Health Newsletter:July 2005

From WebHealth

Diet Can Influence Acne

The old dermatological dogma that diet can play a role in the development of acne has been tossed back and forth. Some parties agree, others disagree. An old study by Fulton et al., which goes back to 1969, claims that patients who ate chocolate bars were compared to those who ate"pseudo-chocolate", and no difference was found between the two groups. Both had the same amount of acne lesions. Critics of this poorly designed study however point out, that the" fake chocolate" contained just as much sugar and just as much trans fat as real chocolate. Trans fats are also known to contribute to inflammation, a condition that is present in acne.

In the meantime a 2002 study that was published in the Archives of Dermatology has taken a closer look at acne. Researchers took a look at islanders from Papua, New Guinea, and the Ache of Paraguay. Both groups eat a non-Western low-glycemic diet. 1315 subjects were checked, and not a single case of acne was found. Even though this is merely an observational study, the results are impressive. Similar results have been reported in Okinawans, the South African Bantus, the Zulu and the Inuit. Even though these groups are continents apart, the common denominator is the same. Each group eats a non-Western diet. Another publication in 2005 in the Journal of the American Academy of Dermatology evaluated data from the Nurses Health Study II for a link between teenage acne and milk intake, and there was indeed a positive association. It may be that a milk allergy could be the explanation. Further evaluation is needed to pinpoint, which active compounds in milk are the culprits.

For now research points out that hyperinsulinemia, a metabolic condition stemming from an overload of highly refined and high glycemic carbohydrate foods, and its related hormonal cascade is the crucial link between the Western diet and acne. Other factors may emerge from investigating how milk consumption worsens acne.

The Medical Post, May 31, 2005, page 29

Power Lines And Childhood Leukemia

High voltage power lines have come under scrutiny in the past, and researchers have examined health risks, especially the cancer risk. Several reports exist that either contradict or support that the magnetic fields associated with power lines can cause cancer. There have been publications that pointed out a link to childhood leukemia, and new research has re-examined the link between childhood leukemia and high voltage power lines.

Under the leadership of Dr. Gerald J. Draper from the University of Oxford new studies have been made available and published in the British Medical Journal. The researchers examined the population living within 1 km from 275 to 400 kV power lines. Dr. Draper's group found no association between the distance from power lines and the overall incidence of cancer.

One finding however was different: children who lived within 200 m of high voltage power lines had a relative risk for leukemia of 1.69-fold as compared to those who lived 600 m away, who had no elevated risk. The relative risk for those living 200 to 600 m away from the lines was still elevated at 1.23-fold (where 1-fold is no risk). The research group points out that the increased risk cannot only be explained by the presence of magnetic fields, and some of the reasons are at this point unknown. Dr. Heather O. Dickinson from the University of Newcastle upon Tyne writes in an accompanying editorial that the magnetic fields surrounding the power lines amount to "about 1% of the earth's magnetic field, which affects all of us at all times."

According to Dr. Draper's research there are only 5 cases of childhood leukemia per year associated with the presence of power lines, and researchers agree that there is a link, however it remains a weak one.

BMJ 2005:330:1279-1280,1290-1293

Acetaminophen And Pets Aggravate Asthma

People with respiratory problems should be cautious in their use of acetaminophen. These are the results of a large cross-sectional study from Great Britain. In the latest piece of mounting evidence British researchers pointed out that people who take acetaminophen regularly are at a higher risk of developing asthma. There are new indications that the drug may worsen respiratory disease and is also linked to COPD (chronic obstructive pulmonary disease).

The study used previously collected data from nearly 13,500 people and was published in the American Journal of Respiratory and Critical Care. It demonstrated that daily users of acetaminophen are more likely to report asthma (odds ratio=1.81) and COPD (odds ratio=1.94) than patients who say that they never used acetaminophen. The study also investigated the relationship between respiratory illness and ASA as well as ibuprofen. Neither of the two seemed to be significantly related to the incidence of respiratory illness. The team of authors led by Dr. Tricia McKeever of the University of Nottingham did spirometry (lung function tests) and found that daily acetaminophen users had an impaired lung function of a 54 ml lower forced expiratory volume per second (FEV1). Ibuprofen users taking the medication between 1 and 5 times a month showed improvement of a 20 ml increase in FEV1. The benefit did not appear in non-users and those who took the medication on a daily basis.

The researchers strongly recommend that patients with respiratory disease should consult with a physician and consider carefully, whether or not to take acetaminophen.

Helping asthmatics to breathe easier has also been the subject of Japanese research. In a small prospective study Japanese researchers compared the need for inhaled corticosteroids between two groups of patients with allergic asthma. One group found new homes for the pets they were allergic to; the other opted to keep the animal at home. At the end of the 15-month average follow-up none of those who removed the pet were taking daily corticosteroids. Opposed to the first group, all but one of the patients who continued to live with their cat, dog, hamster or ferret were on daily corticosteroid treatment ranging from 200 mcg to 1600 mcg per day. Many asthma patients with animal allergies refuse to part with furry friends, but those who can fare better with less medication.

The Medical Post, May 31, 2005, page 49 and 50

Less Alcohol And Fat, More Exercise Battles Cancer

A lot has been said about choosing a healthy lifestyle in the prevention of cancers, but there is even better news now. It is not too late to make a switch to healthy living for those who have been diagnosed with cancer to reap significant benefits.

