A very old drug used to prevent gout may have impressive power to protect the heart. Allopurinol, also sold under the brand name Zyloprim, has been used for more than four decades to lower uric acid levels in the blood. Excessive amounts of uric acid can crystallize and cause excruciating joint pain. Allopurinol was tested in a placebo-controlled trial to see how well it protects the heart from exercise-induced angina. Subjects suffered from chronic chest pain. They were given either allopurinol or a placebo pill and were put on a treadmill. Those taking allopurinol walked 25 percent longer than those on placebo. The Scottish investigators point out that allopurinol has a good safety record and is also very inexpensive.
[The Lancet, June 8, 2010]
Tuesday, June 29, 2010
Bacterial Balance Linked to Colon Cancer
Colon cancer might be a matter of gut ecology. We all have billions of bacteria living in our intestines. For the most part, when we have enough good bacteria they work hard for us. But scientists at the University of North Carolina at Chapel Hill have found a link between bad bacteria and the risk of colon polyps and colon cancer. The samples taken from people undergoing colonoscopies showed that people with adenomas were more likely to have Proteobacteria living in their digestive tracts. The investigators suggest that this work may lead to new ways to detect and possibly prevent colon cancer.
Mold and Mildew Make Asthma Worse
Mold and mildew are common contaminants in basements and crawl spaces under houses. The hot and humid weather of summer is especially conducive to mold and mildew growth. A new study from Boston indicates that these fungi can boost the risk of asthma symptoms, especially among people with a genetic susceptibility. Investigators with the Childhood Asthma Management Program measured the amount of mold spores in the children's homes at the outset of the study. Children whose homes were contaminated with more than 25,000 mold colonies per gram of household dust had more severe attacks if they also had certain variants of a gene that breaks down chitin, a compound found in fungi.
[American Journal of Respiratory and Critical Care Medicine, online, June 21, 2010]
Reducing Risk for Cataracts
Common medications may increase the risk for cataracts. Investigators at the University of Wisconsin studied records from more than 2000 patients over a span of 15 years. People who took drugs that can sensitize the skin or eyes to sun damage were a little more likely to come down with cortical cataracts. Some of the drugs included the diuretic hydrochlorothiazide, which is frequently found in medications to treat hypertension. The popular over-the-counter pain reliever naproxen was also implicated. Antibiotics such as ciprofloxacin, the diabetes drug glyburide and a drug called amitriptyline, which is prescribed for nerve pain and depression, were other contributors. The lead investigator downplayed the significance of the data because she did not want to scare people.
A different study from the University of Wisconsin found that women who did not smoke, maintained a healthy weight and ate lots of vegetables and fruits had an almost 40 percent lower risk of developing cataracts. If you must take medicine that increases the risk of sunburn or cataracts, it makes sense to stay out of the midday sun, and wear a hat and UV blocking sunglasses. Eating leafy greens and other vegetables is good for your heart, your brain and probably your eyes.
[Archives of Ophthalmology, June and August 2010]
Married to Distraction
Click the arrow to play audio file:click here if you cannot view audio player: PP-775.mp3
How can a couple make their marriage better? Paying attention to each other is critical, but what if one of them has ADD? Even without ADD, busy schedules and interruptions with work, text messages, email and other demands can make time together and good communication more challenging. Our guests have personal as well as clinical experience to back up their excellent advice.
Guests: Edward M. (Ned) Hallowell, MD, is a child and adult psychiatrist and founder of the Hallowell Centers for Cognitive and Emotional Health in Sudbury, MA and New York City. He is the author of Driven to Distraction and 17 other books, as well as many scholarly articles. His latest book, written with his wife, is Married to Distraction: Restoring Intimacy and Strengthening Your Marriage in an Age of Interruption.
Sue George Hallowell, LICSW, has been a practicing couples' therapist for more than twenty-five years.
The websites are www.drhallowell.com and www.adhdmarriage.com
The podcast of this program will be available the Monday after the broadcast date. Podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.
Edward M. Hallowell, M.D.
10 TIPS ON MARRIAGE / RELATIONSHIPS
1. Remember what you like about the other person. Keep it in the back of your mind for those moments when you're angry.
2. Think not just about what the other person can do to make things better, but what you can do to make things better.
3. Couples are too busy these days. You've got to make protected time for each other, time just for the two of you, and you need to do this at least a half hour a week, preferably more. Many couples spend more time exercising than being with each other. One way around that is to exercise together!
4. Respect. Respect. Respect. Try always to treat your partner with respect. Repeated put-downs can become a habit and mark the beginning of the end of a relationship.
