Health Newsletter:November 2007
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Contents |
[edit] High Insulin Levels Connected To Colon Polyps
Numerous risk factors have been found to play a role in the development of polyps in the colon: dietary factors play a role, such as the consumption of a high fat diet associated with red meat and related products. As colonic polyps also have a disposition to change into malignant growth, it is reasonable to eliminate nutritional risks and other cancer promoting lifestyle hazards such as smoking. In the meantime new studies were presented at the annual meeting of the American College of Gastroenterology.Dr. Ali A.Siddiqui reported about a review of 652 patients with type 2 diabetes. Those patients whose diabetes was poorly controlled had a higher likelihood of having advanced colonic polyps compared to the group of patients who had better glycemic control. On the long term this translates in a risk reduction of colorectal cancer. A second study, which was reported by Dr. Joseph C.Anderson, examined the correlation between obesity and a significant risk for colorectal cancer. Compared with all the other known risk factors, such as a higher age and smoking a body mass index of 30 or higher conveyed the greatest risk for colonic neoplasia (cancer). There is a common denominator behind both findings, namely higher levels of serum insulin as well as other hormones such as leptin which is a growth-promoting agent. This substance is elevated in the blood levels of patients with type 2 diabetes. Conversely the substance that controls growth, an antiproliferative hormone called adiponectin, is lower in the group with high insulin levels. Dr. Siddiqui reported that patients with poor diabetes control had a six-fold higher risk of having advanced polyps of the colon. Dr. Anderson’s study examined a large group of female patients. He pointed out that a BMI of 30 or higher increased the risk of having colon cancer by 80% in comparison to patients who were not obese. Obese men did not have the same increase in risk, and the gender difference at this point could not be explained. The message however is clear: type 2 diabetes needs to be controlled, weight loss is necessary, and screening for polyps by colonoscopy in the high risk group is imperative.
Dr. Siddiqui and Dr. Anderson at the Annual Meeting of the American College of Gastroenterology in Philadelphia
[edit] Breastfeeding Does Not Eliminate Childhood Allergies
It cannot be stressed enough that breastfeeding is the best possible nutrition for babies. Early nursing gives the child the valuable colostrum, which is high in antibodies and boosts the immune system of the child. Mother’s milk has the optimal composition for the child and the most natural way to nourish a baby. Benefits of nursing extend to the mother as well, and it is sensible to encourage mothers to breastfeed their babies as long as reasonably possible. There are still situations where breastfeeding is not successfully done: despite all efforts there may not be enough milk production. Mastitis and other health problems can hamper breastfeeding. Often well meaning advice can be a source of distress and feelings of being an “inadequate” mother who experiences problems with breastfeeding her baby. There may also be anxiety that the child will not receive the benefits of mother’s milk and as a result may develop health problems later in childhood. At times breastfeeding has been proclaimed to be the best weapon against childhood allergies, but a new publication by Dr. Michael S. Kramer of McGill University in Montreal tells a different story. He studied 17,046 mother-infant pairs that were enrolled at 31 health centers in Belarussia during 1996-97. The rate of breast feeding in these infants who received the breast feeding promotion intervention was a 44.3 % and the rate remained high throughout the first year of life. At the age of 6.5 years the children who had been enrolled at the intervention and standard care centers were examined for allergic symptoms and related diagnoses. Skin prick testing for five common inhalant allergies was also done. The findings showed that the children who had been breastfed exclusively for a long period had no reduction in allergic diseases as compared to infants who were not breastfed. There was no reduction in the incidence of asthma, hay fever or eczema in the group that was examined at the age of 6.5 years. These results point out that more research is needed to explain the recent increase in childhood allergies and asthma.
Comments: Air pollution has already been identified by other researchers to be such a factor, childhood obesity as well. Changes in nutritional patterns may also play a role.
