interrupt the activity of oxidative phosphorylation, a term for the highly efficient way that cells normally use to convert food to energy. As oxygen decreases, the cells switch to glycolysis to produce their energy units, called ATP. Glycolysis is a drastically less efficient way to obtain energy, and so the cancer cells must work even harder to obtain even more food, specifically glucose, to survive. When oxygen levels dip dangerously low, angiogenesis, or the process of creating new blood vessels, begins. The new blood vessels provide fresh oxygen, thus improving oxygen levels in the cell and tumor and slowing the cancer growth-but only temporarily.

ScienceDaily. Low Oxygen Levels Could Drive Cancer Growth, Research Suggests. ScienceDaily. May 3, 2012.http://www.sciencedaily.com/releases/2012/05/120503194219.htm

Garlic and Inflammation (Science Direct)

We investigated the protective effects of garlic sulfur compounds (GSCs), specifically, diallyl sulfide (DAS), diallyl disulfide (DADS), and diallyl trisulfide (DATS), on endotoxin-induced intestinal damage. Wistar rats received by gavage 0.125 or 0.025 mmol/kg body wt of each GSC or the vehicle (corn oil; 2 mL/kg body wt) every other day for 2 weeks before being injected with endotoxin (ip, 5 mg/kg body wt). Control rats were administered corn oil and were injected with sterile saline. Rats were killed at 18 h after injection. Both doses of DAS suppressed endotoxin-induced neutrophilia, serum levels of sICAM-1 and CINC-1, cellular CD11b on neutrophils, and intestinal contents of ICAM-1, CINC-1, TNF-alpha, and IL-1beta (p < 0.05). DADS suppressed endotoxin-induced intestinal contents of ICAM-1, TNF-alpha, and IL-1beta at both doses, but only suppressed the serum sICAM-1 level and cellular CD11b on neutrophils at the low dose (p < 0.05). DATS did not ameliorate the endotoxin-induced serum level of sICAM-1 or CINC-1 but suppressed intestinal IL-1beta at both doses. The low but not the high dose of DATS also ameliorated the intestinal contents of ICAM-1 and TNF-alpha (p < 0.05). All GSCs reversed endotoxin-induced neutrophil infiltration and damage in the intestine, and the order of the effects of these GSCs to normalize intestinal morphology was DAS > DADS > DATS.

La-Chicken de’ E. Coli? (NewHope 360)

The best results for both measures were obtained from an olive extract (a freeze-dried, organic olive water extract powder consisting of 98-99 percent olive pulp and 1-2 percent citric acid), apple-skin extract (containing an 82-percent concentration of a mixture of phenolic compounds), and clove-bud essential oil (up to 90 percent eugenol). Olive extract and lemongrass essential oil reduced E. coli O157:H7 to undetectable levels, while onion powder, which appeared to reduce microbial growth, and olive extract had the greatest inhibitory activity against HCA formation.

Journal of Agricultural and Food Chemistry
March 7, 2012 :Plant Extracts, Spices, and Essential Oils Inactivate Escherichia coli O157:H7 and Reduce Formation of Potentially Carcinogenic Heterocyclic Amines in Cooked Beef Patties

-American Herbal Products Association, Engredea News & Analysis. Plant extracts, essential oils combat E. coli. 3/19/12.

Sugar and Addiction (Dr. Mercola)

  • For 50,000 years or more, humans relied on the hormone leptin to send signals to the brain to regulate what we ate; leptin tells your brain when you’ve had enough to eat
  • It is very important that your brain is able to accurately “hear” the messages leptin sends it, as otherwise your brain thinks you’re starving and will continue to feel hungry; in recent years, many people have become unable to “hear” leptin’s message to stop eating because excess sugar calories are storied as leptin-releasing fat, and the resulting chronic elevation in leptin levels eventually lead to leptin-resistance
  • When you eat sugar it also triggers the production of your brain’s natural opioids — a key initiator of addiction. Your brain essentially becomes addicted to the sugar-induced opioid release, not entirely unlike addictions to morphine or heroin
  • The abnormally high stimulation of your brain’s pleasure receptors by a sugar-rich diet generates excessive reward signals in your brain. These have the potential to override normal self-control mechanisms, create tolerance and withdrawal symptoms, thus leading to addiction and overeating
  • Limiting or eliminating your sugar intake is the most effective way to break free from this disease-causing, over-eating cycle

