Friday, May 30, 2008

Study - Men with Muscles Live Longer

Everyone agrees that aerobic exercise leads to good cardiovascular health. It’s common for healthcare providers to emphasize the benefits of cardiorespiratory fitness, but a new study shows that men with increased muscular strength are likely to live longer. The study was presented at the American College of Sports Medicine 55th Annual Meeting. Senior investigator Jonatan R. Ruiz, PhD, from the unit for preventive nutrition at the department of biosciences and nutrition at Novum, Karolinska Institutet, Huddinge, Sweden, says, "These findings prove the benefits of having greater muscular strength and thus require further research to confirm the combined effects of strength and CRF”(cardio respiratory fitness).

The research was performed between 1980 and 1989, and included 8762 men who were tested for muscular strength and cardio respiratory fitness. Mortality rates were determined December 31, 2003. The men with decreased muscular strength had a 60% higher risk of cardiovascular disease. According to Dr. Ruiz, "This study examines the association between muscular strength and mortality. Other studies used a single measure of muscular strength, but ours used 2 tests," he said. "Muscular strength and CRF combine to provide protective effects against all-cause mortality in men."

The outcome seen is different when compared to other studies that measure the effects of physical fitness and activity alone, warranting further studies about the benefits of staying strong. It challenges the concept that walking and regular physical activity are the best for prevention of heart disease and increasing longevity.

You can start by incorporating weight or resistance training into your daily routine. The benefits of maintaining or improving muscle strength extend beyond the risk of dying from all causes. Improved muscle strength helps everyone maintain independence and prevents disability from injuries. Improved strength allows us to maintain quality of life into our senior years.

Speak with your doctor before engaging in any new exercise activity. You can read more about resistance training and the benefits, as well as recommendations from the American Heart Association here. ◦

FDA Approves Phase 2 Trial for Prostate Cancer Vaccine

The FDA has approved Phase II clinical trials to measure the effectiveness of Ad/PSA (adenovirus/prostate-specific antigen), a vaccine that could help men fight prostate cancer. The first trial has lead David M. Lubaroff, MD, lead investigator of the study, to become “cautiously optimistic” about the benefit of the vaccine for extending and improving quality of life for men with advanced disease. Dr. Lubaroff is professor of urology and microbiology and associate director of the Holden Comprehensive Cancer Center at the University of Iowa, in Iowa City. He presented the findings during the American Urological Association’s 2008 Annual Meeting.

The study involved 32 men who had metastatic prostate cancer. The group received one of three doses of Ad/PSA vaccine, produced by inserting PSA gene into bacteria and viruses, and using immune-stimulatory DNA to help the body search and destroy tumors. The vaccine was successful in producing cancer antibodies in 42% of the group, anti-PSA T-cell responses in 71%, and immune responses in 40% of the patients tested. Predicted survival rate increased in 57% of the men; the longest survival was 71 months. The Phase 2 trial is expected to be completed by December 2010. The first round of testing for prostate cancer vaccine has produced powerful results. The upcoming trial is seeking 82 participants.

Estimates show that 1 in 44 in men aged 40-59 years and 1 in 7 in men aged 60-79 years will develop prostate cancer. The risk increases with age, and the risk for African-Americans is 1.5 times greater than other ethnic groups. Elevated PSA levels are associated with localized and advanced prostate cancer, though the effectiveness of blood testing has been questioned in past studies. A combination of current screening methods and biopsy continue to be the best recommendations for early detection.

According to the National Cancer Institute, “in 2007, an estimated 220,000 men will be newly diagnosed with prostate cancer in the United States and about 28,000 men will die from the disease."A focus on prevention includes awareness of family history and lifestyle modification for prevention. Data from the Health Professionals Follow-Up Study, performed on men age 40 to 75, showed that consuming a lycopene rich diet can reduce the risk of prostate cancer by 35%, and decrease the chance of advanced prostate cancer by 54%. Tomato sauce is rich in lycopenes. Men who consumed two servings a week reduced their chances of developing prostate cancer by 23%. Tomato sauce consumption also helped the spread of prostate cancer by 35%. Lycopene supplements were not shown to produce the same results, making whole food choices our best option for disease prevention. A recent study shows that Vitamin E, Beta Carotene or Vitamin A supplements can have an adverse effect on your health, accelerating the growth of cancer and contributing to poor cardiovascular health.

