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Health Benefits of Dark Chocolate

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Flavonoids in dark chocolate are a naturally occurring antioxidant similar to those found in teas, red wine, and some fruits and vegetables. These flavonoids are thought to have a beneficial effect on the cardiovascular system, and one recent study showed that 6 grams of dark chocolate a day (about one square) lowered systolic and diastolic blood pressure by 2 points each.

The study also claims that dark chocolate may lower low-density lipoprotein (LDL) cholesterol levels by about 5 points. Not a major effect to be sure, but pushing the “bad” cholesterol downwards. Flavonoids also benefit how the lining of the blood vessels function.

“We think a lot of bad things that happen to the cardiovascular system are because the lining of the vessels cracks and becomes inflamed, setting the stage for plaques to form and rupture,” says Robert Sheeler, M.D., a family physician at Mayo Clinic.

Don’t forget, chocolate contains calories and fat, so these findings are not an invitation to go on chocolate binge. Dr. Sheeler says just one square a day (about 30 calories) will provide the health benefits described. He recommends chocolate that contains at least 60% cocoa; milk chocolate by contrast has only 15-25% cocoa, while dark chocolate can contain as much as 80%+ cocoa.

Source: Women’s HealthSource, Mayo Clinic , August, 2008

Stay Healthy in Hot Weather

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Some 200 people in the US die each summer from health problems caused by hot weather, and this number is doubled when the summer is exceptionally hot. Here are three major hot weather threats that can be moderated, or avoided completely.

Heat cramps warn of dehydration and muscular deprivation of needed oxygen. The problem can be solved by drinking cool water, stretching, and light massage of the affected areas.

Heat Exhaustion is apparent when the body temperature is seriously elevated, often above 103 degrees F, and weakness, lethargy, loss of concentration, headache and nausea follow. Judgement can be affected, and the solution is to choose a cool spot, take of excess clothing, drink cool fluids, and apply any available ice packs.

Heat stroke can affect older people who stay at home without air-conditioning. Other victims include men who exercise during hot weather. Weakness and confusion can create delirium, stupor, coma and seizures, so heat stroke should be recognized as a real medical emergency, where survival depends on immediate treatment in a hospital.

Try the following to avoid hot weather health problems:

  • Hydrate: drink 10-12 cups of water daily, more if exercise is involved
  • Stay cool: move into a room with a fan or air-conditioning
  • Stay out of the sun, particularly midday sun, and wear light, loose-fitting clothes
  • Avoid exercising in hot or humid conditions

Source: Harvard Men’s Health Watch, August, 2008

FDA Calls for Warning on Cipro, Levaquin and Other Antibiotics

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The U.S. Food and Drug Administration (FDA) has notified manufacturers of fluoroquinolone antimicrobial drugs that a Boxed Warning in the product labeling concerning the increased risk of tendinitis and tendon rupture is necessary. The medications involved in this action are: Cipro and generic ciprofloxacin, Cipro XR and Proquin XR (ciprofloxacin extended release), Factive (gemifloxacin), Levaquin (levofloxacin), Avelox (moxifloxacin), Noroxin (norfloxacin), and Floxin and generic ofloxacin.

Through its new authority under the Food and Drug Administration Amendments Act of 2007 (FDAAA), the agency also determined that it is necessary for manufacturers of the drugs to provide a Medication Guide to patients about possible side effects.

The FDA has notified the manufacturers of these drugs that a Risk Evaluation and Mitigation Strategy (REMS) is necessary to ensure that the benefits of the drug outweigh the risks. The Medication Guide will be considered to be an element of the REMS. The new Boxed Warning and Medication Guide would strengthen warning information already included in product labeling for the fluoroquinolone class of systemic antimicrobial drugs.

Fluoroquinolones are drugs approved for the treatment or prevention of certain bacterial infections. Like other antibacterial drugs, fluoroquinolones do not treat viral infections such as colds or flu.

“Fluoroquinolones are effective in treating certain bacterial infections, but health care professionals and patients need to be aware of the increased risk associated with the use of these drugs of developing tendinitis and tendon rupture, particularly for certain patient populations,” said Edward Cox, M.D., director, Office of Antimicrobial Products, Center for Drug Evaluation and Research. “The FDA believes it is important to highlight and strengthen information regarding possible side effects of fluoroquinolones because it may affect decisions about the relative risks and benefits associated with these products.”

