Monday, March 30, 2015

Weed Killer, Long Cleared, Is Doubted

Thirty years ago, an Environmental Protection Agency (EPA) committee determined that the popular weed killer Roundup might cause cancer.

Six years later, in 1991, the agency reversed itself after re-evaluating the mouse study that had been the basis for the original conclusions.

Now the issue is back again, in an even bigger way. An agency of the World Health Organization (WHO) has declared that glyphosphate, the active ingredient in Roundup, “probably” causes cancer in people. One piece of evidence the agency cites is that same mouse study.

The declaration drew an angry response from Monsanto, the maker of Roundup, which has accused the agency of having an “agenda” and “cherry picking” the data to support its case.

The conclusion is “markedly at odds with every credible scientific body that has examined glyphosphate safety,” Phillip Miller, Monsanto’s vice president for global regulatory affairs, told reporters on Tuesday.

Glyphosphate, introduced in the 1970s, is the most widely used herbicide in the world, sprayed on farms, in forests, on road sides and in gardens and has a reputation for being benign, as pesticides go. It is now generic and used in many products, not only Roundup.

Friday, March 27, 2015

Blood Fats Hold Vitamin E Captive, Study Shows

High levels of blood fats such as cholesterol and triglycerides can hold vitamin E in the blood and prevent it from reaching the tissues that require it, a small study says.

The findings suggest that checking only blood levels of vitamin E may not show whether a person has adequate levels of vitamin E, the researchers said. They also suggested that past methods used to measure vitamin E levels in tissues are flawed.

The study included 41 young and older adult women and men who ate collard greens treated with a chemical that enabled the researchers to track vitamin E as it moved through the participants’ bodies.

“In simple terms, we believe that less than one-third the amount of vitamin E is actually making it to the tissues where it’s most needed,” study author Maret Traber, a professor for micronutrient research at Oregon State University, said in a university news release.

“People with elevated [fats] in their blood plasma are facing increased inflammation as a result. Almost every tissue in their body is under oxidative attack, and needs more vitamin E,” Traber said. “But the vitamin E needed to protect these tissues is stuck on the freeway, in the circulatory system. It’s going round and round instead of getting to the tissues where it’s needed."

The study was published recently in the American Journal of Clinical Nutrition.

The research is important because more than 90% of Americans who don’t take vitamin E supplements lack the recommended amount of the vitamin in their diet, according to Traber and colleagues. Common dietary sources of vitamin E include cooking oils and some vegetables.

Wednesday, March 25, 2015

Wisdom Wednesday: Cross Training

Cross training technically refers to an athlete training in a sport other than one they compete in with the goal of improving performance in their chosen sport. For our purposes, the goal is to improve overall fitness.

All sports focus on specific parts of the body but also ignore other parts. Running places a lot of stress on the legs, but little on the arms. Cycling is very similar in that regard. Swimming places more emphasis on the arms and significantly less on the legs, especially in long distance swims. All these sports benefit from a strong core, but none of them work the core hard enough to really create the strong core you need. Weight training can quickly strengthen the core and strengthen virtually every muscle group but it tends to cause some loss in flexibility. Stretching, an important aspect of any workout will give you that flexibility but it is often neglected because of time restraints.

Rest is the other vital factor in this equation. By cross training, you can workout several days in a row, but still allow alternating parts of your body to rest.

Let’s use my current workout plan as an example. On Monday and Wednesday, I lift weights. Monday is chest and triceps and Wednesday is back and biceps. I do some abs every workout and hate every minute of it. I’ll cover weight lifting in more detail next week. After I lift weights, I swim. Part of it is convenience; the pool is at the gym. However, swimming after lifting elongates the muscle in the arms and helps drive the lactic acid out of the muscles, speeding recovery.

On Tuesday and Thursday I spin. If I missed a lift, or want to do a little extra work in the weight room, I usually do that prior to spinning class. If I were training for a triathlon, I might swim prior to spinning and then run after spinning to mimic an event.