Know your family history and take your risk factors seriously. Engage in regular exercise to keep your weight stable. The link to obesity and many forms of cancers remains the subject of considerable study.

Researchers continue to gain more insight into the mechanisms of prostate cancer. Prevention is your primary defense. Unfortunately, evidence shows that routine screening may cause more harm than good in causing unnecessary anxiety, leading to biopsies that carry genuine risks, including the chance of erectile dysfunction. The evidence just doesn’t support the benefits of routine screening for prostate cancer, though it is the best tool we have, nor has routine screening shown a decline in the incidence of prostate cancer deaths. You should discuss with your doctor the statistics related to false positive PSA testing, and enlist the help of your healthcare provider when making decisions about biopsy.

Early aggressive treatment still provides the best outcomes. Advances in the development of a prostate cancer vaccine should be viewed as nothing short of fantastic, given the current challenges of early detection. We can also hope the findings will lead to new ways to prevent and treat other forms of cancer.

If you are treating or know someone who is suffering from prostate cancer, and are interested in participating in the vaccine study, you can find more information at

Sources: American Urological Association (AUA) 2008 Annual Meeting: Abstract 526. Presented May 18, 2008. ◦

Thursday, May 29, 2008

Scientific Statement Urges Use of Home Blood Pressure Monitors

A statement published online May 23, 2008 in Hypertension and the Journal of the American Society of Hypertension urges those with high blood pressure to make monitoring a home routine. The benefits of home blood pressure monitoring to patients with kidney disease, heart disease and diabetes are substantial, according to Dr Thomas Pickering (Columbia Presbyterian Medical Center, New York), chair of the writing committee, and colleagues. "Given the amount of accumulated evidence about the value of home blood-pressure monitoring [HBPM], it is time to make HBPM a part of routine management of hypertensive patients, especially those with diabetes, coronary heart disease, chronic kidney disease, substantial nonadherence, or a substantial white-coat effect, writes the committee. The statement is issued on behalf of the American Heart Association (AHA), American Society of Hypertension (ASH), and Preventive Cardiovascular Nurses Association (PCNA).

Improved blood pressure treatment of the 72 million people diagnosed with the condition, and healthcare savings are the primary goals. Blood pressure readings taken at your healthcare provider may not always be accurate. Average readings, taken over time may prove more accurate. Cases of suspected, or borderline high blood pressure can also be better defined when monitored at home. The value to seniors, pregnant women, diabetics and kidney patients is also noted. Home blood pressure monitoring would provide an effective means to measure response to medication.

People who are at risk for complications of high blood pressure should have readings that are less than 130/80. Newer guidelines say everyone’s blood pressure should be less than 135/85.

Drawbacks include the use of unreliable devices. Patients with variable heart rates get inconsistent blood pressure readings. Home monitoring might cause some confusion. Blood pressure equipment meeting international testing standards and should be validated for accuracy. Patients should be taught to measure results against traditional mercury measurements, something that requires training and may be difficult for those who live alone, have hearing impairment or other physical handicaps.

Machines with electronic cuff inflation can be purchased for home use. The cost is between $80 and $100. Fingers devices are not accurate. Wrist devices are accurate, but only if the arm is at heart level and the wrist is straight. They are not generally recommended because of the disadvantages associated with improper placement and use. Most insurance companies will reimburse for the purchase of a device with a doctor’s prescription. For a list of tested and approved home blood pressure monitors, visit the dabl Educational Website.

