Nitrogen from Fertilizers Poses Long-Term Threat to Drinking Water

Even if farmers stopped using nitrogen fertilizers today, levels of dangerous nitrates in rivers and lakes would remain high for decades, researchers report.

Canadian scientists analyzed more than 2,000 soil samples from the Mississippi River Basin and found an accumulation of nitrogen. This buildup was not evident in the upper “plow” layer, but instead was found 2 inches to 8 inches beneath the soil surface.

“We hypothesize that this accumulation occurred not only because of the increased use of fertilizers, but also increases in soybean cultivation and changes in tillage practices over the past 80 years,” researcher Kim Van Meter, a doctoral student at the University of Waterloo in Canada, said in a university news release.

Nitrogen fertilizers have been contaminating rivers and lakes and getting into drinking water wells for more than 80 years, the researchers said. Nitrates in drinking water pose a number of health risks, they added.

Their findings suggest that this nitrogen could still find its way into waterways decades after being applied to fields. The study was published March 15 in the journal Environmental Research Letters.

“A large portion of the nitrogen applied as fertilizer has remained unaccounted for over the last decades,” Nandita Basu, a Waterloo professor, said in the news release.

Wisdom Wednesday: The Mediterranean Diet

This diet became popular in the 1990s even though the American scientist Dr. Ancel Keys publicized the Mediterranean diet while stationed in Italy during World War II. Compared to other Western diets, the Mediterranean diet was seen by others as an enigma. Although fat consumption is high, the prevalence of hypertension, cardiovascular disease, obesity, cancer and diabetes has always been significantly lower in Mediterranean countries than northern European countries and the USA.

The non-English speaking countries of northern Europe, such as Scandinavia, the Netherlands, Belgium, Germany, Switzerland and Austria have adopted the Mediterranean diet to a much greater degree than English speaking nations, such as the UK, Ireland, the USA, Australia and New Zealand. Many experts believe that is why developed English-speaking nations have a lower life expectancy than the other developed nations. The Mediterranean countries consume higher quantities of red wine, while northern European countries and the USA consume more beer. Finally, the Mediterranean diet, compared to the Anglo-Saxon diet, contains much higher quantities of unprocessed foods.

Many with Irregular Heartbeat Missing Out on Stroke-Preventing Treatments

Doctors know that a heart rhythm disorder called atrial fibrillation increases the odds for stroke. But less than half of “a-fib” patients at highest risk for stroke are prescribed recommended blood thinners by their cardiologists, new research finds.

“The findings of our study are surprising given that these patients with atrial fibrillation were treated by a cardiovascular specialist, who should be aware of guideline recommendations” for anticoagulants, such as warfarin, said study lead author Dr. Jonathan Hau. He is a cardiologist and assistant professor of medicine at the University of California, San Diego.

Hau’s team tracked more than 400,000 atrial fibrillation patients in the United States for four years. The investigators found that most were prescribed blood-thinning drugs up to a point. But more than 50% of the very highest-risk patients leave their doctor’s office without a prescription for potentially life-saving blood thinners.

Whether their doctors are ignoring or misinterpreting treatment guidelines isn’t clear, he said. “As with many issues in medicine, there are likely several reasons,” Hau suggested.

Part of the problem could simply be “patient preference,” he said. On the other hand, cardiologists may place too much emphasis on the risk for bleeding that blood thinners pose. But for most patients the benefits are worth the risk.

The study findings are published in the March 16 online edition of JAMA Cardiology.

Brain Bleed Risk from Warfarin Might Be Higher Than Thought

The widely used blood thinner warfarin – also known as Coumadin – may raise the risk of severe bleeding inside the skull by much more than previously thought, a new study suggests.

Researchers examined data from nearly 32,000 U.S. veterans, aged 75 and older, with a common heart rhythm disorder called atrial fibrillation. The investigators found that almost one in three suffered and “intracranial” bleed while taking warfarin for the condition.

“Atrial fibrillation (“a-fib”) is a common heart rhythm disorder in elderly patients. And in patients with a-fib treatment with the blood thinner warfarin reduces the risk of stroke by nearly two-thirds,” explained study lead author Dr. John Dodson.

“However, many clinicians are hesitant to prescribe warfarin in elderly patients, often because of concerns over head trauma due to falls, which can result in catastrophic bleeding,” said Dodson. He is assistant professor of medicine at NYU Langone Medical Center in New York City.

Dodson noted that, until now, “no large study has looked at how common traumatic intracranial bleeding is in clinical practice, or if there are conditions that make patients higher risk.”

