Sunset by the pool

In a few days I’ll be in Miami for functional medicine training on the gastrointestinal tract. I’ll be learning from the elite-of-elite functional and integrative medical trainers; it will be a true Zen-Information Haven for medicine geeks. No doubt, I will be using all my tools for brain support to take advance of all the knowledge. This includes my essential oils, my version of nootropics (brain enhancers), which nourish my nervous system and optimize my memory.

I know I will be furiously taking notes to share with all my readers and clients in the upcoming months. In the meantime, I wanted to leave my readers with the empowering information I promised. As I mentioned last week, I got a little (lot) crazy this month when I was prepping for the October 2014 edition of my “Top Holistic Health Reads.”

I’m committed to staying on top of research and top health news in order that this information doesn’t get drowned out and missed by those seeking wellness support via holistic measures. There has been such an acceleration of science supporting the impact of lifestyle, diet, nutrigenomics, and epigenetics on health, one could spend all day online and still never catch up.

Therefore, here’s my latest update in the top holistic health news for October 2014 that you may have missed but didn’t want to!

Due to my dedication to know too much in order to test my brain capacity, it’s lengthy. Still, I aim to keep it short, sweet, and skim friendly for you. This is why the list is provided and if you want to dive more into the information, I’ll provide the sources and excerpts below the topics.


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  • Stress Signs Differ in Men and Women
  • 80 Percent of Heart Health Linked to Lifestyle
  • Frozen Poop to Help the Poops
  • Bereavement and Immune Function in the Elderly
  • The Size of You and the Size of Your Soda
  • New Pesticide May Be More Toxic Than Agent Orange
  • World’s Largest Ever GMO Safety Study?
    • Links for Both Sides of the GMO Debate (after I researched more information)
  • Chemical Trajectory of Our World
  • What’s In Your Water? (Do You Want to Know)
  • Groups Demand End of Everglades Oil Drilling, Fracking and a Fix for Water Problems
  • 4 New Substances Added to Carcinogen List
  • BPA Exposure and Asthma in Children Linked
  • Sense of Smell Linked to Death
  • Constitutional Claims for Natural Products- Is Food a Drug?
  • What’s In Your Foam?
  • Waist Lines Continue to Rise
  • European Code Against Cancer: 12 Ways to Reduce Your Cancer Risk
  • Obesity and Cancer Link
  • Skirt Size Linked to Cancer Risk
  • Exercise- the New Cure for ADHD?
  • Yoga for Heart Health



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  • Iron Deficiency in Pregnancy Linked to Autism Spectrum Disorder (ASD)
  • Extent of Fructose Sensitivity May Be Genetic
  • Resveratrol to the Bone Rescue
  • Strawberries as a Functional Food
  • Breakfast or No Breakfast?
  • Mediterranean Diet Update
  • A Compound in Vinegar for Anemia?



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  • Antibiotics and Obesity In Children
  • Proton Pump Inhibitors Increase Hospitalization From Low Magnesium
  • How a Diabetes Drug Increased Risk of Heart Problems via the Thyroid
  • Antibiotics and Livestock
  • Antibiotic “Post Era” ?
  • Medical Food Trumps NSAID for Low Back Pain
  • Moxifloxacin Increased Risk for Uvetitis
  • Pharmacogenomics
  • Methotrexate Response and SNPs
  • Do Antiviral Combinations Make Sense?
  • Parkinson’s Drugs and Impulse Control
  • Fatal Drug Reactions Increase
  • New Position on Pain Meds From the American Academy of Neurology
  • Medication Mistakes with Children
  • CRN Decries JAMA for Exaggerating Extent of Findings in New Study of Spiked Products—Yet there’s still no excuse, even one unsafe product is too many





Human Interest Summaries

 stress or relax

Stress Impact on Cardiovascular & Emotional Aspects Differ in Men and Women

The study involved 254 men and 56 women with stable heart disease who did three mentally stressful tasks: a math test, a mirror tracing test and an anger recall test. Stress had a greater impact on blood pressure and heart rate in men, while women were more likely to experience decreased blood flow to the heart and increased clumping of blood cells associated with clot formation. Women also had a greater increase in negative emotions and a larger decline in positive emotions while doing the stressful tasks, according to the study published Oct. 13 in the Journal of the American College of Cardiology.

HealthDay. Stress Affects Women, Men With Heart Disease Differently, Study Shows. October 13, 2014.


80 Percent of Heart Problems Could Be Prevented By Lifestyle

Eighty percent of heart attacks in men are preventable by changes in lifestyle, according to research conducted at the Karolinska Institute. The study, published in the Journal of the American College of Cardiology, surveyed data on over 20,000 Swedish men aged 45-79, who were tracked from 1997 to 2009. The team isolated five aspects of a healthy lifestyle – eating a healthy diet, staying in good shape, exercising regularly, staying away from tobacco and controlling alcohol intake – and surveyed the men on their lifestyles. Based on the findings of the study , the team estimated that practicing the five healthy behaviors could prevent nearly 80 percent of first time heart attacks in men.

RTT. Eighty Percent Of Heart Attacks Are Preventable By Lifestyle Changes. RTT News. September 24, 2014.


Frozen Poop to Help the Poops-It’s Not Science Fiction

I wrote about the power of the microbiome ad nauseam, here’s an application of transferring the science fiction to science application in 20 patients!

A preliminary study published in JAMA demonstrates the potential of treating recurrent Clostridium difficile infection with frozen encapsulated fecal matter administered orally. 

No serious adverse effects were observed and 14/20 of the subjects had a clinical resolution of diarrhea after the first capsule and the remaining 6/20 had resolution after a second capsule taken seven days after the first treatment.

Medical News Today. Fecal capsules resolve Clostridium difficile infection in 90% of patients. Medical News October 13, 2014.


Sense of Smell Linked to Death in US Sample of Older Adults in 5 Year Study

… We sought to determine if olfactory dysfunction is a harbinger of 5-year mortality in the National Social Life, Health and Aging Project [NSHAP], a nationally representative sample of older U.S. adults. 3,005 community-dwelling adults aged 57–85 were studied in 2005–6 (Wave 1) and their mortality determined in 2010–11 (Wave 2). …

Olfactory function is thus one of the strongest predictors of 5-year mortality and may serve as a bellwether for slowed cellular regeneration or as a marker of cumulative toxic environmental exposures. This finding provides clues for pinpointing an underlying mechanism related to a fundamental component of the aging process.

