Too Much Sitting Can Be Deadly – Even if You Exercise

Regular exercise doesn’t erase the higher risk of serious illness or premature death that comes from sitting too much each day, a new review reveals.

Combing through 47 prior studies, Canadian researchers found that prolonged daily sitting was linked to significantly higher odds of heart disease, diabetes, cancer and dying.

Even if the study participants exercised regularly, the accumulated evidence still showed worse health outcomes for those who sat for long periods, the researchers said. However, those who did little or no exercise faced even higher health risks.

“We found the association relatively consistent across all diseases. A pretty strong case can be made that sedentary behavior and sitting is probably linked with these diseases,” said study author Aviroop Biswas, a PhD candidate at Toronto Rehabilitation Institute-University health Network.

“When we’re standing, certain muscles in our body are working very heard to keep us upright,” added Biswas, offering one theory about why sitting is detrimental. “Once we sit for a long time…our metabolism is not as functional, and the inactivity is associated with a lot of negative effects.”

The research was published January 19, in the online issue of Annals of Internal Medicine.

About 3.2 million people die each year because they are not active enough, according to the World Health Organization, making physical inactivity the fourth leading risk factor for mortality worldwide.

Among the studies reviewed by Biswas and his team, the definition of prolonged sitting ranged from 8 to 12 hours per day or more. Sitting, or sedentary activities ubiquitous with sitting such as driving, using the computer or watching TV, shouldn’t comprise more than 4-5 hours of a person’s day, Biswas said, citing guidelines issued by the Public Health Agency of Canada.

Could Nutrients in Fish Shield Fetus from Mercury’s Harms?

Three decades of research in the Seychelles, the islands in the Indian Ocean, found no developmental problems in children born to women who consume ocean fish at a much higher rate than the average American woman, a recent study concluded.

“They eat a lot of fish, historically about 12 fish meals a week, and their mercury exposure from fish is about 10 times higher than that of average Americans,” said study co-author Edwin van Wijngaarden, an associate professor in the University of Rochester’s department of Public Health Sciences in Rochester, N.Y. “We have not found any association between these exposures to mercury and developmental outcomes.”

The omega 3 fatty acids found in fish oil may protect the brain from the potential toxic effects of mercury, the researchers suggested.

They found mercury-related developmental problems only in the children of women who had low omega 3 levels but high levels of omega 6 fatty acids, which are associated with meats and cooking oils, van Wijngaarden said.
“The fish oil is tripping up the mercury.” He said. “Somehow, they are interacting with each other. We found benefits of omega 3s on language development and communications skills.”

The new findings come amid a reassessment regarding the risks and rewards of eating fish during pregnancy.

High levels of mercury exposure can cause developmental problems in children, the researchers noted. Because all ocean fish contain trace amounts of mercury, health experts for decades have advised expecting mothers to limit their fish consumption.

Wisdom Wednesday: The Knee

In athletes, knee injuries are second in frequency only to ankle injuries. So most of us damage our knees during adolescence. Unfortunately, proper care and rehabilitation is not generally performed as we seem to heal pretty quickly and are soon running around again. Of course, this comes back to haunt us latter on in life.

Knee replacement surgery was the 14th most common inpatient procedure in 2009. More than 4.5 million Americans are currently living with at least one total knee replacement (TKR). Over 650,000 knee replacements occurred in 2010.

Osteoarthritis is to blame for 96% of TKR. The conventional understanding of osteoarthritis is that constant wear and tear of the joint from micro trauma, or serious trauma damages the bone and it slowly breaks down. More recently, a theory has evolved that proposes that the trauma actually damages the blood supply to the bone and that it is the loss of blood supply that creates the osteoarthritis. While this seems to be merely semantics, this new theory opens the door for nutritional therapies to prevent and restore damaged bones and joints.

Several studies have found that the less invasive arthroscopic knee surgery has no better outcome than sham surgery. The first study, published in 2002 involved 180 participants randomly assigned to either have the real operation or sham surgery. The sham surgery involved cutting the knee to “fake” the surgery so the patient was unaware that no real surgical procedure had been performed. This multi-center, double blind controlled trial showed arthroscopic surgery had no benefits over sham surgery. In 2008, a Canadian study showed physical therapy alone to be as effective as surgery for osteoarthritis of the knee. The latest study in 2013, found no additional benefit from arthroscopic surgery over physical therapy for meniscal tears.

Can Coffee Protect You From Melanoma?

Coffee drinkers are less likely to suffer from malignant melanoma, and their risk decreases somewhat with every cup they swallow, according to findings published January 20th in the Journal of the National Cancer Institute.

“We found that four or more cups of coffee per day was associated with about a 20% reduced risk of malignant melanoma,” said lead author Erikka Loftfield, a doctoral student at Yale University School of Public Health who is completing her dissertation work at the U.S. National Cancer Institute.

Previous research has shown that coffee drinking could protect against less deadly forms of skin cancer, apparently by mitigating the damage to skin cells caused by the sun’s ultraviolet rays, the researchers said in background notes.