Source: Pickering TG, Houston-Miller N, Ogedegbe G, et al. Call to action on use and reimbursement for home blood pressure monitoring. Hypertension 2008; DOI: 10.1161/hypertensionaha.107.189010. Available at:

Wednesday, May 28, 2008

Study Challenges Ibuprofen for Alzheimer’s Prevention, but “Something is going on”

According to a new report, Ibuprofen offers no better protection against Alzheimer’s disease than any other NSAID (non-steroidal anti-inflammatory drug). The results have challenged the most recent report that showed Ibuprofen use reduces the risk of developing Alzhheimer's disease by 23%. Study investigator, Peter P. Zandi, PhD, from Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland, says,"This is an interesting finding, because it seems to challenge a current theory that the NSAID group that includes ibuprofen may work better in reducing a person's risk of Alzheimer's.

NSAID”S fall into two different categories, or subgroups. Ibuprofen is a selective Ab-42–lowering agent, or SALA. Ab-42 is found in the brain of people with Alzheimer’s disease. Other types of NSAID’s (non-SALA), include aspirin and naproxen. We're being cautioned not to use Ibuprofen or any NSAID to prevent Alzheimer’s disease because of the side effects and the need for further studies.

The newest research pooled data from six studies, involving 13,499 people, and compared the protective effect of SALA’s and non-SALA anti-inflammatories. According to the new investigation, there was no difference between the two when it came to Alzheimer's prevention.

According to Maria Carrillo, director of medical and scientific relations at the Alzheimer's Association in Chicago, “The Alzheimer's Association does not recommend you take NSAIDs on a daily basis because there are a lot of side effects... The jury is still out on whether NSAIDs can be protective against Alzheimer's." Dr. Zandi says, "That leaves a conundrum, a scientific mystery. What's very clear is that observational data is very consistent, that there is a reduction in risk among people using NSAIDs, so there's something going on."

Source: May 28 online issue of Neurology ◦

Saturday, May 24, 2008

Pranayama for Heart Failure

Pranayama is practiced by many in India for health and longevity. Even though it’s considered an alternative form of healing, the benefits are well studied. Western healthcare providers are slow to incorporate alternative therapies into their practice, though many are proven and supported.

Two years ago, Dr. Patricia Uber, speaking at the Heart Failure Society of America 2006 Scientific Sessions, urged heart failure specialists to consider other options for their patients. She suggested prayer, poetry and Pranayama. Her comments that "breath resynchronization therapy" be incorporated into the "armamentarium" of heart-failure therapies were met with applause and approval during the session.

Dr. Uber went on to explain how the breath becomes out of synch with blood pressure waves as heart failure progresses. She cited small studies proving that pranayamic breathing, reciting poetry and performing yoga mantras can restore synchronicity of breath. Exercises that slow breathing improve the function of baroreceptors - nerve endings that regulate blood pressure and heart rate. Improvements in blood pressure can be as effective as medications with regular practice.

Dr. Uber urged health practitioners to “start looking at things that can reduce blood pressure that maybe can reduce neurohormones, that don't have to involve a device but can involve simple practice, such as going to church and the relief you may get from praying, or learning yoga mantras and deep-breathing techniques. These things don't cost much beyond the initial instruction that may actually improve the heart-failure state. As healthcare practitioners, we have to start addressing complementary medicine, even as a preventive method to reduce stress, blood pressure, and heart rate to prevent hypertension and heart failure later on. We'd really be crazy to just keep stacking on neurohormonal antagonism and devices without looking at the mind-body connection."

The message is that there are alternative practices that we all can employ to enjoy better health – pranayama is one suggestion - we know it works. The benefits extend to everyone, not just to those with heart failure. Pranayama has helped cancer patients deal with pain, as well as assisting breast cancer survivors following surgery. Consider the value of the mind-body connection in your daily activities. Better health comes from a variety of activities. ◦

Thursday, May 22, 2008

Fluctuations in Glucose Levels Linked to ICU Deaths

Patients who are critically ill often experience elevated glucose (blood sugar) levels. Past studies have shown that there seems to be a link between acute coronary syndrome, mortality and high blood sugar in patients admitted to the ICU. According to a new study, presented at the American Thoracic Society 2008 International Conference, wide variables in glucose levels among critically ill patients may also contribute to higher death rates, complications and longer hospital stays.