Pinto JM, Wroblewski KE, Kern DW, Schumm LP, McClintock MK (2014) Olfactory Dysfunction Predicts 5-Year Mortality in Older Adults. PLoS ONE 9(10): e107541. doi:10.1371/journal.pone.0107541


Constitutional Claims for Natural Products- Is Food a Drug?

Did you know it’s currently illegal for a food or supplement producer to tell you about their products’ scientifically proven health benefits? As unbelievable as it sounds, a person can be thrown in jail for telling you the walnuts they grow may slow down the growth of prostate tumors, or cherries ease symptoms of arthritis and gout, even though this is truthful, accurate and helpful information for a consumer to know.

This is why a case that was recently heard before U.S. District Court Judge Vanessa L. Bryant could turn out to be a landmark event, as she ruled that the “FDA went too far” in censoring health claims related to green tea and cancer.

Mercola, J. Courts Slaps FDA and FTC for Unjustified Attacks. Health Impact News.October 6, 2014.



Bereavement Stress Effects The Elderly’s Immune Response

…41 young (mean age 32 years) and 52 older adults (mean age 72 years), bereaved and non-bereaved, took part in the study. They completed questionnaires on socio-demographic and health behaviour characteristics, as well as psychosocial variables, and provided a blood sample for analysis of neutrophil function (phagocytosis and reactive oxygen species (ROS) production) and stress hormone analysis.

Conclusions: Reduced neutrophil function among older bereaved participants may be the result of the inability to maintain stress hormone balance, specifically the cortisol:DHEAS ratio.

Bereavement reduces neutrophil oxidative burst only in older adults: role of the HPA axis and immunesenescence. Immun Ageing. 2014; 11: 13. Published online Aug 29, 2014. doi: 10.1186/1742-4933-11-13


Environmental and Food Safety

 apple 2

New Pesticide Approved May Be More Toxic Than Agent Orange

On September 17, 2014 the USDA approved new GE corn and soy and the resultant trigger of an increase in magnitude of pesticides.

Center for Food Safety today condemned the U.S. Department of Agriculture’s (USDA) decision to fully deregulate Dow Chemical’s Enlist corn and soybeans, genetically engineered to withstand repeated spraying of the herbicide 2,4-D. The Environmental Protection Agency (EPA) has yet to approve the accompanying herbicide, which is a blend of 2,4-D and glyphosate.

2,4-D (2,4-dichlorophenoxyacetic acid), produced by Dow Chemical, was a component of “Agent Orange,” the toxic defoliant used in Vietnam. 2,4-D and other herbicides of its class have been independently associated with deadly immune system cancers, Parkinson’s disease, endocrine disruption, and reproductive problems.

USDA Approves New GE Corn and Soy, Triggering Onslaught of Millions of Pounds more Pesticides. Center for Food Safety. September 17th, 2014.

Mercola, J. Herbicide and Insecticide Use on GMO Crops Is Skyrocketing, and Rubber-Stamped Approvals Now Usher in Next-Gen GMOs. October 12, 2014.

Milbourn, C. EPA Announces Final Decision to Register Enlist Duo, Herbicide Containing 2, 4-D and Glyphosate/Risk assessment ensures protection of human health, including infants, children. EPA. October 15, 2014.

Wells, L. EPA ignores health and safety risks; approves drastic increase in use of toxic pesticide 2,4-D. Pesticide Action Network. Pesticide Action Network. October 15, 2014.


Controversy on GMOs Continues


Press Release of World’s Largest Ever GMO Safety Study

According to the Media Advisory; “the $ 25 million ‘Factor GMO’ study will investigate the health effects of a genetically modified (GMO) crop that has been in our food and animal feed supplies for many years.

World’s Largest Ever GMO Safety Study Set for London Launch. Sustainable Pulse. October 22, 2014.


Questions Arise About the Upcoming Study and “Being the First”

This would be a promising development, however, the announcement was short on important details, specifically, the sponsors, funding sources, and scientific expertise. “Factor GMO” didn’t even show up in search engines. However, they did say that the announcement of some of these details would occur on November 11 at The Farmers Club in London, England. So I contacted the venue to see if I could find out more information – and that’s where it got interesting.

Mogel, KH. Questions arise about upcoming “Factor GMO” study. Biology Fortified. October 28, 2014.


Information on GMOs:

European Commission Database

Institute for Responsible Technology


Fearless Parent Interview

University of California and Links to CDC

Summary from Integrative Health Skeptic

(Note- below studies on pesticides, chemicals, and their use in GMO crops)


Size and Soda

Due to concerns in the link of obesity to soda consumption…

Nationally, the beverage companies will: 

  • Leverage their marketing, innovation and distribution strengths to increase and sustain consumer interest in and access to smaller portion sizes, water and no- and lower-calorie beverages.
  • Provide calorie counts, and promote calorie awareness on all beverage company-controlled point-of-sale equipment nationwide.
  • Launch a first-of-its kind national consumer awareness and engagement program – Mixify™ – encouraging teens and their families to balance their calories by moderating what they consume, including beverages, and getting more active.

American Beverage Association. Helping to Fight Obesity In Our Communities. October 8, 2014.


Chemical Trajectory

The trajectory of chemicals appearing as emergent threats to human or environmental health has been recently studied through a meta-analysis of 143,000 peer-reviewed research papers. The work tracks the progress of these chemicals of emerging concern, revealing patters of emergence from obscurity to peak concern and eventual decline, over a span of 30 years.

Arizona State University. New study charts the fate of chemicals affecting health, environment. Science Daily. October 20, 2014.