Growing evidence shows that leptin may influence areas of your brain that control the intensity of your desire to eat. It has also been found that leptin not only changes brain chemistry, but can also “rewire” the very important areas of your brain that control hunger and metabolism. The way your body stores fat is a carefully regulated process that is controlled, primarily, by leptin. If you gain excess weight, the additional fat produces extra leptin that should alert your brain that your body should stop creating and storing more fat and start burning the accumulated excess…Leptin resistance occurs when your body is unable to properly hear leptin’s signals. How does this happen? By overexposure to high levels of the hormone, caused by eating too much sugar.

According to Dr. Lustig, it is virtually impossible to exert enough cognitive willpower to overcome this 24/7 biochemical drive! He states in The Atlantic:i

“The brain’s pleasure center, called the nucleus accumbens, is essential for our survival as a species… Turn off pleasure, and you turn off the will to live… But long-term stimulation of the pleasure center drives the process of addiction… When you consume any substance of abuse, including sugar, the nucleus accumbens receives a dopamine signal, from which you experience pleasure. And so you consume more. The problem is that with prolonged exposure, the signal attenuates, gets weaker. So you have to consume more to get the same effect — tolerance.

And if you pull back on the substance, you go into withdrawal. Tolerance and withdrawal constitute addiction. And make no mistake, sugar is addictive.”

  • – Mercola, J. Why We Eat More Than We are Supposed To. May 26, 2012. http://articles.mercola.com/sites/articles/archive/2012/05/26/sugar-affects-leptin-signals.aspx?e_cid=20120526_DNL_art_2

DHA Helps Preserve Eye Health in Mice Study (VitalChoice Newsletter)

Wetherby, C. New Eye Benefits Seen in Omega-3s. June 7, 2012. VitalChoice Newsletter. http://newsletter.vitalchoice.com/e_article002449110.cfm?x=blc47JJ,b1h0JlRD

As the Canadian team concluded, “DHA supplementation was associated with: preserved retina function at mid-degenerative stages in E4 mice; prevention of age-related functional losses in WT mice; and reduced A2E levels in E4 and WT mice at the oldest age examined.”

“These findings imply that dietary DHA could have broad preventative therapeutic applications … on pathologic and normal age-related ocular processes” (Dornstauder B et al. 2012).

As Dr. Sauve noted, “… there was no increase in this toxin whatsoever. This has never been demonstrated before – that supplementing the diet with DHA could make this kind of difference. This discovery could result in a very broad therapeutic use [of DHA]” (Dornstauder B et al. 2012).

Fish Oil Protects Brain from Toxins and Trauma (Vital Choice)

Wetherby, C. Fish Fat Curbed Rat’s Brain Injuries . June 11, 2012. http://newsletter.vitalchoice.com/e_article002452486.cfm?x=blcNQLw,b1h0JlRD

As hoped, omega-3s kept the bacterial toxin from switching on a pro-inflammatory gene called Nf-kappaB by, which in turn activates microglia cells, causing unintended but damaging side effects on brain cells.

As the Chinese team wrote, “… our results provided the first in vivo (animal) evidence that omega-3 polyunsaturated fatty acids can inhibit the damage of [dopamine-producing] neurons induced by [bacterial] lipopolysaccharide [toxins] …” (Ailing Jia et al 2012)

Methylation Disorders Related to Adverse Perinatal Events with Assisted Reproductive Techniques (Medscape)

Daniel Skora, M.D.; David Frankfurter, M.D. Adverse Perinatal Events Associated With ART.  Posted: 05/30/2012; Semin Reprod Med. 2012;30(02):84-91. http://www.medscape.com/viewarticle/763326

Since the advent of ART, much research has focused on the potential adverse for resultant harm. Prematurity, low birth-weight, PIH, congenital malformations, and CP are closely tied to multiple gestation. With the increase in elective single embryo transfer, there will be a reduction in adversity related to multiple birth. It is understood that underlying causes of infertility, including advanced maternal age, PCOS, thyroid disease, and uterine fibroids, predispose to adverse outcomes. However, imprinting abnormalities do not appear to stem from multiple births, and thus the need to consider the association between fertility treatment and methylation disorders remains essential. These, as well as risks of multi-fetal gestation, must be discussed with patients when considering using assisted reproduction.