5. Play. Let yourselves set aside your inhibitions and be silly. Do foolish things together. Have a pillow fight. Play tag. Tickle each other. Tell jokes. Play pranks on each other. Never take yourselves too seriously. As long as you can laugh, you'll be ok.
6. Celebrate. Studies show that it is more important to be there for your spouse to celebrate good times than it is to be supportive in bad times. Of course, support in bad times matter, but it is even more predictive of success in a relationship if you can celebrate good times together.
7. Present a united front to your kids. Otherwise you will undermine each other. This is not good for you and it is not good for the kids.
8. Say something nice, something you like about your spouse at least once a day.
9. Feel free to make fun of tips on marriage--like these--but don't make fun of taking seriously the idea of each day doing what you can to make your relationship better.
10. Give your spouse permission to have a life of his or her own outside the marriage, be it friends, gro
Monday, June 21, 2010
Diabetes Update
Click the arrow to play audio file:click here if you cannot view audio player: PP-774.mp3
The number of Americans with diabetes has been increasing at an alarming rate. At last count, 23 million Americans had the disease, but more than five million were unaware of it. Diabetes has a huge impact on health and longevity, but the recommendations for treatment have been changing lately. Doctors used to assume that getting blood sugar, blood pressure and cholesterol levels as close to normal as possible was the best approach. But results from the huge ACCORD study are throwing that assumption into question. Get the latest update on diabetes treatment, diet, and vitamin D.
Guests: John Buse, MD, PhD, is Professor of Medicine and Chief of Endocrinology at the University of North Carolina at Chapel Hill and Director of the Diabetes Care Center there. He is past president of the American Diabetes Association.
Saturday, June 19, 2010
High HDL Cholesterol Linked to Lower Cancer Risk
Many people are aware that high levels of high-density lipoprotein cholesterol are good for cardiovascular health. Now a new analysis of 24 studies shows that good HDL cholesterol is associated with a lower risk of cancer as well. The studies included 76,000 people who were given statins and approximately 70,000 who were taking placebo. As HDL levels increase, the risk of being diagnosed with any cancer falls. Cancer risk goes down about 36 percent with each 10 point rise in HDL. It isn't easy to boost HDL, but the scientists suggest exercise, maintaining a healthy weight, not smoking and drinking moderately. Niacin can also raise HDL. These are healthy habits to reduce the risk of heart disease as well as cancer.
[Journal of the American College of Cardiology, June 22, 2010]
Sweets Raise Risk of Pancreatic Cancer
A small Italian study reinforces the results of prior research on pancreatic cancer and diet. The investigators questioned 326 people with pancreatic cancer about their diet and lifestyle. Each patient was matched to two healthy adults who answered the same questions. The research team found that a third of the people, those who ate the most sugary foods, were 78 percent more likely than those in the lowest third to have pancreatic cancer. The worst offenders were sweet foods that raise blood sugar quickly, like jam, candy, honey and sugar. There was no link with diabetes or obesity. The absolute risk for any individual is still low, since pancreatic cancer is relatively rare. But together with earlier research showing a link between sugary drinks and pancreatic cancer, this study suggests that regular consumption of sweets may increase the risk of this rare but deadly disease.
Whole Grains May Hold Off Diabetes
Could brown rice help ward off type 2 diabetes? Harvard scientists analyzed data collected in three large long-term epidemiological studies. They included almost 200,000 individuals, mostly women, in the Nurses' Health Studies 1 and 2 and the Health Professionals Follow-Up Study. The researchers adjusted for many other factors including exercise habits, smoking, weight, age, and other dietary habits.
They found that people who ate white rice five times or more in a month had a higher likelihood of type 2 diabetes. Previous research from China has shown a similar pattern. The researchers estimate that replacing just 1/3 serving of white rice with brown rice could lower the chance of developing diabetes by about 16 percent. Replacing that white rice with other whole grains such as barley, which raises blood sugar more slowly, would reduce the diabetes risk even more, by about 36 percent. They recommend that most carbohydrate intake should come from whole grains rather than refined grains as a way to mitigate the epidemic of type 2 diabetes.
Vitamin B6 May Protect Against Lung Cancer
Not all smokers develop lung cancer. One possible reason may be their nutrient consumption. The EPIC study, which stands for European Prospective Investigation into Cancer and Nutrition, includes more than 500,000 participants. Investigators found that people with higher blood levels of vitamin B6 and the amino acid methionine were less likely to be diagnosed with lung cancer. The researchers were quick to point out that changing diet or taking supplements could not adequately counteract the dangers of smoking. Nevertheless, eating a diet high in beans, grains, meat, poultry, fish along with some fruits, vegetables and nuts may be wise, along with quitting or not taking up smoking.