The study was presented by Hasan Al-Dorzi, MD, a pulmonary critical care consultant at King AbdulAziz Medical City/King Fahad National Guard Hospital in Riyadh, Saudi Arabia, who said, "We know that at a cellular level...there is evidence of this up-and-down fluctuation of glucose being harmful to cells. We also know from diabetes research that diabetic patients, who have up-and-down fluctuations, even when not in hospital, have a higher incidence of complications”, suggesting once again that current guidelines for managing glucose levels in the ICU should be revisited.

One solution suggested by Dr. Al-Dorzi is to find advances in technology that would link present computerized devices to a rapid insulin infusion system. He says, "If we have devices in the future that allow for continuous monitoring of blood glucose, and we have on hand computerized protocols that can detect changes more rapidly and allow insulin infusion rapidly, we can correct these fluctuations in a short time and improve the outcomes of our patients." Ellen Burnham, MD, assistant professor of medicine at the University of Colorado in Denver suggested during an interview, "Perhaps we can't take a 1-size-fits-all approach to managing blood sugar, and need to tailor our management to each patient and particular condition.” Dr. Burnham admitted that the problem is challenging.

I personally wonder if a renewed focus on nutritional status might also be helpful for better glucose control in critically ill patients.

Source: - From American Thoracic Society (ATS) 2008 International Conference ◦

Tuesday, May 20, 2008

Cholesterol Medications Linked to Eye Disease

Many patients balk at the prospect of taking cholesterol lowering medications. The benefits, according to studies, are profound, but worries persist about the ill effects. Many patients report muscle aches, fatigue, and even memory loss. Lowering cholesterol too much has even been associated with a possible link to cancer. According to a new study, statins (cholesterol lowering drugs) might hasten the progression of age-related macular degeneration (AMD), a disease that leads to blindness and affects more than ten million Americans.

The researchers looked at data from the Age-Related Eye Disease Study to determine if statins have a beneficial effect on protecting the eyes from macular degeneration and glaucoma, as previously suggested. A study from 2006 found that the drugs may improve blood flow in the retinal arteries and veins, reducing the risk of all eye diseases associated with impaired ocular circulation.

The study was presented at the Association for Research in Vision and Ophthalmology 2008 Annual Meeting, following an analysis of 1266 subjects who were followed for eleven years. The patients had neovascular AMD and/or central geographic atrophy (CGA). CGA is a condition that causes loss of vision in the center of the eye, and neovascular AMD refers to an abnormal growth of blood vessels in the macula of the eye.

The researchers found that AMD advanced in 481 patients, 323 developed AMD, and 233 experienced CGA. The authors concluded that the use of cholesterol lowering drugs seemed to promote advanced neurovascular age-related macular degeneration.

Caution is urged regarding the study: "We are not saying that statins are a risk factor in the progression of age-related AMD. There are a lot of confounding variables. But what this study shows is that they don't seem to have a beneficial effect.”

Despite the findings, Dr Frederick L Ferris III (National Eye Institute) says, “We don't want patients to be concerned about the effects of statins on their eyes”. Statins still have well documented effects on the lives of patients.

Dr. John T Thompson (University of Maryland, Baltimore) said during an interview, "The significance here is that there have been conflicting reports as to whether statins are protective, and this study says that they are not. There needs to be further studies to sort this out."

Sources: The Use of Statins and the Development of AMD in AREDS

Statins improve blood flow in the retinal arteries and veins

More Evidence that Marijuana May be Linked to Heart Attack

The results of a small study, published online May 13, 2008 in Molecular Psychiatry, has researchers speculating that chronic, heavy marijuana use leads to major increases in triglyceride levels. Dr. Subramaniam Jayanthi from the National Institute on Drug Abuse, and colleagues, say the finding may be the reason marijuana has a negative impact on the cardiovascular system. The results of past studies have linked marijuana to increased risk of heart attack, especially in mid-life, but exactly why this occurs is speculative.