Antioxidants Help reduce oxidation damage in cataracts (Molecular Vision)

These data indicate that lutein or zeaxanthin supplementation protects lens protein, lipid, and DNA from oxidative damage and improves intracellular redox status upon oxidative stress. The protective effects are comparable to that of ?-tocopherol, except that lutein and zeaxanthin cannot compensate for GSH depletion. The data imply that sufficient intake of lutein and zeaxanthin may reduce the risk for senile cataract via protecting the lens from oxidative damage. (Shasha Gao, et al. Lutein and zeaxanthin supplementation reduces H2O2-induced oxidative damage in human lens epithelial cells. Molecular Vision 2011; 17:3180-3190 <http://www.molvis.org/molvis/v17/a343> 12/7/2011).

What’s Your Pain (Medscape)

The Institute of Medicine’s 2011 report, Relieving Pain in America, recognized this complexity, championing “biopsychosocial care,” which affirms that “why one person suffers an injury and reports modest pain and another with a similar injury reports serious pain depends on many factors: genetic characteristics, general health status and comorbidities, pain experiences from childhood on, the brain’s processing system, the emotional and cognitive context in which pain occurs, and cultural and social factors.”[4]

DRUG UPDATES

Common Medicines Tied to Urinary Incontinence (Medscape).

Douglas, D. Common Medicines Tied to Urinary Incontinence (Medscape). June 11, 2012. http://www.medscape.com/viewarticle/765476?src=mp&spon=18

NEW YORK (Reuters Health) Jun 11 – An apparent association between some common medications, including antihistamines and angiotensin II receptor blockers (ARBs), and urinary incontinence (UI) suggests a need for further study, researchers say.

Safety of Statins (Medscape)

Miao Hu, PhD; Bernard M.Y. Cheung, PhD, FRCP; Brian Tomlinson, MD, FRCP. Safety of Statins: An Update. Medscape. Posted: 05/22/2012; Ther Adv in Drug Safe. 2012;3(3):133-144. © 2012 Sage Publications, Inc. http://www.medscape.com/viewarticle/763800

Abstract “Statins are widely used and have been proven to be effective in the prevention of atherosclerotic vascular disease events, primarily by reducing plasma low-density lipoprotein cholesterol concentrations. Although statins are generally well tolerated and present an excellent safety profile, adverse effects from muscle toxicity and liver enzyme abnormalities may occur in some patients. Myopathy and rhabdomyolysis are rare with statin monotherapy at the approved dose ranges, but the risk increases with use of higher doses, interacting drugs and genetic predisposition. Asymptomatic increases in liver transaminases with statin treatment do not seem to be associated with an increased risk of liver disease. Therefore, statin treatment can be safely used in patients with mild to moderately abnormal liver tests that are potentially attributable to nonalcoholic fatty liver disease and can improve liver tests and reduce cardiovascular morbidity in this group of patients. The risks of other unfavorable effects such as the slightly increased risk of new-onset diabetes and potentially increased risk of haemorrhagic stroke are much smaller than the cardiovascular benefits with the use of statins.

