Health Newsletter:August 2007
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[edit] Framingham Study Examines Obesity Over 32 Year Period
The Framingham Study has answered a lot of questions regarding hardening of the arteries and what risk factors led to it (smoking, high blood pressure, excessive weight etc.) Now the offspring of this test population have been included in this study and the topic that was examined was how obesity spreads. The body mass index (weight in kilograms divided by the square of the height in meters) defines obesity as being 30.0 or higher. With the obesity having reached epidemic proportions recently, it is important to find out how this condition develops. About 12,000 people were enrolled in the study and they were examined as part of the Framingham Study in intervals between 1971 and 2003. The lead investigators were Nicholas A. Christakis, M.D., Ph.D., M.P.H., and James H. Fowler, Ph.D. Statistical methods were used to see whether weight gain in one person would be linked to an increasing weight in a brother/sister, spouse, friends or neighbors. Not surprisingly, they found that social ties were at the source of the spread of obesity and there were three main sources for this. The study showed that people the influence to gain weight comes from friends with a risk of 57% on average, a husband/wife with a risk of 37% and from an adult sibling with a risk of 40%. Influences from the same sex were higher than from the opposite sex. Smoke cessation was not related to the development of obesity. Overall it seems that network phenomena and social ties exert the biggest influence on our body image. This has important implications for public health officials and the quest to help people overcome the health hazards of obesity. Obesity is not an obscure condition that starts for no apparent reason. Obesity is passed on socially through habits that are copied: calorie-rich food that is shared and sessile life styles that are adopted (lack of exercise and fitness).
N Engl J Med. 2007; 370-379
[edit] Nicotine Addiction Found More Often With Impulsive Behavior
Why do major depression and nicotine addiction often occur together in middle aged people? This is what Dr. Qiang John Fu, assistant professor of community health in biostatistics at Saint Louis University School of Public Health, asked himself and he conducted a study involving 3,360 pairs of middle-aged, predominantly Caucasian twins to find out. Twin studies are a powerful tool to sort out environmental factors from genetic factors. In this particular study the twins had served in the Vietnam war and 45% were fraternal, the rest were identical twins. With identical twins 100% of the genes are identical while the fraternal twins share about half of the genes. The researchers found that a group of twins who were addicted to nicotine also had a behavioral disorder, called conduct disorder. This can be well defined with psychological tests and is characterized by behaviors such a stealing, fighting, vandalizing, running away from home and drug addiction (including addiction to nicotine). They were also the ones who were much more vulnerable to develop major depression. As published in the June issue of Twin Research and Human Genetics Dr. Fu, MD, PhD, the lead researcher explained that he found a set of genes that are responsible for the development of major depression and for addiction to nicotine. These individuals attempt to self-treat depression with cigarette smoking. Linked with this can also be the conduct disorder mentioned above. These findings may lead to newer approaches in terms of treatment.
June issue of Twin Research and Human Genetics
[edit] Alcohol Can Be Culprit in Irregular Heart Beat
Dr. Gregory M. Marcus, an electrophysiologist at the University of California, San Francisco gave a presentation at the Annual Meeting of the Heart Rhythm Society about the effect of alcohol on the heart in younger people. This convention took place at the Colorado Convention Center at Denver/Co. where from May 9 to 12, 2007 about 11,000 physicians and scientists gathered to discuss the newest in irregular heart beats (arrhythmias) and new treatments. Dr. Marcus found that in persons younger than 60 years of age one alcoholic drink per day could lead to atrial fibrillation (=atrial fib) or to atrial flutter. He found in persons older than 60 years he was not able to show a statistically significant risk effect of alcohol, but he pointed out that in this older population there were other risks like older age by itself and hypertension, both of which were independent risk factors for atrial fib/atrial flutter. This was a case study where 195 consecutive patients with atrial fib/atrial flutter were studied. 2/3 of them were 60 or younger. There were also 185 controls with 75% who had supraventricular arrhythmias and 25% with healthy hearts. There was a linear dose-response curve between number of alcoholic drinks consumed per day and atrial flutter. With atrial fibrillation there was a tendency in this way, but it had not reached quite statistical significance. This study is the first one to show that in the younger age group there is sensitivity, at least in those who came down with atrial fib or atrial flutter, of the conductive nerve fibers in the atrial wall tissue to the effects of alcohol. Alcohol seems to reduce the effective refractory period of atrial tissue. Dr. Marcus called this the arrhythmogenic effect of alcohol. It is not clear at the present time how to balance the cardioprotective effect of moderate alcohol intake against this newly found arrhythmogenic effect. Also, why would the younger age group be more vulnerable to this effect than the older generation? Is there perhaps a subpopulation of more sensitive patients? These are unanswered questions, but at any rate it is important that those who had atrial fibrillation or atrial flutter refrain from alcohol, as they have shown to be especially sensitive to this arrhythmogenic effect.
Dr. Gregory M. Marcus at the Annual Meeting of the Heart Rhythm Society
[edit] More Fiber in Diet Lowers Diabetes Risk
Skipping breakfast seems to be nothing unusual for many individuals. Busy lives and hectic schedules contribute to a rush in the early morning. It has been emphasized by several articles, that breakfast is indeed important for a healthy jump start of the day. A German study which has been published in the May 14 edition of the Archives of Internal Medicine points out more clearly why breakfast may well be the most important meal of the day. More than 25,000 adults were enrolled in a study, which found that the intake of fiber can be an effective nutritional tool to reduce the risk of developing type 2 diabetes. The connection between type 2 diabetes and the intake of cereal, fruit, vegetable and associated fiber intake, also the intake of soluble and insoluble fiber and magnesium were closely examined. During the seven year period of follow-up 844 cases of diabetes 2 were identified. The study found that the consumption of 29 grams per day of soluble fiber was associated with a significantly lower risk of 21% less diabetes. Soluble fibre, including pectin is mostly found in fruit, vegetables and legumes. Roughage alone such as wheat bran, whole grains and brown rice was not associated with a lower diabetes risk. Once the source of fiber was broken down according to origin (fruit, vegetable or cereal), the study found that the participants who consumed the highest part of cereal fiber had a 28% lower risk of diabetes compared to those who had the lowest amount of cereal fiber intake. High magnesium intake was associated with a 23% lower risk. It has to be stressed that not every breakfast cereal qualifies as a source of high cereal fiber. Consumers must become educated and be aware of the fiber content in food servings to ensure that they are getting the necessary amount to reap the benefits.
May 14, 2007 Edition of the Archives of Internal Medicine
[edit] New Cure For Drug Resistant Bacteria At The Horizon
Drug resistant bacteria (like MRSA, methicillin resistant Staphylococcus aureus) have developed in many hospitals and have caused more than 2 million infections in the US alone of which 90,000 people died. Yet so far research regarding this problem has been very slow and unsuccessful. In Canada there was an outbreak of E.coli in September of 2006, which left 14 people severely ill and simultaneously there was a similar outbreak in the US leaving three people dead.
Dr. Redinbo, PhD in biochemistry and biophysics, from the University of North Carolina at Chapel Hill made an astounding discovery in his lab. He tested some of the older medications used for osteoporosis treatment, the biphosphonates clodronate and etidronate, to see whether they would have an effect on stopping the multiplication of these harmful bacteria. Dr. Redinbo’s work was published in the July 13 edition of the Proceedings of the National Academy of Sciences. Dr. Redinbo’s team found that an enzyme, called relaxase, is at the center of the development of antibiotic resistance. When resistance develops, there is a genetic transformation that takes place, like a mini Darwinian selection process where the most resistant bacteria survive and multiply. The resistant bacteria mate with each other and with bacteria that are not yet resistant. This process involves the relaxase enzyme system, some DNA stranding and a strand exchange. In this way new resistant bacteria are formed. Experiments under the supervision of Dr. Redinbo found that this process can be stopped by the phosphate-rich compound, biphosphonates (clodronate and etidronate). Other chemicals were found to not be as effective. The relaxase system is found in a number of problem bacterial strains, Staphylococcus strains, drug resistant Acinetobacter strains and others. Unfortunately the biphosphonates have some side-effects like stomach soreness and birth defects. The researcher said that he hopes that these drugs and perhaps others with less side-effect will offer new treatments for antibiotic resistant bacteria.
July 13 edition of the Proceedings of the National Academy of Sciences