Original Source Abstract:

A meta-analysis was conducted to inform the epistemology, or theory of knowledge, of contaminants of emerging concern (CECs). The CEC terminology acknowledges the existence of harmful environmental agents whose identities, occurrences, hazards, and effects are not sufficiently understood. Here, data on publishing activity were analyzed for 12 CECs, revealing a common pattern of emergence, suitable for identifying past years of peak concern and forecasting future ones: dichlorodiphenyltrichloroethane (DDT; 1972, 2008), trichloroacetic acid (TCAA; 1972, 2009), nitrosodimethylamine (1984), methyl tert-butyl ether (2001), trichloroethylene (2005), perchlorate (2006), 1,4-dioxane (2009), prions (2009), triclocarban (2010), triclosan (2012), nanomaterials (by 2016), and microplastics (2022 ± 4). CECs were found to emerge from obscurity to the height of concern in 14.1 ± 3.6 years, and subside to a new baseline level of concern in 14.5 ± 4.5 years. CECs can emerge more than once (e.g., TCAA, DDT) and the multifactorial process of emergence may be driven by inception of novel scientific methods (e.g., ion chromatography, mass spectrometry and nanometrology), scientific paradigm shifts (discovery of infectious proteins), and the development, marketing and mass consumption of novel products (antimicrobial personal care products, microplastics and nanomaterials). Publishing activity and U.S. regulatory actions were correlated for several CECs investigated.

Rolf U. Halden. Epistemology of contaminants of emerging concern and literature meta-analysis. Journal of Hazardous Materials, 2014; DOI: 10.1016/j.jhazmat.2014.08.074


What’s In Your Water?

An analysis of a Minnesota Zumbro River sample reports on components from urban wastewater-derived sources and agricultural sources (see above) explained 50% of the variance in the data.


Principal components analysis (PCA) was used to identify sources of emerging organic contaminants in the Zumbro River watershed in Southeastern Minnesota. Two main principal components (PCs) were identified, which together explained more than 50% of the variance in the data. Principal Component 1 (PC1) was attributed to urban wastewater-derived sources, including municipal wastewater and residential septic tank effluents, while Principal Component 2 (PC2) was attributed to agricultural sources. The variances of the concentrations of cotinine, DEET and the prescription drugs carbamazepine, erythromycin and sulfamethoxazole were best explained by PC1, while the variances of the concentrations of the agricultural pesticides atrazine, metolachlor and acetochlor were best explained by PC2. Mixed use compounds carbaryl, iprodione and daidzein did not specifically group with either PC1 or PC2. Furthermore, despite the fact that caffeine and acetaminophen have been historically associated with human use, they could not be attributed to a single dominant land use category (e.g., urban/residential or agricultural). Contributions from septic systems did not clarify the source for these two compounds, suggesting that additional sources, such as runoff from biosolid-amended soils, may exist. Based on these results, PCA may be a useful way to broadly categorize the sources of new and previously uncharacterized emerging contaminants or may help to clarify transport pathways in a given area. Acetaminophen and caffeine were not ideal markers for urban/residential contamination sources in the study area and may need to be reconsidered as such in other areas as well.

Identifying sources of emerging organic contaminants in a mixed use watershed using principal components analysis. Environ Sci Process Impacts. 2014 Sep 24;16(10):2390-9. doi: 10.1039/c4em00324a.

Blum, D. A Rising Tide of Contaminants  . New York Times. September 25, 2014.



Groups Demand End of Everglades Oil Drilling, Fracking And Fix Water Problems

Citizens draw the line against new oil drilling in Greater Everglades after unauthorized fracking threatens water supplies and triggers county and state lawsuits; they call on Scott to shut down all new Everglades oil drilling and update state regulations to 1) ban fracking and all forms of extreme extraction, 2) set a one mile buffer zone from drill site to family home, 3) secure DEP stronger enforcement powers, with significant penalties and fines.

NAPLES, FL—The Stonecrab Alliance, Food & Water Watch, Clean Water Initiative, and ReThink Energy Florida are organizing an “It’s All About the Water” march to Governor’s Rick Scott’s beachfront home starting at 4 p.m., Saturday, October 18, beginning at the Naples Pier.  The groups intend to shut down new Everglades oil drilling and fracking and urge Scott to fix a broad range of water problems in Florida.  By land and by sea, participants will march on the beach and paddle from the Naples Pier to the Governor’s beachfront home.  Banners, signs, and flags will spell out concerns.  Solidarity Fish from the east coast will make visible the need to send clean water south from Lake Okeechobee.

Dyer, K. Groups Demand End of Everglades Oil Drilling, Fracking And Fix Water Problems. October 15, 2014.



What’s In Your Foam?

There’s an unusual service run by a Duke University lab

The lab’s offer was simple. First, the lab instructed, wield a pair of scissors. Grab something made with polyurethane foam—say, a mattress or the innards of a couch cushion. Cut a small chunk from the foam. Wrap the surgical work in tinfoil, ziplock seal it and mail the crime-scene-looking evidence off to Durham, North Carolina. Wait up to 45 days, the lab said, and it’ll arrive: a report detailing toxic flame retardants embedded in the foam.

Revine, G. How to Test a Couch for Toxins. The Atlantic. September 26, 2014.


4 New Substances Added to Carcinogen List

Four new substances have been added to a list of chemicals that may cause cancer compiled by the U.S. Department of Health and Human Services (HHS).

The list of known carcinogens now includes a chemical called ortho-toluidine, which is used to make rubber chemicals, pesticides and dyes. Recent research has linked the substance to bladder cancer in people.

Three other substances were added to a list of agents that are “reasonably anticipated to be human carcinogens.” These include a cleaning solvent called 1-bromopropane, a wood preservative mixture known as pentachlorophenol and cumene, which can be found in fuel products and even tobacco smoke. [12 Worst Hormone-Disrupting Chemicals & Their Health Effects]

Gannon, M. 4 New Substances Added To List Of Carcinogens. Life Science. October 2, 2014.

HHS. HHS Releases 13th Report on Carcinogens. National Institute for Environmental Health Sciences. October 2, 2014.


Impacts in Children

Almost twins

BPA Exposure and Asthma in Children Linked

The authors examined whether BPA exposure was associated with lung function using forced expiratory volume in the first second of expiration (FEV1) , with wheeze and with a pattern of wheeze in children during their first five years. The study involved a group of 398 mother-infant pairings. Maternal urine samples were collected during pregnancy at 16 and 26 weeks and child urine samples were collected annually to assess gestational and child BPA exposure.

Every 10-fold increase in the average maternal urinary BPA concentration was associated with a 14.2 percent decrease in the percentage predicted FEV1 at 4 years old but no association was seen at 5 years old. Every 10-fold increase in the average maternal urinary BPA concentration was marginally associated with a 54.8 percent increase in the odds of wheezing. While the average maternal urinary BPA concentration was not associated with the type of wheeze (phenotype), a 10-fold increase in the 16-week maternal urinary BPA concentration was associated with a 4.27-fold increase in the odds of persistent wheeze. Child urinary BPA concentrations were not associated with FEV1 or wheeze.