Antibiotic Linked to Heart Disease (Mercola.com)

Mercola, J. Eating This Feeds Bacteria That Can Poke Holes Through Your Gut. Mercola.com. June 20 2012

  • Recent research found that the macrolide antibiotic Azithromycin increases your chances of dying from a cardiovascular event by 250 percent within the first five days of usage, compared to taking amoxicillin. Those who already have heart problems are at an even greater risk of dying from the drug, which parallels Vioxx that had killed 60,000 people by the time it was removed from the market in 2004
  • Antibiotics are indiscriminate bactericides, meaning they kill ALL bacteria, both good and bad, and many of the immediate and long-term side effects are related to this fact, as disrupting your gut flora has a detrimental effect on your overall immune system
  • The greatest danger posed by antibiotics does not come from prescribed courses of antibiotics, but rather from the food you eat. The prevalence of antibiotics found in both conventionally-grown meats and vegetables has the potential to throw off, or contribute to intestinal imbalance and subsequent immune system dysfunction
  • It’s estimated that the non-therapeutic use of antibiotics in livestock accounts for 70 percent of the total antibiotic use in the US, and when all agricultural uses are considered, the share could be as high as 84 percent
  • On December 22, 2011, the US FDA posted a notice in the Federal Register that it was effectively reneging on its plan to reduce the use of antibiotics in agricultural animal feed. Instead, the agency issued voluntary guidelines in April of this year, suggesting that livestock should only be treated with antibiotics to cure illness, not to enable growth

Actos Linked to Bladder Cancer (Mercola.com)

  • Hundreds of lawsuits have been filed in connection with the diabetes drug Actos, a drug that France and Germany pulled from the market a year ago after it was found to cause bladder cancer and tumors in people using it for type 2 diabetes.
  • A drug company whistleblower has come forward with a lawsuit against Takeda Pharmaceuticals, stating that its drug Actos is bringing in “tens of billions of dollars in sales” at the expense of the lives of people still taking the drug.
  • The company allegedly under-reported and fraudulently reported serious adverse events linked to Actos, including heart failure, stroke, cancer, suicide, homicidal ideation and more, making the drug appear safer than it actually is
  • The former drug-company insider alleges that Takeda’s corporate culture is riddled with systemic fraud and deceit with motivation to falsely report and underreport not only serious congestive heart failure events, but other serious side effects experienced by people taking Actos, driven by an economic desire to falsely enhance Actos’ safety profile and to increase sales
  • Much of the underreporting appeared to occur from late 2007 to January 2010, just as the news that Avandia was dangerous broke out. By limiting their reports of adverse events, they were able to (falsely) make it appear as though Actos was “a safe alternative” to Avandia, allowing them to gain a significant portion of the diabetes drug market at the expense of patients’ lives
  • The only known way to prevent and reverse type 2 diabetes is to reestablish proper leptin and insulin signaling, which is done through a proper diet and exercise; there is NO drug that can accomplish this

Mercola, J. Dangerous Diabetes Drug Still on Market Despite Whistleblower Efforts. Mercola. com. June 14. http://articles.mercola.com/sites/articles/archive/2012/06/14/dangerous-diabetes-drug-still-on-market-despite-whistleblower-efforts.aspx

Bisphosphates and Bone Health (NEJM)

Dennis M. Black, Ph.D., Douglas C. Bauer, M.D., Ann V. Schwartz, Ph.D., M.P.H., Steven R. Cummings, M.D., and Clifford J. Rosen, M.D. Continuing Bisphosphonate Treatment for Osteoporosis — For Whom and for How Long?. N Engl J Med 2012; 366:2051-2053May 31, 2012

The table shows that numbers needed to treat are much higher for those with no preexisting fracture who have a femoral neck T score above ?2.0 after an initial treatment period, which suggests that such women can discontinue treatment and have a relatively low risk of subsequent vertebral fracture. This group of patients would include many of those who originally began receiving bisphosphonates when they had a bone mineral density above the osteoporotic range or for the prevention of bone loss.

For patients who have discontinued treatment after 5 years, there are currently no data to guide clinicians in determining when and whether to resume treatment. The role of repeat assessment of bone mineral density, bone turnover markers, and other clinical indicators is currently under study.

