Are your calcium supplements actually useless?

August 25, 2010 by  
Filed under HEART AND STROKE

Many of us swallow vitamin supplement pills each day, including calcium for bone health. Clinical guidelines on osteoporosis recommend supplementation with calcium especially for those who are at high risk for bone loss and fractures.

But the truth is, the benefits of calcium supplements are rather unclear, not to mention contradictory. Previous studies have shown that:

  • Calcium can protect against vascular disease.
  • Calcium can cause vascular disease by hastening vascular calcification.

So what now?

A group of researchers at the University of Auckland in New Zealand conducted a systematic search of electronic databases and conducted a meta-analysis of randomized clinical trials of calcium supplements compared to placebo. The results of the meta-analysis might have answered the calcium supplement question once and for all and can be summarized below:

  • Calcium supplements were associated with a significant increase (about 30%) in incidence of heart attacks.
  • Calcium supplements were also associated with trend of increased risk of stroke and mortality, although the increase is much smaller and not statistically significant.

These findings were consistent in all 5 trials included in the analysis and the increase of MI risk due to the supplements also increased with higher dietary calcium intake. Age, gender and type of supplement did not influence the results.

What is even more disappointing is the finding that calcium supplements have very little benefits when it comes to preventing fractures.

How reliable are the current results?

Some experts speculate that misdiagnosis of heart burns caused by the supplements as cardiac chest pains may have given erroneous results. This is based on the fact that many of the heart attack reported occurred within an average of 3.6 years after calcium supplementation was started. However, calcification of the blood vessels should take longer than that.

In addition, the studies analyzed were only those that did not include vitamin supplementation. It is common clinical practice, however, that calcium and vitamin D supplements are coadministered for osteoporosis. It is not clear whether vitamin D, which supposedly has cardiovascular protective properties, combined with calcium would give the same results.

However, the majority of experts agree is the fact that calcium supplements do not seem to prevent fracture indicates it is practically useless to take them even if the supplements as such are safe and do not cause heart problems.

According to senior author Dr Ian R Reid:

“Clinicians should tell their patients that, for most older people, the risks of calcium supplements outweigh the benefits. Changing to calcium-rich foods may be appropriate.”

According to independent expert Dr John Schindler (University of Pittsburgh Medical Center in Pennsylvania:

“I think the safest thing to tell your patients right now is if you can get your dietary calcium from good dietary sources, such as yogurt, sardines, and skim milk, that potentially might be all you need to ward off the risk of osteoporosis. Then we don’t have to deal with this increased cardiovascular risk.”

Statins and diabetes

February 18, 2010 by  
Filed under HEART AND STROKE

Some antidiabetes drugs are said to increase risk for cardiovascular disease. Can it also be true the other way around? That is what the JUPITER (short for Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin) study reported – that some statins may increase the risk for type 2 diabetes. Statins are cholesterol-lowering drugs commonly prescribed for those who are a t risk for cardiovascular events.

A more recent meta-analysis conducted by researchers at the University of Glasgow showed that indeed, statin users may be at risk for developing diabetes mellitus. However, it should be emphasized that the increase in risk is very slight, and doesn’t really outweigh the benefits of statins.

According to study investigator Dr David Preiss

“We found that there was indeed a risk of diabetes, about 9%, but it isn’t a worrying increase as had been suggested by other studies. Then again, it wasn’t a completely flat result. We did see something. Our message would be that people on statins should be those we think are at moderate to high cardiovascular risk in the future. If you look at that group of patients, then what we really want to see come out of the study is a reassuring message, because there is little question that the protective effects in reducing heart attacks, strokes, and so on heavily outweigh this risk of developing diabetes.”

Health experts who were not part of the study are appreciative of how the authors carefully worded their findings so as not to create panic among statin users. They are that the media would the same and be objective about what they report. Statins are the bestsellers of many pharmaceutical firms so it’s no wonder that statin-bashing is a favorite pastime of many.

According to Dr Richard Karas of Tufts Medical Center in Boston who was involved in the meta-analysis study:

“This is another opportunity for the media to really scare the pants off people, and I think their findings are very carefully worded—there is a statistically significant but slight increase in the risk of diabetes. It’s a provocative finding, but it’s also of modest strength because it’s information culled from studies not designed to answer this question.”

Statins are drugs designed to lower LDL-cholesterol, thereby reducing the risk for heart attacks and stroke. The majority of experts agree that the benefits of statins exceed the slight risk of diabetes. Clinicians are advised not to drastically change clinical practice based on these findings alone.

Aspirin: good for the heart, bad for the tummy

February 4, 2010 by  
Filed under HEART AND STROKE

Aspirin or acetyl salicylic acid has been around for more than 100 years. It has gone from a simple headache and fever remedy to the wonder drug that it is today, used in the treatment and prevention of more serious conditions such as heart disease and even cancer. You can get aspirin everywhere, as an over-the-counter (OTC) drug from your pharmacy or as less than a dollar a bottle from your supermarket.

Yet, despite its wonderful healing powers, aspirin can have some serious side effects just like every drug. Unfortunately, not many of us are aware of these side effects.

A recent New York Times report tackled the issue of “an aspiring a day…” with the expertise of Dr. Neena S. Abraham, a gastroenterologist at the Michael E. DeBakey V.A. Medical Center and associate professor of medicine at the Baylor College of Medicine in Houston.

Dr Abraham warns us of the following:

  • Aspirin can cause damage in the gastrointestinal (GI) tract from mouth to anus. The most common of these side effects are ulcers and bleeding.
  • The risk for GI bleeding is two- to four-fold higher in aspirin users than in non-aspirin users.
  • Aspirin can bring on side effects even at “baby doses” of 81 mg a day.
  • Special formulations such as buffered or enteric coated aspirin do not eliminate the risks.
  • Use of OTC aspirin results in 5 extra cases of ulcer bleeding per 1,000 patients per year.

In addition, we should be aware of the risk factors that make us more susceptible to aspirin-induced GI bleeding:

Dr. Abraham gives the following recommendations to patients:

  • Aspirin, even it is an OTC medication should only be taken after a thorough cardiovascular risk assessment by a qualified health professional.
  • The risks and benefits of aspirin use should be thoroughly assessed. If the benefits exceed the risk of GI bleeding, then aspirin should only be sued at the minimum dose of 81 mg a day.
  • For patients who have high-risk profiles for ulcers and GI bleeding, other alternatives should be looked into. Using stomach-protecting medications such as proton pump inhibitors might minimize the risks.

