Certain chemicals that are widely used in sunscreens and other products because they protect against UV light are associated with an increased risk of developing the gynecological condition endometriosis, a new study shows.
But the Personal Care Products Council, a group that represents cosmetics manufacturers, called the study "weak" and "unconvincing" and said it shouldn't scare people away from safe sun practices, including sunscreen use.
Sunscreen Ingredient May Mimic Estrogen
The study, which is published in Environmental Science & Technology, measured concentrations of five kinds of chemicals called benzophenones in the urine of more than 600 women who were evaluated for endometriosis.
Benzophenones are used in a variety of products because they protect against UV light. In small amounts, that helps to stabilize the formulations of products that are stored in clear containers, like nail polish. At higher concentrations, and when they are applied to the skin, they are powerful sunscreens.
Endometriosis is a painful condition that occurs when tissue from the inside of the uterus grows outside of the uterus. When this tissue grows in other parts of the body, typically spilling into the abdomen around the ovaries or fallopian tubes, it behaves as if it were still in the uterus, thickening and shedding each month in sync with a woman's menstrual cycle. Endometriosis can lead to scarring and infertility.
Studies estimate that about 1 in 10 women have the condition, and some research suggests that it is becoming more common.
Benzophenones are easily absorbed through the skin. Studies by the CDC have found benzophenones in the urine of 97% of people tested.
Scientists are concerned about benzophenones because the body may mistake them for hormones.
"These compounds are estrogenic. They mimic estrogen in the body," says researcher Kurunthachalam Kannan, PhD, a professor of public health and environmental health sciences with the New York State Department of Health's Wadsworth Center in Albany.
Kannan says benzophenone-3, which appears on sunscreen labels as oxybenzone, is even more strongly estrogenic than bisphenol-A (BPA), a chemical found in certain plastics that's recently been the subject of regulatory scrutiny.
The cause of endometriosis is not known, but the condition is fed by the female hormone estrogen. Treatment sometimes involves taking medications that lower estrogen levels.
Study Ties Benzophenones to Endometriosis
Overall, the study found that only one kind of benzophenone, a chemical known as benzophenone-1, was significantly associated with the risk that a woman would have endometriosis.
Women with the highest amounts of benzophenone-1 in their urine had a 65% greater chance of having endometriosis compared to women with the lowest levels.
Benzophenone-1 is a chemical additive that's mostly used in nail polishes, according to the cosmetics industry web site CosmeticsInfo.org, but it also forms when the body breaks down oxybenzone, the major ingredient in sunscreen.
Differing Opinions
"We find it to be a very weak study and quite unconvincing," says Linda Loretz, PhD, director of safety and regulatory toxicology for the Personal Care Products Council, a group that represents the interests of the cosmetics industry.
Loretz points out that researchers had no information about whether the women used sunscreen or how much they used, which makes it impossible to know how they were exposed to the chemicals.
"I don't think consumers should be concerned," she says. "I think safe sun practices are much more important."
Women in the study who lived in California had higher benzophenone concentrations in their urine if they were tested during the summer months.
That suggests that sunscreen is playing a role in exposure, says Sonya Lunder, MPH, a senior analyst with the Environmental Working Group (EWG) in Washington, D.C.
A separate study by the CDC also found "higher concentrations in lighter-skinned people and also in the summertime, which points to the role of sunscreen in the measurement in our bodies," Lunder says.
The Environmental Working Group publishes its own guide to sunscreen safety, and they have flagged oxybenzone, a chemical that's found in half of all sunscreens, as an ingredient that people should avoid.
"We have raised concerns about it over the past couple of years as these kinds of studies come out -- our concern level matches up with it," Lunder says.
"The studies in people are still pretty small, pretty limited, but they are backed up by a series of laboratory studies finding that this chemical and this whole family of chemicals, really, has estrogenic effects," she says.
In addition to acting like estrogen in the body, Lunder says many people are simply sensitive to oxybenzone and that it can cause skin irritation.
The EWG says safer sunscreens are those that are mineral-based with ingredients zinc oxide or titanium dioxide as natural UV blockers.
Source: http://www.medscape.com/viewarticle/763761?sssdmh=dm1.784103&src=nldne
Welcome to my collection of health articles. Most of them contain little nuggets of health wisdom that we can easily apply to our daily lives. As you can gather, I've been consuming all sorts of supplements over the years, most of them from iherb. They deliver on time (DHL), and prices are good. If you're a first-time buyer, use my code 'pot089' to enjoy up to $10 off.
Thursday, 24 May 2012
Moderate coffee intake protects against stroke
A new meta-analysis, including the most contemporary studies that have examined coffee consumption and risk of cardiovascular events in a general population, has found that moderate intake may help protect against ischemic stroke [1].
Presenting the results at the recent European Society of Hypertension (ESH) European Meeting on Hypertension 2012, Dr Lanfranco D'Elia (Federico II University of Naples, Italy) told heartwire : "The first message is that coffee intake is not associated with a higher risk of stroke," which he says is reassuring. "Second, the analysis showed that low to moderate intake--one to three cups of coffee per day--was associated with lower risk of stroke in the general population, across a wide range of countries, including some in Europe, the US, and Japan."