The study authors say that marijuana creates a resistance to blood flow. Senior author Dr Jean Luc Cadet (National Institute on Drug Abuse) explained, "A lot of people in cardiology have probably not been following the literature on marijuana, as most of it comes from the perspective of the neurologist or neuropsychiatrist. But in researching this topic, we came across a lot of papers suggesting that marijuana has acute cardiovascular effects, and we ourselves published a paper in 2005 showing that heavy marijuana users had increased resistance to brachial flow."

We know that heart disease risk can be measured by several inflammatory biomarkers that promote clot formation in the lining of the blood vessels. In one study, it was shown that transient spikes in triglyceride levels from diet can cause enough inflammation to immediately increase our risk of heart attack. The current study found that marijuana users experience increased levels of ApoC3, a major lipoprotein that delays the breakdown of triglycerides.

The study is admittedly small, but Dr. Cadet is encouraging physicians to ask their patients about marijuana use to measure their risk factors for heart attack and stroke. He hopes to also see larger studies. “Doctors should ask patients about a history of drug abuse, and if they have been smoking marijuana, it may be worth checking triglyceride levels."

In conclusion, the authors say: "The observed increases in apolipoprotein C3 in the marijuana users hint of the possibility that chronic marijuana abuse could lead to impairments of cellular energetics and mitochondrial function, which are critical events associated with myocardial infarction, stroke, and ischemic/reperfusion damage."

Keep your cholesterol and triglyceride levels in check by avoiding processed food. Stay away from Trans -fats, cholesterol laden foods and saturated fat. Avoid tobacco and get at least 30 minutes of moderate physical activity five days a week. Alcohol is also known to increase triglyceride levels.

If you smoke marijuana, speak with your medical provider about your health risks. If you experience chest pain associated with smoking marijuana, the study presented here should provide some genuine insight about the potential dangers to your heart.

Source: HeartWire

Related: Smoking Marijuana May Increase Risk of Dying After a Heart Attack

Thursday, May 15, 2008

More Clues to Cancer Found in Food

A team of researchers from Maastricht University in the Netherlands have studied the association between cancer and the chemical acrylamide-a substance known to cause cancer in mice. The study is published in the May issue of The American Journal of Clinical Nutrition.

Acrylamide is found in French fries, potato chips, coffee, fried and baked foods, olives, and even breakfast cereals. It’s also used for food packaging, and to manufacture cosmetics and plastics.

We have known for years that acrylamide is present in much of our food. What we haven’t known is whether it poses a health risk to humans. Researchers from the Netherlands began looking at data from a large study on diet and cancer that began in 1986. Acrylamide intake was estimated among 121000 participants who revealed their eating habits by way of a questionnaire. The study focused on cancer rates and acrylamide intake. The group was followed for thirteen years. The age range was 55 to 70, and the participants consumed an average of 22 micrograms of Acrylamide daily, a little less than 21/2 ounces of French fries. Those who ate the highest amounts of the chemical showed a 59% greater risk for kidney cancer than those who ate the least, and the risk was highest in smokers.

A study published last December in the journal Cancer Epidemiology Biomarkers and Prevention showed that non -smoking, post-menopausal women who consumed higher amounts of acrylamide were at greater risk for ovarian and endometrial cancer.

The research has come under criticism from experts who say the study authors were looking for a link between acrylamide and cancer, so they found one. Jeff Stier, associate director of the American Council on Science and Health says…” people should not confuse association with causation."