Photo credit: stock.xchng

Accidental eye injuries: causes and prevention

July 1, 2009 by  
Filed under Featured, VISION

eye_seriesHow’s this for statistics to make you think seriously about protecting your eyes:

  • More than a million people in the US have eye injuries each year.
  • Accidental eye injury is one of the leading causes of vision loss and impairment.
  • 90% of the said injuries are actually preventable.

Although a lot of eye injuries may occur in the workplace, many people are not aware that a lot of injuries also happen at home and at leisure time.

Here are major ways of injuring your eyes:

Fireworks and firecrackers

In almost every country, fireworks are part of national celebrations. Today is Canada Day. The 4th of July is just around the corner. Fireworks are beautiful and fun but they can cause major injuries, including the eyes, to users as well as to bystanders. Keep firecrackers out of little children’s sight and reach. Not only are they fire hazards, they can also cause injuries.

Chemicals

Those who are dealing with chemicals in the workplace wear eye protection gear. I’ve worked in a lab before and knew the risks and the precautionary measures. What we tend to forget is that household chemicals can also be hazardous and can cause permanent eye damage. Medicine.Net recommends that

when using household chemicals, read instructions and labels carefully, work in a well-ventilated area and make sure to point spray nozzles away from you.

Machinery and appliances

Household appliances and machinery can also cause eye injuries. Look at your hobby room, your workshop. Do you wear protective eyewear when you use that electric saw? That potter’s wheel? The kitchen blender? Any other moving machinery?

How about the lawnmower or the power trimmer? Projectiles in the form of stones, branches and pieces of debris can shoot from these machines during use. These projectiles present risk not only for the machine operator but for the bystanders as well.

Sports and recreation

Sports and other recreational activities are fun but they can cause eye damage, too. A blow from a hockey stick, puck, or ball can have some devastating effect on the eye. In April, I posted a resource post on Sports Eye Safety.

So what do we do in case of an eye injury?

Medicine.Net recommends:

For more information about eye injury prevention, check out recommendations by the American Academy of Ophthalmology

Obesity and surgery

June 25, 2009 by  
Filed under OBESITY

surgeonObese patients and their doctors may face special challenges when undergoing and performing surgery. Health experts warn that health care provider should not underestimate the risks but on the other hand, should not dismiss obese patients as hopeless cases. The American Heart Association recently released a new Science Advisory on performing surgery on obese patients Let us look at  some of the issues surrounding obesity and surgery.

Proper evaluation is difficult in obese patients.

Performing an evaluation in highly obese patients can be difficult because of many co-existing conditions. Heart problems in particular are easily underestimated during a physical examination. According to lead author Dr. Paul Poirier,

A severely obese patient can be technically difficult to evaluate prior to surgery. For example, severely obese people might feel chest tightness that could be a symptom of their obesity or of an underlying cardiac problem. Doctors need to carefully evaluate severely obese patients before they have surgery.”

Surgery can be difficult in obese patients.

Surgeons report that surgery can be challenging in severely obese patients. There was a big scandal in the UK a few years ago when some health care providers refused to perform surgery on obese patients

Obese patients are prone to complications.

Obese patients are more likely to suffer complications after surgery such as infections, and pulmonary embolism, and are more likely to stay on a ventilator and have a prolonged hospital stay.

Obese patients are not at higher risk for death.

Despite of these, the mortality rates during surgery do not depend on body mass index (BMI). According to Dr. Poirier

“Some surgeons are under the impression that severely obese patients are more likely to die in surgery than people who are not obese, and won’t operate on them as a result. This is not true. Severely obese patients are at increased risk for pulmonary embolism, wound infection and other conditions. But they are not more likely than their lower-weight counterparts to die as a result of surgery.”

The AHA advisory recommends the following:

  • The recommendations are meant for all health care providers, from cardiologists, to surgeons, to anesthesiologists, providing pre-operative evaluation recommendations, as well as recommendations on management and care for obese patients during and after any type surgery, be it a knee replacement or a heart operation.
  • The health care provider should especially pay attention to obesity-related conditions such as:
  • The health providers should take into consideration age, gender, as well as the abovementioned conditions as independent factors for mortality or complication from surgery.
  • Health care providers should advise patients to be as healthy as possible before surgery. This may include losing weight, keeping blood pressure under control (for those with hypertensiotn, or keeping blood sugar level under control (for those with diabetes).
  • Extra, non-invasive tests may be performed if it aid in pre-surgery evaluation, such as ECG or chest X-ray.
  • Surgeons should discuss with patients the risks associated with a particular surgery for a patient their size.

In providing this advisory, the AHA aims to give obese patients the best possible care they deserve.

Can your pulse rate predict your heart attack risk?

May 4, 2009 by  
Filed under HEART AND STROKE

heart2Researchers and scientists are continuously searching for ways to predict who is most likely to have a heart attack and who isn’t. French researchers report this could be as easy as measuring a person’s pulse rate three times.

The study looked at 7,746 French male civil servants. Their heart rates (measured by their pulse rates) were measured at rest (baseline), right before physical exercise (mild mental stress in anticipation of the exercise) and during exercise.

The results of the study show that “men whose heart rate increased the most during mild mental stress just before an exercise test had twice the risk of dying of a sudden heart attack in later life than men whose heart rate did not increase as much.”

The highest increase in heart rate during the mild mental stress was at least 12 beats a minute, the lowest, less than four beats per minute. The study participants who exhibited the highest increase in heart rate had twice the risk of sudden death due to a cardiac event compared to men who had the lowest increase.

However, those participants who had the highest increase in heart rate during the actual physical exercise had less 50% the risk of death compared with the men whose heart rate increased the least. The highest incidence of death due to a cardiac event occurred among the participants who increased their heart rate the most during mild mental stress and the least during exercise. There were none reported among those whose heart rate increased the least during mild mental stress and the most during the exercise test.

The authors think that the mechanism behind this effect lies with interaction between the autonomic (ANS) and sympathetic nervous systems (SNS). Vagus nerves are an important part of the ANS which controls the body’s autonomic functions including the heart beat. The SNS is responsible for increasing the heart rate and the dilation of blood vessels in the voluntary muscles and constriction of blood vessels in the skin and intestines during physical exercise.