Monday, March 23, 2015

Recess: An Essential Part of the School Day

Recess is an essential part of children’s school days that can help set students up for success once they head back to the classroom, a new study suggests. Art by Clker

Yet, many schools are cutting back on recess or not offering quality recess time. This may have unintended negative consequences, the Stanford University researchers cautioned.

“Recess isn’t normally considered part of school climate, and often is shortchanged in tight fiscal times, but our research shows that [recess] can be a critical contributor to positive school climate in low-income elementary schools,” study co-author Milbrey McLaughlin, the founding director of Stanford’s John W. Gardner Center, said in a university news release.

When planned well, recess can boost attendance as well as academic performance, the research showed. It can also help kids make friends, learn how to resolve conflicts and gain a more positive outlook about learning, particularly for those in low-income schools, the study’s authors noted. High-quality recess can also curb bullying among students, according to the researchers.

Trained, full-time coaches were sent to six low income elementary schools to improve their recess programs. The coaches, teachers and principal from each school were interviewed. The researchers also conducted student focus groups and observed recess periods. They compared their findings to other schools with a variety of programs ranging from poor to very good.

The study revealed that good recess programs rely on adult supervision and guidance. Conflicts can arise when children do not agree on games and rules.

Friday, March 20, 2015

When It Comes to Jogging, Easy Does It

“In this study, the dose of running that was most favorable for reducing mortality was jogging 1 to 2.4 hours per week, with no more than three running days per week,” said study researcher Jacob Marott of the Frederiksberg Hospital in Copenhagen, Denmark. The best pace was slow or average – about 5 miles per hour, he added.

Out of a pool of about 5,000 Danish adults, Marott and his colleagues followed nearly 1,100 healthy joggers and 413 sedentary people for more than 12 years. The joggers noted their hours and frequency of jogging, and their perception of their pace.

The strenuous joggers, the investigators found, were as likely to die during that time period as the sedentary non-joggers. Light joggers and moderate joggers fared better, in that order.

The findings were released online Feb. 2 in advance of publication in the Feb. 10 edition of the Journal of the American College of Cardiology.

What is it about strenuous running that might be harmful? “We believe that long-term strenuous endurance exercise may induce pathological structural remodeling of the heart and large arteries,” Marott said.

However, a U.S.-based researcher said the debate about the optimal dose of running for longevity is far from resolved.

The new study has limitations, said D.C. Lee, an assistant professor of kinesiology at Iowa State University, who co-authored an editorial accompanying the study.

Wednesday, March 18, 2015

Wisdom Wednesday: Swimming

Swimming is kind of like riding a bike, once you learn you never forget. However, for many of us we never got beyond the basics of swimming. It can be a little daunting and maybe embarrassing to try to learn how to swim well as an adult.

The benefits of swimming are well worth the effort. It is one of the few non-weight bearing sports so it’s easy on the joints as we age. Anyone with a decent swimming stroke can continue swimming through their entire life.

It is also excellent cardiovascular exercise. The rhythm of the arm stokes and breathing create a pattern that naturally puts you in your aerobic zone. With a little bit of training, you can sustain that pattern indefinitely.

There are two basic approaches to swimming distance. First, there is the long distance swim. I see many people just get in the pool and swim a mile or more without stopping. While the cardiovascular benefit is great, form and efficiency usually suffer. Most of these swimmers display very poor arm motion as their muscles fatigue and appear sloppy and slow in the water.

The second approach, the one I prefer, is interval training. Intervals create short periods of rest that allow your arm muscles to recover, removing some of the excess lactic acid. This allows for much better form and in turn, more effective stroke production and speed.

Monday, March 16, 2015

Immune System Changes Tied to Chronic Fatigue Syndrome

Chronic fatigue syndrome appears to be linked to specific changes in a person’s immune system, particularly increased amounts of chemical messengers that regulate immune responses, researchers report.

