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
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
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
Thursday, 12 April 2012
Cruciferous veggies boost survival in Chinese breast cancer patients
Consuming cruciferous vegetables may have a positive impact on survival in breast cancer patients, according to the results of a new study.
The Shanghai Breast Cancer Survival Study, a large population-based study of Chinese breast cancer survivors, revealed that the consumption of cruciferous vegetables after a diagnosis of breast cancer was associated with improved survival in Chinese women.
The researchers, led by Sarah J. Nechuta, MPH, PhD, a postdoctoral research fellow at Vanderbilt University in Nashville, Tennessee, discovered that cruciferous vegetable intake during the first 36 months after diagnosis boosted survival by reducing risk for total mortality, breast-cancer-specific mortality, and recurrence.
They observed that across increasing quartiles of cruciferous vegetable consumption, the risk for total mortality decreased by 27% (to 62%), the risk for breast-cancer-specific mortality decreased by 22% (to 62%), and the risk for recurrence decreased by 21% (to 35%).
Lifestyle differences
Dr. Nechuta cautioned that population differences must be considered in this recent study. "First, commonly consumed cruciferous vegetables in China include turnip, Chinese cabbage/bok choy, and greens, whereas broccoli and brussels sprouts are the most commonly consumed cruciferous vegetables in the United States and other Western countries," she said.
"Second, the amount of intake among Chinese women is much higher than that of American women," she continued. "The level of bioactive compounds, such as isothiocyanates and indoles, suspected of playing a role in the anticancer effects of cruciferous vegetables, depend on the amount and type of cruciferous vegetables consumed."
She suggested that breast cancer survivors in the United States follow the general nutrition guidelines of eating vegetables daily, and consider increasing their intake of cruciferous vegetables, such as cabbage, cauliflower, and broccoli, as part of a healthy diet.
Anti-cancer properties
The protective effect of cruciferous vegetables is already well-known. Previous studies have reported that the intake of raw cruciferous vegetables, including broccoli, broccoli sprouts, cabbage, and cauliflower, was associated with a reduced risk for bladder cancer (Cancer Epidemiol Biomarkers Prev. 2008;17:938-944). The consumption of cruciferous vegetables might also help protect smokers from lung cancer, according to some data.
Preliminary research has shown that the consumption of broccoli sprouts can interfere with the development of gastritis and gastric cancer. In addition, consuming broccoli sprouts appears to enhance antioxidant and anti-inflammatory enzymes in the stomach.
"In our 2002 study, sulforaphane killed helicobacter directly in the test tube," said Jed W. Fahey, MS, ScD, a nutritional biochemist in the Lewis B. and Dorothy Cullman Cancer Chemoprotection Center at the Johns Hopkins University School of Medicine, Baltimore, Maryland, in an interview at that time, referring to a previous study (Cancer Prev Res [Phila]. 2009;2:353-360). "It also reduced the rate of gastric cancer in mice."
"The key take-home message harkens back to the old message — eat veggies," said Dr. Fahey. "We're now giving people the science that shows why eating fruits and vegetables are good for your health."
Source: American Association for Cancer Research (AACR) 103rd Annual Meeting: Abstract LB-322. Presented April 3, 2012.
The Shanghai Breast Cancer Survival Study, a large population-based study of Chinese breast cancer survivors, revealed that the consumption of cruciferous vegetables after a diagnosis of breast cancer was associated with improved survival in Chinese women.
The researchers, led by Sarah J. Nechuta, MPH, PhD, a postdoctoral research fellow at Vanderbilt University in Nashville, Tennessee, discovered that cruciferous vegetable intake during the first 36 months after diagnosis boosted survival by reducing risk for total mortality, breast-cancer-specific mortality, and recurrence.
They observed that across increasing quartiles of cruciferous vegetable consumption, the risk for total mortality decreased by 27% (to 62%), the risk for breast-cancer-specific mortality decreased by 22% (to 62%), and the risk for recurrence decreased by 21% (to 35%).