The FLEX and HORIZON trials showed that bone loss after discontinuation of therapy (the primary end point in both studies) was only modest as compared with that during continued therapy, suggesting a similarly persistent effect of alendronate (5 years) and zoledronic acid (3 years). Observational studies show that there is greater bone loss after discontinuation of risedronate therapy, and there are no data regarding effects after discontinuation of ibandronate therapy. Therefore, we believe that recommendations regarding discontinuation should be limited to alendronate and zoledronic acid.

Long-Term Bisphosphonates to Prevent Fractures. (Medscape)

Andrew Kaunitz, MD. Bisphosphonates to Prevent Osteoporotic Fractures: When Is Long-term Treatment Appropriate?.Medscape. June 12, 2012. http://www.medscape.com/viewarticle/764704?src=mp&spon=38

Because bone loss resumes more quickly after discontinuation of risedronate therapy and no data have assessed bone mass trends following discontinuation of ibandronate therapy, the following 2 recommendations apply specifically to the use of oral alendronate or IV zoledronic acid:

  1. Women with femoral neck T-scores less than -2.5 after 3-5 years of treatment, particularly older women with a history of fracture, represent those at highest risk for future fracture and benefit from long-term use of bisphosphonates.
  2. In contrast, women with femoral neck T-scores greater than -2.0 after 3-5 years of therapy, particularly younger menopausal women and those without a fracture history, have a low future risk for fracture and are not likely to benefit from long-term treatment with bisphosphonates.

The Lifestyle Factors That Affect Bone Loss (Susan Brown)

Everything has a cause! In this beautifully written blog, Dr. Brown provides a comprehensive list of what causes bone life from diet, exercise, medications, and nutritional deficiencies.

-Brown, S. Rethinking Osteoporosis. Better Bones blog. 3/14/12.  http://www.betterbones.com/osteoporosis/secondaryosteoporosis.aspx

Money-Drug Connection-Too Tight? (Dr. Mercola)

  • The chemical, biotech, pharmaceutical, and processed food industries have become wellsprings of fraud, deception, and all manner of criminal behavior in pursuit of profits
  • When it comes to making money many industries throw ethics and integrity out the window. A star witness for the manufacturers of flame retardants was recently exposed for fabricating heart-wrenching cases of infants burned to death in fires in a passionate testimony before California legislators. The incidents he cited never occurred, and the infant victims did not exist. The doctor has defended his use of bold-faced lies to influence legislators, stating he was not under oath
  • Since lifting the ban on direct-to-consumer advertising three decades ago, the US healthcare system has metamorphosed from a public service network into one of the largest corporate profit machines on the planet. Nineteen drug companies made AllBusiness.com’s Top 100 Corporate Criminals List for the 1990s
  • A bi-partisan probe of drug marketing practices was recently triggered by the huge jump in deadly overdoses from painkillers known as opioids, which now surpass overdose deaths caused by cocaine and heroin combined. Senate Finance Committee Chairman Max Baucus and Senator Chuck Grassley have sent letters to three major drug makers, demanding documents about their financial connections to seven medical groups that may have promoted misleading information about the risks and benefits of opioid use while receiving financial support from the manufacturers
  • In the largest bust to date, federal agents have charged 197 people in schemes that cheated the Medicare system out of $452 million. The government also suspended payments to 52 provider organizations as part of the bust- Mercola, J. Beware: These Best-Selling Products Can Make You Sick. May 28, 2012. http://articles.mercola.com/sites/articles/archive/2012/05/28/flame-retardant-health-hazards.aspx?e_cid=20120528_DNL_art_1

Meds for Chronic Disease Minus the Doc: Not a Good Idea (Medscape)

Sandra Adamson Fryhofer, MD. Meds for Chronic Disease Minus the Doc: Not a Good Idea. Medscape. June 12, 2012. http://www.medscape.com/viewarticle/765078?src=mp&spon=38

Instead of getting a prescription from a physicians, patients could go to a kiosk located in a pharmacy, click on the answers to a few questions, and then their medication would be dispensed automatically. No physician visit, no appointment, no invoice. Would this save money? It’s questionable.

Testimony by pharmacists at this hearing made it clear that this would not be so much cost saving as cost shifting. Making and programming these kiosks is also not free. That money will come from somewhere. The over-the-counter drug salesforce sees major revenue, which would be a bonanza for pharmaceutical sales.

