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MILK AND HEART DISEASE:
NEW YORK (Reuters Health) - In older men, consuming more than 187 ml (about 250 ml is one glass) per day of milk may cut the risk of stroke and heart disease, according to a report in the June issue of the Journal of Epidemiology and Community Health.

This finding "challenges the belief that because milk drinking raises blood cholesterol level, it increases the risk of vascular disease," Dr. P. C. Elwood, from Llandough Hospital in Cardiff, UK, and colleagues note.

By accurately characterizing the usual diets of a representative sample of men, the study is said to add to the "already substantial body of evidence" that milk drinking is tied to a reduced risk of stroke and heart disease.

Involved were 665 men in South Wales who were between 45 and 59 years old when first evaluated from 1979 to 1983. After recording their weight and food intake for seven days, the subjects were followed for 20 years to assess the occurrence of cardiovascular events.

Men whose milk intake was at or above the median level (187 ml per day) were 48% less likely to experience an ischemic stroke and 12% less likely to have a heart disease event than men who drank lesser amounts. All cause mortality in these groups, however, was comparable.

The authors note that only a randomized trial is likely to fully characterize the association between milk intake and the risk of cardiovascular events. Nevertheless, they also point out that such a study might have to involve more than 20,000 subjects, a number of whom would be obliged to avoid milk for as long as 5 years.

J Epidemiol Community Health 2005;59:502-505.





STATINS PROTECT US FROM COLON CANCER:
In a case-control study, the use of statins for at least five years apparently halved the risk of developing colorectal cancer. The findings are published in The New England Journal of Medicine for May 26, but were reported last June at a medical convention. This is the report filed at the time:

NEW ORLEANS, June 7, 2004 (Reuters Health) - In a population-based, case-control study conducted in Israel, statin use was associated with a 46% reduction in the risk of colorectal cancer (CRC) in adjusted analyses.

These findings, reported at the 40th annual meeting of the American Society of Clinical Oncology, support prior studies showing that HMG-CoA reductase inhibitors have antitumor effects.

At a briefing with reporters, Dr. Stephen B. Gruber of the University of Michigan said, "these observational data suggest that statins deserve further investigation in chemoprevention and therapeutic clinical trials."

The study involved 1849 Israeli colorectal cancer patients and 1959 healthy controls matched for age, gender, and ethnicity. Statin use, most often pravastatin or simvastatin, was more common in controls (11.3%) than in CRC cases (5.8%).

"In our study, use of statins for at least 5 years was associated with a 51% reduction in the risk of colorectal cancer, with an odds ratio of 0.49," Dr. Gruber reported. This association remained largely unchanged in analyses adjusting for age, hypercholesterolemia, ethnicity, aspirin or NSAID use, and APC mutations, with an odds ratio of 0.54.

The use of non-statin cholesterol-lowering agents, such as fibrates, was not associated with reduced risk of colorectal cancer, suggesting that the protective effect is specific to statins.

Mechanistic studies provide support for the antitumor effects of statins, Dr. Gruber said. "We know that statins inhibit RAS and RhoA, two proteins that are potentially carcinogenic," he said.

In the current New England Journal, two editorialists hope the study findings might move medicine beyond the "one drug, one disease" model. "It's tempting to think," they say, "that systemically targeting multiple diseases common to aging is not only theoretically feasible but within our reach."

N Engl J Med 2005;352:2184-2192.



POMEGRANATE JUICE AND PROSTATE CANCER:
Will pomegranate juice help prevent prostate cancer? Well, drinking 8 ounces per day of pomegranate juice significantly increases the PSA doubling time in men with recurrent prostate cancer, according to the results of a phase II study presented Monday at the annual meeting of the American Urological Association in San Antonio.

"The average PSA doubling time before the men began using pomegranate juice was 15 months," lead author Dr. Allan J. Pantuck, from the University of California at Los Angeles, told Reuters Health. "The average time after treatment was 37 months. So, there was almost a 2-year increase in the doubling time."

Pomegranate juice contains a number of antioxidants thought to have anti-cancer effects, Dr. Pantuck noted. In addition, the juice contains phytoestrogens that could be useful in combating prostate cancer, in particular.