The study adds to growing evidence that chronic fatigue syndrome is caused by a malfunctioning immune system, said lead author Dr. Mady Hornig. She is director of Translational Research at the Jerome L. and Dawn Greene Infectious Disease Laboratory at Columbia University’s Mailman School of Public Health, in New York City.

The immune system of a new chronic fatigue syndrome patient appears unable to shut down or reduce its response to an infection that has passed, Hornig said.

Instead, the system continues to pump out large amounts of cytokines – chemical messengers that coordinate the response of the immune system’s may cell types. However, this only seems to occur during the first 3 years of the disease.

“Their immune system is no longer resilient and able to bounce back after this cytokine surge” in response to an infection, Hornig said. “We need the system to be regulated, so it shuts off after the disease is gone, and that isn’t happening here.”

Doctors now can look for increased levels of these chemicals in the blood of patients who might have chronic fatigue syndrome, potentially aiding in their diagnosis, she said.

The new study, published February 27 in the journal Science Advances, comes on the heels of a new Institute of Medicine (IOM) report that declared chronic fatigue syndrome a “legitimate” illness that should be treated by doctors as a disease rather than an emotional problem.

Between 836,000 and 2.5 million Americans suffer from chronic fatigue syndrome, and an estimated 84 to 91% of people with the disorder are not diagnosed, according to the IOM. Chronic fatigue syndrome tends to strike people in their 40s and 50s, and occurs four times more often in women than men.

Friday, March 13, 2015

Typical Adult Over 30 Gets Flu Twice Every 10 Years

A new British study finds that the typical person over 30 only gets the flu about twice every decade.

“For adults, we found that influenza infection is actually much less common that some people think,” said study senior author Dr. Steven Riley, of Imperial College London. His team published its findings March 3 in the journal PLoS Biology.

“In childhood and adolescence, it’s much more common, possibly because we mix more with other people,” Riley said in a journal release. For adults over 30, “the exact frequency of infection will vary depending on background levels of flu and vaccination,” he added.

The study team analyzed blood samples from volunteers in southern China to assess their levels of antibodies against nine different flu strains that circulated there between 1968 and 2009.

“This is the first time anyone has reconstructed a group’s history of infection from modern-day blood samples,” said Dr. Adam Kucharski, who worked on the study at Imperial College London.

From the blood test results, the investigators concluded that children get the flu an average of every other year, but that flu infections become less frequent as people move through childhood and early adulthood.

“There’s a lot of debate in the field as to how often people get flu, as opposed to flu-like illness caused by something else,” Kucharski noted. Even though people may think they have influenza, “symptoms could sometimes be caused by common cold viruses, such as rhinovirus or coronavirus.”

On the other hand, flu can sometimes be milder than many people realize. “Some people might not realize they had flu, but the infection will show up when a blood sample is subsequently tested,” Kucharski said.

Wednesday, March 11, 2015

Wisdom Wednesday: Circadian Rhythms

Circadian rhythms are physical, mental, and behavioral changes that follow a roughly 24-hour cycle, responding primarily to light and darkness in the environment. They are found in most living things, including tiny microbes.

Biological clocks throughout the body control these rhythms. The “master clock” or suprachissmatic nucleus (SCM) is located in the hypothalamus of the brain. Circadian rhythms influence sleep-wake cycles, hormone release, body temperature and other body functions. They have been linked to various sleep disorders, including insomnia.

As daylight strikes our eyes this information is relayed to the brain, the SCM receives this data and stimulates the pineal gland to produce melatonin. At night, the SCM activates the melatonin, cutting off most of the stimulation to the hypothalamus, and we get drowsy.

Melatonin is a hormone and it has a modulating effect on all the other hormones in the body. Please review these two blogs – “The Evolution of Sleep: 700 Million Years of Melatonin” posted on 10/13/14 and “Chaste Tree” posted 8/20/14. This modulating effect pushes hormone production toward homeostasis. The effect is mild, but often very effective. So if your testosterone is a little low and the estrogen a little high, melatonin will drive the testosterone production up and the estrogen production down.