However D'Elia stressed that these results apply to the general population only and that findings with regard to coffee intake and risk in those with cardiovascular disease have been conflicting. Nevertheless, he believes that "one coffee a day is not dangerous for people with heart disease."
Protective effect independent of most identifiable confounders
D'Elia and colleagues performed a meta-analysis of the available prospective studies, including those that estimated baseline coffee consumption and risk of stroke in the general population, from 1966 to 2011. However, the majority of studies included were performed in the late 2000s, including a recent Swedish study and one from the Netherlands.
One to three cups of coffee per day was associated with lower risk of stroke in the general population.
For this analysis, coffee consumption was stratified into moderate (one to three cups/day), high (three to six), and very high (six or more) and compared with the reference category (zero to one). For each study, the values of relative risk (RR) and their confidence interval were extracted and then combined using a random effect model. Eight general-population studies were included in the analysis, for a total of 11 cohorts (484 757 participants, 7272 stroke events, follow-up two to 24 years).
In the pooled analysis, habitual moderate coffee consumption was associated with decreased risk of stroke (RR 0.86, 95% CI 0.75–0.98; p < 0.02).
Stroke risk in the high-consumption category showed a trend in the same direction, toward a reduction (RR 0.87, 95% CI 0.70–1.08; p=0.02), which reached statistical significance upon sensitivity analysis with the exclusion of a single outlier study (RR 0.81, 95% CI 0.70–0.95; p=0.01).
Habitual very high coffee consumption was not associated with any effect on stroke risk (RR 1.05, p=0.71).
D'Elia said that unlike low to moderate coffee intake, both "high" and "very high" consumption showed a significant heterogeneity between studies.
Statistical analysis did not find any significant sources of heterogeneity (length of follow-up, publication year, gender, countries, etc) that affected the relationship between coffee intake and stroke risk, but he noted, "We cannot exclude the potential limitations of the analysis around the standardization of coffee preparation or different types of coffee.
"The results of this meta-analysis, which included prospective studies of samples of the general population, indicate that coffee consumption is not associated with a higher risk of stroke and that actually habitual moderate consumption may exert a protective effect independently from most identifiable confounders," he concluded.
Source: http://www.medscape.com/viewarticle/763742?sssdmh=dm1.784103&src=nldne
Presenting the results at the recent European Society of Hypertension (ESH) European Meeting on Hypertension 2012, Dr Lanfranco D'Elia (Federico II University of Naples, Italy) told heartwire : "The first message is that coffee intake is not associated with a higher risk of stroke," which he says is reassuring. "Second, the analysis showed that low to moderate intake--one to three cups of coffee per day--was associated with lower risk of stroke in the general population, across a wide range of countries, including some in Europe, the US, and Japan."
However D'Elia stressed that these results apply to the general population only and that findings with regard to coffee intake and risk in those with cardiovascular disease have been conflicting. Nevertheless, he believes that "one coffee a day is not dangerous for people with heart disease."
Protective effect independent of most identifiable confounders
D'Elia and colleagues performed a meta-analysis of the available prospective studies, including those that estimated baseline coffee consumption and risk of stroke in the general population, from 1966 to 2011. However, the majority of studies included were performed in the late 2000s, including a recent Swedish study and one from the Netherlands.
One to three cups of coffee per day was associated with lower risk of stroke in the general population.
For this analysis, coffee consumption was stratified into moderate (one to three cups/day), high (three to six), and very high (six or more) and compared with the reference category (zero to one). For each study, the values of relative risk (RR) and their confidence interval were extracted and then combined using a random effect model. Eight general-population studies were included in the analysis, for a total of 11 cohorts (484 757 participants, 7272 stroke events, follow-up two to 24 years).
In the pooled analysis, habitual moderate coffee consumption was associated with decreased risk of stroke (RR 0.86, 95% CI 0.75–0.98; p < 0.02).
Stroke risk in the high-consumption category showed a trend in the same direction, toward a reduction (RR 0.87, 95% CI 0.70–1.08; p=0.02), which reached statistical significance upon sensitivity analysis with the exclusion of a single outlier study (RR 0.81, 95% CI 0.70–0.95; p=0.01).
Habitual very high coffee consumption was not associated with any effect on stroke risk (RR 1.05, p=0.71).
D'Elia said that unlike low to moderate coffee intake, both "high" and "very high" consumption showed a significant heterogeneity between studies.
Statistical analysis did not find any significant sources of heterogeneity (length of follow-up, publication year, gender, countries, etc) that affected the relationship between coffee intake and stroke risk, but he noted, "We cannot exclude the potential limitations of the analysis around the standardization of coffee preparation or different types of coffee.
"The results of this meta-analysis, which included prospective studies of samples of the general population, indicate that coffee consumption is not associated with a higher risk of stroke and that actually habitual moderate consumption may exert a protective effect independently from most identifiable confounders," he concluded.