According to lead researcher Professor Xavier Jouven

“There is a balance between the accelerator (sympathetic activation) and the brake (vagal activation). If vagal withdrawal occurs it is like releasing the brake. During an ischaemic episode, when blood flow to the heart is reduced, sympathetic activation occurs to counteract it. However, if there is no protection by the vagal tone (the brake), the activation can become uncontrolled and then it becomes dangerous. Our underlying assumption, which this study appears to have proved correct, is that the faster the vagal withdrawal in response to mental stress, the greater will be – during an ischaemic episode – the damaging effect of sympathetic activation unopposed by vagal activity.”

Heart attacks or myocardial infarctions are a major health problem in many developing countries. The US alone reports between 200,000 to 400,000 deaths due to heart attack each year. In 27 European countries, the mortality count is 486,000.

This method of predicting who is susceptible and who is not is easy, cheap, and non-invasive. However, it has only been tested for men. It still remains to be seen whether the same pulse rate readings can be a predictor of heart attack in women.

Preeclampsia may not just be a temporary pregnancy complication

February 25, 2009 by  
Filed under HEART AND STROKE

Preeclampsia belongs to a group of hypertensive disorders of pregnancy. Other related disorders are pregnancy-induced hypertension and toxaemia. These conditions can cause life-threatening pregnancy complications that endanger both the mother and the baby.

The conditions are all characterized by elevated blood pressure during the second half of pregnancy but in addition, preeclampsia is characterized by increased concentrations of proteins in the urine.

About 10% of pregnancies are affected by pregnancy-induced hypertension while preeclampsia affects 5 to8% of pregnancies. Preeclampsia is common in low-income countries, where it occurs in about 1 out of every 100 up to 1 out of 700 pregnancies. In contrast, it estimated to occur in about 1 in 1000 pregnancies (Source: Clinical Evidence BMJ).

Aside from high blood pressure, symptoms of preeclampsia also include “swelling, sudden weight gain, headaches and changes in vision“.

It has always been thought that once the baby is delivered, the condition of preeclampsia is resolved. Apparently not, according to this joint research by American and Danish researchers. The effects of preeclampsia may actually track through life and brings with it increased risk for future cardiovascular problems including hypertension, diabetes and blood clots. And the risks increase with every pregnancy.

According to lead author Dr. Michael J. Paidas, director of the Program for Thrombosis and Hemostasis in Women’s Health in the Department of Obstetrics, Gynecology & Reproductive Science at Yale University:

The only reliable treatment for preeclampsia is delivery of the baby. But while delivery may ‘cure’ preeclampsia in the moment, these mothers are at high risk of chronic hypertension, type 2 diabetes mellitus and blood clots for the rest of their lives.

There is therefore a great need to prevent preeclampsia not only to prevent complications that threaten both mother and baby, but also to prevent long-term health problems.

According to MayoClinic, preeclampsia may be caused by the following:

  • Insufficient blood flow to the uterus
  • Damage to the blood vessels
  • A problem with the immune system
  • Poor diet

The risk factors for the condition are

  • First pregnancy
  • Preeclampsia in a previous pregnancy
  • Maternal age above 35
  • Pregnancy with multiples
  • Obesity
  • Gestational diabetes
  • Family of history preeclampsia
  • Underlying medical conditions before pregnancy such as cardiovascular disease, diabetes, or kidney disorder.

Aside from medical management, lifestyle changes can also help prevent or manage preeclampsia. Previous studies, for example, indicate that preeclampsia can be prevented by exercise and intake of dietary fiber.

Synthetic HDL has potential to control cholesterol levels

February 10, 2009 by  
Filed under HEART AND STROKE

Two main types of cholesterol are found in our body, the low density lipoprotein (LDL) and the high density lipoprotein (HDL) cholesterol. LDL is considered to be the “bad” cholesterol and should therefore be kept low whereas HDL is the “good” cholesterol whose high levels bring some positive effects. High levels of LDL cholesterol results in a condition called hyperlipidemia and can cause cardiovascular disorders.

Researchers at the Northwestern University have just created a synthetic HDL, a molecule very similar to the naturally occurring HDL, from its molecular size to its surface composition.

“We have designed and built a cholesterol sponge. The synthetic HDL features the basics of what a great cholesterol drug should be,” according to researcher Prof Chad A. Mirkin of the Northwestern School of Medicine.

The synthetic HDL was synthesized in the lab with two lipid layers covered by the main component of natural HDL – the APOA1 protein and a gold nanoparticle in its core.

According to Dr. Shad Thaxton, another researcher in the team

“Cholesterol is essential to our cells, but chronic excess can lead to dangerous plaque formation in our arteries. HDL transports cholesterol to the liver, which protects against atherosclerosis. Our hope is that, with further development, our synthetic form of HDL could be used to increase HDL levels and promote better health.

Currently available anti-cholesterol drugs such as statins are effective in lowering LDL cholesterol levels but can’t increase the HDL levels. The sponge-like synthetic HDL is supposed to be able “sop up” the bad lipoproteins, thereby, lowering LDL while increasing HDL at the same time. It is hope that the future of hyperlipidemia management lies in this new molecule.

High LDL cholesterol levels and low HDL levels are risk factors for coronary heart disease and stroke. The risk profiles based on LDL, HDL and total (LDL + HDL) cholesterol levels are as follows:

  • High LDL cholesterol values above 130 mg/dL indicate increased risk.
  • HDL values below 40 mg/dL indicate increased risk.
  • A total cholesterol level of <200 mg/dL reflects a low risk for cardiovascular disease.
  • A total cholesterol level of 200 to 240 mg/dL indicates moderate/borderline risk.
  • A total cholesterol above 240 mg/dL is considered to be high risk.

It will take another while till the effectiveness and safety of the synthetic HDL can be tested and proven. In the meantime, the American Heart Association (AHA) recommends the following ways in keeping your cholesterol levels under control:

Photo credit: Stock.Xchng

Antioxidant supplements: do they work?