The FDA has conducted a new analysis of the available literature and post-marketing adverse event reports. This new analysisreconfirmsthat use of fluoroquinolones is associated with an increased risk of tendon rupture. It alsodemonstrates that despite the current warning of tendon rupture in the labeling for the fluoroquinolones, large numbers of tendon-related adverse events continue to be reported. The FDA considers this new analysis to be “new safety information” as defined in FDAAA.

The FDA also issued Information for Health Care Professionals today to alert health care professionals to the increased risk of tendinitis and tendon rupture in patients taking these drugs and to highlight new information concerning who may be at higher risk for this side effect.

The risk of developing fluoroquinolone-associated tendinitis and tendon rupture is further increased in people older than 60, in those taking corticosteroid drugs, and in kidney, heart, and lung transplant recipients. Patients experiencing pain, swelling, inflammation of a tendon or tendon rupture should be advised to stop taking their fluoroquinolone medication and to contact their health care professional promptly about changing their antimicrobial therapy. Patients should also avoid exercise and using the affected area at the first sign of tendon pain, swelling, or inflammation.

Manufacturers are being notified of the need to change labeling so that all of the drugs in the class carry uniform updated warning language. These warnings would apply to fluoroquinolones for systemic use (e.g., pills, tablets, capsules and injectable formulations). The warnings would not apply to fluoroquinolones for topical ophthalmic or otic use (e.g., eye and ear drops).

Fluoroquinolone manufacturers are required to submit the safety labeling changes, including the strengthened warnings and the Medication Guide, to the FDA within 30 days, or to provide a reason why they do not believe such labeling changes are necessary. If they do not submit new language, or the FDA disagrees with the new language the company proposes, FDAAA provides strict timelines for resolving the labeling changes and allows the agency to issue an order directing the labeling change as deemed appropriate to address the new safety information. In addition, in accordance with FDAAA, sponsors will be required to assess whether their REMS are achieving the goal of informing patients of the risk of tendon-rupture. These assessments may include a survey of patients’ and prescribers’ understanding of the risks of tendon-rupture and whether the Medication Guide is being distributed and dispensed with the drug.

Health care professionals should consider the potential benefits and risks for each patient. While most patients tolerate these medicines well, occasionally some will develop other serious adverse reactions that may include convulsions, hallucinations, depression, abnormalities in heart rhythm, or severe diarrhea.

Source: FDA, July 8, 2008

Controversial Recommendation to Consider Statins for Kids with High Cholesterol

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The American Academy of Pediatrics has issued new cholesterol screening and treatment recommendations for children that suggest cholesterol screening, and possible use of statins for certain children.

The policy statement, “Lipid Screening and Cardiovascular Health in Childhood,” recommends cholesterol screening of children and adolescents with a family history of high cholesterol or heart disease. It also recommends screening patients whose family history is unknown or those who have other factors for heart disease including obesity, high blood pressure or diabetes.

The AAP suggests that screening should take place after age two, but no later than age 10. The best method for testing, according to the organization’s policy statement, is a fasting lipid profile. If a child has values within the normal range, testing should be repeated in three to five years.

The American Academy of Pedatrics suggests that for children who are more than eight years old and who have high LDL concentrations, cholesterol-reducing medications should be considered. Younger patients with elevated cholesterol readings should focus on weight reduction and increased activity while receiving nutritional counseling.

The policy statement also recommends the use of reduced-fat dairy products, such as two percent milk, for children as young as one year of age for whom overweight or obesity is a concern.

Source: American Academy of Pediatrics, July 7, 2008

Traveler’s Diarrhea Vaccine Shows Promise

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Each year between 20%-50% of international travelers—about 10 million people— develop diarrhea. The onset of “Traveler’s Diarrhea” (TD) usually occurs within the first week of travel but may occur at any time while traveling, and even after returning home. In a recent study by researchers at The University of Texas School of Public Health, a new patch-based travelers’ diarrhea vaccine has been found to provide significant relief from diarrhea. The study results were published in a recent edition of the Lancet.

