Sunday, February 24, 2008

An Oldie Vies for Nutrient of the Decade

NYT February 19, 2008

Researchers are trying to understand how much vitamin D is necessary for optimal health. Are you taking enough?

http://www.nytimes.com/2008/02/19/health/19brod.html?ex=1361163600&en=abade0993ceae829&ei=5124&partner=permalink&exprod=permalink

Gentlemen, 5 Easy Steps to Living Long and Well

By NICHOLAS BAKALAR
Published: NYT February 19, 2008
Five behaviors in elderly men are associated not only with living into extreme old age, a new study has found, but also with good health and independent functioning.

http://www.nytimes.com/2008/02/19/health/19agin.html?ex=1361163600&en=5db0c3d4c165532e&ei=5124&partner=permalink&exprod=permalink

Good Question: Do Cellphones Affect Fertility?

By Tara Parker-Pope
Published: February 19, 2008

A reader asks about the links between cell phone use and fertility.
http://well.blogs.nytimes.com/2008/02/19/the-inbox-cell-phones-and-sperm/

Thursday, February 21, 2008

Can a Drug That Helps Hearts Be Harmful to the Brain?

More good news for statin drugs...

WSJ- February 12, 2008

Cognitive side effects like memory loss and fuzzy thinking aren't listed on the patient information sheet for Lipitor, the popular cholesterol-lowering drug. But some doctors are voicing concerns that in a small portion of patients, statins like Lipitor may be helping hearts but hurting minds.

"This drug makes women stupid," Orli Etingin, vice chairman of medicine at New York Presbyterian Hospital, declared at a recent luncheon discussion sponsored by Project A.L.S. to raise awareness of gender issues and the brain. Dr. Etingin, who is also founder and director of the Iris Cantor Women's Health Center in New York, told of a typical patient in her 40s, unable to concentrate or recall words. Tests found nothing amiss, but when the woman stopped taking Lipitor, the symptoms vanished. When she resumed taking Lipitor, they returned.

Pfizer Inc.'s Lipitor is the world's best-selling medicine, with revenues of $12.6 billion in 2007. The company says that its safety and efficacy have been demonstrated in more than 400 clinical trials and 145 million patient years of experience, and that the extensive data "do not establish a causal link between Lipitor and memory loss." Pfizer also says it draws conclusions about adverse events from a variety of sources "as opposed to anecdotal inferences by individual providers with a limited data pool."

World-wide, some 25 million people take statins, including Zocor, Mevacor, Crestor, Pravachol and Vytorin. As a group, they are widely credited with reducing heart attacks and strokes in people at high risk, though the benefits are less clear in people who are not at high risk, particularly women and the elderly. Some 15% of patients complain of side effects; muscle aches and liver toxicity are the most recognized to date. But anecdotes linking statins to memory problems have been rampant for years.

On balance, most cardiologists see little cause for concern. "The benefits far outweigh the risks," says Antonio Gotto, dean of the Weill-Cornell Medical School and past president of the American Heart Association. Dr. Gotto, who has consulted for most of the statin makers and been involved in many of the trials, says "I would hate to see people frightened off taking statins because they think it's going to cause memory loss."

Thinking and memory problems are difficult to quantify, and easy for doctors to dismiss. Many people who take statins are elderly and have other conditions and medications that could have cognitive side effects.

Still, the chronology can be very telling, says Gayatri Devi, an associate professor of neurology and psychiatry at New York University School of Medicine, who says she's seen at least six patients whose memory problems were traceable to statins in 12 years of practice. "The changes started to occur within six weeks of starting the statin, and the cognitive abilities returned very quickly when they went off," says Dr. Devi. "It's just a handful of patients, but for them, it made a huge difference."

Researchers at the University of California at San Diego are nearing completion of a randomized controlled trial examining the effects of statins on thinking, mood, behavior, and quality of life. Separately, the UCSD researchers are collecting anecdotal experiences of patients, good and bad, on statins; memory problems are the second most common side effect, after muscle aches, in about 5,000 reports to date.

Still, the chronology can be very telling, says Gayatri Devi, an associate professor of neurology and psychiatry at New York University School of Medicine, who says she's seen at least six patients whose memory problems were traceable to statins in 12 years of practice. "The changes started to occur within six weeks of starting the statin, and the cognitive abilities returned very quickly when they went off," says Dr. Devi. "It's just a handful of patients, but for them, it made a huge difference."

Researchers at the University of California at San Diego are nearing completion of a randomized controlled trial examining the effects of statins on thinking, mood, behavior, and quality of life. Separately, the UCSD researchers are collecting anecdotal experiences of patients, good and bad, on statins; memory problems are the second most common side effect, after muscle aches, in about 5,000 reports to date.

"We have some compelling cases," says Beatrice Golomb, the study's lead researcher. In one of them, a San Diego woman, Jane Brunzie, was so forgetful that her daughter was investigating Alzheimer's care for her and refused to let her babysit for her 9-year-old granddaughter. Then the mother stopped taking a statin. "Literally, within eight days, I was back to normal -- it was that dramatic," says Mrs. Brunzie, 69 years old.

Doctors put her on different statins three more times. "They'd say, 'Here, try these samples.' Doctors don't want to give up on it," she says. "Within a few days of starting another one, I'd start losing my words again," says Mrs. Brunzie, who has gone back to volunteering at the local elementary school she loves and is trying to bring her cholesterol down with dietary changes instead.

"I feel very blessed -- I got about 99% of my memory back," she adds. "But I worry about people like me who are starting to lose their words who may think they have just normal aging and it may not be."

Of course, not every case of mental decline can be reversed by stopping statins. In fact, there's some evidence that statins may ward off Alzheimer's by reducing plaque and inflammation in the brain.

On the other hand, the brain is largely cholesterol, much of it in the myelin sheaths that insulate nerve cells and in the synapses that transmit nerve impulses. Lowering cholesterol could slow the connections that facilitate thought and memory. Statins may also lead to the formation of abnormal proteins seen in the brains of Alzheimer's patients.

The cognitive changes can affect men as well as women. But women on statins are often simultaneously losing estrogen due to menopause, which can also cause cognitive changes. "Women are getting hit with a double whammy," says Elizabeth Lee Vliet, a women's health physician in Tucson, Ariz., who has a background in neuroendochronology.

Side effects are always highly individual. Most patients tolerate statins very well, and heart disease remains the leading cause of death in the U.S. for men and women.

But it pays to think hard about whether you really need to be on a statin -- or if you could accomplish your goals with diet and exercise instead. "Some people want to take a pill and think they can eat whatever they want," says Nieca Goldberg, a cardiologist and medical director of the Women's Heart Program at the New York University School of Medicine. She says she typically prescribes statins for women who have elevated cholesterol and have already had a heart attack. But for younger women with high cholesterol and no other risk factors, she encourages lifestyle changes.

"I try to initiate diet modifications and physical activity in all my patients -- even if they still need medication, I can give them a lower dose," says Dr. Goldberg. "I try to make the point that we are all in this together."

If you do need to be on cholesterol-lowering medication, pay close attention to any side effects and talk with your doctor. You may have a different experience with a different dose or different statin. Also remember that the doctor taking care of your heart condition may not be as experienced in other body parts. "You really need a balanced approach," says Dr. Vliet. But "each physician may be looking at only one part of the elephant -- that's the way medicine is practiced in the U.S.

As Jane Brunzie says, "I learned through this experience that you have to use your own brain, as well as your doctor's brain, when it comes to your health."

http://online.wsj.com/article_email/SB120277403869360595-lMyQjAxMDI4MDEyNjcxNzY0Wj.html#CX

Cell phone linked to salivary gland tumors

TEL AVIV, Israel, Feb. 14 (UPI) -- An Israeli scientist is investigating a possible link between heavy cell phone use and tumors of the salivary gland.

Dr. Siegal Sadetzki of Tel Aviv University investigated nearly 500 people who had been diagnosed with benign and malignant tumors of the salivary gland and found that frequent cell phone users had a higher risk of developing tumors, the university said Thursday in a release.

Patients who used a cell phone heavily on the side of the head where the tumor developed were found to have a 50 percent greater risk of developing a tumor of the parotid salivary gland, compared to those who did not use cell phones.

The report was published in the American Journal of Epidemiology.

"Unlike people in other countries, Israelis were quick to adopt cell phone technology and have continued to be exceptionally heavy users," Sadetzki said in a statement. "Therefore, the amount of exposure to radio frequency radiation found in this study has been higher than in previous cell phone studies."

Sadetzki recommends that people use hands-free devices at all times, hold the phones away from the body while talking and make fewer and shorter phone calls.

Lights at Night Are Linked to Breast Cancer

washingtonpost.com

02-20-08

Women who live in neighborhoods with large amounts of nighttime illumination are more likely to get breast cancer than those who live in areas where nocturnal darkness prevails, according to an unusual study that overlaid satellite images of Earth onto cancer registries.

The finding adds credence to the hypothesis that exposure to too much light at night can raise the risk of breast cancer by interfering with the brain's production of a tumor-suppressing hormone.

"By no means are we saying that light at night is the only or the major risk factor for breast cancer," said Itai Kloog, of the University of Haifa in Israel, who led the new work. "But we found a clear and strong correlation that should be taken into consideration."

Scientists have known for years that rats raised in cages where lights are left on for much of the night have higher cancer rates than those allowed to sleep in darkness. And epidemiological studies of nurses, flight attendants and others who work at night have found breast cancer rates 60 percent above normal, even when other factors such as differences in diet are accounted for.

On the basis of such studies, an arm of the World Health Organization announced in December its decision to classify shift work as a "probable carcinogen." That put the night shift in the same health-risk category as exposure to such toxic chemicals as trichloroethylene, vinyl chloride and polychlorinated biphenyls (PCBs).

The mechanism of such a link, if real, remains mysterious, but many scientists suspect that melatonin is key. Secreted by the pineal gland in the brain, the hormone helps prevent tumor formation. The body produces melatonin primarily at night, and levels drop precipitously in the presence of light, especially light in the blue part of the spectrum produced in quantity by computer screens and fluorescent bulbs.

In keeping with the melatonin hypothesis, mice in cages with night lighting have normal cancer rates if they get shots of the hormone. And blind women, whose eyes cannot detect light and so have robust production of melatonin, have lower-than-average breast cancer rates.

Kloog and his colleagues took a previously untried approach to testing the link. They obtained satellite data from NASA that showed in great detail how much light was emitted spaceward from neighborhoods throughout Israel.

Although the light levels that reached the satellite were about one-tenth their intensity on Earth, the approach provides an accurate measure of which areas are brighter or darker than others and by how much.

The team then overlaid that map with local statistics on cases of breast cancer and, for comparison, lung cancer, which is caused mostly by smoking and so would not be expected to be linked to light.

After using neighborhood data to correct for other factors that can affect cancer rates, including wealth, ethnicity and the average number of children in families living in those localities, the researchers found no link between night lighting and lung cancer, they report in this week's online issue of the journal Chronobiology International.

But the researchers found the breast cancer rate in localities with average night lighting to be 37 percent higher than in communities with the lowest amount of light; and they noted that the rate was higher by an additional 27 percent in areas with the highest amount of light.

Abraham Haim, a University of Haifa chronobiologist involved in the study, said the findings raise questions about the recent push to switch to energy-efficient fluorescent bulbs, which suppress melatonin production more than conventional incandescent bulbs. "This may be a disaster in another 20 years," Haim said, "and you won't be able to reverse what we did by mistake." He called for more research before policies favoring fluorescent lights are implemented, and for more emphasis on using less light at night.

Jim Burch, a University of South Carolina epidemiologist and biostatistician familiar with the study, called the approach and findings "fascinating."

"The study has limitations," including not measuring levels of indoor lighting, "but it supports the overall idea," Burch said. "I think there is enough evidence to suggest we ought to be thinking about this more carefully."

For more news, or to subscribe to the newspaper, please visit http://www.washingtonpost.com

Tuesday, February 12, 2008

Artificial Sweeteners Linked to Weight Gain

New research indicates that saccharin and other sugar substitutes may not be such a sweet deal for weight watchers
By Lisa Stein

You know those no-guilt diet drinks you chug by the gallon, and the fake sugar you dump in your coffee to stay trim? Bad news: a new study suggests that artificial sweeteners may actually make it harder to control your weight.

Psychologists at Purdue University's Ingestive Behavior Research Center report that nine rats given yogurt sweetened with no-cal saccharin ended up eating more and gaining more weight and body fat than eight fellow rodents given yogurt containing plain old glucose (a simple sugar with about 15 calories per teaspoon, the same as table sugar).

Study authors Susan Swithers and Terry Davidson speculate the reason is that the faux sweetener messes with the brain, fooling it into revving up the body's metabolism in anticipation of a never-to-come calorie load.

Typically, they say, the taste buds, sensing something sweet, signal the brain to prep the digestive system to gear up for a caloric onslaught; when the expected sugar jolt (extra calories) fails to materialize, the body gets rattled and has trouble bouncing back and regulating appetite when other food is available. As a result, rats eat more or expend less energy than they would have had they had the real thing.

"The data clearly indicate that consuming a food sweetened with no-calorie saccharin can lead to greater body-weight gain and adiposity [fat] than would consuming the same food sweetened with a higher-calorie sugar," the authors write in the journal Behavioral Neuroscience. They say that other artificial sweeteners—aspartame, sucralose and acesulfame—could have a similar effect.

The researchers note that the findings jive with other emerging evidence—including a study published last month in the American Heart Association's journal, Circulation—that shows people who down diet drinks are at a higher risk for obesity and metabolic syndrome (a medley of medical problems such as abdominal fat, high blood pressure and insulin resistance that puts people at risk for heart disease and diabetes).

They acknowledge, however, that more research is needed. After all, just because this counterintuitive effect may occur in rats does not necessarily mean it also happens in humans. Still, let it serve as a warning to anyone who may have a false sense of security that artificial sweeteners are all it takes to be fit and healthy.

Behavioral Neuroscience

http://www.apa.org/journals/releases/bne-feb08-swithers.pdf

Saturday, February 9, 2008

Even More Bad News for Diet Soda

Vital Signs
Symptoms: Metabolic Syndrome Is Tied to Diet Soda
By NICHOLAS BAKALAR
Published: February 5, 2008
Researchers have found a correlation between drinking diet soda and metabolic syndrome and elevated blood pressure.

http://circ.ahajournals.org/cgi/content/abstract/CIRCULATIONAHA.107.716159v1

Hawthorn Berry Eases Symptoms of Heart Failure

Vital Signs
Regimens: An Herbal Extract Eases Symptoms of Heart Failure
By NICHOLAS BAKALAR
Published: February 5, 2008
The herbal supplement hawthorn extract is effective in treating symptoms of chronic heart failure, new research suggests.

http://www.cochrane.org/reviews/en/ab005312.html