December 16, 2008 by  
Filed under HEART AND STROKE

Resource post for December

In an era when people are becoming more and more health-conscious, vitamin pills are becoming more and more popular. Millions of people are swallowing vitamin supplement pills everyday, believing that these medications are beneficial to their health, especially their hearts. These supplements range from vitamin cocktails to omega-3’s to antioxidants. These “power pills” or “health supplements” are supposed to keep our body strong and healthy and prevent a wide range of diseases, from heart disease to high blood pressure, from aging to cancer.

In this resource post, I am reviewing the recent updates on vitamin and antioxidant supplementation and answer the question: Do we really need them?

Vitamin supplements

A 2007 meta-analysis by Bjelakovic and colleagues on vitamin supplements came up with surprising results: not only are the benefits of antioxidants suspect, they can actually increase overall mortality. A group of researchers analysed data from clinical trials which used supplementation of the antioxidants vitamin A, vitamin E, beta-carotene, vitamin C and selenium used as stand-alone supplements or in combination in people with a variety of health conditions. The results showed that most of these vitamins actually do not have a discernable health benefits to those who took them. Furthermore, vitamins A and E and beta-carotene (but not Vitamin C) and selenium can actually result in increased mortality.

Based on their results, Bjelakovic and colleagues discourages the use of synthetic vitamin supplements. Instead, we should go for the natural sources of these vitamins – fresh fruits, vegetables and nuts.

Antioxidant supplements

In a more recent review paper, the same researchers evaluated several clinical trials involving over 200,000 people which compared the efficacy of antioxidant supplements versus placebo in the primary and secondary prevention of cardiovascular gastrointestinal, neurological, ocular, dermatological, rheumatoid, renal, and endocrinological disorders

The authors reported that:

We found no evidence to support antioxidant supplements for primary or secondary prevention. Vitamin A, beta-carotene, and vitamin E may increase mortality. Future randomised trials could evaluate the potential effects of vitamin C and selenium for primary and secondary prevention. Such trials should be closely monitored for potential harmful effects. Antioxidant supplements need to be considered medicinal products and should undergo sufficient evaluation before marketing.

Folic acid and vitamin B

It has always been a popular belief that folic acid and vitamin B can protect us from the monsters which are heart disease and stroke by reducing the levels of the amino acid homocysteine in the blood. Homocysteine is believed to be a biomarker for cardiovascular diseases. Unfortunately, the results of this long-term trial seem to cast doubts on the homocysteine theory.

The trial included more than 5,400 U.S. women who were health professionals. Some had a history of cardiovascular disease, and others had three or more coronary risk factors, such as high blood pressure, obesity or diabetes. Half of the women took a daily combination pill containing 2.5 milligrams of folic acid, 50 milligrams of vitamin B6, and 1 milligram of vitamin B12, while the other half took a placebo.”

These women were “blinded” – that means they didn´t know whether they were taking vitamins or placebo – and followed-up for more than 7 years. The results of the trial were a bit disappointing. 14.9% of those who took the vitamin pills had at least 1 cardiovascular event, such as a heart attack or stroke. 14.3% of those who were given placebo also had at least 1 cardiovascular event within the same period of time. The difference between the 2 groups was not significant.

The study results had important implications, namely:

  • The homocysteine – cardiovascular link needs to be re-examined; homocysteine may not be an appropriate biomarker for cardiovascular disease.
  • Taking folic acid does not prevent cardiovascular disease.
  • Flour in the US and some other countries is fortified with folic acid. Additional supplementation is not necessary except for pregnant women.

Pregnant women are routinely advised to take folic acid supplement to prevent birth defects that can affect the baby´s nervous system, leading to the condition of spina bifida. Natural sources of folic acid are green leafy vegetables and citrus fruits.

Vitamin D and calcium

This trial evaluated the effects of vitamin D and calcium supplements on blood pressure and hypertension risk of healthy women. The study involved 36,252 postmenopausal women who were followed up for about 7 years. The results show that

“the precision of this study excludes a BP-lowering effect of calcium supplementation of clinical or public health importance…[the analysis] “is strongly suggestive of an absent relationship between vitamin D intake and hypertension”

Selenium and Vitamin E

A more recent development comes from the large-scale study called SELECT (Selenium and Vitamin E Cancer Prevention Trial) which assessed whether selenium and vitamin E supplements can prevent prostate cancer as suggested by earlier studies. Recently, about 5 years into the study, the National Cancer Institute (NCI) decided to stop the study due to lack of preventive effects as well as”concerning” findings that showed a slight increase risk of developing prostate cancer among those who took vitamin E and diabetes among those who took selenium. Even though the “slight increased risks” observed in this study of 35,000 healthy men were not statistically significant, they are risks that couldn’t be ignored.

What the experts have to say

The American College of Cardiology and American Heart Association (AHA) do not recommend the use of antioxidant supplements as specified in 2002 Guideline Update in for the management of chronic angina. In 2005, the AHA science advisory board issued that statement that “scientific data do not justify the use of antioxidant vitamin supplements” in the prevention of cardiovascular diseases.

“… in agreement with many in the field, we conclude that the existing scientific database does not justify routine use of antioxidant supplements for the prevention and treatment of CVD.25-28,29 This conclusion is consistent with theAmerican College of Cardiology/American Heart Association 2002 Guideline Update for the management of patients with chronic stable angina, which states that there is no basis for recommending that patients take vitamin C or E supplements or other antioxidants for the express purpose of preventing or treating coronary artery disease…”

Conclusion

Vitamins and minerals are essential for our health. But we have to be careful about our sources of essential nutrients. In spite of all the claims of these supplements, they are no substitute to the natural fresh fruits, vegetables, and nuts as well as a healthy lifestyle.

 

Photo credit: stock.xchng

Resource article for July: Alcohol and CVD Part I

July 22, 2008 by  
Filed under HEART AND STROKE

Part I: The Health Benefits of Alcohol – “Eat, drink and be healthy”

Drinking alcohol has been linked to a wide range of health effects, ranging from the very good to the very bad. A post in June reported on the adverse effects of heavy drinking on cardiovascular health. On the other hand, light to moderate drinking has been shown to have long lasting beneficial effects. The only problem is how to determine the boundary between healthy and unhealthy alcohol consumption. Some researchers are concerned that recent reports about the health benefits of alcohol may mislead people to drink more than they should, thereby doing more harm than good to their health.