In the study, 170 travelers to Mexico and Guatemala were monitored. Of 59 individuals receiving the vaccine, only 3 suffered from severe or moderate diarrhea, while close to 24 people who took the placebo suffered from moderate or severe diarrhea.

“These results suggest that the Iomai patch has the potential to fundamentally change the way we approach prevention of this disease, an ailment against which we now have very few weapons,” said Herbert L. DuPont, M.D., professor and director of the Center for Infectious Diseases at The University of Texas School of Public Health and the principal investigator of the trial. “If these results are replicated, the Iomai vaccine will have the potential to not only mitigate a disease that sickens millions each year but also keep some patients from going on to develop the chronic symptoms of irritable bowel syndrome.”

The Trek Study was done in collaboration with UT Houston, the Johns Hopkins Bloomberg School of Public Health and other institutions. Two doses of the vaccine patch or a placebo were given to each volunteer, 2 to 3 weeks apart. The last dose was given a week before travel.

Detailed diaries were kept by travelers, with in-country checkups. The study was designed to evaluate the safety of the vaccine and the incidence of enterotoxigenic E. coli (ETEC) bacteria—the most common cause of travelers’ diarrhea. No vaccine-related serious side effects were reported. Of the few vaccinated patients who became sick, the diarrhea lasted only half a day on average, while those in the placebo group endured two days of illness and more than twice as many loose stools. Although not statistically significant, the frequency of new-onset irritable bowel syndrome, a long-term consequence of travelers’ diarrhea, was three times greater in placebo than vaccine recipients.

Approximately 55 million travelers are expected to visit countries where bacteria causing diarrhea are endemic, notably Africa, Asia and Latin America, and of these it is anticipated that 20 million will contract diarrhea. Apart from abdominal cramps and dehydration, travelers are also at higher risk of developing irritable bowel syndrome. Children are at special risk in the developing world, where diarrhea linked to enterotoxigenic E sickens 210 million children, killing an estimated 380,000 of them each year.

“Bacterial diarrheal disease is a significant medical problem both for children and travelers, and our technology represents both an advance in vaccine delivery and a breakthrough in the field of infectious disease,” said Gregory Glenn, M.D., Iomai’s chief scientific officer. “We look forward to targeting both the significant travelers’ market and developing the vaccine for the children in the developing world who still suffer serious morbidity and mortality from this disease.”

Researchers at The University of Texas School of Public Health studied the patch-based vacine as part of the Phase 2 study in conjunctoin with the Iomai Corporation. Iomai plans to initiate a Phase 3 program for the needle-free vaccine patch vaccine in 2009. If approved, the Iomai vaccine would be the first vaccine for travelers’ diarrhea available in the United States.

Source: Lancet, June 2008

Overtime Work Can Lead to Anxiety and Depression

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Overtime work habits can lead to anxiety and depression, according to a study conducted by Norweigan researchers.

Using a standard screening questionnaire to measure symptoms of anxiety and depression, Elisabeth Kleppa and colleagues at the University of Bergen, Norway, analyzed data on hours worked by a large sample of Norwegian men and women. Scores for anxiety and depression were compared for 1,350 workers putting in 41 to 100 hours of overtime a week, and some 9,000 workers working regular hours (40 or less) without overtime.

Overtime work was linked to higher anxiety and depression scores among both men and women, while “possible” depression rose from about 9% for men working regular hours to 12.5% for those working overtime. “Possible” depression rates in women rose from 7% to 11% and for men and women the “possible” anxiety and depression rates were higher among workers with lower incomes and for less—skilled workers.

The relationship between overtime and anxiety/depression was strongest among men who worked the most overtime—49 to 100 hours per week. Men working such very long hours also had higher rates of heavy manual labor and shift work and lower levels of work skills and education.

Health and safety concerns have been raised in previous studies, but these concentrated on shift work rather than overtime. European Union work rules allow employees to refuse to work more than 48 hours per week. These latest results show increased rates of anxiety and depression among overtime workers, supporting the European Union directive.