Roger Clemens, DrPH and spokesperson for the American Society of Nutrition says that mice used in studies were exposed to 300 times the amount of acrylamide than humans, according to FDA and World Health Organization estimates. Even though all of us consume acrylamides, our exposure does not seem to be increasing, meaning we might be able to rest easy about the study results. Clemens points out however, that we should still limit our intake of French fries and potato chips, noting, "Balance, moderation and variety are the keys to a healthful lifestyle."

The current authors hope that other scientists will follow-up with more research. In the meantime, perhaps we should all limit our acrylamide intake.

Source: ◦

Sunday, May 11, 2008

Ibuprofen May Protect from Alzheimer’s disease

Scientists have found that taking Ibuprofen may ward off the development of Alzheimer’s disease. According to a team of investigators at Boston University School of Medicine, people who took Ibuprofen long term, specifically more than five years, were 40% less likely to have the disease. Alzheimer's protection fell to 25% with the use of other non-steroidal anti-inflammatory drugs. Author Steven Vlad, MD, said in a statement from the American Academy of Neurology, "These results suggest that the effect may be due to specific NSAIDs rather than all NSAIDs as a class”.

Amyloid beta-1-42 (Aβ 1-42) plaque is a major contributor to the development of Alzheimer’s disease. The researchers initiated the study to see if NSAID’s might delay the onset of Alzheimer’s disease by protecting against beta-1-42 (Aβ 1-42), a protein that accumulates n the brain, interfering with electrical impulses between the neurons.

The study looked at 49,349 veterans age 50 and up, between 1998 and 2005 who developed Alzheimer’s disease. A comparison was made of 196,850 subjects from the same population, comparing the use of Ibuprofen and other drugs in the same class. Investigators observed those who did not use the medication, took it up to one year, more than one year but up to two, more than two, and up to three, and so on to five years and more. Ibuprofen and Naproxen were the most widely prescribed NSAIDS among the groups. The authors found that higher dosing and longer use provided the best protection.

For now, the results are only observational. The authors hope to see clinical trials to provide even better information about NSAID protection for Alzheimer’s disease, especially Ibuprofen. ◦

Wednesday, May 7, 2008

Screening Men for Osteoporosis-New Clinician Guidelines

The American College of Physicians has issued guidelines for performing bone mass density tests in older men, recognizing that “osteoporosis if not just a woman’s disease”. Lead author, Amir Qaseem, MD, PhD, MHA concludes: "Older men, especially those over the age of 65, need to be assessed regularly for their risk of osteoporosis." The recommendations come about because of the increasing incidence of osteoporosis among men. The guidelines are published in the May 6 issue of the Annals of Internal Medicine.

Men, who experience fractures as the result of loss of bone mass, are twice as likely to die from complications when compared to women with fractures. The evidence comes from a review of articles published on MEDLINE from 1990 to 2007. Articles from experts were reviewed as well as other referenced material that evaluated risk fractures in men.

The osteoporosis foundation is urging clinicians to screen high-risk men from age 50 to 70 and all men over 70 by using a BMD or bone mass density test, also known as a DEXA scan. For men who have already suffered a fracture, BMD testing is recommended to determine the severity of the fracture.

Risk factors for men include androgen deprivation, spinal cord injury and advanced age. Sedentary lifestyle, poor dietary intake of calcium, low body mass index, weight loss of more than 10% and the use of prescription steroids are all indications that bone density should be viewed.

According to estimates, the incidence of osteoporosis in men is expected to increase by 50% during the next fifteen years, and the rate of hip fractures is expected to double. The current statistics for osteoporosis in men are 7%, 5% and 3% in whites, African –Americans and Hispanics respectively.

The risk of complications, the need for surgery and associated morbidity make routine screening a valuable tool for decreasing the burden of unnecessary injuries and hospitalization in men who are candidates for drug therapy to treat osteoporosis.

You doctor may now be asking questions about your calcium intake, tracking changes in your weight and insisting that more men get busy exercising to decrease the risk of osteoporosis. According to Dr. Qaseem, “Osteoporosis . . . is significantly under diagnosed and undertreated in men”. ◦