The study, tracking outcomes between 2002 and 2012, found that rates of traumatic intracranial bleeding among seniors with atrial fibrillation was higher than previously reported.

“Nearly one-third of patients experienced more than one episode of traumatic intracranial bleeding” Dodson pointed out, and many patients “also still experienced strokes during this time period.”

Wisdom Wednesday: Weight Watchers

Weight Watchers was founded by Jean Nidetch, a Brooklyn homemaker, in 1963. She says she was an “overweight housewife” who was very partial to cookies. Nidetch had tried several fad diets and had finally lost 20 pounds but was concerned her ‘weak resolve’ would mean a return of the body weight. She got in touch with several friends and started a support group.

This support group evolved and soon there were weekly classes. In 1978 the food company H. J. Heinz bought Weight Watchers. Nidetch is still a consultant. The thrust of the Weight Watcher’s program is on regular meetings, monitoring and encouragement, through self-help group type sessions. The dieter aims for a target weight or BMI (body mass index) between 20 and 25.

There is some science to support the physiological benefits of positive reinforcement. Research published in the journal Psychiatry suggests “social support reduces stress-induced cortisol release.” Excess cortisol has far-reaching negative effects on the endocrine system, including insulin resistance and weight gain.

The point system employed by Weight Watchers is considered by many as the easiest tool to help a person lose weight over the long term. Dieters learn how to self monitor on a daily basis. A simple way to calculate points is (Calories + (Fat x 4) – (Fiber x 10)/ 50

Food portions are assigned points. If a food is high in fiber and/or low in fat, it is worth fewer points. The higher the fiber content, or the lower the fat content, the more of that food you can eat each day.

Dieters can either join a Weight Watchers program online or in person.

Doctors May Be Missing Chances to Treat Prediabetes

More than one-third of U.S. adults have prediabetes, which means their blood sugar levels are higher than normal, but not high enough to be diagnosed with diabetes. People with prediabetes are at risk for circulatory problems, kidney disease, and nerve and retinal damage, the study authors said.

“We know that prediabetes is considered one of the biggest risk factors for the development of diabetes, with estimates ranging from 15-30% of people with prediabetes developing diabetes within five years,” said lead investigator Arch Mainous III. Mainous is chair of the department of health services research, management and policy in the College of Public Health and Health Professions at the University of Florida.

“We also know that 90% of people who have prediabetes don’t know they have it. So the question becomes, where is the doctor in all this? Is the doctor identifying people with prediabetes, telling them about it and providing treatment? That’s what we wanted to find out,” he said in a university news release.

Mainous and his colleagues analyzed 2012 federal government survey data on people aged 45 and older who had doctor-ordered blood tests within the past 90 days. About 34% of them had blood sugar levels that indicated prediabetes.

However, very few of those patients were told they had prediabetes and only 23% of them began treatment for the condition, such as lifestyle changes or drug therapy, according to the study. The findings were published March 8 in the Journal of the American Board of Family Medicine.

“Even with blood test results in front of them, physicians weren’t detecting prediabetes in their patients in terms of making a diagnosis or providing some sort of management or treatment,” Mainous said.

Stool Test Effective for Detecting Colon Cancer

Tests for blood in the stool can consistently detect colon cancer when used on an annual basis, and they are effective even in the second, third and fourth years of screening, a new study says.

The researchers said these findings suggest that the stool test could be a reasonable screening alternative to colonoscopy – currently considered the gold standard for colon cancer screening.

Known as fecal immunochemical tests, experts examine stool samples for microscopic amounts of blood shed by colon tumors, explained study co-author Dr. Douglas Corley, a research scientist with Kaiser Permanente in Oakland, Calif.

Doctors have been concerned that fecal blood tests might become less effective over time, hampering their usefulness as a screening tool, he said.

Researchers tracked annual fecal blood tests performed on nearly 325,000 Kaiser Permanente patients in California during a four-year period.

The first year of screening with fecal blood tests detected colon cancer in 84.5% of participants who were diagnosed with the disease, the study reported.

“We found that the sensitivity for cancer was somewhat higher in the first year, and that’s not surprising,” Corley said. “The first year you screen someone, for breast cancer or for anything, you’re going to find cancers that have been there for a while that may be larger or are easier to detect.”

However, the effectiveness of the fecal blood test varied between 73% and 78% in years two through four. That means the test remained capable of picking up new tumors as they grew to a detectible size, the researchers said.