Lifestyle differences
Dr. Nechuta cautioned that population differences must be considered in this recent study. "First, commonly consumed cruciferous vegetables in China include turnip, Chinese cabbage/bok choy, and greens, whereas broccoli and brussels sprouts are the most commonly consumed cruciferous vegetables in the United States and other Western countries," she said.
"Second, the amount of intake among Chinese women is much higher than that of American women," she continued. "The level of bioactive compounds, such as isothiocyanates and indoles, suspected of playing a role in the anticancer effects of cruciferous vegetables, depend on the amount and type of cruciferous vegetables consumed."
She suggested that breast cancer survivors in the United States follow the general nutrition guidelines of eating vegetables daily, and consider increasing their intake of cruciferous vegetables, such as cabbage, cauliflower, and broccoli, as part of a healthy diet.
Anti-cancer properties
The protective effect of cruciferous vegetables is already well-known. Previous studies have reported that the intake of raw cruciferous vegetables, including broccoli, broccoli sprouts, cabbage, and cauliflower, was associated with a reduced risk for bladder cancer (Cancer Epidemiol Biomarkers Prev. 2008;17:938-944). The consumption of cruciferous vegetables might also help protect smokers from lung cancer, according to some data.
Preliminary research has shown that the consumption of broccoli sprouts can interfere with the development of gastritis and gastric cancer. In addition, consuming broccoli sprouts appears to enhance antioxidant and anti-inflammatory enzymes in the stomach.
"In our 2002 study, sulforaphane killed helicobacter directly in the test tube," said Jed W. Fahey, MS, ScD, a nutritional biochemist in the Lewis B. and Dorothy Cullman Cancer Chemoprotection Center at the Johns Hopkins University School of Medicine, Baltimore, Maryland, in an interview at that time, referring to a previous study (Cancer Prev Res [Phila]. 2009;2:353-360). "It also reduced the rate of gastric cancer in mice."
"The key take-home message harkens back to the old message — eat veggies," said Dr. Fahey. "We're now giving people the science that shows why eating fruits and vegetables are good for your health."
Source: American Association for Cancer Research (AACR) 103rd Annual Meeting: Abstract LB-322. Presented April 3, 2012.
Wednesday, 4 April 2012
Chocolate: a healthy nibble
Chocolate is increasingly shedding its reputation as a sweet treat only. More research is uncovering health benefits when the dark stuff is eaten in moderation.
At the annual meeting of the American Chemical Society here, a three-hour symposium was devoted to cocoa science and technology. Cocoa researchers from around the world gathered to share their latest findings, passing chocolate bars around the audience as they talked science.
Here is an update on questions chocolate lovers may have.
What Can Chocolate Do for Your Heart Health?
While some heart benefits of chocolate are solid, others are still under debate, says Eric Ding, PhD, instructor of medicine and nutritional epidemiologist at Harvard Medical School. At the symposium, he discussed his review of 24 published studies on chocolate.
The studies included more than 1,100 people. Researchers looked at how their chocolate-eating habits affected their heart disease risk factors such as high blood pressure.
"The blood pressure-lowering effect is well known," he says. His team found that, on average, systolic blood pressure declined slightly, less than two points on average, in chocolate eaters. Systolic blood pressure is the top number of a blood pressure measurement, and in people older than 50, this can be a stronger risk factor for heart disease than the lower, or diastolic, measurement.
There is also solid evidence that chocolate can increase HDL or "good" cholesterol, Ding and his colleagues found. In general, the lower your LDL and the higher your HDL, the better your chances of preventing heart disease and other chronic conditions.
With chocolate, insulin resistance improved, a benefit if you have diabetes or want to avoid it, Ding says.
Blood flow also improved with a bit of chocolate, another benefit, he says.