The JAMA Network Journals. Prenatal BPA exposure associated with diminished lung function in children. Science Daily. 6 October 2014.

Adam J. Spanier, Robert S. Kahn, Allen R. Kunselman, Eric W. Schaefer, Richard Hornung, Yingying Xu, Antonia M. Calafat, Bruce P. Lanphear. Bisphenol A Exposure and the Development of Wheeze and Lung Function in Children Through Age 5 Years. JAMA Pediatrics, 2014; DOI: 10.1001/jamapediatrics.2014.1397


E Cigs  & Toxic Second Hand Exposure

SAN DIEGO — Almost one-third of adverse-event reports for e-cigarettes are related to secondhand exposure, according to a US Food and Drug Administration (FDA) analysis. The numbers are increasing, and complaints are consistent with airway irritation, nicotine exposure, and possible nicotine toxicity.

“We need to start to understand these products better, not only in users, where we have very few data, but also in nonusers,” said Beth Durmowicz, MD, medical officer at the FDA, who presented the research here at the American Academy of Pediatrics 2014 National Conference and Exhibition.

The findings suggest that, as with traditional cigarettes, parents should keep e-cigarettes away from children and avoid using or recharging them near young people.

Kling, J. e-Cigarettes Have Secondhand Adverse Effects. Medscape Medical News > Conference News. October 13, 2014.



Wi-Fi and Kids


There are over 1,000 peer-reviewed scientific studies that link the impacts of communication-frequency radiation to serious health problems including cancer, neurological disease, immune dysfunction, disruption of the blood-brain-barrier, DNA damage, infertility, and statistically significant neurological and cognitive disorders such as headaches, dizziness, tremors, decreased memory and attention, autonomic nervous system dysfunction, decreased reaction times, sleep disturbances, and visual disruptions.


“Radiation exposures are higher for children than adults because children have thinner skulls, and their brains have higher water and higher ion (charged particle) content…these three factors enhance radiation penetration.” – Pediatr Nurs. 2013;39(2):65-70

Habakus, L. Cupertino, We Have a Problem. WiFi & Kids. October 15, 2014.


Lifestyle & Wellness Updates


Waist Lines Continue to Rise

According to a recent JAMA study,12, 13 the obesity rate among American adults has continuously climbed over the last decade. Between 1999 and 2012, the average age-adjusted waist circumference increased from 95.5 centimeters (37 19?32 inches) to 98.5 centimeters (38 25?32 inches). Abdominal fat also rose from 46.4 percent in 1999-2000 to 54.2 percent in 2011-2012. The United Kingdom is facing a similar health crisis. According to September 17 article in Mail Online:14

Earl S. Ford, Leah M. Maynard, Chaoyang Li. Trends in Mean Waist Circumference and Abdominal Obesity Among US Adults, 1999-2012JAMA. 2014;312(11):1151-1153. doi:10.1001/jama.2014.8362.

Mercola, J. Artificial Sweeteners Raise Your Risk of Diabetes by Altering Your Gut Microbiome. October 1, 2014.


Obesity and Cancer Link

Rates of obesity have increased significantly over the last three decades in the United States and globally. In addition to contributing to heart disease and diabetes, obesity is a major unrecognized risk factor for cancer. Obesity is associated with worsened prognosis after cancer diagnosis and also negatively affects the delivery of systemic therapy, contributes to morbidity of cancer treatment, and may raise the risk of second malignancies and comorbidities. Research shows that the time after a cancer diagnosis can serve as a teachable moment to motivate individuals to adopt risk-reducing behaviors. For this reason, the oncology care team—the providers with whom a patient has the closest relationships in the critical period after a cancer diagnosis—is in a unique position to help patients lose weight and make other healthy lifestyle changes. The American Society of Clinical Oncology is committed to reducing the impact of obesity on cancer and has established a multipronged initiative to accomplish this goal by 1) increasing education and awareness of the evidence linking obesity and cancer; 2) providing tools and resources to help oncology providers address obesity with their patients; 3) building and fostering a robust research agenda to better understand the pathophysiology of energy balance alterations, evaluate the impact of behavior change on cancer outcomes, and determine the best methods to help cancer survivors make effective and useful changes in lifestyle behaviors; and 4) advocating for policy and systems change to address societal factors contributing to obesity and improve access to weight management services for patients with cancer.

Ligibel, E, et al. American Society of Clinical Oncology Position Statement on Obesity and Cancer. October 1, 2014. JCO.2014.58.4680 doi: 10.1200/JCO.2014.58.4680 JCO


Skirt Size Linked to Breast Cancer Risk

Conclusions CSS is associated with BC risk independent of BMI. A unit increase in UK SS (eg, 12–14) every 10-years between 25 and postmenopausal-age is associated with postmenopausal BC risk by 33%. Validation of these results could provide women with a simple and easy to understand message.

Association of skirt size and postmenopausal breast cancer risk in older women: a cohort study within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). BMJ Open 2014;4:e005400 doi:10.1136/bmjopen-2014-005400

Oaklander, M. Waist Size Linked to Breast Cancer, Study Finds. Time. September 25, 2014.


European Code Against Cancer: 12 Ways to Reduce Your Cancer Risk

Chustecka, Z. ‘What Can I Do to Reduce My Risk for Cancer?’ Medscape Medical News > Oncology. October 14, 2014.



Exercise & Brain

Playing a tough basketball game.







Read all about the updates on brain health including:

  • the impact of personality
  • exercise
  • the golden spice

Yoga for Heart Health

The use of yoga as an effective cardiac rehabilitation in patients with chronic heart failure (CHF) remains controversial.

We performed a meta-analysis to examine the effects of yoga on exercise capacity and health-related quality of life (HRQOL) in patients with CHF. Methods: We searched MEDLINE, Cochrane Central Register of Controlled Trials, Excerpta Medica database, LILACS, Physiotherapy Evidence Database, The Scientific Electronic Library Online, and Cumulative Index to Nursing and Allied Health (from the earliest date available to December 2013) for randomized controlled trials (RCTs) examining the effects of yoga versus exercise and/or of yoga versus control on exercise capacity (peakVO2) and quality-of-life (HRQOL) in CHF. Two reviewers selected studies independently. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I2 test.