But would this really benefit patients? In my opinion, no. If this proposal goes into effect, we should expect more out-of-pocket costs for patients. If medications are no longer available by prescription, then they most likely will not be covered by insurance. Higher out-of-pocket costs could create a barrier to appropriate management of chronic diseases.

We are not talking about treating yeast infections. We are not talking about giving flu shots, which has a limited protocol and everyone over age 6 months needs them every year. What we are talking about is treating chronic diseases, which is a big-ticket item. About 75 cents of every US healthcare dollar is spent treating chronic diseases.

We are talking here about medications to treat the leading risk factors for heart disease, the number-one killer of patients in this country. While it is reasonable to have EpiPens® available over the counter to treat life-threatening allergic reactions, that approach won’t work for medications for high blood pressure and high cholesterol.What happens if these patients have a heart attack? They don’t have a doctor.

…Research by the National Consumer Medication Adherence Campaign finds that one of the most motivating factors promoting medication adherence is confidence in the physician, who tells the patient to take the medication.The FDA has not offered any evidence establishing that this proposal is safe or that outcomes are improved when patients with hypertension, high cholesterol, asthma, or migraine headaches self-diagnose and manage these or other serious chronic medical conditions on their own.

HEALTH

Consumers See Health Potential in Holistic Medicine and Make Investment, Despite Recession (Holistic Primary Care)

According to Loren Israelsen, executive director of the United Natural Products Alliance, a Utah-based industry trade group, total sales of dietary supplements and “nutraceuticals” represented $924 million for the state of Utah alone. In 2012, the figure will hit $7.2 billion. There’s been consistent growth every year for the past 20 years, to the tune of 11% per year. This growth has continued steadily since 2008 when the current economic recession began.

Speaking at the UNPA’s recent 20th annual meeting, Mr. Blumenthal noted that roughly one in five consumers believe herbs represent important tools for maintaining health; roughly 39% of all baby boomers and 41% of Gen-Xers are using herbs for health maintenance, prevention and—yes—treatment of diseases. Roughly 20% say they have increased their use of supplements since the economic downturn. -Erik Goldman. Despite Recession, Natural Medicine Continues to Grow. 5/24/12. Holistic Primary Care.

The Power of Group, Faith, & Weight (Time: Healthland)

Jeffrey Kluger. Blessed Are the Sleek? Why God Wants You to Be Thin: Megapastor and bestselling author Rick Warren believes he has an answer to America’s obesity epidemic — and it lies in the Book of Daniel. May 31, 2012. http://healthland.time.com/2012/05/31/blessed-are-the-sleek-why-god-wants-you-to-be-thin/
Read more: http://healthland.time.com/2012/05/31/blessed-are-the-sleek-why-god-wants-you-to-be-thin/#ixzz1wy7mKiGf

It wasn’t vegetarianism or vigorous exercise that had worked that magic — though those were part of it. Instead, it was a belief that it was impossible to serve God fully if you were out of shape or unwell. For Daniel, getting fit was a triumph of faith — and Warren was convinced his church members could find motivation the same way.With that was born the Daniel Plan, a sweeping program of smart eating (and yes, lean meats are included), workout classes, small-group support meetings, walk and worship sessions and more, much of it made available both in person and online. Warren recruited three marquee names from the world of medicine — Drs. Mehmet Oz, Daniel Amen and Mark Hyman (all of different faiths) — to help spread the good-health message, and the Saddleback members fell in love with the plan. More than 15,000 of them have signed up so far and in the past 18 months alone, they have lost a collective 260,000 lbs.

Stress, Sickness, and Chronic Disease (Medline)

MONDAY, April 2 (HealthDay News) — A new study involving the common cold may help explain why stress, which dampens the immune system, seems to trigger inflammation in many people.

That would appear contradictory, because the immune system creates inflammation (for example, the redness around a wound) to help the body heal. But the research suggests that high and long-term levels of stress contribute to inflammation. In turn, the inflammation can lead to conditions such as heart disease, asthma and autoimmune disorders, in which the immune system turns against the body.