They decided to see if this protection extended to melanoma, the leading cause of skin cancer death in the United States and the 5th most common cancer. In 2013, there were an estimated 77,000 new cases of melanoma and about 9,500 deaths from the cancer, according to the study.

They found that people who drank the most coffee every day enjoyed a lower risk of melanoma, compared with those who drank little or no coffee. There was also a trend toward more protection with higher intake. People who drank one to three cups a day had about a 10% decreased risk of melanoma compared with those who drank none at all, while those who drank four or more cups had a 20% decreased risk.

The study only uncovered an association between coffee consumption and melanoma risk; it didn’t prove a cause-and-effect relationship.

Only 23 Percent Protection from This Year’s Flu Vaccine

A new study finds the current vaccine reduces your risk of needing medical care because of flu by only 23%.

Most years, flu vaccine effectiveness ranges from 10 to 60% reported the U.S. Centers for Disease Control and Prevention (CDC).

Despite the reduced effectiveness of this season’s flu shot, “vaccination is still important,” said lead report author Brendan Flannery, an epidemiologist with the CDC. “But there are ways of treating and preventing flu that are especially important this season,” he added.

These include early treatment with antiviral drugs and preventing the spread of flu by washing hand and covering coughs, he said.

Twenty-three percent effectiveness means that there is some benefit – a little less flu in the vaccinated group. Flu is usually more common among unvaccinated Americans, Flannery said, “but this year there is a lot of influenza both in people who are vaccinated and in people who are unvaccinated.”

The findings are published in the January 16th issue of the Morbidity and Mortality Weekly Report.
In flu seasons when the vaccine is well matched to the circulating H3N2 strains, effectiveness has been between 50-60%, the CDC said. This year, however, about 70% of the H3N2 virus seen has been different from the H3N2 strains in the vaccine, which explains its reduced effectiveness, Flannery said.

This year’s shot is most effective – 26% - for children 6 months old through 17 years. Older people get less benefit – just 12% of those 18 to 49 years and 14% for those 50 and older, the CDC said.

Wisdom Wednesday: Red Yeast Rice

About once a month a patient will tell me their primary care physician recommended red yeast rice because their cholesterol is high. It was bad enough when I just had to counsel patients against the use of this dangerous supplement. Now I have to convince them that their doctor gave them bad advice.

Red yeast rice (RYR) is made from yeast (Monascuspurpureus) grown on rice. It is a dietary staple in some Asian countries. Processed red yeast rice supplements include red yeast rice extract (RYRE), which is any extract of red yeast rice, and Xuezhikang, an alcohol extract of red yeast rice.

RYR contains several compounds known as monacolins, which block the production of cholesterol. One of these, monacolin K, has the same structure as the drugs lovastatin and mevinolin. Studies suggest that RYR use may lead to a 10-33% reduction in low-density lipoprotein (LDL, or “bad”) cholesterol.

While that all sounds good, physicians should not be recommended this supplement, nor should anyone take it.

There are several problems with this supplement:

The first issue is dosage. There is no standardized amount of monacolins or lovastatin in these products. One tablet may contain as much as 20mg of lovastatin (twice the recommended starting dose to lower cholesterol) and the next tablet may contain little or none of the active compounds. If the supplement company standardizes the active compounds, like the manufacturer Pharmanex did with Cholestin, the FDA ruled that should be considered a drug not a dietary supplement. The U.S. District Court followed suit and ruled that Cholestin is an unapproved drug and it was removed from the U.S. market.

The second issue is potential toxicity and death from citrinic acid. Again, the levels of this toxic chemical vary from tablet to tablet and brand to brand.

Exercise, Diet May Be Key to Beating a Common Irregular Heartbeat

Atrial fibrillation (AF) is a potentially dangerous form of irregular heartbeat for older Americans.

However, a new study suggests health changes in eating and exercise habits can help ease the condition.

According to the Australian researchers, AF is the most common cause of irregular heartbeat, and it’s been linked to a heightened risk for dementia, stroke and death.

The new study included more than 149 people who had undergone a procedure called catheter ablation to treat the condition. In this procedure, the tissue surrounding the problem area in the heart is burned.

In addition, 61 of the patients also took part in an aggressive “risk factor management" program after they underwent catheter ablation. The program was designed to reduce lifestyle risk factors such as being overweight, having high blood pressure, high cholesterol or high blood sugar levels, sleep breathing problems (such as sleep apnea), and smoking and drinking.

After five years, patients who managed these lifestyle factors were five times more likely to be alive and to be free of heart rhythm problems such as AF than those who hadn’t gotten healthier – 87% versus 18%.

“This is a very important finding because it shows the huge gap between what happens when patients are able to manage the underlying risks of their health and those who rely solely on medical intervention,” lead author Dr. Rajeev Pathak, a cardiologist and electrophysiology fellow at the University of Adelaide in Australia, said in a university news release.