Source: http://www.medscape.com/viewarticle/763742?sssdmh=dm1.784103&src=nldne
Zinc May Shorten Cold Symptoms in Adults, but Not Children
Oral zinc formulations may lessen the duration of cold symptoms in adults, but not in children, according to the findings of a meta-analysis.
Michelle Science, MD, from the Hospital for Sick Children, Toronto, Ontario, Canada, and colleagues published their findings online May 7 in the Canadian Medical Association Journal.
Of the 17 included trials, 8 trials involving patients with naturally acquired colds revealed that zinc reduced the duration of cold symptoms compared with placebo (mean difference, −1.65 days; 95% confidence interval [CI], −2.50 to −0.81 days), albeit with significant heterogeneity (I 2, 95%). Subgroup analysis revealed a statistically significant interaction between adults and children (P < .0001), as zinc reduced the duration of cold symptoms in adults (mean difference, −2.63; 95% CI, −3.69 to −1.58), but not in children (mean difference, −0.26; 95% CI, −0.78 to 0.25), with slightly lower heterogeneity (adults, I 2, 82%; children, I 2, 84%).
The authors noted that a previous meta-analysis reported the efficacy of zinc against common cold symptoms, but that significant heterogeneity was reported for the primary outcome. "The efficacy of zinc therefore remains uncertain, because it is unknown whether the variability among studies was due to methodologic diversity (i.e., risk of bias and therefore uncertainty in zinc's efficacy) or differences in study populations or interventions (i.e., zinc dose and formulation)," the authors write.
After a search of the MEDLINE, Embase, Cochrane, CINAHL, and AMED databases, the authors included randomized controlled trials that evaluated the efficacy of oral zinc as a single agent against placebo or no treatment with no restrictions placed on participant age, language, or year of publication. The authors excluded trials that evaluated intranasally administered zinc or orally administered zinc in combination with other modalities.
Additional subgroup analysis revealed a significant interaction for zinc formulation (P = .003), as zinc acetate (mean difference, −2.67; 95% CI, −3.96 to −1.38), but not zinc gluconate (mean difference, −1.72; 95% CI, −3.89 to 0.44) or zinc sulfate (mean difference, −0.31; 95% CI, −0.89 to 0.28), reduced the duration of symptoms compared with placebo. Regarding adverse events, only bad taste (8 trials; risk ratio [RR], 1.65; 95% CI, 1.27 - 2.16) and nausea (9 trials; RR, 1.64; 95% CI, 1.19 - 2.27) were more frequently observed in patients treated with zinc.
The limitations of the study included the large level of unexplained heterogeneity, the potentially ineffective blinding related to the taste of the placebo, the funding of all included studies by industry, and the performance of most studies in developed countries.
The authors indicated that uncertainty remains regarding the efficacy of zinc against common cold symptoms. "Although oral zinc treatment may attenuate the symptoms of the common cold, large high-quality trials enrolling adults and children are needed," the authors write. "Until further evidence becomes available, there is only a weak rationale for physicians to recommend zinc for the treatment of the common cold."
Source: http://www.medscape.com/viewarticle/763394?sssdmh=dm1.782072&src=nldne
Michelle Science, MD, from the Hospital for Sick Children, Toronto, Ontario, Canada, and colleagues published their findings online May 7 in the Canadian Medical Association Journal.
Of the 17 included trials, 8 trials involving patients with naturally acquired colds revealed that zinc reduced the duration of cold symptoms compared with placebo (mean difference, −1.65 days; 95% confidence interval [CI], −2.50 to −0.81 days), albeit with significant heterogeneity (I 2, 95%). Subgroup analysis revealed a statistically significant interaction between adults and children (P < .0001), as zinc reduced the duration of cold symptoms in adults (mean difference, −2.63; 95% CI, −3.69 to −1.58), but not in children (mean difference, −0.26; 95% CI, −0.78 to 0.25), with slightly lower heterogeneity (adults, I 2, 82%; children, I 2, 84%).
The authors noted that a previous meta-analysis reported the efficacy of zinc against common cold symptoms, but that significant heterogeneity was reported for the primary outcome. "The efficacy of zinc therefore remains uncertain, because it is unknown whether the variability among studies was due to methodologic diversity (i.e., risk of bias and therefore uncertainty in zinc's efficacy) or differences in study populations or interventions (i.e., zinc dose and formulation)," the authors write.
After a search of the MEDLINE, Embase, Cochrane, CINAHL, and AMED databases, the authors included randomized controlled trials that evaluated the efficacy of oral zinc as a single agent against placebo or no treatment with no restrictions placed on participant age, language, or year of publication. The authors excluded trials that evaluated intranasally administered zinc or orally administered zinc in combination with other modalities.