The next series of resource posts will be dedicated to the link between alcohol consumption and cardiovascular disorders. In the first 2 posts, I will review recent studies on the pros and cons of alcohol consumption. This first part concentrates on the pros.

 What are the health benefits of alcohol?

Light-to-moderate alcohol drinking has been linked to increased levels of good cholesterol HDL and lower risk for coronary heart disease (CHD). These protective effects seem to be stronger in men than in women and in people living in the Mediterranean region. Light-to-moderate drinking leads to increase in HDL cholesterol whereas heavy drinking has been linked to increased LDL cholesterol.

 How do we define light-to-moderate alcohol intake?

In one research, 20 g or less of alcohol per day seems to be a good amount but increasing this can reverse the effect. However, first time or occasional drinkers should be very careful because even low amounts of alcohol can have a string impact on their health [1].

Danish researchers defined moderate alcohol intake as 1 to 14 units of alcohol a week. 1 unit of alcohol is equivalent to half a pint of beer with normal strength, or half of a glass of wine, or a single shot of a spirit [2].

In another study however, researchers report that 1 glass of red wine might be the threshold between good and bad. After a drinking a second glass, the heart rates of the study participants increased and the heart started to pump more blood that needed [3].

Still another study reports that 2 drinks are too much and can increase a woman’s risk of having breast cancer by 10% [4].

So how does alcohol protect us from CHD?

The mechanisms behind this protection are not so clear. It seems that it is not only alcohol but also other substances in wine and other alcoholic drinks which can reduce plaque deposits in the arteries, helps prevents blood clot formation and increases the concentrations of good (HDL) cholesterol in the blood. Some of these compounds [5] are:

  • Resveratrol is supposed to have anti-cancer and anti-inflammatory properties
  • Melatonin is a strong antioxidant that can counteract oxidative stress and inflammation
  • Flavonoids are strong antioxidants found in many fruit and vegetables.

 Which type of alcoholic beverage is best?

Wine has always been the choice for healthy drinking. It is not the alcohol that gives the protective effect but other substances found in wine. And it also depends on the type of wine. In this study, French wines were found to be better for the heart than German wine. French wines are rich in flavonoids, polyphenols and phytoalexins and have the potential to protect against atherosclerosis. Red wine seems to be richer in resveratol than white wine. The red grape skin produces resveratrol during the fermentation process. The reason why some wines are healthier that others is because of the type of soil where the grapes are grown, not where the wine mature in [5].

Some studies have shown that beer can also have some beneficial effects. In Bavaria (Germany) and the Czech Republic where beer is preferred over wine, moderate beer consumption have shown some protective effects similar to those observed in the Mediterannean region [6].

 Alcohol and food

Drinking alcohol on an empty stomach is a no-no – alcohol is best taken with food. In this study of 2609 white adult New Yorkers, drinking alchohol outside meals, regardless of the amount or the type consumed was found to have a significant effect on hypertension risk. Light to moderate drinking with meals, however, can lower blood pressure, positively affect blood lipids and dissolved blood clots [7].

 A little bit of alcohol goes well with exercise

A study by Danish researchers show than combining exercise with alcohol may actually prolong your life. They studied11,914 men and women, their lifestyle and alcohol consumption for almost 20 years [2]. Their results show that

  • Non-drinking couch potatoes have the highest risk of having heart problems – 49% higher than the others.
  • The physically active teetotalers have about 33% lower risk than those leading sedentary lifestyles.
  • The physical active moderate drinkers have almost 50% lower risk than those leading sedentary lifestyles.
  • Among those who are active and doing similar amounts of exercise, the moderate drinkers won hands down, having 30% less likelihood to have heart disease than their non-drinking counterparts.

 Now, this review of several studies indicates that alcohol indeed has some health benefits. But before you reach for that bottle, take note that the definition of light-to-moderate drinking is not so clear, and that the protective benefits of alcohol depends on many factors including gender, diet, and the type of drink. And that is not all. In the second part of this series, I’ll be telling you about the dangerous side of alcohol. Stay tuned!

 Sources:

Know your diagnostic tools: coronary calcium scan

July 10, 2008 by  
Filed under HEART AND STROKE

What is a coronary calcium scan?

A coronary calcium scan is a diagnostic tool that looks for the calcium deposits in the walls arteries of the heart.

Why calcium?

Calcium can accumulate on the walls of the arteries leading to calcification. In addition to fatty deposits, calcification is a major component in the formation of plaques in the arteries. These calcifications can lead to obstruction of blood vessels which causes heart attacks, strokes and other cardiovascular disorders.

Who needs the scan?

According to the National Heart Lung and Blood Institute (NHLBI)

A coronary calcium scan is most useful for people who are at moderate risk for a heart attack. … People at moderate risk have a 10 to 20 percent chance of having a heart attack within the next 10 years. The coronary calcium scan may help doctors decide who within this group needs treatment.”

How does a calcium scan work?

According to NHLBI, 2 machines can be used to perform calcium scan – the electron beam computed tomography (EBCT) and multidetector computed tomography (MDCT). Both these machines are attached to an x-ray machine to make detailed pictures of your heart. From the pictures, doctors can discern calcifications in the coronary arteries and determine your risk for heart problems in the next 2 to 10 years. The patient must lie quietly for 10 minutes in the scanner machine. Otherwise, the procedure is safe, easy, and pain-free.

Any recent research on calcium scans?

A recent article published in the July issue of Journal of the American College of Cardiology reported that coronary calcium scans can predict the likelihood of heart attacks, even in older adults.

“Researchers studied 35,383 adults, aged 40 to 80, in Torrance, CA and Nashville, TN, for an average of 5.8 years after having a coronary artery calcium scan. Among these research volunteers, 3,570 were age 70 or older. In total, 838 deaths were recorded, 320 in women and 518 in men. The study found the overall death risk was higher among those with higher coronary arterial calcium scores.”

Previous studies showed that calcium scans can predict overall death risk in young adults, those with diabetes, those suffering from renal failure, and smokers. This study shows that the scan is effective in measuring overall death risk in the elderly as well.

Calcium scans may currently be the best diagnostic tool that can predict the likelihood of  a heart attack. Knowing the overall death risk of a patient is important. Patients and their doctors can decide on prevention measures that can lower the risk, including diet, medications, interventions, exercise and other lifestyle changes.