"Altogether the results suggest strong benefits against cardiovascular disease," Ding tells WebMD.
The report is published in The Journal of Nutrition.
What Else Can Chocolate Do?
Other studies on the health benefits of chocolate are in earlier phases and are preliminary.
Chocolate may help those with type 2 diabetes minimize the ill effects of high blood sugar levels after eating, says Stephen L. Atkin, MD, a researcher at the Hull York Medical School in the U.K. He gave 10 patients with type 2 diabetes small amounts of chocolate an hour before he gave them glucose to simulate a meal.
He found improvements in their blood vessel functioning, which in turn could help reduce heart disease risk.
Chocolate may help patients with congestive heart failure, says Francisco Villarreal, MD, PhD, a professor at the University of California, San Diego, who also spoke at the symposium. In congestive heart failure, the heart doesn't pump enough blood to meet the body's needs.
In a small study with five patients, he gave them about 100 milligrams of a flavonol called epicatechin, found in chocolate, every day for three months.
He measured a substance called nitric oxide, which regulates the contractibility of the blood vessels and affects blood pressure. He found "a very significant increase" in nitric oxide levels.
The study was funded by the National Institutes of Health and The Hershey Company. Villarreal is co-founder of a company developing epicatechin as a treatment.
Other research, which has not yet progressed to people, is looking at the potential of chocolate to treat migraine as well as inhibit colon cancer.
What Is the ''Magic'' Ingredient in Chocolate?
A flavonol called epicatechin, an antioxidant, turns up in much chocolate research.
"The flavonol epicatechin warrants further study,'' Villarreal says. It seems to have an effect on the powerhouse of the cell, known as the mitochondria. "Many diseases, including Alzheimer's, seem to have a mitochondrial component," he says.
He suspects the antioxidant properties aren't the whole reason epicatechin has benefits.
Reality Check: How Much Chocolate Is Enough?
The doses used in studies are all over the place. However, scientists involved in cocoa research seem to love the words "in moderation." At this point, there is no established serving size of chocolate for heart health. A moderate portion size of chocolate is about 1 ounce.
In his studies, Villarreal has found that half a square is the ''sweet spot" for good effects.
Dark chocolate is most often studied and found to have health effects.
A serving a day would be considered moderate, says Rene D. Massengale, PhD, a food chemist in Bloomington, Ind., and a spokesperson for the Institute for Food Technologists. She reviewed the findings but was not involved in the research. She has consulted in the past for Hershey's.
Perspective is crucial, she says. "Eating a lot of chocolate because you think you are going to get the health benefit, but having a 3,000-calorie diet, is not going to do you any good," she tells WebMD.
Eating chocolate definitely won't lower your body mass index (BMI), Ding tells WebMD. He disputes the conclusion of a research letter published this week in the Archives of Internal Medicine, finding that regular chocolate eaters have lower BMIs.
His review of 24 rigorous studies, he says, finds no effect. "The cocoa flavonoids absolutely yield no BMI or weight change," he says.
And those chocolate bars that were passed around at the meeting?
By any chocolate lover's standard, they would have to be described as teeny.
Source: http://www.medscape.com/viewarticle/761340?sssdmh=dm1.772780&src=nldne
Check out these chocolate products:
At the annual meeting of the American Chemical Society here, a three-hour symposium was devoted to cocoa science and technology. Cocoa researchers from around the world gathered to share their latest findings, passing chocolate bars around the audience as they talked science.
Here is an update on questions chocolate lovers may have.
What Can Chocolate Do for Your Heart Health?
While some heart benefits of chocolate are solid, others are still under debate, says Eric Ding, PhD, instructor of medicine and nutritional epidemiologist at Harvard Medical School. At the symposium, he discussed his review of 24 published studies on chocolate.
The studies included more than 1,100 people. Researchers looked at how their chocolate-eating habits affected their heart disease risk factors such as high blood pressure.