Additional subgroup analysis revealed a significant interaction for zinc formulation (P = .003), as zinc acetate (mean difference, −2.67; 95% CI, −3.96 to −1.38), but not zinc gluconate (mean difference, −1.72; 95% CI, −3.89 to 0.44) or zinc sulfate (mean difference, −0.31; 95% CI, −0.89 to 0.28), reduced the duration of symptoms compared with placebo. Regarding adverse events, only bad taste (8 trials; risk ratio [RR], 1.65; 95% CI, 1.27 - 2.16) and nausea (9 trials; RR, 1.64; 95% CI, 1.19 - 2.27) were more frequently observed in patients treated with zinc.
The limitations of the study included the large level of unexplained heterogeneity, the potentially ineffective blinding related to the taste of the placebo, the funding of all included studies by industry, and the performance of most studies in developed countries.
The authors indicated that uncertainty remains regarding the efficacy of zinc against common cold symptoms. "Although oral zinc treatment may attenuate the symptoms of the common cold, large high-quality trials enrolling adults and children are needed," the authors write. "Until further evidence becomes available, there is only a weak rationale for physicians to recommend zinc for the treatment of the common cold."
Source: http://www.medscape.com/viewarticle/763394?sssdmh=dm1.782072&src=nldne
Yoga shows promise in rheumatoid arthritis
Young women with rheumatoid arthritis (RA) showed improvement after practicing Iyengar-style yoga for 6 weeks, a new study shows.
Women in this pilot study reported improvement in general health, vitality, self-efficacy, and several other measures, although not in pain intensity.
"It seems to be a very feasible, practical treatment for patients with rheumatoid arthritis," one of the researchers, Kirsten Lung, a research associate at the University of California Los Angeles (UCLA) pediatric pain program, told Medscape Medical News.
The results are not surprising to Kathleen Sluka, PhD, a physical therapist who researches pain at the University of Iowa, Iowa City. All kinds of physical activity can help with rheumatoid arthritis, she told Medscape Medical News. Sluka was not involved in this study.
The study was presented here at the American Pain Society (APS) 31st Annual Scientific Meeting.
Alternative strategy
Some drugs for RA can pose risks for younger patients, so the UCLA researchers are looking for alternatives. In Iyengar yoga, practitioners use blocks, straps, cushions, and other props to stretch and strengthen their muscles.
The UCLA researchers recruited 26 women with RA ranging in age from 21 to 35 years. On average they had had RA for 10.5 years.
The researchers randomly assigned 11 of these women to classes in Iyengar yoga and the other 15 to a wait list for yoga classes.
After 6 weeks, they asked both groups to fill out several surveys about their condition. The yoga group showed improvements on several measures, including the Short-Form 36 (SF-36) for general health, the SF-36 for vitality, the Pain Disability Index (PDI), the Health Assessment Questionnaire (HAQ), the Brief Symptom Inventory (BSI)-18 for somatization and global severity, the Chronic Pain Acceptance Questionnaire, the Functional Assessment of Chronic Illness Therapy, the Five Facet Mindfulness Questionnaire (FFMQ) for nonjudging of inner experience, the Arthritis Self-Efficacy Scale (ASES) for pain, and the Global Improvement Scale.
The wait-list group's scores held more or less constant on these measures.
For example, on the SF-36, where higher scores indicate a better health-related quality of life, the yoga group's scores rose from 47.1 ± 25 to 60.2 ± 21.4, whereas the wait-listed women's scores declined from 51.0 ± 22.3 to 47.0 ± 16.7.
On the PDI, where higher scores indicate more disability, the yoga group improved from 26.5 ± 19.3 to 13.5 ± 14.5, whereas the control group went from 18.7 ± 18.7 to 15.5 ± 17.3. These effects were statistically significant (P < 0.05).
The yoga group reported no adverse reactions.
On several other measures, however, the yoga intervention did not register statistically significant effects. These included the Numeric Rating Scale of pain intensity; the SF-36 for bodily pain; the SF-36 for mental health; the HAQ for disability; the Disease Activity Score (DAS28); the BSI for depression and anxiety; the FFMQ for observing, describing, and awareness; the FFMQ for nonreaction; and the ASES for function.
That may be because the study was so short, said Lung. "But 6 weeks did a world of good for those involved."
Dr. Sluka says that physical exercise usually takes about 8 weeks to show significant effects. All kinds of exercise can help with RA, she says. "Yoga is just another form of exercise," she said.
By strengthening muscles, exercise prevents joints from moving in uncomfortable ways. "And it re-engages pain inhibitory pathways," she said. Yoga might add additional benefits by calming patients' stress.
But the study is not conclusive, she points out, because it is very small. And in general it is very had to control for the placebo effect in a trial of exercise therapies.
Still, the study is worthwhile, she said, because it shows people with RA they have another option for getting exercise. "Some people like to run. Some people like to life weights. Some people like to do yoga."
Source: http://www.medscape.com/viewarticle/764345?sssdmh=dm1.787408&src=nldne
Women in this pilot study reported improvement in general health, vitality, self-efficacy, and several other measures, although not in pain intensity.