Photo credit

How earthquakes can affect your heart and your health

May 20, 2008 by  
Filed under HEART AND STROKE

In the wake of last week’s catastrophic earthquake in China, we can only imagine the trauma that the victims and their families went through – trauma that will probably stay with them for the rest of their lives. With such  trauma comes psychological stress and with increased stress comes elevated cardiovascular risk.

Several research studies have investigated the effect of acute stressors such as catastrophes and natural disasters on the cardiovascular well-being of the victims and people in the vicinity. A review article by Dr. JE Dimsdale of the University of California at San Diego shows that many of these studies observed an increased cardiovascular risk after earthquakes.

Several specific studies were conducted in conjunction with specific incidents, as follows:

In 1994, on the day of the Northridge, California earthquake, the numbers of deaths due to cardiovascular events was significantly higher compared to the same date in previous years.

During the Hanshin-Awaji earthquake in Japan in 1995, the blood pressure of many patients increased, and didn’t lower at night time as blood pressure normal does – the so-called the nocturnal “dip” in blood pressure.

Another study coincided with the 1999 earthquake in Taiwan. Twelve patients were at that time being routinely studied with Holter monitoring. Results of the Holter monitor were examined and showed dramatic differences between the readings minutes before and minutes after the earthquake. There were pronounced increases in heart rate at the time of the quake of up to 160 beats per minute. However, it’s not only the heart rate that changed abruptly.

“Perhaps more interesting was the observation that the HR variability itself changed, with a relative drop in high-frequency variability and an increase in the low-frequency/high-frequency ratio, denoting relative withdrawal of parasympathetic nervous system activity and an increase in sympathetic nervous system (SNS) activity. These changes were attenuated in patients who were receiving beta-blockers.”

In 2004, Japan was again hit, this time in the Central Nigata area. In total, 3 strong earthquakes and 90 after-shocks occurred in a period of 1 week. During this period, a dramatic increase in incidence of pulmonary embolism was observed.

The underlying mechanism for [the increased cardiovascular] risk is unclear. Given the emergency conditions surrounding a massive earthquake, it is difficult to conduct fine-grained experimental or epidemiologic studies. Thus, it is not known how much of the risk is conveyed by the emotional trauma acting alone versus factors like forgetting to take routine medications, living in cramped emergency quarters, facing disrupted sleep, and so on. Given the chaos surrounding massive disasters, it is unlikely that such data would ever be gathered.”

 The moral lesson of these stories is that acute stressors – which can come in many different forms, including earthquakes – affect our health almost immediately. This knowledge can help us and our doctors in the control and management of cardiovascular events during stressful times.

Source:

Dimsdale, J E. Psychological Stress and Cardiovascular Disease. Journal of the American College of Cardiology. Medscape 6 May 2008

Health Advantages and Risks of Dieting

May 15, 2008 by  
Filed under OBESITY

Nearly everyone thinks that dieting would be a good idea. For many, it is. A recent study showed that the average American now consumes about 22% more calories than those of only a generation ago. With that, it isn’t hard to see why obesity could be a problem.

But dieting is not without risks, especially in an age when so many fad diets clamor for attention. The desire to lose weight rapidly can lead to health problems that outweigh the benefits of dieting. Rapid weight-loss dieting in particular can lead to a ‘rebound’, defeating the purpose in the first place.

* First, what do we mean by ‘diet’ in this context?

No matter what specific weight loss plan one chooses, the basic equation of weight loss can not be eliminated: more calories consumed than burned equals weight gain as the body stores the excess in fat. Conversely, more calories used than taken in leads to weight loss, over the long run.

In a resting state, we burn about 70 calories per hour. In a vigorous hour-long hike we burn about 440 calories. A brisk walk for an hour will use up about 240 calories, jogging nearly 600. But balance that against the average 2,000 calorie per day diet. That shows it can be very difficult to lose weight solely by exercise.

On the other hand, reducing caloric intake means reducing the amount of certain foods and drinks. It may mean an apple rather than a candy bar. It might mean fruit juice instead of that high-calorie cappuccino. The cravings that typically accompany dieting can be hard to quell.

* Second, dieting has to be done right to be beneficial. It requires the right weight loss plan.

Too-rapid weight loss from drastic diets leads to a ‘rebound’ effect. All too many dieters know the frustration of seeing hard-to-shed pounds return a few months or a year later. It tends to encourage subsequent overeating as the dieter is motivated to just give up.

Dieting by foregoing needed nutrients presents even more of a health risk. We need a certain amount of unsaturated fats daily to have proper nerve function and hormone balance. Carbohydrates are the body’s basic energy source, which is used to power everything we do from simple movements to life-preserving cellular reactions. Sodium and potassium are vital to proper heart and nerve function.

But there are definite health advantages for an individual who commits to a healthy diet and weight loss plan.

Obesity is a factor in the development of diabetes. It increases the odds of coronary heart disease. It increases stress on bones. It often plays a role in depression. All these are serious health issues and dieting is one of the best ways to combat obesity.

It isn’t mere vanity to want an attractive body, either. An attractive body is one that is fit. That leads to ample energy to carry out whatever goals one wants to pursue. Lack of energy makes it much harder to motivate oneself to complete challenging tasks.

There’s nothing wrong with wanting an attractive form for psychological or social purposes either. Humans are social. It’s appropriate to take pride in having achieved a certain body type, within the limits of what is possible to each of us. It presents an image of self-regard and that psychological self-assessment is a significant factor in basic health.

Done well, taken up as a long-term lifestyle strategy and not as a quick fix, dieting is healthy.

Skin Cancer: The Naked Truth

May 7, 2008 by  
Filed under CANCER

May is Skin Cancer Awareness Month.

Skin Cancer includes

  • Basal Cell Carcinoma
  • Squamous Cell Carcinoma
  • Melanoma

Last month Battling Cancer covered Melanoma in an exclusive post you can find in the archives.

The National Cancer Institute estimates there will be more than 1,000,000 newly diagnosed cases of non melanoma skin cancers in the U.S. in 2008 and less than 1,000 deaths.