[JAMA, June 16, 2010]
Monday, June 14, 2010
Health News Update
Click the arrow to play audio file:click here if you cannot view audio player: PP-773.mp3
Last month on The People's Pharmacy, a caller asked about weight gain while working the night shift. We promised an answer. Her question applies to a lot of folks: roughly 10 million Americans work night shifts. How does this affect their weight and their health?
Resveratrol has a reputation for heart health. New research suggests that this compound found in grapes and peanut skins can also benefit the brain.
Which dietary evil is worse: saturated fat or refined carbohydrates? Danish researchers are looking for the answer.
Vitamin D has surfaced in the famous Framingham study as an important factor in preventing type 2 diabetes. Are you getting as much as you need?
Explore the stories behind the health headlines.
Guest: Frank Scheer, PhD, is Assistant Professor of Medicine at Harvard Medical School, Associate Neuroscientist for the Division of Sleep Medicine in the Department of Medicine at Brigham and Women's Hospital and Associate Director of the Medical Chronobiology Program at Brigham and Women's Hospital
Saturday, June 12, 2010
Getting the Red Out of Rosacea
It's called acne rosacea, but the name is confusing. This skin condition is nothing like your teenager's pimples.
Rosacea affects women more than men and usually strikes during middle age. It causes redness of the cheeks, nose and forehead. Fine red lines can often be seen just under the skin and some people also experience pimple-like blemishes.
Dermatologists are still debating the causes of rosacea. Research suggests that one important factor is inflammation triggered by cathelicidin, one of the skin's innate immune defenses against bacteria, fungi and some viruses (Journal of Investigative Dermatology, May, 2010).
Treatment has involved oral antibiotics (doxycycline, minocycline, tetracycline) and topical antimicrobials (metronidazole). A topical gel containing azelaic acid (Finacea) can reduce the production of cathelicidin and improve symptoms.
Despite standard therapy, some readers remain unsatisfied: "I have been suffering from rosacea for years. A dermatologist prescribed both metronidazole cream and minocycline twice daily. These were ineffective.
"I am a 47-year-old male, and exercise regularly (run and bicycle), 5'8" and weigh 139 lbs. I eat a healthy diet.
"I drink alcohol occasionally, mainly red wine and beer. My cholesterol is low and I take no medications. What else could I do for my rosacea?"
Alcohol is frequently blamed as a trigger, so this reader should cut back to see if that helps. Other non-standard approaches include using antibacterial soap: "I bought a generic, clear, liquid antibacterial soap in a pump bottle and have been using it for two months. I quit using the Metrogel at the same time and have had NO flare-ups since using the antibacterial soap! This is an easy and inexpensive remedy that you may already have at your sink."
Another reader applies organic raw apple cider vinegar to the affected skin, washing it off with a gentle cleanser after 30 minutes. Helga offered her approach: "Jason Vitamin K Creme Plus works wonderfully well. It totally eliminated rosacea for me and several other people. Use it twice a day; it doubles as moisturizer."
Dianne told her own story: "I was diagnosed with rosacea over 10 years ago and was on metronidazole. I still had problems with breakouts on my face after being in the sun. Later, I was also diagnosed with ocular rosacea that felt like sand in my eyes every morning and throughout the day. I was advised to take eye drops for the condition.
"About five years ago I started taking Juice Plus vitamins. There were no claims with the product that it would help rosacea, although it certainly claimed to boost one's immune system.
My rosacea has totally disappeared. My ophthalmologist and my dermatologist can find no evidence of rosacea any more."
Omega-3 fatty acid supplements have helped a few readers. Another reader specified daily cod liver oil.
Italian researchers have found that dietary supplements containing silymarin and MSM (methylsulfonylmethane) may ease redness (Journal of Cosmetic Dermatology, March, 2008).
There does not seem to be a single approach to rosacea that works well for everyone. Trial and error may be the best way to find out how to calm this inflammatory skin condition.
Gout Drug Benefits Heart
A very old drug used to prevent gout may have impressive power to protect the heart. Allopurinol, also sold under the brand name Zyloprim, has been used for more than four decades to lower uric acid levels in the blood. Excessive amounts of uric acid can crystallize and cause excruciating joint pain. Allopurinol was tested in a placebo-controlled trial to see how well it protects the heart from exercise-induced angina. Subjects suffered from chronic chest pain. They were given either allopurinol or a placebo pill and were put on a treadmill. Those taking allopurinol walked 25 percent longer than those on placebo. The Scottish investigators point out that allopurinol has a good safety record and is also very inexpensive.