The research “suggests the kind of diseases that are going to be affected by stress,” said study lead author Sheldon Cohen, professor of psychology at Carnegie Mellon University in Pittsburgh. “They’re diseases in which inflammation is a key aspect.” –  Medline Plus. Why Stress Might Make You Sick. April 2, 2012. http://www.nlm.nih.gov/medlineplus/news/fullstory_123638.html

Job Strain & Fatigue (Medscape)

Grace Sembajwe, et al. Effects of Job Strain on Fatigue: Cross-sectional and Prospective Views of the Job Content Questionnaire and Effort–reward Imbalance in the GAZEL Cohort. 05/28/2012; Occup Environ Med.  2012;69(6):377-384.http://www.medscape.com/viewarticle/763716

In our analyses, we found that psychological demands and overcommitment at work were positively associated with overall mental and physical fatigue 8 years later, even after a majority of the participants had retired. Social support and workplace rewards were also important.

This preliminary work highlights the role of psychosocial work factors in the experience of overall fatigue (mental and physical) and continues to validate the various subcomponents of psychosocial stress as measured by the JCQ and ERI in a combined model.

Delete Your Email, Increase Your Health(UCI Iriving Today)

Source: UCI Iriving Today. Email ‘vacations’ decrease stress, increase concentration: UCI findings could boost on-the-job productivity. May 03, 2012.http://today.uci.edu/news/2012/05/nr_email_120503.php

Being cut off from work email significantly reduces stress and allows employees to focus far better, according to a new study by UC Irvine and U.S. Army researchers.

Heart rate monitors were attached to computer users in a suburban office setting, while software sensors detected how often they switched windows. People who read email changed screens twice as often and were in a steady “high alert” state, with more constant heart rates. Those removed from email for five days experienced more natural, variable heart rates.

“We found that when you remove email from workers’ lives, they multitask less and experience less stress,” said UCI informatics professor Gloria Mark.

Thrive in the Future by Understanding the ACE Study (Dr. Northrup)

Dr. Northrup. Thrive in the Future by Understanding the ACE Study. June 6, 2012. http://www.drnorthrup.com/blog/2012/06/thrive-in-the-future-by-understanding-the-ace-study

The Adverse Childhood Experiences (ACE) study scientifically validates something many physicians, including me, have experienced. The environment that you are raised in can have a significant impact on your health and habits for a long, long time. The ACE study comprehensively documents the long-term affects of abuse and household dysfunction, linking it to health risks and even death. You are not your past. You are not your genes. But certain health outcomes are tied to certain risk factors. This is actually great news! While you can’t change your genes or your past, you CAN make changes in your life today that reduce or even eliminate those risk factors… And then, you can even take it up a notch and flourish!

In 1998, Dr. Vincent Felitti, the head researcher on the ACE study, published his findings in the American Journal of Preventative Medicine1. This huge study was conducted with more than 17,000 participants, all middle-class and middle-aged, by the Kaiser Permanente Health Care Center in San Diego. What he found was that adverse childhood experiences were vastly more common than was previously recognized or acknowledged.

In fact, slightly more than half of the participants had grown up in a) dysfunctional homes, with missing or alcoholic (or drug using) parents, or with a depressed or mentally ill person, b) had suffered sexual, physical, or emotional abuse, or c) a experienced a combination of “a” and “b.”

D’Adamo Discusses Digestive Health (D’Adamo Personalized Nutrition Newsletter)

It is estimated that 10-20% of Americans suffer from irritable bowel syndrome (IBS) or Crohn’s disease, disorders that involve the entire digestive tract. Dr. D’Adamo discusses nutritional and lifestyle strategies that can help you manage this condition and reduce the likelihood of further attacks. Recorded May 10, 2012 at D’Adamo Personalized Nutrition in Williamsburg.