Based on encouraging results in cell culture and in animal models of prostate cancer, Dr. Pantuck said his team decided to conduct a clinical trial of pomegranate juice in 48 men with rising PSA levels after surgery or radiotherapy for their malignancy. As noted, the subjects were instructed to consume 8 ounces of pomegranate juice daily.

The treatment was well tolerated and no serious adverse effects were seen, the report indicates. Moreover, none of the men developed metastatic disease during the study.

In addition to the increase in PSA doubling time, in vitro testing showed decreased cell proliferation and increased apoptosis. Urine testing confirmed the presence of pomegranate polyphenols in all men.

Given these promising findings, Dr. Pantuck noted that a multicenter phase III randomized trial is now in the works.

The study was funded by the Stewart and Lynda Resnick Trust, which own the POM Wonderful pomegranate juice company. None of the investigators disclosed any affiliations.


FOOD ALLERGIES:
The most common ones are:
Milk and milk products
Fish and Shellfish
Wheat and corn (corn syrup is found is many sugar products)
Chocolate and caffeine
Eggs, citrus, soy, and beef
Refined sugar
Food colorings and food chemicals such as citric acid (found in most sweets, soft drinks - which often contain benzoic acid also, fruit juices, tomatoes, and potatoes) and aspartic acid (found in the artificial sweetener aspartame – also called Nutrasweet or Equal)
The usual way to identify food allergies is by recording the history (as was mentioned earlier) and initiating an elimination diet followed by individual food challenges. The elimination diet involves not eating for 10 to 14 days the foods that by history (1) are eaten frequently, (2) craved, (3) make the patient feel better, and (4) are difficult for the patient to stop eating. On day 11 or 15, the patient begins to reintroduce into the diet every 2 or 3 days one of the foods that had been eliminated. The patient pays careful attention to how she or he feels during the 24 hours after beginning an elimination diet. As noted above, some of the common foods to which many people have adverse reactions include milk and milk products, wheat, corn, refined sugar, chocolate, caffeine, eggs, citrus, soy, beef, food colorings, and food chemicals.
Several blood tests are available that measure antibodies to individual food extracts. Measuring IgE antibody levels may be helpful for identifying classical food allergy reactions, except for some hidden or delayed food allergy problems.

TYLENOL:
Take TYLENOL with confidence as an alternative to these other drugs. These studies examined participants taking acetaminophen at 4000 mg/day, the maximum recommended dosage, and reported the following results — When acetaminophen 4000 mg/day was taken continuously for up to 12 months, participants showed no evidence of clinically important adverse events or changes in liver function. Acetaminophen showed comparable efficacy to Rx-strength Naproxen for OA hip and knee pain. Acetaminophen showed comparable efficacy to Celebrex 200 mg/day for OA knee pain. The safety and efficacy of acetaminophen have been established through 50 years of clinical use and scientific investigation.

STOOLS CARDS FOR BLOOD:
6-sample stool cards for blood had a specificity of 93.9% and a sensitivity of 23.9%. A single card from a rectal exam had a specificity of 97.5% and a sensitivity of only 4.9%. We cannot rely on this test to rule out colon cancers, but they still can pick up 24 percent of colon cancers this way.

METABOLIC SYNDROME:
The metabolic syndrome, which includes diabetes or prediabetes, abdominal obesity, unfavorable lipid profile and hypertension, triples the risk of myocardial infarction or stroke and doubles mortality from these conditions. It also increases the risk of developing type 2 diabetes, if not already present, fivefold. Recent data from Australia and the U.S. suggest that up to one quarter of the adult population may have the metabolic syndrome.
The new diagnostic criteria are central obesity, defined as waist equal to or more than 37 inches for males and 31.4 inches for females in Europids, and ethnic-specific levels in Chinese, Japanese and South Asians; together with two of the following: raised triglycerides of at least 150; low HDL-cholesterol, defined as less than 40 in males and less than 50 in females; raised blood pressure of at least 130/85 mm Hg; and fasting blood sugar, defined as glucose equal to or greater than 100 or previous diagnosis of diabetes or impaired glucose tolerance.
What does it mean to you to have "Metabolic Syndrome"?   It means twice the chance of a heart attack or stroke and three times the chance of dying from the heart attack or stroke.  It means five times the chance of Diabetes if you don't have Diabetes already.