Two studies met the selection criteria (total: 30 yoga and 29 control patients). The results suggested that yoga compared with control had a positive impact on peak VO2 and HRQOL. Peak VO2, WMD (3.87 95% CI: 1.95 to 5.80), and global HRQOL standardized mean differences (-12.46 95% CI: -22.49 to -2.43) improved in the yoga group compared to the control group.

Yoga enhances peak VO2 and HRQOL in patients with CHF and could be considered for inclusion in cardiac rehabilitation programs. Larger RCTs are required to further investigate the effects of yoga in patients with CHF.

Mansueto Gomes-Neto, Erenaldo Sousa Rodrigues-Jr, Walderi Monteiro Silva-Jr, Vitor Oliveira Carvalho. Effects of Yoga in Patients with Chronic Heart Failure: A Meta-Analysis. Arq. Bras. Cardiol., ahead of print Epub Oct 10, 2014.



 photo 2 (3)

Iron Deficiency in Pregnancy Linked to ASD

Iron deficiency affects 40%-50% of pregnancies. Iron is critical for early neurodevelopmental processes that are dysregulated in autism spectrum disorder (ASD). We examined maternal iron intake in relation to ASD risk in California-born children enrolled in a population-based case-control study (the Childhood Autism Risks from Genetics and the Environment (CHARGE) Study) from 2003 to 2009 with a diagnosis of ASD (n = 520) or typical development (n = 346) that was clinically confirmed using standardized assessments. Mean maternal daily iron intake was quantified on the basis of frequency, dose, and brands of supplements and cereals consumed each month from 3 months before pregnancy through the end of pregnancy and during breastfeeding (the index period), as reported in parental interviews. Mothers of cases were less likely to report taking iron-specific supplements during the index period (adjusted odds ratio = 0.63, 95% confidence interval: 0.44, 0.91), and they had a lower mean daily iron intake (51.7 (standard deviation, 34.0) mg/day) than mothers of controls (57.1 (standard deviation, 36.6) mg/day; P = 0.03). The highest quintile of iron intake during the index period was associated with reduced ASD risk compared with the lowest (adjusted odds ratio = 0.49, 95% confidence interval: 0.29, 0.82), especially during breastfeeding. Low iron intake significantly interacted with advanced maternal age and metabolic conditions; combined exposures were associated with a 5-fold increased ASD risk. Further studies of this link between maternal supplemental iron and ASD are needed to inform ASD prevention strategies.

Schmidt RJ, Tancredi DJ, Krakowiak P, Hansen RL, Ozonoff S.Maternal Intake of Supplemental Iron and Risk of Autism Spectrum Disorder. Am J Epidemiol. 2014 Sep 22. pii: kwu208. [Epub ahead of print]


Extent of Fructose Sensitivity Genetic

The study recruited 21 adults with half the people were lean and seemingly healthy; the other half were obese and at high risk of developing diabetes. Subjects drank either 75 grams of glucose, fructose, or a combination and then had their blood sugar tested for the next five hours.

Glucose had only a minimal impact on the hormone, called fibroblast growth factor 21, or FGF21. But fructose increased its levels; the largest dose increased hormone levels fourfold within two hours on average. The obese subjects had higher levels of FGF21 to begin with. And after they ate fructose, their peak levels of the hormone rose much higher than in the lean subjects.

O’Connor, A. Vulnerability to Fructose Varies, Health Study Finds. New York Times. October 13, 2014.


Resveratrol to the Bone Rescue.

Participants: The study population comprised 74 middle-aged obese men with MetS recruited from the general community, of which 66 completed all visits. Mean age of participants was 49.3 ± 6.3 years and mean body mass index was 33.7 ± 3.6 kg/m2.

Intervention: Oral treatment with 1.000 mg RSV (RSVhigh), 150mg RSV (RSVlow), or placebo daily for 16 weeks.

Conclusions: Our data suggest that high-dose RSV supplementation positively affects bone, primarily by stimulating formation or mineralization. Future studies of longer duration comprising populations at risk of osteoporosis are needed to confirm these results.

Resveratrol Increases Bone Mineral Density and Bone Alkaline Phosphatase in Obese Men: A RandomizedPlacebo-Controlled Trial. J Clin Endocrinol Metab. 2014 Oct 16:jc20142799. [Epub ahead of print:]

Polyphenol helps improve bone density in men with metabolic syndrome. Designs for Health: Science Update. Oct 24, 2014

McCall, B. The Weaker Sex: Men With Osteoporosis Are Neglected. Medscape Medical News. October 09, 2014.


Strawberries as a Functional Food

Emerging research provides substantial evidence to classify strawberries as a functional food with several preventive and therapeutic health benefits. Strawberries, a rich source of phytochemicals (ellagic acid, anthocyanins, quercetin, and catechin) and vitamins (ascorbic acid and folic acid), have been highly ranked among dietary sources of polyphenols and antioxidant capacity. It should however be noted that these bioactive factors can be significantly affected by differences in strawberry cultivars, agricultural practices, storage, and processing methods: freezing versus dry heat has been associated with maximum retention of strawberry bioactives in several studies. Nutritional epidemiology shows inverse association between strawberry consumption and incidence of hypertension or serum C-reactive protein; controlled feeding studies have identified the ability of strawberries to attenuate high-fat diet induced postprandial oxidative stress and inflammation, or postprandial hyperglycemia, or hyperlipidemia in subjects with cardiovascular risk factors. Mechanistic studies have elucidated specific biochemical pathways that might confer these protective effects of strawberries: upregulation of endothelial nitric oxide synthase (eNOS) activity, downregulation of NF-kB activity and subsequent inflammation, or inhibitions of carbohydrate digestive enzymes. These health effects may be attributed to the synergistic effects of nutrients and phytochemicals in strawberries. Further studies are needed to define the optimal dose and duration of strawberry intake in affecting levels of biomarkers or pathways related to chronic diseases.

Basu A1, Nguyen A, Betts NM, Lyons TJ. Strawberry as a functional food: an evidence-based review. Crit Rev Food Sci Nutr. 2014;54(6):790-806. doi: 10.1080/10408398.2011.608174.