Even moderate overtime hours appear to increase the risk of ‘mental distress’, although the study offers no conclusions as to how working long hours results in increased anxiety and depression. It is surmised that working overtime leads to increased “wear and tear,” or that individuals with characteristics predisposing to anxiety and depression (such as low education and job skills) are more likely to take jobs requiring long work hours.

Source: Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM), June, 2008.

Pigs Raised with Antibiotics Exhibit Lower Levels than “Organic” Pigs

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A new study finds that although the demand for antibiotic-free pigs is increasing, pigs raised without antibiotics are more likely to have bacteria and parasites.

Pigs raised outdoors without antibiotics had higher rates of three food-borne pathogens than pigs on conventional farms, according to a comparison made between antibiotic-free and conventional methods.

“Animal-friendly, outdoor farms tend to have a higher occurrence of Salmonella, as well as higher rates of parasitic disease,” said lead study author Wondwossen Gebreyes, associate professor of veterinary preventive medicine at Ohio State University.

More than 50% of pigs reared on antibiotic-free farms tested positive for Salmonella, compared to 39 percent of conventionally raised pigs infected with the bacterial pathogen. The Toxoplasma gondii parasite was detected in 6.8 percent of antibiotic-free pigs compared to 1.1 percent of conventionally raised pigs. compared to 1.1 percent of conventionally raised pigs. And two naturally raised pigs of the total 616 sampled tested positive for Trichinella spiralis, a parasite considered virtually eradicated from conventional U.S. pork operations.

The U.S. Department of Agriculture recommends that consumers cook fresh pork to an internal temperature of 160 degrees Fahrenheit, since thorough cooking ensures that these infectious agents in food animals should pose no risk to human health. Gebreyes won’t recommend one type of pork production practice over another.

“We are just doing the science and showing the results,” he said. “Does having an antibiotic-free and animal-friendly environment cause the re-emergence of historically significant pathogens? I think that is an extremely important question for consumers, policymakers and researchers to consider.”

In an earlier published paper, Ian Philips, et al., wrote “The use of antibiotics in food animals selects for bacteria resistant to antibiotics used in humans, and these might spread via the food to humans and cause human infection, hence the banning of growth-promoters. The actual danger seems small, and there might be disadvantages to human and to animal health. The low dosages used for growth promotion are an unquantified hazard. Although some antibiotics are used both in animals and humans, most of the resistance problem in humans has arisen from human use. Resistance can be selected in food animals, and resistant bacteria can contaminate animal-derived food, but adequate cooking destroys them. How often they colonize the human gut, and transfer resistance genes is not known.”

It’s important to note that the study was funded by a grant from the National Pork Board. The results were published in a recent issue of the journal Foodborne Pathogens and Disease.

Sources:

  • J. Journal of Antimicrobial Chemotherapy, Vol. 53, No. 1. (1 January 2004), pp. 28-52
  • Foodborne Pathogens and Disease, April 1, 2008, 5(2): 199-203.

Nicotine Content In Womens’ Toenails Can Predict Heart Disease

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The level of nicotine in womens’ toenails can predict the risk of coronary heart disease, say researchers from the University of California, San Diego.

By analyzing the nicotine levels in the toenails of more than 60,000 women, the researchers found that those who had suffered heart disease had on average twice the levels of nicotine in their toenails than women without heart disease.

“Using toenail nicotine is a novel way to objectively measure exposure to tobacco smoke, and ultimately, to increase our understanding of tobacco-related illnesses,” explained Wael Al-Delaimy, Ph.D., Department of Family and Preventive Medicine, UC San Diego School of Medicine. “It has advantages over using other biomarkers and could become a useful test to identify high-risk individuals in the future. This would be especially helpful in situations where smoking history is not available or is biased.”

Researchers found no difference in age, body mass index, aspirin use, or history of high cholesterol corresponding to the toenail nicotine levels. Women with the highest toenail nicotine levels were physically less active, had a lower body mass index, drank a higher amount of alcohol, and were more likely to have histories of high blood pressure, diabetes, and family history of heart attack than women with lower levels.