Defining the other skin cancers:

Basal Cell Carcinoma is the most common type of skin cancer and most easily treated and begins in the basal level of the skin or epidermis. This cancer grows slowly and rarely spreads, unless left untreated. It is not uncommon for it to recur in the same spot. Per the Mayo Clinic, it usually appears this way:

  • pearly or waxy bump on your face, ears or neck
  • A flat, flesh-colored or brown scar-like lesion on your chest or back

Squamous Cell Carcinoma occurs upper level of the epidermis and may spread to the fatty tissue and to the lymph nodes if left untreated. The first stage of squamous cell carcinoma may be a precancerous lesion called actinic keratosis. Per The May Clinic it usually appears this way:

  • A firm, red nodule on your face, lips, ears, neck, hands or arms
  • A flat lesion with a scaly, crusted surface on your face, ears, neck, hands or arms

Risk Factors for non Melanoma Skin Cancer:

  • UV light exposure-natural and artificial and a history of severe sunburns
  • Fair Skin-occurs more often in people with fair skin, freckles and light hair
  • Immune Suppression-a weakened immune system due to other factors
  • Sex-Men have a higher incidence
  • History of skin cancer
  • Chemicals-exposure to arsenic, tar, coal, and paraffin
  • Exposure to radiation
  • HPV infection
  • Smoking
  • History of skin diseases that impair the ability of the skin to repair or increases risks of sunburn
  • Rare condition called Basal Cell Nevus Syndrome

Prevention includes knowing your UV index and regulation of sun exposure, using sunscreen, protective clothing and avoiding tanning beds, and chemicals related to risk.

The Environmental Protection Agency, (EPA) provides an easy website, as part of their SunWise Program to determine the UV index for your area of the U.S. so you can take preventative measures to regulate your exposure.

Cancer Research UK, provides links to the UV index for different parts of the UK and Europe.

Diagnosis and Treatment:

Early detection is the key and this involves regular physical exams to assess your skin. Diagnosis will determine if skin cancer is local or metastasized and will stage the cancer. This is done by biopsy.

Treatment options may include:

  • chemotherapy-may include a topical cream
  • radiation
  • cryosurgery-freezing the cells and removing them
  • excision-cutting out the cancer
  • laser therapy-utilizing a beam of light to vaporize the cancer cells.
  • curettage and electrodesiccation-scraping cancer cells with a blade and using a needle
  • Mohs surgery-done by a specialist usually for recurring or larger skin cancer. A doctor removes the cancer cells layer by layer

Further Resources:

The Skin Cancer Connection . com offers an informative article on topical skin cancer treatments.

Skin Cancer Basics from M.D. Anderson


May Skin Cancer Events:

As part of May, Skin Cancer Awareness Month, The American Society for Dermatologic Surgery and Olay has teamed up to offer free screenings with a dermatologic surgeon for you and a friend. The initiative, Skin Cancer Takes Friends can be seen in magazine ads (such as MORE magazine), and features actress Marcia Cross. For more details see the website.

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The Skin Cancer Foundation Road to a Healthy Skin Tour may be in your neighborhood soon. The customized Winnebago starts off at the Today Show in NYC on May 2 and then heads across the U.S. giving free skin exams provided by local board certified dermatologists. The tour is sponsored by Aveeno, Rite Aid and Columbia Sportswear. Check the site to see the tour dates and locations.

Battling Books:

The Eggplant Cancer Cure: A Treatment for Skin Cancer and New Hope for Other Cancers from Nature's PharmacyThe Eggplant Cancer Cure: A Treatment for Skin Cancer, and New Hope for Other Cancers From Nature’s Pharmacy by Bill Cham (2008)

Skin Cancer by Robert A. Schwartz (2008)

Skin Cancer by Keyvan Nouri (2007)

100 Questions & Answers about Melanoma & Other Skin Cancers by Edward F. McClay, Mary-Eileen T. McClay, and Jodie Smith (2004)

The M Word

April 17, 2008 by  
Filed under CANCER

Melanoma

A type of cancer that forms in the melanocyte cells, which are the cells that form the melanin or pigment of the skin. Melanoma is less common than other skin cancers, but is the most serious type of skin cancer. Like other skin cancers, it is often curable in the early stages. It can occur anywhere on the skin, but most likely occurs in the trunk of men and the legs of women. The face and neck are also common sites. Melanoma can spread to other parts of the body.

Risk Factors May Include:

  • UV light exposure-natural and artificial and a history of severe sunburns
  • Moles-excessive number of normal moles (over 50) and large number of atypical moles (dysplastic nevi)
  • Fair Skin-occurs more often in people with fair skin, freckles and light hair
  • Family History-10% of all people diagnosed have a family history
  • Immune Suppression-a weakened immune system due to other factors
  • Age-the most common cancer in people younger than 30, but more likely to occur in older populations
  • Sex-Men have a higher incidence
  • History of Melanoma-people who have had melanoma are at greater risk for a second diagnosis
  • Xeroderma Pigmentosum-a rare inherited genetic condition that prevents the skin from repairing

For more information on risk factors see the American Cancer Society site.

Read more

Schizophrenia Diseases

March 24, 2008 by  
Filed under SCHIZOPHRENIA

By Robin Kumar Lim

Schizophrenia (literally “split mind”) is often thought of as a split or dual personality. However, this disease is best defined as a disorganization of normal thought and feeling. It is probably caused by the malfunctioning of the cells through which information flows within the brain. Symptoms usually appear in late adolescence or early adulthood, and extreme mental stress almost always triggers them. The illness is lifelong, but acute attacks tend to come and go, and usually occur at times of emotional upheaval or personal loss.

What are The Symptoms?

Some popular novels, plays and movies have encouraged us to think of schizophrenia in extremely narrow and dramatic terms. Schizophrenia has been presented quite often in terms of the split personality, two seemingly individual and separate people living within the same body.

For most people with schizophrenia, an attack begins with a gradual, or occasionally sudden, withdrawal from day-to-day activities. The person’s speech may become increasingly vague, and he or she may seem to be unable to follow a simple conversation. An acute attack happens unexpectedly. Often the onset is so gradual that it is difficult to know when psychotic symptoms appear. Among such symptoms are apparently disconnected remarks, along with blank looks, that are followed by sudden statements that seem to spring into the speaker’s mind.