How inflammation, insulin, and lifestyle affect health (Dr. Mercola)

  • Chronic inflammation is the source of many diseases, including cancer, obesity, and heart disease, which essentially makes it the leading cause of death in the U.S.
  • High insulin levels promote inflammation and speed up your body’s aging processes, and insulin resistance is a hallmark of most chronic diseases. Avoiding sugars and grains, and getting regular exercise are two of the most potent ways to help normalize your insulin levels and avoid insulin resistance
  • Feeling stressed can create a wide variety of physiological changes, such as impairing digestion, excretion of valuable nutrients, decreasing beneficial gut flora populations, decreasing your metabolism, and raising triglycerides, cholesterol, insulin, and cortisol levels
  • While diet accounts for about 80 percent of the health benefits you reap from a healthy lifestyle, exercise and getting proper sleep are also cornerstones of good health that, if ignored, can have a dramatically negative impact on your longevity
  • High blood pressure is primarily related to your body producing too much insulin. Over 85 percent of those with hypertension can normalize their blood pressure through simple lifestyle modifications, such as avoiding sugars and grains, exercising regularly, optimizing your vitamin D levels, and getting sufficient amounts of animal-based omega-3 fats such as krill oil

Mercola, J. Doctor Says: If There’s a Single Marker Lifespan, This Would Be It. http://articles.mercola.com/sites/articles/archive/2012/06/06/eft-on-chronic-inflammation.aspx?e_cid=20120606_DNL_art_1.June 06 2012

Hygiene Hypothesis Support (Science-abstract)

Olszak T, An D, Zeissig S, Vera MP, Richter J, Franke A, Glickman JN, Siebert R, Baron RM, Kasper DL, Blumberg RS.Microbial exposure during early life has persistent effects on natural killer T cell function.Science. 2012 Apr 27;336(6080):489-93. Epub 2012 Mar 22.Comment in. Nat Rev Immunol. 2012;12(5):319. PMID: 22442383

Exposure to microbes during early childhood is associated with protection from immune-mediated diseases such as inflammatory bowel disease (IBD) and asthma. Here, we show that in germ-free (GF) mice, invariant natural killer T (iNKT) cells accumulate in the colonic lamina propria and lung, resulting in increased morbidity in models of IBD and allergic asthma as compared with that of specific pathogen-free mice. This was associated with increased intestinal and pulmonary expression of the chemokine ligand CXCL16, which was associated with increased mucosal iNKT cells. Colonization of neonatal-but not adult-GF mice with a conventional microbiota protected the animals from mucosal iNKT accumulation and related pathology. These results indicate that age-sensitive contact with commensal microbes is critical for establishing mucosal iNKT cell tolerance to later environmental exposures.

Safe Levels of Lead in children Lowered (CDC, ACCLP)

CDC concurred to ACCLP’s recommendations to lower blood levels from blood levels of 10ug/dl to 5 ug/dl related to support of toxicity and affects on health.

Recommendations of the Advisory Committee for Childhood Lead Poisoning Prevention. January 4, 2012. http://www.cdc.gov/nceh/lead/ACCLPP/Final_Document_030712.pdf

·  CDC Response to Advisory Committee on Childhood Lead Poisoning Prevention Recommendations in “Low Level Lead Exposure Harms Children: A Renewed Call of Primary Prevention.” May 16, 2012 http://www.cdc.gov/nceh/lead/ACCLPP/CDC_Response_Lead_Exposure_Recs.pdf

Gluten Free Summer Treat!  (Gluten Free Goddess)

You’ll need:
About 4 cups of peaches, peeled and cut up into pieces and divided in half
1 cup coconut milk or your favorite non-dairy alternative
1/2 to 3/4 cup organic light brown sugar, to taste
1 teaspoon bourbon vanilla
1 teaspoon light rum- may omit

Karina. Vegan Peach Ice Scream. http://glutenfreegoddess.blogspot.com/2008/08/vegan-peach-ice-scream.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+blogspot%2FMVjL+%28Gluten-Free+Goddess%29&utm_source=June+2012%2C+Vol+7%2C+Issue+6&utm_campaign=June+2012+e-newsletter&utm_medium=email