"It seems to be a very feasible, practical treatment for patients with rheumatoid arthritis," one of the researchers, Kirsten Lung, a research associate at the University of California Los Angeles (UCLA) pediatric pain program, told Medscape Medical News.
The results are not surprising to Kathleen Sluka, PhD, a physical therapist who researches pain at the University of Iowa, Iowa City. All kinds of physical activity can help with rheumatoid arthritis, she told Medscape Medical News. Sluka was not involved in this study.
The study was presented here at the American Pain Society (APS) 31st Annual Scientific Meeting.
Alternative strategy
Some drugs for RA can pose risks for younger patients, so the UCLA researchers are looking for alternatives. In Iyengar yoga, practitioners use blocks, straps, cushions, and other props to stretch and strengthen their muscles.
The UCLA researchers recruited 26 women with RA ranging in age from 21 to 35 years. On average they had had RA for 10.5 years.
The researchers randomly assigned 11 of these women to classes in Iyengar yoga and the other 15 to a wait list for yoga classes.
After 6 weeks, they asked both groups to fill out several surveys about their condition. The yoga group showed improvements on several measures, including the Short-Form 36 (SF-36) for general health, the SF-36 for vitality, the Pain Disability Index (PDI), the Health Assessment Questionnaire (HAQ), the Brief Symptom Inventory (BSI)-18 for somatization and global severity, the Chronic Pain Acceptance Questionnaire, the Functional Assessment of Chronic Illness Therapy, the Five Facet Mindfulness Questionnaire (FFMQ) for nonjudging of inner experience, the Arthritis Self-Efficacy Scale (ASES) for pain, and the Global Improvement Scale.
The wait-list group's scores held more or less constant on these measures.
For example, on the SF-36, where higher scores indicate a better health-related quality of life, the yoga group's scores rose from 47.1 ± 25 to 60.2 ± 21.4, whereas the wait-listed women's scores declined from 51.0 ± 22.3 to 47.0 ± 16.7.
On the PDI, where higher scores indicate more disability, the yoga group improved from 26.5 ± 19.3 to 13.5 ± 14.5, whereas the control group went from 18.7 ± 18.7 to 15.5 ± 17.3. These effects were statistically significant (P < 0.05).
The yoga group reported no adverse reactions.
On several other measures, however, the yoga intervention did not register statistically significant effects. These included the Numeric Rating Scale of pain intensity; the SF-36 for bodily pain; the SF-36 for mental health; the HAQ for disability; the Disease Activity Score (DAS28); the BSI for depression and anxiety; the FFMQ for observing, describing, and awareness; the FFMQ for nonreaction; and the ASES for function.
That may be because the study was so short, said Lung. "But 6 weeks did a world of good for those involved."
Dr. Sluka says that physical exercise usually takes about 8 weeks to show significant effects. All kinds of exercise can help with RA, she says. "Yoga is just another form of exercise," she said.
By strengthening muscles, exercise prevents joints from moving in uncomfortable ways. "And it re-engages pain inhibitory pathways," she said. Yoga might add additional benefits by calming patients' stress.
But the study is not conclusive, she points out, because it is very small. And in general it is very had to control for the placebo effect in a trial of exercise therapies.
Still, the study is worthwhile, she said, because it shows people with RA they have another option for getting exercise. "Some people like to run. Some people like to life weights. Some people like to do yoga."
Source: http://www.medscape.com/viewarticle/764345?sssdmh=dm1.787408&src=nldne
Coffee consumption linked to lower risk for death
The controversy about whether coffee is harmful or healthful just got a jolt of java.
Results from the largest study carried out to date indicate that coffee consumption was inversely associated with total and cause-specific mortality.
Men who drank 2 to 3 cups of coffee daily had a 10% decrease in their risk for death during the 13 years of the study compared with men who drank no coffee. Women who drank 2 to 3 cups of coffee daily had a 13% decrease in their risk for death.
The study, conducted by Neal Freedman, PhD, from the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, and colleagues, appears in the May issue of the New England Journal of Medicine.
"Considerable attention has been focused on the possibility that coffee may increase the risk of heart disease, particularly since drinking coffee has been associated with increased low-density lipoprotein cholesterol levels and short-term increases in blood pressure," the authors note.
However, the results of prior studies looking into that association have been inconsistent. The authors say that may be because of differences in the way the studies were conducted (case-controlled vs prospective study designs) or because previous researchers have not adequately controlled for potentially confounding variables such as tobacco smoking.
In addition to those potential limitations, the authors note, the total number of deaths examined in previous studies has been relatively small.
In an effort to address those issues, this group of researchers checked into the association of coffee consumption with subsequent total and cause-specific mortality in 229,119 men and 173,141 women who completed questionnaires as part of the wide-ranging National Institutes of Health–AARP Diet and Health Study.
When joining the study, participants were given questionnaires that, among other things, asked them about their coffee consumption. Ages at that baseline assessment ranged from 50 to 71 years. People with cancer or heart disease and those who had a history of stroke were excluded from the study.