Why toenails? The toenails have an advantage over other existing biomarkers of smoking because they grow more slowly. The levels detected in the nails represent nicotine taken up from blood by nails during growth. The slow growth rates of toenails provide a more stable estimate of average exposure, which is most relevant for illnesses related to tobacco smoke, such as heart disease. Using toenail samples in epidemiological studies is also an attractive concept because they’re easy to collect and store for relatively low cost.

The study was conducted by researchers at University of California, San Diego, School of Medicine, in collaboration with colleagues from Harvard University, and published in the April, 2008 issue of the American Journal of Epidemiology.

Health of Obese Teens Better After Laparoscopic Surgery

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The results of a new study show that the overall health of obese teenagers improved after they underwent laparoscopic gastric banding surgery.

The study’s lead author, Ilene Fennoy, MD, a pediatric endocrinologist at Morgan Stanley Children’s Hospital of NewYork-Presbyterian and clinical professor of pediatrics at Columbia University College of Physicians and Surgeons, said that this type of surgery – called the Lap Band procedure – is a safe and effective way for morbidly obese teens to lose weight. The procedure has been approved for use in adults by the FDA, but not yet for teenagers.

Dr. Fennoy observed that obesity-related health problems, such as diabetes and high blood pressure, are common in extremely obese teenagers, who have had to rely on non-surgical methods or high-risk surgeries to lose weight; and to date few treatments have been effective in helping adolescents. “Laparoscopic gastric banding offers the possibility of a new therapy for morbidly obese adolescents who have medical complications,” Dr. Fennoy said.

The study involved 14 morbidly obese adolescents, 6 boys and 8 girls, aged between 14 and 17 years, with the objective of documenting the impact of Lap-Band on the medical complications of obesity or their risk factors.

In order to shrink the stomach without using staples, a band goes round the upper part of the stomach, to create a small pouch that restricts food intake. The surgeon implants a small access port, and after the surgery the doctor periodically adjusts the gastric band by inflating or deflating a saline-filled balloon that lies inside the band. If desired, the procedure is reversible.

Dr. Fennoy stated that patients lost an average of 20 pounds within 6 months of the operation. While blood pressure remained virtually unchanged, major improvements were noted, including levels of fat in the blood, average blood sugar, liver function and a measure of immune response.

“Laparoscopic gastric banding provides a reasonable solution for obese young people who need to lose a large amount of weight,” Fennoy said.

Source: Endocrine Society, 9th Annual Meeting, June, 2008

Risk of Childhood Allergy and Atopic Diseases Increased by Traffic Pollution

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The risk of childhood allergy and atopic diseases is increased 50% by traffic-related pollution, according to a recent study by a German research organization.

“Children living very close to a major road are likely to be exposed not only to a higher amount of traffic-derived particles and gases but also to more freshly emitted aerosols which may be more toxic,” writes Dr. Heinrich. He continued: “Our findings provide strong evidence for the adverse effects of traffic-related air pollutants on atopic diseases as well as on allergic sensitization.”

The study’s author, Joachim Heinrich, Ph.D., of the German Research Center for Environment and Health at the Institute of Epidemiology, in Munich, checked close to 2900 children aged 4, and more than 3000 children aged 6 to establish their rates of asthma and allergy in relation to longterm exposure to traffic-related pollution.

Both groups of children came from the Munich area, and their exposure to traffic pollutants was calculated on the basis opf their homes’ distance from major roads at birth, and at two, three and six years of age. The parents completed questionnaires documenting their child’s respiratory symptoms and diagnoses, and the children were evaluated for asthma, wheezing, sneezing and eczema. The children were checked for food allergies at age six, and air was tested for particulate matter nd nitrogen dioxide at 40 high traffic areas between 1999 and 2000.

Significant positive associations were found between the distance to the nearest road and incidence of asthmatic bronchitis, hay fever, eczema and allergic sensitizations. Also noted was a relationship between proximity to a road and risk of allergic sensitization—subjects living closest to major roads had an almost 50% greater risk of allergic sensitization.

In this study, it was possible to determine that economic factors were not a confounding variable in the analysis, but there was a clear difference in the children’s allergic development with relation to their proximity to a road.

Source: American Journal of Respiratory and Critical Care Medicine, June, 2008 (2nd ed)