Clinically, the two most revealing questions I ask my patients are “How are you sleeping?” and “How is your sex drive?” The answers tell me much about the patient’s general health, specifically how well the endocrine system is functioning. Typically, new patients are struggling in both these areas of function.

Monday, March 9, 2015

Multiple Sclerosis Linked to Lower Levels of Key Nutrients in Women

Women with multiple sclerosis (MS) have lower levels of important antioxidant and anti-inflammatory nutrients than those without the disease, new research finds.

“Since MS is a chronic inflammatory disorder, having enough nutrients with anti-inflammatory properties may help prevent the disease or reduce the risk of attacks for those who already have MS,” study author Sandra Cassard, of John Hopkins University in Baltimore, said in a news release from the American academy of Neurology.

The study included 27 white women with MS, aged 18 to 60, and a “control” group of 30 age-matched healthy white women.

On average, the MS patients had lower levels of five antioxidant or anti-inflammatory nutrients: folate, vitamin E, magnesium, lutein-zeaxanthin and quercetin.

Among the women with MS, average daily intake of food folate was 244 mcg, compared with 321 mcg among healthy women, the study found. The recommended daily intake is 400 mcg.

Average daily magnesium intake was 254 mg among MS patients and 321 mg among health women. The recommended daily intake is 320 mg.

The women with MS also had a lower percentage of calories from fat than the healthy women, according to the study that is scheduled for presentation at the upcoming American Academy of Neurology annual meeting in Washington, D.C.

Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

Friday, March 6, 2015

C. difficile Infected Almost Half a Million in Single Year

C. difficile caused nearly half a million infections and was associated with about 29,000 deaths in 2011, according to new data released today by the Centers for Disease Control and Prevention (CDC). Photo by ClipArtLord

“C. difficile is a bacteria that causes severe diarrhea and damage to the colon, and is often triggered by exposure to antibiotics. Infections with C. difficile have become increasingly common over the last few decades and are seen in patients in healthcare facilities as well as people in their communities,” Michael Bell, MD, deputy director, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infections Diseases, CDC, Atlanta, Georgia, said in a CDC telebriefing.

“In the past, patients infected with C. difficile have had diarrhea related to antibiotic use that was often perceived as a nuisance, but not a major problem. Unfortunately, the type of C. difficile circulating in the US today produces such a powerful toxin that [it] can cause a truly deadly diarrhea,” Dr. Bell explained.

“Patients receiving antibiotics are now at risk for not just mild diarrhea, but intense illness that can cause damage to the bowel so painful and severe that part of the colon needs to be surgically removed, a condition called toxic megacolon.”

These findings from the CDC were reported in an article published in the February 26 issue of the New England Journal of Medicine.

“In the absence of a vaccine, future efforts to prevent C. difficile will cross health care settings and focus more on appropriate antibiotic use, which has been shown to be successful in decreasing rates of C. difficile infection in England, where a multifaceted program including antimicrobial stewardship was implemented,” the authors explain.

“The prevention of C. difficile infection is a U.S. priority, with 2020 national reduction targets being established and all hospitals participating in the Hospital Inpatient Quality Reporting Program of the Centers for Medicare and Medicaid Services, which has reported data regarding C. difficile infection to the National Healthcare Safety Network since 2013,” they conclude.

My Take:
C. difficile is not a bacteria that is “circulating in the US today.” It is a normal commensal member of the digestive tract. Indiscriminate use of antibiotics over many years has caused “genetic drift” and created this monster in our guts. When additional antibiotics are used in a patient with the resistant strain, the antibiotic distorts the microbiome of the gut. This allows the C. difficile to take over. Too often, the result is death. Any vaccine that prevented C. difficile could have disastrous effects on the health of the gut. Let’s hope no one is short sighted enough to develop such a vaccine.

Most cases occur in hospitals when patients on placed on antibiotics as a precaution, regardless of the diagnosis. The “people in the community” are usually children given antibiotics for their cold or flu by pediatricians. Of course the antibiotics are of little or no value in treating colds or flues, but are routinely prescribed. Please review my blogs “Serious Diarrheal Infection in Kids Linked to Antibiotics” posted March 14, 2014 and “Study Finds Many Flu Patients Not Treated Appropriately” posted on August 1, 2014.