Dr. Bruce Johnson, director of the Lowe Center for Thoracic Oncology at the Dana-Farber Cancer Institute says that it is helpful to impress on cancer patients to cut down on fat and to exercise more in order to reduce their risk for recurrence. Dr. Jeffrey Meyerhardt, an assistant professor of medicine at Harvard Medical School, also points out that in the past studies have shown that physical activity can lower the risk of developing colon cancer, but his new research is the first to suggest a benefit for people who already have the disease. A study including 832 patients with Stage III colon cancer who had been treated with surgery and chemotherapy showed that the cancer survival rate (where no disase was present) was 49% higher in those who were moderately active. The activity was either a two to three mph walk, six days a week, or other equivalents: running fast two times a week, or playing tennis three times a week.

In a second study breast cancer was investigated in a group of patients who adopted a low-fat diet. Compared to those who continued to eat their regular food they were about one-fourth less likely to suffer a breast cancer recurrence in the next five years. This report comes from Dr. Rowan Chlebowski at the Harbor-UCLA Medical Center in Los Angeles. This was a larger study involving 2,437 women ages 48 to 79 years. The goal was to reduce fat intake to 20% or less of daily calories. The women were not taught to reduce total calories; just fat was reduced: no butter, margarine or baked goods. By five years, less than 10% of women on the low-fat diet had a breast cancer recurrence, compared with more than 12% of those on their usual diet. This translates into a relative risk reduction of 24%, concludes Dr. Chlebowski.

Breast Cancer Risk From Longterm Daily Alcohol Consumption As Compared To Non-Drinkers

Research about alcohol intake and the risk of developing breast cancer is especially important for women.The study comes also from the Dana-Farber Cancer Institute in Boston. Dr. Wendy Chen, a medical oncologist, reports that the more alcohol consumed regularly, the greater the risk. A study involved 121,700 registered nurses who were 30 to 55 years old in 1976. This study went on for 14 years and between 1980 and 1990 alcohol consumption questions were asked on several occasions; the women were followed up until 2004. Women who drank 5 to 9.9 grams of alcohol per day on average (the equivalent of a half-glass of wine) were 6% more likely to develop breast cancer than teetotalers. Women who consumed 10 to 19.9 grams per day saw their risk increase to 21%, and those who drank more than 20g per day, which means two drinks per day, were 37 % more likely to develop breast cancer. The finding of increased breast cancer rates was an independent risk factor associated solely with alcohol consumption.

There has been a lot of hoopla lately about the benefits of a glass of wine for heart health, and the phrase of "everything in moderation" consoles us, that a little bit cannot hurt. It turns out, that a little bit on a daily basis, alcohol in this case, can be a risky choice for women (see dose-response curve in the graph). A link has been erstablished between alcohol and breast cancer.

The Medical Post, June7, 2005, page 20

Tooth Implants For Better Health

Missing teeth are often just ignored -why bother? There are still all the others around to assume the necessary functions! The truth is different: missing teeth can affect us in the way we eat, speak, rest, and appear. They can influence our behavior and overall functioning. A missing tooth can also compromise the dental health of its neighbor. In the past the only options for missing teeth was either dental bridges or dentures. Bridges and dentures still have their place now, but the benefits for dental implants are significant.

• They help to preserve remaining natural bone structure.
• They reduce the need to cut out adjacent teeth for a bridge.
• They eliminate the need for removable partials or dentures and the sores that may go along with them.
• The roof of the mouth does not need to be covered by removable partials or complete dentures.
• They look, feel and work just like natural teeth.
• They support face shape, smile and provide confidence when eating and speaking.
• A few exceptions apply: people who smoke and people who have diabetes, particularly when uncontrolled and severe, have much less success with implants, as healing is impaired. However, you may consider quitting smoking and diabetes may be able to be controlled better with the help of a specialist. Other patients who have pacemakers, artificial heart valve replacements or other implanted devices may have to stay away from implants and they may have to stick to more conventional methods such as bridges and dentures.

The dentist will do a thorough examination to decide, whether you are a candidate for dental implants. Each tooth will be examined and a medical and dental history will be taken. Special x-rays (panoramic and tomograms) are needed to determine whether there is enough bone available. This helps to decide whether the implants can be placed directly, or whether grafting more bone will be necessary. This step is very important. It also helps the dentist to identify important structures, like nerves, sinuses and adjacent tooth roots. You will discuss all the treatment options with your dentist, which also helps to clarify expectations about the final results. This comprehensive treatment plan can be compared to building the foundation of a house. The foundation has to be solid, so the final structure holds up. A properly done dental implant should be a one-time job.

The procedure itself is done in the dental office or in a surgical suite under a local anesthetic, and over-the-counter pain medication may be needed after the surgery. The time it takes to heal can be variable. It may take up to six months, but it is important that healthy bone develop around your implant, which is the strong bond that is needed to hold the implant in place. Once the healing is complete, your dentist takes a final impression, which is needed by the dental laboratory to create the permanent teeth. Once the permanent teeth are placed you will receive care and a dental hygienist will instruct you in dental hygiene. Special plastic cleaning instruments are used to avoid scratching the titanium surface of the implant. Just as with natural teeth, implant-retained teeth need to be cleaned daily and need to be regularly checked by a dentist.

Looking at the overall picture it is clear, that the dental health and function of our teeth closely relates to every facet of our overall health, from speech to the function of our digestive tract and proper nutritional status, which affects cardiovascular health as well. A tooth implant involves a lot of detail work and effort, but its benefits are far reaching.

Other links re dental implants:

Family Health, Vol. 21, No.2, Summer 2005 (June), page 9-13; published by The College of Family Physicians of Canada