Strawberries Reduce Cancer Risk

In a prospective five-year cohort study in an elderly population, higher consumption of fresh strawberries and other fruits and vegetables was associated with significantly reduced cancer mortality. The authors attribute these observations to the carotenoid content of fruits and vegetables known to exert anti-carcinogenic effects.[ix]

…Other studies show that strawberries can even reverse early stage esophageal cancer.

King, M. 8 Juicy Reasons to Eat Strawberries. GreenMed Info. October 7, 2014.


Breakfast May Help Young Girls

This was a randomized, crossover trial in which 16 girls alternated between three morning routines, with each routine lasting six days:

  • No breakfast
  • Low-Protein 350-calorie breakfast: 15% protein (13 grams / a half ounce), 65% carbs, and 20% fat
  • High Protein 350-calorie breakfast: 40% protein (35 grams / 1¼ ounces), mostly from egg and beef), 40% carbs, and 20% fat

In addition to providing equal fat content, both breakfast meals were similar in fiber and sugar content, palatability, and appeal. Each six-day period was followed by food-craving questionnaires and blood sampling for dopamine levels throughout the morning…

The results showed three things:

  • Both breakfast meals reduced post-meal cravings for sweet and savory foods and increased dopamine levels, while the no-breakfast routine yielded no changes in cravings or dopamine levels.
  • High-protein breakfasts tended to yield the greatest drops in post-meal savory cravings and sustained increases in dopamine levels prior to lunch.
  • The participants’ post-breakfast (or no breakfast) dopamine levels followed the protein content of their breakfast: eating more protein meant release of more dopamine.

Weatherby, C. Can Paleo-Style Breakfasts Curb Food Cravings? VitalChoice Newsletter. October 27, 2014.

Clinton, S. Eating Breakfast Increases Brain Chemical Involved in Regulating Food Intake and Cravings, MU Researchers Find. University of Missouri. Oct. 15, 2014.



Mediterranean Diet Update

REUS, SPAIN — Eating a Mediterranean diet supplemented with either nuts or extra-virgin olive oil as opposed to eating a low-fat diet was more likely to reverse metabolic syndrome 5 years later, in a new study[1]. This was largely due to a greater likelihood of having a smaller waist by following Mediterranean diet or having decreased blood glucose levels by eating the diet that was supplemented with nuts.

However, the onset of metabolic syndrome in participants who did not have it at baseline was similar in all three diet groups.

These findings, from the PREDIMED study, were published October 14, 2014 in CMAJ.


The current study analyzed data from 5801 participants in PREDIMED.

Busko, M. Mediterranean Diet Reverses Metabolic Syndrome in PREDIMED. Heartwire. October 14, 2014.


A Compound in Vinegar for Anemia?

Researchers seeking novel treatments for anemia found that giving acetate, the major component of household vinegar, to anemic mice stimulated the formation of new red blood cells.

UT Southwestern Medical Center. Acetate supplements speed up red blood cell production, anemia research shows. ScienceDaily. September 29, 2014.

Min Xu, Jason S Nagati, Jian Xie, Jiwen Li, Holly Walters, Young-Ah Moon, Robert D Gerard, Chou-Long Huang, Sarah A Comerford, Robert E Hammer, Jay D Horton, Rui Chen, Joseph A Garcia. An acetate switch regulates stress erythropoiesis. Nature Medicine, 2014; 20 (9): 1018 DOI: 10.1038/nm.3587




Antibiotics and Obesity In Children

Antibiotics kill some of the bacteria in the stomach and could leave the body in a state where it is more likely to become obese, Bailey said. The drugs could also change which foods taste good or change your activity pattern due to other side effects. For the new study, published in JAMA Pediatrics, Bailey and his coauthors used data from health records collected between 2001 and 2013 from 64,580 children. They had data on doctor visits during the children’s first five years of life.

Almost 70 percent of the kids were exposed to antibiotics before age two with an average of about two prescriptions per child. By age two, 23 percent of the kids were overweight or obese for their age, which rose to 30 percent at age three and 33 percent at age four.

The more times the children had been exposed to antibiotics at a younger age, the more likely they were to be obese later on. Obesity was specifically linked to broad-spectrum antibiotics, like amoxicillin or tetracycline, not narrow-spectrum antibiotics like azithromycin. (Broad-spectrum means the antibiotic acts against a broad range of disease-causing bacteria.) Kids who had been exposed to antibiotics at least four times before age two were 11 percent more likely to be obese later than kids who had not been exposed to any antibiotics.

Doyle, K. Antibiotics in infancy may be linked to childhood obesity: study. Reuters. September 29, 2014.


Proton Pump Inhibitors Increase Hospitalization From Low Magnesium

After allowing for other characteristics that increase the risk of hypomagnesemia (including other illnesses), current PPI use was associated with a 43% increased risk of hypomagnesemia. Among patients receiving diuretics, PPI use increased the risk of hypomagnesemia by 73% whereas among patients not receiving diuretics, PPI use did not significantly increase the risk of hypomagnesemia. Finally, the researchers calculated that 76,591 individuals would need to be treated with a PPI as an outpatient for 90 days to result in one additional hospitalization with hypomagnesemia.

Conclusion: PPIs are associated with a small increased risk of hospitalization with hypomagnesemia among patients also receiving diuretics. Physicians should be aware of this association, particularly for patients with hypomagnesemia…

Zipursky, J, Macdonald, E, Hollands, S, Gomes, T, Mamdani, M, Peterson, JM, Lathia, N, Juurlink,D. Proton Pump Inhibitors and Hospitalization with Hypomagnesemia: A Population-Based Case-Control Study. PLOS One. September 30, 2014. DOI: 10.1371/journal.pmed.1001736


How a Diabetes Drug Increased Risk of Heart Problems via the Thyroid

A new study has claimed that a common diabetes pill can radically raise the risk of heart disease and other health complications. The study suggested that metformin, which is used to treat Type 2 diabetes, can increase the risk of people with an underactive thyroid suffering from low thyroid-stimulating hormone (TSH) levels. The researchers surveyed 74,300 patients who received metformin and sulfonylurea, another common diabetes drug, over a 25-year period where 5,689 had treated hypothyroidism, and 59,937 had normal thyroid function.