It was fascinating to watch the press and medical profession react to a couple of cases of Ebola here in the U.S. Meanwhile, there is no apparent alarm that we may very well create our own form of the black plague from indiscriminate use of antibiotics.

The Bottom Line:
The use of antibiotics must be specific and short term. Please do not allow your child to take them unless there is really good evidence to support the need.

If you have had antibiotic therapy recently, please consult with a qualified nutritionist who will help support your microbiome. I successfully treated a couple of cases of C. difficile last year with basic nutritional supplementation.

Source: February 25, 2015 Medscape Medical News

Wednesday, March 4, 2015

Wisdom Wednesday: Spinning

Spinning is cycling minus all the risk factors. You are on a stationary bike in an air conditioned room. There are no road hazards (think flat tires), no wind to ride against, no rain, and best of all – no traffic! While I suppose it is possible to fall off a stationary bike, in several years of classes, I have yet to witness such an event. I know competitive cyclists that do all their training in spinning classes to avoid the dangers of the road.

It does not have the beauty of the road. My wife and I did a five day, self-guided tour of Vermont and Western Mass last summer and the scenery was remarkable. Our training rides at home are generally up and down A1A in South Florida with the Atlantic Ocean as a backdrop.

To keep it interesting, spinning classes have an instructor guiding you through a workout of 45 minutes to an hour, varying intensity, speed, and bike position. If sitting on a bike is hard on your bum, spinning might be for you as you often get to stand and pedal. The class begins with a gentle warm up, then a series of simulated climbs and sprints to keep your heart rate up and burn calories. Each series is followed by a short recovery period to bring the heart rate down and allow you to hydrate.

The bikes are equipped with computers to monitor your cycles per minute (CPM), watts of energy produced, calories burned, heart rate, millage, and resistance. The instructor uses resistance and CPM recommendations so you can mimic their efforts.

I always wear my heart rate monitor as an additional guide through the class. I try to get up to my aerobic zone as soon as possible and keep my heart rate there for the first 10-15 minutes. As the intensity of the class increases my heart rate will go above my aerobic zone, but I never exceed my Vmax (maximum heart rate) and always return to my aerobic zone at least once every 10 minutes. In a 45 minute class I will generally burn about 500 kcal.

Monday, March 2, 2015

Aspirin ‘Resistance’ May Make for Worse Strokes

People who are “resistant” to aspirin may be at risk for larger, more severe strokes, South Korean researchers report.

Doctors often prescribe low-dose aspirin to people at high risk of stroke because the drug helps prevent blood clots. But for about 28% of stoke patients in a new study, aspirin didn’t keep blood from clotting. And their strokes were worse than strokes suffered by aspirin-uses who weren’t resistant to the drug.

“Aspirin resistance is an important predictor of severe stoke and large stroke size in patients taking aspirin before having a stroke,” said lead researcher Dr. Mi Sun Oh, of the department of neurology at Hallym University College of Medicine in Seoul.

What causes aspirin resistance isn’t known. Other studies have found that 5-45% of patients have this problem, but doctors do not routinely test for it.

“In patients at high risk for stroke with aspirin resistance, different anti-clotting drugs – such as Plavix – can be considered as alternatives to prevent another stroke or decrease stroke severity,” Oh said.

The findings of the study were released February 23, ahead of its official presentation in April at the annual meeting of the American Academy of Neurology in Washington, D.C. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

For the study, Oh and colleagues studied 310 patients who had been taking aspirin for at least seven days before they suffered an ischemic stroke. Aspirin resistance was checked within 24 hours of hospital admission.

The researchers found that nearly 28% of the patients were resistant to aspirin. Their strokes ranged from 3 to 11 on a stroke severity score, compared with scores of 1 to 6 among aspirin responders.