During the 13-year study (1995 - 2008), 33,731 men and 18,784 women died. When the investigators used age-adjusted models to assess those results, they found that risks for death were elevated for coffee drinkers compared with those people who did not drink coffee.
However, those who drank coffee were also more likely to be smokers, and when the researchers adjusted for smoking status as well as other potentially confounding variables, a very different picture emerged.
"In this large, prospective U.S. cohort study, we observed a dose-dependent inverse association between coffee drinking and total mortality, after adjusting for potential confounders (smoking status in particular)," they write.
More specifically, they found that men who consumed 6 or more cups of coffee each day were 10% less likely to die during the study period than were men who did not drink coffee. For women, the reduction in risk was even greater, at 15%.
Hazard ratios for mortality in men who drank coffee compared with men who did not (P < .001 for trend across categories) were:
Less than 1 cup of coffee per day: 0.99 (95% confidence interval [CI], 0.95 - 1.04),
1 cup: 0.94 (95% CI, 0.90 - 0.99),
2 to 3 cups: 0.90 (95% CI, 0.86 - 0.93),
4 to 5 cups: 0.88 (95% CI, 0.84 - 0.93), and
6 or more cups: 0.90 (95% CI, 0.85 - 0.96).
Corresponding hazard ratios for women (P < .001 for trend across categories) were:
Less than 1 cup of coffee per day: 1.01 (95% CI, 0.96 - 1.07),
1 cup: 0.95 (95% CI, 0.90 - 1.01),
2 to 3 cups: 0.87 (95% CI, 0.83 - 0.92),
4 to 5 cups: 0.84 (95% CI, 0.79 - 0.90), and
6 or more cups: 0.85 (95% CI, 0.78 - 0.93).
As for cause-specific mortality, the researchers say they noted inverse associations for deaths resulting from heart disease, stroke, diabetes, respiratory disease, infections, injuries, and accidents, but the same was not true of deaths from cancer.
"In contrast, there was no significant association between coffee consumption and deaths from cancer in women," the researchers say. They also found a borderline positive association in men. Of the 13,402 deaths from cancer, 880 deaths were in men who consumed at least 6 cups of coffee each day (hazard ratio, 1.08; 95% CI, 0.98 - 1.19; P = 0.02 for trend).
Mortality rates were similar across all subgroups, the researchers note. That included people who had never smoked as well as those who at baseline described themselves as being in very good or excellent health.
The authors emphasize several limitations of the study. For one, coffee consumption was assessed at only a single point in time (upon entry into the study), so it is possible that consumption patterns might have changed over time.
In addition, the researchers note that they lacked specifics on how study participants prepared their coffee, and it could be that healthful and/or harmful attributes of the coffee might change depending on how it is prepared.
Still, they note, this study was larger than any previous study, and the number of deaths (>52,000) was more than double that in any earlier study.
"Our results provide reassurance with respect to the concern that coffee drinking might adversely affect health," they conclude.
Source: http://www.medscape.com/viewarticle/763962
Results from the largest study carried out to date indicate that coffee consumption was inversely associated with total and cause-specific mortality.
Men who drank 2 to 3 cups of coffee daily had a 10% decrease in their risk for death during the 13 years of the study compared with men who drank no coffee. Women who drank 2 to 3 cups of coffee daily had a 13% decrease in their risk for death.
The study, conducted by Neal Freedman, PhD, from the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, and colleagues, appears in the May issue of the New England Journal of Medicine.
"Considerable attention has been focused on the possibility that coffee may increase the risk of heart disease, particularly since drinking coffee has been associated with increased low-density lipoprotein cholesterol levels and short-term increases in blood pressure," the authors note.
However, the results of prior studies looking into that association have been inconsistent. The authors say that may be because of differences in the way the studies were conducted (case-controlled vs prospective study designs) or because previous researchers have not adequately controlled for potentially confounding variables such as tobacco smoking.
In addition to those potential limitations, the authors note, the total number of deaths examined in previous studies has been relatively small.
In an effort to address those issues, this group of researchers checked into the association of coffee consumption with subsequent total and cause-specific mortality in 229,119 men and 173,141 women who completed questionnaires as part of the wide-ranging National Institutes of Health–AARP Diet and Health Study.
When joining the study, participants were given questionnaires that, among other things, asked them about their coffee consumption. Ages at that baseline assessment ranged from 50 to 71 years. People with cancer or heart disease and those who had a history of stroke were excluded from the study.
During the 13-year study (1995 - 2008), 33,731 men and 18,784 women died. When the investigators used age-adjusted models to assess those results, they found that risks for death were elevated for coffee drinkers compared with those people who did not drink coffee.
However, those who drank coffee were also more likely to be smokers, and when the researchers adjusted for smoking status as well as other potentially confounding variables, a very different picture emerged.
"In this large, prospective U.S. cohort study, we observed a dose-dependent inverse association between coffee drinking and total mortality, after adjusting for potential confounders (smoking status in particular)," they write.