The study demonstrated that in the group with hypothyroidism, there were 495 incidences of low thyroid-stimulating hormone (119.7 per 1000) per year compared with 322 in the normal group (4.5 per 1000).

ANI. Common diabetes pill might increase heart disease risk. Business Standard. September 23, 2014.

Fournier JP, Yin H, Yu OH, Azoulay L. Metformin and low levels of thyroid-stimulating hormone in patients with type 2 diabetes mellitus. CMAJ. 2014 Sep 22. pii: cmaj.140688. [Epub ahead of print]


Antibiotics and Livestock

The amount of antibiotics sold for use in livestock rose substantially in recent years, according to the Food and Drug Administration, a pattern that experts said was troubling given the efforts to battle antibiotic resistance in humans.

Taverniseoct, S. Antibiotics in Livestock: F.D.A. Finds Use Is Rising. Time. October 2, 2014.


“Post Era” Antibiotics?

  • According to the CDC, drug-resistant organisms in the American food supply pose “a serious threat” to public health and “should be phased out”
  • Large scale meat production is a primary breeding ground of drug-resistant bacteria, as low doses of antibiotics are routinely fed to livestock to promote growth and compensate for unsanitary living conditions
  • The White House recently announced a five-year plan to address antibiotic resistance. But we cannot afford to wait five years. Scientists already warn strep throat could be fatal in as little as 10 years from now
  • Two million Americans are infected with antibiotic-resistant bacteria each year, and at least 23,000 of them die as a result of those infections
  • Between 1973 and 2011, there were 55 antibiotic-resistant foodborne outbreaks in the US. More than half of these outbreaks involved pathogens resistant to five or more antibiotics

Mercola, J. White House Plan to Address Antibiotic Resistance Is Too Weak to Protect Human Health. October 8, 2014.


Medical Food Trumps NSAID for Low Back Pain

…Theramine, an amino acid blend 68405-1 (AAB), is a physician-prescribed only medical food. It contains neurotransmitter precursors and systems for increasing production and preventing attenuation of neurotransmitters. A double-blind controlled study of AAB, low-dose ibuprofen, and the coadministration of the 2 agents were performed. The primary end points included the Roland Morris index and Oswestry disability scale. The cohort included 122 patients aged between 18 and 75 years. The patients were randomized to 1 of 3 groups: AAB alone, ibuprofen alone, and the coadministration of the 2 agents. In addition, C-reactive protein, interleukin 6, and plasma amino acid concentrations were measured at baseline and 28 days time points.

…Arginine, serine, histidine, and tryptophan levels were substantially reduced before treatment in the chronic pain syndrome and increased toward normal during treatment. There was a direct correlation between improvement in amino acid concentration and treatment response. Treatment with amino acid precursors was associated with substantial improvement in chronic back pain, reduction in inflammation, and improvement in b

Reduction in Pain and Inflammation Associated With Chronic Low Back Pain With the Use of the Medical Food Theramine. American Journal of Therapeutics. September 18, 2014. doi: 10.1097/MJT.0000000000000068


Moxifloxacin Increased Risk for Uvetitis

Moxifloxacin appears to increase the risk for uveitis according to a case-control study published online October 2 in JAMA Ophthalmology. Ciprofloxacin was also associated with increased risk, but there was little to no increase seen for levofloxacin.

“The results of the present study are consistent with those of case reports that have suggested an association between oral moxifloxacin and uveitis,” the investigators maintain. In addition, the study confirms that this adverse effect most commonly occurs with a first dispensed prescription.

London, S. Evidence Linking Some Fluoroquinolones to Uveitis Grows. Medscape Medical News. Medscape. Com. October 07, 2014


Methotrexate Response in Rheumatoid Arthritis (RA) Patients and SNPs

Patients & methods: We analyzed 27 genetic variants in DHFR, TYMS, MTHFR, ATIC and CCND1 genes.

Results: We included 124 RA patients treated with MTX monotherapy. In multivariate analyses two variants in the MTHFR gene were associated with response, rs17421511 (p = 0.024) and rs1476413 (p = 0.0086), as well as one in the DHFR gene, rs1643650 (p = 0.026). The ATIC rs16853826 variant was associated with toxicity (p = 0.039).

Conclusion: MTHFR, DHFR and ATIC genetic variants can be considered as pharmacogenetic markers of outcome in RA patients under MTX monotherapy.

Juliana Salazar, Patricia Moya, Albert Altés, César Díaz-Torné, Jordi Casademont, Dacia Cerdà-Gabaroi, Hèctor Corominas, Montserrat Baiget. Polymorphisms in Genes Involved in the Mechanism of Action of Methotrexate-Are They Associated With Outcome in Rheumatoid Arthritis Patients? Pharmacogenomics. 2014;15(8):1079-1090. (Medscape:


Do Antiviral Combinations Make Sense?

Dr. Hayden and colleagues suggest that the therapeutic use of influenza antiviral combinations could increase antiviral potency while reducing the emergence of resistance.

No combinations of proven value for treating severe influenza are available, so they summarize published information regarding influenza antiviral combinations and comment on antiviral and immunomodulator combinations that have received preclinical and some clinical investigation in their September 9 Lancet Infectious Diseases online paper.

Boggs, W. Antiviral Combinations Make Sense for Severe Flu. Medscape from Reuters Health Information. October 13, 2014.


Parkinson’s Drugs and Impulse Control

Objectives  To analyze serious adverse drug event reports about these impulse control disorders received by the US Food and Drug Administration (FDA) and to assess the relationship of these case reports with the 6 FDA-approved dopamine receptor agonist drugs.

Design, Setting, and Participants  We conducted a retrospective disproportionality analysis based on the 2.7 million serious domestic and foreign adverse drug event reports from 2003 to 2012 extracted from the FDA Adverse Event Reporting System.

Conclusions and Relevance  Our findings confirm and extend the evidence that dopamine receptor agonist drugs are associated with these specific impulse control disorders. At present, none of the dopamine receptor agonist drugs approved by the FDA have boxed warnings as part of their prescribing information. Our data, and data from prior studies, show the need for more prominent warnings.