[The Lancet, June 8, 2010]
Pain Relievers Raise Risk of Heart Attacks
Common pain relievers used by millions every day appear to increase the risk of a heart attack. Danish scientists studied health records of over one million citizens between 1997 and 2005. The average age of the participants was around 40. Those who used the pain reliever ibuprofen had a higher risk of stroke. Higher doses were also associated with an increased risk of heart attack.
This isn't the first time non-steroidal anti-inflammatory drugs have been implicated in cardiovascular complications. When Vioxx was withdrawn from the market several years ago it was because of an increased risk of heart attack and stroke. The Dutch researchers found that the prescription NSAID diclofenac, sold under the brand names Cataflam and Voltaren, was about as risky as the banned Vioxx. One pain reliever seemed less problematic, however. Naproxen, sold under the brand name Aleve, was not linked to heart attacks or strokes. Patients, especially those with high blood pressure or other risk factors for heart disease, should discuss the new findings with their
Sunday, June 6, 2010
Does Shark Cartilage Fight Cancer?
Several years ago there was a lot of interest in shark cartilage as a cancer prevention approach. The pitch centered on the idea that sharks don't get cancer. Now a study has tested a special prescription-strength shark cartilage compound against human cancer. In the trial, patients got either shark cartilage or placebo for their non-small-cell lung cancer. About 80 percent of all lung cancers fall into this category. Unfortunately, there was no difference in survival between those on shark cartilage and those on placebo. The authors suggest that this study offers oncologists a convincing answer to the question of whether shark cartilage would be beneficial. The authors conclude it is not.
[Journal of the National Cancer Institute, online May 26, 2010]
Avoiding Endocrine Disruptors
Hormone-disrupting chemicals are coming under increasing scrutiny. Over the last few decades scientists have identified a large number of compounds that can mimic hormones like estrogen. These endocrine disruptors include bisphenol A, a common chemical found in hard plastic, and phthalates, a group of compounds found in pliable plastic like IV bags and tubing, vinyl shower curtains, pacifiers, and many cosmetics and skin creams. In this review, the authors point out that endocrine disruptors have been associated in animals with obesity, infertility and increased rates of cancer. These hormone experts are especially worried about exposure during pregnancy and early development. They support policies that would reduce children's exposure to endocrine disrupting compounds.
How Sinful Is Your Steak?
Americans are passionate about food. We're not suggesting that they are fanatical about gourmet cooking like the French. After all, the U.S. is the home of fast food.
What gets Americans excited is dietary dogma, especially if it disagrees with what they have been told. That explains why sparks fly whenever the benefits of low-carb versus low-fat diets are discussed.
We recently interviewed Eric Westman, MD, one of the authors of The New Atkins for a New You. This diet book summarizes recent research supporting a low-carb approach for weight loss and cholesterol control. While some listeners were pleased to hear of this approach, others were appalled. They left comments on our Web site such as:
"To promote anyone who says that saturated fats are less harmful than healthy carbohydrates is dangerous and disingenuous."
Another opined: "We've gone from demonizing one macronutrient (fat) to demonizing another (carbohydrates). This is not productive. Successful weight loss does not come from swapping fat and carbs, it comes from eating fewer calories than are burned. ...The tendency to demonize certain types of food just shows how far people will go to blame their weight problems on something other than how much they eat."
This comment sums up the feelings of many listeners: "The overwhelming peer-reviewed, non-biased research from reputable journals shows Atkins-type diets to be unhealthy and ineffective.
"Ornish-type diets [low-fat] are healthy and effective as are other vegetarian and non-processed diets and good research backs this up."
People have been told for decades that fat makes you fat and saturated fat clogs your coronary arteries. These beliefs have been stated as fact by so many authorities for so long they are ingrained in the American psyche. People have a hard time accepting data that does not confirm these views.
A new analysis from Harvard, however, could cause dismay among the diet dictocrats. The investigators assessed data from 20 studies that met quality criteria. More than one million people were included as subjects.
Here is the bottom line: "When all data were pooled, consumption of unprocessed red meat (eg, unprocessed meat from beef, pork, lamb) was not associated with risk of coronary heart disease or diabetes mellitus" (Circulation, online, May 17, 2010).
This conclusion is going to be very hard to swallow for both health professionals and the public at large. It flies in the face of long-established conventional wisdom.
That's not to say the study let all meat products off the hook. This huge meta-analysis discovered that processed meats (bacon, hot dogs, salami, sausage, pepperoni, bologna, etc) were linked to both heart disease and diabetes. The authors propose that the high sodium and nitrate preservative content of such packaged products may be the culprits.
Because U.S. dietary guidelines have emphasized limiting saturated fat for so long, many people see steak as a sinful indulgence that takes them one step closer to a heart attack. Perhaps they should be more concerned about hot dogs, bacon and bologna
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