British Medical Journal(BMJ)2007;335:815 (October 20, 2007)
[edit] Vibration For Higher Bone Density
Osteoporosis remains a health concern not only for postmenopausal women. It is true that females in the higher age group are more affected by lack of bone density, but the problem exists also in males. It has often been noted that a good pair of running and walking shoes is one of the best investments to stay out of the nursing home. For the case of osteoporosis this is true: for several decades Dr.Clinton Rubin (PhD), professor and chairman of biomedical engineering at the State University of New York in Stony Brook has been exploring how mechanical factors affect bone, muscle and cartilage. They started out with the view that vigorous impact generated by running or jumping are best. On closer examination they found that smaller impacts than those generated by running, but repeated 20 to 50 times a second were just as beneficial for the bone structure. Muscle fibers actually do exactly that. During daily activities they oscillate these frequencies and the signal is transmitted to the bone. As there is a loss of fibers that occurs with age, externally applied vibration can help compensate for this loss. Dr. Rubin and his colleagues have developed a platform which generates low magnitude oscillations. Users are standing on the platform for 10 to 20 minutes per day. Several clinical trials have found that this device known as Juvent 1000 is safe and beneficial for bone health. Small studies that have been performed involving dialysis patients with renal osteodystrophy and children with disabling conditions like cerebral palsy have shown improved bone structure after using the platform. A Toronto-based study involving 160 patients under Dr.Angela Cheung is on its way and Dr. Douglas Kiel, the director of medical research at Hebrew Senior Life is hoping to recruit 200 men and women older than 65 in the Boston area. At this point Osteoporosis Canada is not endorsing vibration platforms as a treatment for osteoporosis, until the benefits are confirmed in further studies. The vibration platform has the potential to offer non-pharmacological intervention for metabolic bone diseases like osteoporosis. In the meantime the Juvent 1000 has already been licensed as a medical device by Health Canada. It is not to be confused with other devices that are marketed as exercise machine under the names such as Power Plate, Vibraflex or Galileo, which produce vibrations that exceed standards for workplace exposure to vibration. Power Plate should not be used by persons where increased circulation could aggravate conditions such as infections, cancer or acute thrombosis. Even though Juvent 1000 has lower magnitude vibrations, users should be aware of the fact that it is not indicated for use in patients who have congestive heart failure.
The Medical Post, October 9, 2007, page 1, 38 and 39
[edit] Choline Crucial For Brain Development
In the past folate made headlines as a necessary nutrient for healthy fetal development. Whereas prenatal supplements are now the norm, it remains important that women in their childbearing years –and actually anybody who wants to keep well- are concerned with healthy nutrition. As nutrients are closer researched, more is known about the impact nutritional compounds have on our health. Dr. Steven Zeisel, director of the University of North Carolina Nutrition Research Center in Chapel Hill, N.C. delivered an important message at the annual meeting of the American College of Nutrition at the end of September this year. Choline has been found to be of great importance for a normal pregnancy outcome. The unfortunate news is also that many women of childbearing age are not consuming enough of it. Availability of the nutrient during pregnancy is important for normal fetal brain and spine development. It is found in abundance in eggs, chicken, turkey, beef and lamb. Most premenopausal women are resistant to dietary choline deficiency, but Dr. Zeisel pointed out that in his research he has found that genetic variations that are common in the population alter the human requirement for choline at least twofold. These gene variants are present in about 40% of women, and as a result thin offspring may be at a higher risk for neural tube defects and lifelong memory problems, if the choline levels are not adjusted. For pregnant women choline is “the new folate”. The importance of a nutrient however does not stop after pregnancy. Previous studies on older age groups have shown that 77% of men and 80% of postmenopausal women developed fatty liver or muscle damage, if there was choline deprivation. The current recommendation of choline is 550 mg per day for men and 425 mg per day for women. The previously mentioned genetic variant increases this requirement, and it may be prudent to test premenopausal women for this condition.
The Medical Post, October 16, 2007, page 19
[edit] Hepatitis A Vaccine Helps After Exposure
Vaccinations for infectious diseases like Hepatitis A and B are the best way to protect oneself of the serious consequences of this illness. It is recommended for people who are travelling to areas where the disease is common and where food and water sources are not safe. Vaccination has not always been available, and protection after exposure to hepatitis was the most pressing concern. The treatment of choice was administering immune globulin to those who had been exposed the disease, and if the treatment was given within a few days of exposure, the onset of hepatitis could mostly be averted. Dr. John C. Victor from the University of Michigan, Ann Arbor examined the usefulness of hepatitis A vaccine in cases where an unvaccinated person was exposed to the disease. A study was performed in the city of Almaty, Kazakhstan, which has an intermediate endemicity for hepatitis A virus. The persons who had been in contact with hepatitis A had not received the protective vaccination and as a result they would have come down with the disease. They were given age-appropriate dosages of hepatitis A vaccine or immune globulin within 14 days after exposure. Of those who receive the immune globulin 3.3% were confirmed with a symptomatic infection. Of those who received the hepatitis A vaccination 4.4% showed symptomatic infection. Most of the world population remains at a moderate to high risk for hepatitis. If outbreaks occur, the best protection to non-vaccinated person is still a dose of immune globulin, especially if the person is immunocompromised. Vaccination with hepatitis A vaccine has been found to be as effective as effective for an otherwise healthy individual. It also has the benefit of long-term protection against the disease, which immune globulin alone does not offer.
New England Journal of Medicine(NEJM) 2007;357:1685-1694 and NEJM 2007;357:1757-1759.