Schizophrenics often believe that others hear and “steal” their thoughts. Sometimes they fear they have lost control of bodily movement as well as thought, as if they were puppets. They frequently believe they hear voices, often hostile ones. Less commonly, they have hallucinations of odd physical sensations, of being given poison, or otherwise being attacked by others. In time many schizophrenics build up a set of beliefs in a fantasy world. They may express exaggerated feelings of happiness, bewilderment, or despair. They may laugh at a sad moment or cry without cause. Or they may seem devoid of feeling, so that it becomes almost impossible to make emotional contact with them.

There are several types of schizophrenia that are characterized by the predominant symptoms, but the only practical distinction that most doctors now make is between the paranoid and other types. The main symptom of a person with paranoid schizophrenia is constant suspicion and resentment, accompanied by fear that people are hostile or even plotting to destroy him or her.

What are The Risks?

Most young and middle-aged patients in mental hospitals are there because they are schizophrenic. About 1 person in 1000 has been treated for the disorder. Men and women are equally susceptible. Paranoid schizophrenia is most common in early adulthood (late 20’s through 30’s).

The abnormality of brain chemistry that underlies schizophrenia can be inherited, but if it runs in your family, you will not necessarily have schizophrenic attacks. You may, however, have either a “schizoid personality” (a tendency towards extreme shyness and withdrawal) or a “paranoid personality” (a tendency towards over-sensitivity and distrustfulness) .

People who have attacks of schizophrenia in its most severe forms may physically harm themselves or others, or may try to commit suicide .

What Should be Done?

If you suspect that someone in your family is schizophrenic, try to get them to see a physician. It may not be easy. People who are becoming mentally ill often refuse to admit it. Even those who realize that something is wrong have a fear of being “put away.” But medical care is vital. Do not leave a person who seems extremely disturbed alone. The presence of a relative or friend to reassure them, or even keep them from hurting themselves until help arrives, may be essential. People with symptoms similar to those of schizophrenia are usually admitted to a hospital for a preliminary period of observation. During this time tests are carried out to make sure these symptoms are not due to a physical illness such as a brain tumor.

What is Treatment?

Severe cases must be treated in a hospital. Treatment usually involves the use of drugs, psychotherapy and rehabilitation.

The most effective drugs are regular doses of special tranquilizers designed to modify abnormal brain chemistry. As symptoms gradually disappear, doses are reduced, and all medication may be discontinued when the acute attack ends. Some people, however, need long-term medication. They may either take pills regularly or be given an injection every two to four weeks. Occasionally antidepressant drugs are also prescribed . In rare cases electroshock therapy (EST) may be recommended.

Techniques of psychotherapy vary, but the goal is the same: to help the patient understand the stresses that contributed to the current attack. This can help the person learn how to prevent future stresses from leading to further illness.

The final stage of treatment is rehabilitation, which helps people who are recovering from attacks to regain normal skills and behavior patterns. In the early stages of hospital treatment schizophrenics are generally given occupational therapy. As their condition improves, they are given increasingly complex tasks and pressures, and these eventually approximate the tasks and pressures of the world outside. Once the acute phase of the illness is over, the schizophrenic prepares for a return to the outside world by making periodic visits from hospital to home or to a half-way house.

What are The Long-Term Prospects?

Many people recover from an attack of schizophrenia well enough to return to a relatively normal life. But they may have further attacks. In some people the condition becomes chronic. Such a person will always be withdrawn and emotionally unresponsive, but they generally avoid severe attacks of the disorder with the aid of constant medication.

Author has an experience of more than 4 years writing about diseases and conditions He also holds experience writing about diseases treatment and diseases causes

Article Source: EzineArticles.com/?expert=Robin_Kumar_Lim

Smoking Marijuana And The Risks Of Schizophrenia

November 19, 2007 by  
Filed under SCHIZOPHRENIA

By Christian Shire

Only a philosopher could discover that the human being is completely absurd since this fact means that humanity is totally crazy. A psychiatrist could not come to that conclusion without being considered crazy.

Only a poet could listen to the inner voice of the unconscious wisdom, recognize her ignorance and feel how horrible it is to live in a place where everyone is crazy.

The cure of schizophrenia and psychosis is the total and absolute respect to the moral principles of goodness. A schizophrenic is someone who is completely dominated by the wild side of his or her conscience.

In case the patient is a murderer, one must learn how to forgive oneself, which is usually impossible to achieve since no one can forgive one’s own faults when they have caused despair and misery.

Schizophrenia is a very serious mental and psychic disease that cannot be cured because the wild side has completely dominated the human conscience. There is no human personality in the psychic sphere. This is why schizophrenics cannot recuperate their human conscience once they lose it.

However, they can learn the meaning of their actions and can regain their humanity if they are willing to endure suffering. Suffering is medicine when it gives the patient the necessary conditions that help one become sensitive.

In case schizophrenic patients are victims of other people’s cruelty, they must learn how to forgive their enemies, which is impossible because their enemies hurt them too much.

Schizophrenia is the result of human craziness, the massive craziness that governs our world, a world where terror, violence, immorality, hypocrisy, poverty and indifference coexist. This is the insane world of the crazy human being!

Psychosis is also the result of the same global insanity…

In fact, schizophrenic and psychotic patients are the biggest victims of violence and indifference.

However, they can regain their mental, psychological and emotional health through dream interpretation, even though the process is very difficult and time-consuming. Everything is difficult when we have to deal with diseases as terrible as schizophrenia and psychosis.

Time and many efforts are required, but the patients can be cured!

This is a miracle!

We can cure these horrible diseases and save the people who are affected by them today, but we must surely focus on craziness prevention from now on!

We must put an end to all the horrors of our lives, so that schizophrenia and psychosis ceases to exist in our population.

Massive psychotherapy is indispensable for humanity if we wish to save the human race and our own planet, since we have almost destroyed all the natural sources, and created an imbalance in the nature of Earth.

Unconditional and unrestricted peace, truth, wisdom, patience, piety and goodness are the cures for schizophrenia and psychosis.

Only when we become organized and everyone will be sensitive instead of being indifferent to the horrors they “don’t have the power to eliminate,” will humanity be characterized by psychological, mental and emotional health.

Prevent Depression and Craziness through the scientific method of Dream Interpretation discovered by Carl Jung and simplified by Christina Sponias, a writer who continued Jung’s research in the unknown region of the human psychic sphere.

Learn more at: www.booksirecommend.com

Article Source: EzineArticles.com/?expert=Christina_Sponias

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.