"The blood pressure-lowering effect is well known," he says. His team found that, on average, systolic blood pressure declined slightly, less than two points on average, in chocolate eaters. Systolic blood pressure is the top number of a blood pressure measurement, and in people older than 50, this can be a stronger risk factor for heart disease than the lower, or diastolic, measurement.
There is also solid evidence that chocolate can increase HDL or "good" cholesterol, Ding and his colleagues found. In general, the lower your LDL and the higher your HDL, the better your chances of preventing heart disease and other chronic conditions.
With chocolate, insulin resistance improved, a benefit if you have diabetes or want to avoid it, Ding says.
Blood flow also improved with a bit of chocolate, another benefit, he says.
"Altogether the results suggest strong benefits against cardiovascular disease," Ding tells WebMD.
The report is published in The Journal of Nutrition.
What Else Can Chocolate Do?
Other studies on the health benefits of chocolate are in earlier phases and are preliminary.
Chocolate may help those with type 2 diabetes minimize the ill effects of high blood sugar levels after eating, says Stephen L. Atkin, MD, a researcher at the Hull York Medical School in the U.K. He gave 10 patients with type 2 diabetes small amounts of chocolate an hour before he gave them glucose to simulate a meal.
He found improvements in their blood vessel functioning, which in turn could help reduce heart disease risk.
Chocolate may help patients with congestive heart failure, says Francisco Villarreal, MD, PhD, a professor at the University of California, San Diego, who also spoke at the symposium. In congestive heart failure, the heart doesn't pump enough blood to meet the body's needs.
In a small study with five patients, he gave them about 100 milligrams of a flavonol called epicatechin, found in chocolate, every day for three months.
He measured a substance called nitric oxide, which regulates the contractibility of the blood vessels and affects blood pressure. He found "a very significant increase" in nitric oxide levels.
The study was funded by the National Institutes of Health and The Hershey Company. Villarreal is co-founder of a company developing epicatechin as a treatment.
Other research, which has not yet progressed to people, is looking at the potential of chocolate to treat migraine as well as inhibit colon cancer.
What Is the ''Magic'' Ingredient in Chocolate?
A flavonol called epicatechin, an antioxidant, turns up in much chocolate research.
"The flavonol epicatechin warrants further study,'' Villarreal says. It seems to have an effect on the powerhouse of the cell, known as the mitochondria. "Many diseases, including Alzheimer's, seem to have a mitochondrial component," he says.
He suspects the antioxidant properties aren't the whole reason epicatechin has benefits.
Reality Check: How Much Chocolate Is Enough?
The doses used in studies are all over the place. However, scientists involved in cocoa research seem to love the words "in moderation." At this point, there is no established serving size of chocolate for heart health. A moderate portion size of chocolate is about 1 ounce.
In his studies, Villarreal has found that half a square is the ''sweet spot" for good effects.
Dark chocolate is most often studied and found to have health effects.
A serving a day would be considered moderate, says Rene D. Massengale, PhD, a food chemist in Bloomington, Ind., and a spokesperson for the Institute for Food Technologists. She reviewed the findings but was not involved in the research. She has consulted in the past for Hershey's.
Perspective is crucial, she says. "Eating a lot of chocolate because you think you are going to get the health benefit, but having a 3,000-calorie diet, is not going to do you any good," she tells WebMD.
Eating chocolate definitely won't lower your body mass index (BMI), Ding tells WebMD. He disputes the conclusion of a research letter published this week in the Archives of Internal Medicine, finding that regular chocolate eaters have lower BMIs.
His review of 24 rigorous studies, he says, finds no effect. "The cocoa flavonoids absolutely yield no BMI or weight change," he says.
And those chocolate bars that were passed around at the meeting?
By any chocolate lover's standard, they would have to be described as teeny.
Source: http://www.medscape.com/viewarticle/761340?sssdmh=dm1.772780&src=nldne
Check out these chocolate products:
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