Reports of Pathological Gambling, Hypersexuality, and Compulsive Shopping Associated With Dopamine Receptor Agonist Drugs . JAMA Intern Med. Published online October 20, 2014. doi:10.1001/jamainternmed.2014.5262


Fatal Drug Reactions Increase

Anaphylaxis-related deaths were identified by using the 10th clinical modification of the International Classification of Diseases system diagnostic codes on death certificates from the US National Mortality Database. Rates were calculated by using census population estimates.

Results- There were a total of 2458 anaphylaxis-related deaths in the United States from 1999 to 2010. Medications were the most common cause (58.8%), followed by “unspecified” (19.3%), venom (15.2%), and food (6.7%). There was a significant increase in fatal drug-induced anaphylaxis over 12 years: from 0.27 (95% CI, 0.23-0.30) per million in 1999 to 2001 to 0.51 (95% CI, 0.47-0.56) per million in 2008 to 2010 (P < .001). Fatal anaphylaxis caused by medications, food, and unspecified allergens was significantly associated with African American race and older age (P < .001). Fatal anaphylaxis to venom was significantly associated with white race, older age, and male sex (P < .001). The rates of fatal anaphylaxis to foods in male African American subjects increased from 0.06 (95% CI, 0.01-0.17) per million in 1999 to 2001 to 0.21 (95% CI, 0.11-0.37) per million in 2008 to 2010 (P < .001). The rates of unspecified fatal anaphylaxis decreased over time from 0.30 (95% CI, 0.26-0.34) per million in 1999 to 2001 to 0.09 (95% CI, 0.07-0.11) per million in 2008 to 2010 (P < .001).

Conclusion- There are strong and disparate associations between race and specific classes of anaphylaxis-related mortality in the United States. The increase in medication-related deaths caused by anaphylaxis likely relates to increased medication and radiocontrast use, enhanced diagnosis, and coding changes.

Fatal anaphylaxis in the United States, 1999-2010: Temporal patterns and demographic associations. Journal of Allergy and Clinical Immunology. September 30, 2014 (online). DOI:

The most common cause of fatal allergic reactions in the United States are medicines, especially antibiotics and radiocontrast agents used in imaging studies, a new analysis found.

Using data from the National Center for Health Statistics, researchers found 2,458 cases of fatal anaphylaxis from 1999 through 2010. Almost 60 percent of the deaths, or 1,446, were caused by reactions to drugs, and in cases where the specific drug was known, half were caused by antibiotics. The rate of drug-induced fatal reactions almost doubled over the period.

Insect stings caused 15.2 percent of the fatalities and food 6.7 percent. The cause was not recorded in a fifth of the cases.

Bakalar, N. Drugs Cause Most Fatal Allergic Reactions, Study Finds. New York Times. October 6, 2014.


New Position on Pain Meds From the American Academy of Neurology

The Patient Safety Subcommittee requested a review of the science and policy issues regarding the rapidly emerging public health epidemic of prescription opioid-related morbidity and mortality in the United States. Over 100,000 persons have died, directly or indirectly, from prescribed opioids in the United States since policies changed in the late 1990s. In the highest-risk group (age 35-54 years), these deaths have exceeded mortality from both firearms and motor vehicle accidents. Whereas there is evidence for significant short-term pain relief, there is no substantial evidence for maintenance of pain relief or improved function over long periods of time without incurring serious risk of overdose, dependence, or addiction. The objectives of the article are to review the following: (1) the key initiating causes of the epidemic; (2) the evidence for safety and effectiveness of opioids for chronic pain; (3) federal and state policy responses; and (4) recommendations for neurologists in practice to increase use of best practices/universal precautions most likely to improve effective and safe use of opioids and to reduce the likelihood of severe adverse and overdose events.

Franklin GM. Opioids for chronic noncancer pain: A position paper of the American Academy of Neurology. Neurology. 2014 Sep 30;83(14):1277-84. doi: 10.1212/WNL.0000000000000839.

Park, A. For Back Pain or Headache, Painkillers Do More Harm than Good. Time. September 29, 2014.

Opioid prescribing rates in US vary widely between states, CDC reports. BMJ 2014; 349 doi:


Medication Mistakes with Children

(Reuters) – Roughly every eight minutes from 2002 through 2012, a child in the U.S. experienced a medication mistake, according to a new study of calls to poison control hotlines.

The number and rate of reported medication mistakes rose during the 11-year study, except for cough and cold medicines, the researchers report in the journal Pediatrics.

The reduction in mistakes with cough and cold medicines follows a multipronged campaign to decrease the use of these products among young children, which suggests education is helpful in reducing errors, Henry Spiller, one of the study’s authors, told Reuters Health.

Seaman, A. Medications mistakes common among young children. Reuters. Oct 20, 2014.


CRN Decries JAMA for Exaggerating Extent of Findings in New Study of Spiked Products—Yet there’s still no excuse, even one unsafe product is too many

Washington, D.C., October 21, 2014—In response to a research letter, “Presence of Banned Drugs in Dietary Supplements Following FDA Recalls,” published today in the Journal of the American Medical Association (JAMA), the Council for Responsible Nutrition (CRN), the leading trade association for the dietary supplement and functional food industry, issued the following statement:

Statement by Steve Mister, president & CEO, CRN:

“Any time adulterated health products get to consumers or remain on the market after the FDA has determined they are potentially unsafe illustrates a weakness in the enforcement of the nation’s food and drug laws. Responsible manufacturers and marketers of dietary supplements applaud strong enforcement measures by FDA to address illegal products that contain undisclosed, active pharmaceutical ingredients (APIs). We have zero tolerance for this problem and welcome not only recalls, but also criminal enforcement against companies that put consumers at risk.

However, the promotion of a new study in JAMA grossly misrepresents the extent of the situation and understates the success of FDA’s efforts. We agree with the authors that FDA must increase the aggressiveness by which it enforces the drug laws targeted to illegal products. But the study found that of the 274 products that were recalled over the three-year period, only 27 remained on the market—meaning that FDA’s action successfully rid consumers of 90 percent of the implicated products. Of the 27 remaining, 18 of the products were identified as containing APIs after being recalled; the other nine had been reformulated. In other words, the FDA’s recall efforts had a more than 93 percent success rate (256 out of 274).1

CRN Decries JAMA for Exaggerating Extent of Findings in New Study of Spiked Products—Yet there’s still no excuse, even one unsafe product is too many. Modern HCP. October 23, 2014.


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