LEAD:
The following products contained high levels of lead: Jamieson™, Natural Sources Calcium Magnesium contained 1.9 mcg of lead per daily serving. Weil™, Andrew Weil, M.D., Balanced Cal-Mag contained 2.3 mcg of lead per daily serving. Gummy Vites children”s vitamins contain lead. Also the following lipsticks contain lead: Christian Dior, Lancome, Clinique, YSL (highest amount of lead), Estee Lauder,Shiseido, Red Earth lip gloss, Chanel lip conditioner, Market America-Motnes lipstick.





DIABETES RISK
Know your future risk of diabetes and this web site: http://drs.dife.de/test/init/en. When asked to put your weight and height in centimeters, multiple your inches by 2.54
DIABETES AND STROKE:
A recent study called EPIC showed the chance of stroke 4 times as high in poorly controlled diabetics with an A1C value over 7.



 

.ANTIPHOSPHOLIPID SYNDROME
This is a difficult diagnosis to make. Patients can have heart attacks, strokes, recurrent miscarriages, venous or arterial clots, kidney failure from small vessel damage in the kidneys. It is an autoimmune disorder which involves coagulation and phospholipids. It can cause either too much clotting or too much bleeding. Of interest is that the brain can be targeted and early senility, seizures, and abnormal muscle movements can occur.

PRAVACHOL AND ASPIRIN:
Treatment with this combination reduces the risk of heart attack by 31% compared with aspirin alone and by 26% versus Pravachol alone. Also, there were significant risk reductions for stroke.

PRAVACHOL:
To lower cholesterol, this is the "statin" of choice now for patients on Plavix or Amiodarone because of new drug interactions found with Zocor and other "statins".

MILK:
There is absolutely no reason to worry that you can get Mad Cow disease from milk or cheese. It is not transmitted this way. Also, attempts to infect chickens or pigs with mad cow have failed.

SCIATICA:
Pain (dull, aching, or burning), tingling, or numbness down the back of the leg may be sciatica. Muscle weakness on the leg can occur. This condition is called sciatica, named after the sciatic nerve. It is fairly common and improves without treatment in a few days to six weeks. However, in up to 25 percent, the pain can be so severe that it interferes with daily activities and requires treatment. Sciatica is an inflammation or irritation of the sciatic nerve, which is the longest nerve in the body, beginning at the spinal cord in the lower back and extending through the buttock and down the legs to the heels. Usually, the pain is felt on only one side of the body. Sciatica can be caused by prolonged sitting in a recliner position, injury, infection, diabetes, arthritis, slipped disc or rarely tumors. When a disc protrudes, it can pinch the sciatic nerve. The pain is often worse at night or during sitting, coughing, or sneezing. The pain sometimes is only felt in the foot. Onset is most likely between age 30 and 50. Treat with 3 Advil or Aleve twice a day after meals. Take Prilosec (over-the-counter) one a day to protect the stomach from the Advil or Aleve. Apply heat, then cold, to the lower back. Hang (not upside down). Stand and arch your back with your belly button pouching forward. Call me promptly if the pain worsens or starts to interfere with daily activity, if weakness of the leg or trouble with bladder or bowel control occurs. Rarely surgery is necessary to fix the problem.

FISH OIL:
The Feb '03 Lancet medical journal says that long chain fatty acids in fish oil protect against cardiovascular disease several ways including an anti-inflammatory effect that stabilizes atherosclerotic plaques in the artery walls. In contrast, n-6 PUVA (polyunsaturated fatty acids) in vegetable oils produce inflammation and add to plaque instability. Plaque instability causes rupture and ulceration of the plaque which then produces a heart attack or stroke by suddenly closing down the artery. Therefore, we should avoid sunflower oil (linoleic acid), palm oil, and soybean oil, even flaxseed oil since they contain Omega 6 fatty acids and take fish oil or more cold water fish. Walnuts and walnut oil is very healthy for you.  Omega-3 fish oil can also lower triglycerides and very-low density lipoprotein.  They give some protection against dementia in published studies and provide some benefits in cystic fibrosis patients. To lower triglycerides, you would need a combined total of 2000 mgs of EPA and DHA taken daily.