More specifically, they found that men who consumed 6 or more cups of coffee each day were 10% less likely to die during the study period than were men who did not drink coffee. For women, the reduction in risk was even greater, at 15%.
Hazard ratios for mortality in men who drank coffee compared with men who did not (P < .001 for trend across categories) were:
Less than 1 cup of coffee per day: 0.99 (95% confidence interval [CI], 0.95 - 1.04),
1 cup: 0.94 (95% CI, 0.90 - 0.99),
2 to 3 cups: 0.90 (95% CI, 0.86 - 0.93),
4 to 5 cups: 0.88 (95% CI, 0.84 - 0.93), and
6 or more cups: 0.90 (95% CI, 0.85 - 0.96).
Corresponding hazard ratios for women (P < .001 for trend across categories) were:
Less than 1 cup of coffee per day: 1.01 (95% CI, 0.96 - 1.07),
1 cup: 0.95 (95% CI, 0.90 - 1.01),
2 to 3 cups: 0.87 (95% CI, 0.83 - 0.92),
4 to 5 cups: 0.84 (95% CI, 0.79 - 0.90), and
6 or more cups: 0.85 (95% CI, 0.78 - 0.93).
As for cause-specific mortality, the researchers say they noted inverse associations for deaths resulting from heart disease, stroke, diabetes, respiratory disease, infections, injuries, and accidents, but the same was not true of deaths from cancer.
"In contrast, there was no significant association between coffee consumption and deaths from cancer in women," the researchers say. They also found a borderline positive association in men. Of the 13,402 deaths from cancer, 880 deaths were in men who consumed at least 6 cups of coffee each day (hazard ratio, 1.08; 95% CI, 0.98 - 1.19; P = 0.02 for trend).
Mortality rates were similar across all subgroups, the researchers note. That included people who had never smoked as well as those who at baseline described themselves as being in very good or excellent health.
The authors emphasize several limitations of the study. For one, coffee consumption was assessed at only a single point in time (upon entry into the study), so it is possible that consumption patterns might have changed over time.
In addition, the researchers note that they lacked specifics on how study participants prepared their coffee, and it could be that healthful and/or harmful attributes of the coffee might change depending on how it is prepared.
Still, they note, this study was larger than any previous study, and the number of deaths (>52,000) was more than double that in any earlier study.
"Our results provide reassurance with respect to the concern that coffee drinking might adversely affect health," they conclude.
Source: http://www.medscape.com/viewarticle/763962
Kudzu extract curbs alcohol intake
The isoflavone puerarin, extracted from kudzu, the invasive Chinese vine that runs rampant in several parts of the United States, was found to slow the rate of alcohol consumption in a small pilot study and may be useful to deter binge drinking.
The study, led by David M. Penetar, PhD, from McClean Hospital and Harvard Medical School, Boston, Massachusetts, was published online May 9 in Drug and Alcohol Dependence.
"We started looking at kudzu in our laboratory 15 years ago," Dr. Penetar told Medscape Medical News. Study coauthor David Y.-W. Lee, PhD, from the Department of Bio-Organic and Natural Products Laboratory at McLean Hospital, in Belmont, Massachusetts, has a lot of experience with Chinese medicine. "He knew that extracts of the kudzu root have been used to treat alcohol-related problems for years," he said.
With animal studies showing that these extracts reduced alcohol consumption, the next step was to see whether this would work in humans, Dr. Penetar said.
The study included 10 healthy adult volunteers (average age, 25.8 years, ±3.2 years) who drank an average of 17.6 drinks (±9.7) per week. None of the study participants had an alcohol abuse problem, Dr. Penetar noted.
"They were all students or working, young adults, and we screened very carefully so that we did not include people in the study who did have drinking problems," he said.
Acting as their own controls, the participants took puerarin, 1200 mg daily, in a double-blind, placebo-controlled crossover design for 1 week before an afternoon drinking session.
The drinking sessions were conducted in a "natural setting" that was furnished like a small apartment living room with an overstuffed recliner, bookshelves, pictures, carpeting, lamps, a TV, a DVD player, and stereo equipment. It also had a small kitchen area with a sink and a small refrigerator where beer, juice, and water were kept.
The volunteers came individually to the apartment-laboratory on 4 separate occasions for a drinking session. They had to abstain from drinking alcohol from 11:00 pm the night before and were not allowed to consume caffeinated drinks after 9:00 am on the day of the drinking session.
The drinking sessions began at 4:30 pm and lasted 1.5 hours. The volunteers had access to up to 6 bottles of their preferred brand of beer, in addition to juice and water.
"This was a simulation of a binge drinking episode, where you drink a lot of drinks at the beginning," Dr. Penetar said.
The researchers also recorded the time spent drinking, the sip volumes, and the total amount of alcohol that was consumed.
When the volunteers took the kudzu extract, they drank significantly less. On average, they consumed 3.5 (±0.55) beers when treated with placebo, and 2.4 (±0.41) beers when treated with puerarin.
After taking placebo, 3 volunteers drank 5 beers, and 1 drank all 6 beers. In contrast, after taking puerarin, none of the volunteers drank 5 or 6 beers. Also, after taking puerarin, the volunteers decreased sip size, took more sips to finish a beer, and took longer to drink each beer. They also took longer to open the next beer when on puerarin.
"They didn't stop completely, but they did reduce how much they drank. We think this compound may help people who binge drink to cut back on how much they consume," Dr. Penetar said.
The extract did not have any adverse effects and did not make anyone sick, he added.
Promising Study
Joanne Fertig, PhD, of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in Rockville, Maryland, which funded the study, told Medscape Medical News that the study was promising, but small.
The human laboratory model, in which volunteers drank in a natural, living room–type setting, is an interesting one, she said.
"This is a good example of a human laboratory study, in which people are brought into comfortable settings where researchers can measure how much of the drink is being taken with each sip, and also whether people are drinking more slowly under one condition as opposed to another. It is an interesting model to study drinking behavior," Dr. Fertig said.
The caveats are that the study results are very preliminary and that the population in the study were not alcohol dependent, she said.
"So, the bottom line is it's interesting, it's preliminary, it's small, and we are going to continue funding it," Dr. Fertig said.
Source: http://www.medscape.com/viewarticle/764263?sssdmh=dm1.787408&src=nldne
The study, led by David M. Penetar, PhD, from McClean Hospital and Harvard Medical School, Boston, Massachusetts, was published online May 9 in Drug and Alcohol Dependence.
"We started looking at kudzu in our laboratory 15 years ago," Dr. Penetar told Medscape Medical News. Study coauthor David Y.-W. Lee, PhD, from the Department of Bio-Organic and Natural Products Laboratory at McLean Hospital, in Belmont, Massachusetts, has a lot of experience with Chinese medicine. "He knew that extracts of the kudzu root have been used to treat alcohol-related problems for years," he said.
With animal studies showing that these extracts reduced alcohol consumption, the next step was to see whether this would work in humans, Dr. Penetar said.
The study included 10 healthy adult volunteers (average age, 25.8 years, ±3.2 years) who drank an average of 17.6 drinks (±9.7) per week. None of the study participants had an alcohol abuse problem, Dr. Penetar noted.
"They were all students or working, young adults, and we screened very carefully so that we did not include people in the study who did have drinking problems," he said.
Acting as their own controls, the participants took puerarin, 1200 mg daily, in a double-blind, placebo-controlled crossover design for 1 week before an afternoon drinking session.
The drinking sessions were conducted in a "natural setting" that was furnished like a small apartment living room with an overstuffed recliner, bookshelves, pictures, carpeting, lamps, a TV, a DVD player, and stereo equipment. It also had a small kitchen area with a sink and a small refrigerator where beer, juice, and water were kept.
The volunteers came individually to the apartment-laboratory on 4 separate occasions for a drinking session. They had to abstain from drinking alcohol from 11:00 pm the night before and were not allowed to consume caffeinated drinks after 9:00 am on the day of the drinking session.
The drinking sessions began at 4:30 pm and lasted 1.5 hours. The volunteers had access to up to 6 bottles of their preferred brand of beer, in addition to juice and water.
"This was a simulation of a binge drinking episode, where you drink a lot of drinks at the beginning," Dr. Penetar said.
The researchers also recorded the time spent drinking, the sip volumes, and the total amount of alcohol that was consumed.
When the volunteers took the kudzu extract, they drank significantly less. On average, they consumed 3.5 (±0.55) beers when treated with placebo, and 2.4 (±0.41) beers when treated with puerarin.
After taking placebo, 3 volunteers drank 5 beers, and 1 drank all 6 beers. In contrast, after taking puerarin, none of the volunteers drank 5 or 6 beers. Also, after taking puerarin, the volunteers decreased sip size, took more sips to finish a beer, and took longer to drink each beer. They also took longer to open the next beer when on puerarin.
"They didn't stop completely, but they did reduce how much they drank. We think this compound may help people who binge drink to cut back on how much they consume," Dr. Penetar said.
The extract did not have any adverse effects and did not make anyone sick, he added.
Promising Study
Joanne Fertig, PhD, of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in Rockville, Maryland, which funded the study, told Medscape Medical News that the study was promising, but small.
The human laboratory model, in which volunteers drank in a natural, living room–type setting, is an interesting one, she said.
"This is a good example of a human laboratory study, in which people are brought into comfortable settings where researchers can measure how much of the drink is being taken with each sip, and also whether people are drinking more slowly under one condition as opposed to another. It is an interesting model to study drinking behavior," Dr. Fertig said.
The caveats are that the study results are very preliminary and that the population in the study were not alcohol dependent, she said.
"So, the bottom line is it's interesting, it's preliminary, it's small, and we are going to continue funding it," Dr. Fertig said.
Source: http://www.medscape.com/viewarticle/764263?sssdmh=dm1.787408&src=nldne
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