FIBER:
Increasing fiber to 30 grams a day will prevent colon cancer. Previous reports contradicted this conclusion, but new studies confirm the benefit. It is hard to get 30 grams a day but it is worth the effort. Grape-nuts and Fiber One cereal seem to be the most palatable ways. One prune has five grams of fiber.

There are two main types of fiber to learn about:

Water-soluble fiber like apple pectin, Metamucil, beans, oat bran (not oatmeal as much) will lower cholesterol by 6% and often slow down the activity in the small bowel aiding irritable bowel patients. Metamucil, because of this, can be constipating in some patients even though it is labeled as a laxative.

Nonwater-soluble fiber such as wheat bran does not lower cholesterol, but for reasons not known, decreases the incidence of heart attacks. This fiber is the healthiest for the colon, speeding up colon movements and resulting in bulkier stools which are easier to pass. For this reason, hemorrhoids and constipation are best helped by Fiber One cereal. Also, look for "whole grain" as the first ingredient when buying your bread.

EXERCISE AND THE BRAIN:
Even moderate physical activity was associated with enhanced mental functioning in the aging brain according to the online edition of the journal Proceedings of the National Academy of Sciences, Feb. 16, 2004. Consider 10 minutes of exercise daily. Schedule it for a certain time every day and tell yourself you will not accept any excuses. Just like your teeth need brushing every day at a certain time, your body needs, craves, and deserves its exercise at a certain time of your choosing, each and every day. You will notice that you think better, have more energy, sleep better, feel stronger, have less shortness of breath when walking briskly. You will look and feel younger. A Harvard study years ago showed exercise can even help depression.

DRUG INTERACTION:

Go online to DrugDigest.com and click on The Interaction Checker for interactions on prescription drugs, over-the-counter drugs, supplements, food and alcohol.

OSTEOPOROSIS:

Fosamax is a weekly pill that can reduce fractures of the spine by 81 percent in postmenopausal women and can reduce fractures of the hip by 51 percent in postmenopausal women who have had a prior vertebral (spine) fracture.

POLYCYSTIC OVARY SYNDROME:
Polycystic ovaries can cause male hormone excess and excess hair in women. Other causes of androgen excess include benign growth of the adrenal gland, adrenal cancers, ovarian tumors, and an insulin-resistance syndrome with acanthosis nigricans (black areas in the armpits). Workup includes thyroid blood tests, tests for adrenal hyperplasia (a 17-OH Progesterone level in the follicular phase of the menstrual cycle), blood sugar and insulin levels, androgen levels (total and free testosterone, DHEAS level).

 

HYPERTENSION: Does coffee,tea or cola have an association?

Neither caffeinated nor decaffeinated coffee showed a positive association with incident hypertension. The data for caffeinated tea were inconclusive, but a positive trend was shown in the NHS II cohort. "By contrast, there was a highly significant association between cola intake (sugared or low-calorie cola) and incident hypertension that was consistent across the cohorts," the researchers say. Not caffeine, but some other compound in soda drinks?
Winkelmayer et al speculate that it is not caffeine but some other compound found in soda-type soft drinks that could be responsible for the increased risk in hypertension. Cola beverages were associated with an increased risk of diabetes in the NHS II cohort in a previous study [2], they note.Such studies have attributed these associations to the glycemic load of corn syrup and the advanced glycation end products of caramel coloring found in soda drinks, they say. While they acknowledge the limitations of their study—including the fact that the diagnosis of hypertension was self-reported—"whether caffeinated soft drinks are causally related to the risk of hypertension and its underlying mechanism will require further study," they conclude.







Sources


Winkelmayer WC, Stampfer MJ, Willett WC, et al. Habitual caffeine intake and the risk of hypertension in women. JAMA 2005; 294: 2330-2335.
Schulze MB, Manson JE, Ludwig DS, et al. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle