Vitamin D levels linked to weight-loss surgery outcomes

Low levels of vitamin D have long been identified as an unwanted hallmark of weight loss surgery, but now findings of a new Johns Hopkins study of more than 930,000 patient records add to evidence that seasonal sun exposure -- a key factor in the body's natural ability to make the "sunshine vitamin" -- plays a substantial role in how well people do after such operations.

Results of the study, published online Dec. 14 in the journal Obesity Science & Practice, reveal interplay among vitamin D status, seasons, geography and surgery outcomes, according to Leigh Peterson, Ph.D., M.H.S., a nutritionist and postdoctoral research fellow at the Johns Hopkins Center for Bariatric Surgery, who led the research.

Specifically, the researchers found that patients undergoing bariatric surgery in the United States during winter -- January to March, the time of lowest vitamin D levels -- fared worse than patients who had procedures in the summer. Similarly, patients having surgery in the north seemed to have more complications than those in the south.

"Sun exposure is critical in the synthesis of vitamin D, so the notion that people living in less sunny northern states may suffer from vitamin D deficiency is not surprising," says Peterson. "What is remarkable is how closely sun exposure, vitamin D and surgical outcomes were linked."

For the study, researchers reviewed records of more than 930,000 bariatric operations performed in the United States between 2001 and 2010. Overall, they report, post-procedural complications were rare, with fewer than 1 percent of patients developing infections. A more common outcome was spending a few extra days in the hospital, and this showed the strongest relationship with both season and geography.

The researchers found, Peterson says, a disproportionate number of those who fared worse hailed from areas north of latitude 37 degree -- roughly South Carolina -- than areas south of it. For example, areas north of latitude 37 degrees yielded almost 150,000 more patients with an extended length of stay -- more than three days in the hospital -- after surgery than areas south of that latitude. Considering that more than 300,000 of the operations, or over one-third of the total in the study, led to extended hospitalization, 71 percent of these surgical complications occurred north of 37 degrees.

Furthermore, the researchers noticed, adverse outcomes, such as nonhealing wounds, wound infections, wound separation and delayed wound healing, clustered in colder seasons marked by less sunshine. For example, more than twice as many patients experienced delayed wound-healing complications in the winter -- 349 patients, or 0.16 percent of operations reviewed -- than in the summer -- 172 patients, or 0.07 percent of operations reviewed.

The investigators caution that this observational study using medical records has limitations, and it is not enough to recommend the routine use of vitamin D supplements as a strategy to prevent or reduce the risk of postsurgical complications. Vitamin D supplements are often prescribed after weight loss surgery because of evidence that the operations reduce the ability of the gut to absorb the nutrient.

The investigators emphasize that further research is needed to determine the appropriate pre-emptive treatment with vitamin D in patients undergoing bariatric surgery. Experts believe that most people can and should get Vitamin D from brief, regular sun exposure, a healthy diet and possibly supplementation. While it is rare, excessive vitamin D intake can cause symptoms, such as nausea, constipation, confusion and abnormal heart rhythm. However, the researchers note, obesity is a well-known risk factor for vitamin D deficiency, and patients preparing to undergo weight loss operations should be screened for it.

Bariatric surgery serves to reduce weight for obese individuals or patients with diabetes and other conditions by reducing stomach size and/or bypassing a portion of the intestines. Nearly 200,000 bariatric surgeries occur annually in the United States. Costs for the procedure vary from $15,000 to $30,000 and are frequently covered by insurance.

"The growing rates of obesity and increased popularity of bariatric surgeries mean that primary care clinicians and bariatric surgeons should consider screening their patients and correcting any confirmed vitamin D deficiency," says Peterson.

In general, she says, nutritional deficiencies can fuel inflammation, higher infection risk and delayed wound healing.

The researchers say they are next planning a study measuring patients' vitamin D levels before and after surgery to help determine optimal doses for supplementation.

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The above post is reprinted from materials provided by Johns Hopkins Medicine. Note: Materials may be edited for content and length.

Mothers should be cautious when discussing weight with daughters

In an article recently published in the journal Body Image, Hillard and her colleagues, fellow Notre Dame psychology graduate student Rebecca A. Morrissey, and Notre Dame faculty members Dawn M. Gondoli, associate professor of psychology, and Alexandra F. Corning, research associate professor of psychology, reported on results from their study of a representative group of sixth- through eighth-grade girls and their mothers.

"Generally, we found that for the daughters who were being encouraged to lose weight by their mothers, outcomes were worse if their mothers were not also discussing their own weight concerns," Hillard said. "The daughters who were being encouraged to lose weight but whose moms were not also discussing their own weight concerns were more at risk for development of disordered eating, based on the higher scores on measures of dieting behavior and drive for thinness they reported in eighth grade."

Hillard acknowledged that the study findings as a whole suggested more about what mothers should not be talking about than what they should. "After all," she said, "the best outcomes were found for daughters whose mothers were not engaging in either type of conversation. They do shed light on the complexity of the issue of talking to children about their weight in ways that don't lead to poor health outcomes in the long run."

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Story Source:

The above post is reprinted from materials provided by University of Notre Dame. The original item was written by Michael O. Garvey. Note: Materials may be edited for content and length.

Study Suggests Link Between Gum Disease, Breast Cancer Risk

 Gum disease might increase the risk for breast cancer among postmenopausal women, particularly those who smoke, a new study suggests.

Women with gum disease appeared to have a 14 percent overall increased risk for breast cancer, compared to women without gum disease. And that increased risk seemed to jump to more than 30 percent if they also smoked or had smoked in the past 20 years, researchers said.

"These findings are useful in providing new insight into what causes breast cancer," said lead author Jo Freudenheim, a professor of epidemiology at the University at Buffalo's School of Public Health and Health Professions in New York.

"There is good evidence, though, that good dental care is important in any case and that treatment of periodontal disease is important for the health of the mouth," she said.

But more study is needed before there is enough evidence to say that gum disease causes breast cancer or other diseases, Freudenheim said. This study did not prove a cause-and-effect link between the two, a point made by several experts not involved with the study.

A number of studies have found an association between gum disease and other chronic diseases, including stroke, heart attack and other cancers, Freudenheim said.

"There is much to learn about why we see these associations," she said. "In particular, we don't know yet if treating the gum disease would decrease risk of these other diseases."

The report was published Dec. 21 in the journal Cancer Epidemiology, Biomarkers & Prevention.

Dr. Ashish Sahasra, an orthodontist in Garden City, N.Y., said, "This is going to open a lot of people's eyes to the potential link between gum disease and breast cancer."

Periodontal disease can cause many health problems, he said. "Gum disease is very common, and sometimes it goes undiagnosed or misdiagnosed and many people don't pay attention to it, but it's a serious disease that needs to be treated immediately," he added.

For the study, Freudenheim and her colleagues collected data on nearly 74,000 postmenopausal women who took part in the Women's Health Initiative study. None of the women had a history of breast cancer. After an average follow-up of almost seven years, more than 2,000 women were diagnosed with breast cancer.

The researchers found that women who were smoking at the time of the study appeared to have a 32 percent higher risk for breast cancer if they had gum disease, but the association was not statistically significant, Freudenheim said, because there weren't many current smokers among the women in the study. Among women who had quit smoking sometime within the past 20 years, those with gum disease seemed to have a 36 percent higher risk of breast cancer.

In addition, women who had never smoked but had gum disease seemed to have a 6 percent increased risk of developing breast cancer, and those who had quit more than 20 years before and had gum disease had an 8 percent higher risk, the study suggested.

Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, said, "Although there is a possibility that there is a direct link between gum disease and an increased risk of breast cancer, this study does not prove a direct link."

More study needs to be done to see if inflammatory factors such as gum disease contribute to the development of breast cancer, she said.

"Women with gum disease may lead lives that are less healthy overall, such as eating poorly, not exercising and drinking excessively," Bernik explained.

Dr. Leonard Lichtenfeld, deputy chief medical officer for the American Cancer Society, said, "We have to be cautious about putting too much emphasis on this study, but look at it in the context of overall health." Gum disease might be a sign of overall poor health and not the specific cause of breast cancer, he said.

SOURCES: Jo Freudenheim, Ph.D., professor, epidemiology, School of Public Health and Health Professions, University at Buffalo, New York; Stephanie Bernik, M.D., chief, surgical oncology, Lenox Hill Hospital, New York City; Ashish Sahasra D.M.D., orthodontist, Garden City, N.Y.;Leonard Lichtenfeld, M.D., deputy chief medical officer, American Cancer Society; Dec. 21, 2015, Cancer Epidemiology, Biomarkers & Prevention

Sudden Cardiac Arrest May Not Be So Sudden

Sudden cardiac arrest may not be as sudden as doctors have thought, researchers report.

Roughly half of cardiac arrest patients experience telltale warning signs that their heart is in danger of stopping in the month preceding their attack, new study findings suggest.

Those symptoms can include any combination of chest pain and pressure, shortness of breath, heart palpitations, and flu-like sensations (such as nausea, back pain and/or abdominal pain), the researchers said.

The problem: less than one in five of those who experience symptoms actually reach out for potentially lifesaving emergency medical assistance, the investigators found.

"Most people who have a sudden cardiac arrest will not make it out alive," warned study co-author Dr. Sumeet Chugh, associate director of the Heart Institute and director of the Heart Rhythm Center at Cedars-Sinai Medical Center in Los Angeles. "This is the ultimate heart disease, where you die within 10 minutes. And less than 10 percent actually survive," he said.

"For years we have thought that this is a very sudden process," Chugh added. "But with this study we unexpectedly found that at least half of the patients had a least some warning signs in the weeks before. And this is important, because those who react by calling their loved ones or calling 911 have a fivefold higher chance of living. So, this may open up a whole new paradigm as to how we may be able to nip this problem in the bud before a cardiac arrest even happens."

Chugh and his colleagues published their findings in the Jan. 5 issue of the Annals of Internal Medicine.

Though many people use the terms interchangeably, cardiac arrest is not the same as a heart attack. While a heart attack results from arterial blockage that cuts off blood flow to the heart, a cardiac arrest occurs when the heart's electrical activity goes awry and the heart stops working.

Upwards of half of all heart-related deaths in the United States occur as the result of cardiac arrest, killing 350,000 Americans every year, the study authors noted.

The new study focused on nearly 840 patients, aged 35 to 65, whose symptoms were tracked prior to experiencing a cardiac arrest between 2002 and 2012. Three-quarters were men, and all were enrolled in an ongoing study in Oregon.

The result: 50 percent of men and 53 percent of women experienced at least some warning symptoms before their hearts stopped.

Chest pain, said Chugh, was the most common symptom among men, while shortness of breath was the most common among women.

More than nine in 10 of those who had symptoms said they resurfaced 24 hours before their cardiac arrest, according to the study.

But only 19 percent called 911. Those who did were more likely to have a history of heart disease or chest pain that wouldn't subside.

The upside: nearly one-third of those who called 911 survived, versus 6 percent among those who did not, the researchers reported.

"It's not that everyone with chest pain is going to get a cardiac arrest," stressed Chugh. "It could just be too much exercise or heartburn."

But for people with a history of heart disease, it is more likely that these symptoms signal a real problem, he added.

"Still, this is our first foray into symptom identification," Chugh said. "We cannot yet say what patients should do until we look into this further."

Nevertheless, Dr. John Day, president of the Heart Rhythm Society and director of Heart Rhythm Services at Intermountain Medical Center Heart Institute in Murray, Utah, described the study findings as a "wake-up call for patients and doctors."

Day said that "the problem, of course, is that many of these symptoms may have other explanations. Flu-like symptoms, which can affect nearly everybody at some point during the winter, is a vague thing to really put your finger on and know that it's about your heart. So it's certainly challenging to find the right signal through all the noise," he added.

"But these signs should not be ignored," Day said. "Particularly if you have risk factors for heart disease, such as a family history of heart problems or high blood pressure, cholesterol, diabetes or a known heart condition."

SOURCES: Sumeet Chugh, M.D., associate director, Heart Institute, and director, Heart Rhythm Center, Cedars-Sinai Medical, Los Angeles; John Day, M.D., president, Heart Rhythm Society, and director, Heart Rhythm Services, Intermountain Medical Center Heart Institute, Murray, Utah; Jan. 5, 2016, Annals of Internal Medicine

Being 'Fat But Fit' Won't Cut Your Risk of Premature Death

New research seems to contradict the idea that people might escape the health hazards associated with obesity if they're "fat but fit."

The new study suggests that the health benefits of physical fitness are offset by obesity. No matter their fitness level, normal-weight men had a lower risk of dying during the study than did the most physically fit obese men, the researchers said.

Still, it's important to note that the study wasn't designed to prove a cause-and-effect relationship. This type of study can only show a link between physical fitness and the risk of premature death.

Findings were published in the Dec. 20 issue of the International Journal of Epidemiology.

The study included more than 1.3 million Swedish men. Their health was followed for an average of almost 30 years, according to the researchers, led by Peter Nordstrom from Umea University in Sweden.

To measure aerobic fitness, the men rode an exercise bicycle until they were too tired to continue.

The men in the top 20 percent of aerobic fitness had a 48 percent lower risk of death from any cause during the study period compared with those in the bottom 20 percent, the investigators found.

However, the beneficial effects of physical fitness decreased as obesity increased, the researchers said. And, for the most obese, even the highest levels of physical fitness couldn't provide health benefits to offset the risks from obesity.

The study authors concluded that being "fat but fit" still poses health risks.

SOURCE: International Journal of Epidemiology, news release, Dec. 20, 2015

U.S. Task Force Stays Neutral on Cholesterol Screening for Kids

There's not enough evidence to recommend screening all children and teens for high cholesterol, experts say.

It's not clear if such screening up to age 20 reduces the risk of cardiovascular disease in adulthood, the U.S. Preventive Services Task Force said in a draft recommendation released Monday. This is unchanged from a 2007 recommendation.

"There is currently not enough research to determine whether screening all average-risk children and adolescents without symptoms leads to better cardiovascular health in adulthood," task force vice chair Dr. David Grossman said in a news release from the task force.

"In addition, the potential harms of long-term use of cholesterol-lowering medication by children and adolescents are not yet understood," Grossman added.

The task force is an independent, volunteer panel of national experts in prevention and evidence-based medicine.

All children and teens should eat a healthy diet, exercise and maintain a normal weight, the task force advised.

"The task force recognizes the importance of cardiovascular health for young people and calls for more research on the benefits and harms of screening and treating young people for high cholesterol," task force member Dr. Douglas Owens said in the news release.

SOURCE: U.S. Preventive Services Task Force, news release, Dec. 21, 2015

HealthDay

Newest miracle food may be avocado, which has potential cancer-busting properties

First it was blueberries. Then the tart, deep red seeds of pomegranates. Now it's avocado's turn in the spotlight.Long revered as a superfood with good vitamin and fat content, the fleshy green fruit is being used in the development of a drug that researchers hope will one day be able to fight blood cancer.

In a study published in the journal Cancer Research, Paul Spagnuolo, a professor at the University of Waterloo in Ontario, Canada, writes of a fat in avocados that combats acute myeloid leukemia (AML), a rare and deadly form of cancer, by targeting leukemia stem cells while leaving healthy cells unharmed
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Newest miracle food may be avocado, which has potential cancer-busting properties

First it was blueberries. Then the tart, deep red seeds of pomegranates. Now it's avocado's turn in the spotlight.

Long revered as a superfood with good vitamin and fat content, the fleshy green fruit is being used in the development of a drug that researchers hope will one day be able to fight blood cancer.

In a study published in the journal Cancer Research, Paul Spagnuolo, a professor at the University of Waterloo in Ontario, Canada, writes of a fat in avocados that combats acute myeloid leukemia (AML), a rare and deadly form of cancer, by targeting leukemia stem cells while leaving healthy cells unharmed.

“The stem cell is really the cell that drives the disease,” Spagnuolo said in a statement accompanying the publication of the study, explaining that the continued presence of those cells is why so many patients with leukemia relapse.

The prognosis for AML patients is devastating because there are few treatment options. For 90 percent of those who are older than 65, the disease is fatal in five years. Spagnuolo hopes a new drug made from avocatin B -- the name of the lipid that has been shown to destroy leukemia stem cells -- may help increase their life expectancy or quality of life.

A drug for leukemia derived from avocados is still years away, but even those without cancer can still benefit from the food.

Past studies have shown that eating a lot of avocados is associated with lower blood cholesterol. In one study that involved putting people with slightly elevated levels on a diet rich in avocados for just seven days, researchers saw a 17 percent decrease in cholesterol levels.

http://www.washingtonpost.com/news/to-your-health/wp/2015/06/18/newest-miracle-food-is-avocado-which-has-potential-cancer-busting-properties/

Trans Fats From Foods May Worsen Memory, Study Finds Men who ate more performed poorly on word recall test

Trans fats may play havoc with your memory along with your cholesterol levels, a new study suggests.

Younger men who ate high levels of trans fats performed more poorly on a memory test involving word recall than those who ate lower levels, the researchers found.

In the study, men with high daily intake of trans fat recalled 12 to 21 fewer words, out of an average score of 86, said lead author Dr. Beatrice Golomb, a professor of family and preventive medicine at the University of California, San Diego School of Medicine.

"It's a pretty sizeable relationship," Golomb said. "This adds to a body of evidence that trans fats are not something that people should be sticking in their mouth."

But, it's important to note that the study wasn't designed to definitively prove a cause-and-effect relationship; it can only show an association between higher consumption of trans fats and worsened recall.

The findings were published online June 17 in the journal PLOS One.

Golomb's study appears the day after the U.S. Food and Drug Administration announced a three-year phase-out of partially hydrogenated oils from the American food supply. These oils are a primary source of trans fats.

Golomb calls trans fats an "anti-food," noting that they increase levels of "bad" LDL cholesterol while simultaneously driving down levels of "good" HDL cholesterol.

Trans fats also increase inflammation and interfere with hormone production, which might explain the association between trans fats and memory, she said.

"The purpose of food is to provide your body with the nutrients it needs to function properly," Golomb said. "This actually does the opposite. It subverts cellular and organ function."

Golomb decided to look into trans fats following another study in which chocolate was favorably linked to memory. Chocolate is an antioxidant that has anti-inflammatory properties, so it stood to reason that trans fats might harm memory by promoting inflammation, she said.

In the study, researchers evaluated data from 645 healthy men who were asked to complete a dietary survey and take part in a memory test.

The test involved a set of 104 cards, each bearing a word. The men had to say whether each word was new, or had been shown to them before.

On average, men 45 and younger recalled 86 words. But for each additional gram of trans fats consumed daily, their performance dropped by 0.76 words, the study revealed.

Men whose daily diet contained about 16 grams of trans fats recalled 12 fewer words correctly, while men who consumed as much as 28 grams of trans fats daily recalled about 21 fewer words, the study found.

"This study does provide 'food for thought' about potential adverse effects of dietary trans fatty acids on cognitive [mental] function," said Dr. Marc Gordon, chief of neurology for Zucker Hillside Hospital in Glen Oaks, N.Y.

However, Gordon said that the study doesn't prove a direct link between trans fats and memory, but only shows a potential association that might have some other explanation.

Besides causing inflammation, trans fats might also inhibit the body's production of omega 3 fatty acids, which play a crucial role in brain function, Golomb said.

"It would not be unexpected for that to lead to worse brain function," she said.

Trans fats also might affect a person's serotonin levels, said Jim White, a nutrition expert in Virginia Beach, Va., and a spokesman for the Academy of Nutrition and Dietetics. Serotonin is a hormone that regulates mood, appetite and sleep, and also plays a role in brain function.

"If trans fat is reducing serotonin levels, it can really affect depression and memory," said White, noting that previous studies have shown increased depression in people who consume high amounts of trans fats.

On June 16, the FDA ruled that partially hydrogenated oils are no longer "generally recognized as safe," the designation that for decades has allowed companies to use the oils in a wide variety of food products.

Companies have until June 18, 2018 to either reformulate their products and remove all partially hydrogenated oils, or petition the FDA to permit specific uses of the oils, the agency announced.

Even though food manufacturers have cut trans fats by 86 percent since 2003, trans fats still make up 2 percent to 3 percent of the average American diet -- about 5 to 6 grams a day, White said.

"I normally don't recommend cutting out anything completely in the diet," White said. "Our bodies even need a small amount of saturated fats to sustain them. But I tell people, do not consume anything with trans fats in them. This is a nutrient that's been nothing but negative."

The study focused on men because there were too few women to include in the analysis, Golomb said. But she added that she saw no reason why trans fats would affect women differently than men.

http://consumer.healthday.com/vitamins-and-nutrition-information-27/food-and-nutrition-news-316/trans-fats-from-foods-may-worsen-memory-study-finds-700500.html

Can U.S. Health-Care System Afford New, Improved Cholesterol Drugs?

A new class of powerful cholesterol drugs is poised to hit the market, and doctors are both hopeful about their potential, and worried that insurers won't pay for them.

The drugs, known as PCSK9 inhibitors, can drastically cut LDL cholesterol -- the "bad" kind linked to increased risks of heart attack and stroke. And they are expected to open up a new option for people who cannot take statins, the drugs that have been the standard for cholesterol-lowering since the 1980s.

Last week, an advisory panel to the U.S. Food and Drug Administration recommended the agency approve two PCSK9 inhibitors: alirocumab (Praluent) and evolocumab (Repatha).

The FDA, which usually follows the recommendations of its advisory panels, is expected to OK both drugs.

Some cardiologists have heralded PCSK9 inhibitors as a breakthrough -- particularly for patients who can't take statins because of side effects, such as intolerable muscle pain, and for those whose LDL does not decline enough with statins or other current drugs.

"I think this is fantastic news for those patients," said Dr. Thomas Whayne, director of the Lipid Management Clinic at the University of Kentucky's Gill Heart Institute.

The downside, as Whayne sees it, is that insurers may not be willing to pay in all cases. "I think we'll have some tremendous battles with pharmacy benefit managers," he said.

Why? Because PCSK9 inhibitors are complex, injectable drugs called monoclonal antibodies, which are expensive to produce. And they are expected to be priced accordingly -- running up to $12,000 a year, according to a recent estimate from CVS Health, one of the nation's largest pharmacy benefit managers.

By comparison, many statins are available as generics, and can cost as little as a few dollars a month, according to Consumer Reports.

CVS Health warned that PCSK9 inhibitors could put a "great cost" on the health-care system. As many as 15 million Americans could be candidates for the drugs, the company said -- and those people would be taking the medications for years, if not decades.

It's likely that some patients will have difficulty getting insurance coverage, agreed Jack Hoadley, a research professor at Georgetown University's Health Policy Institute, in Washington, D.C.

"In these situations, the insurance companies can end up looking like the bad guy if they put up obstacles," Hoadley said.

On the other hand, he added, there are legitimate reasons for payers to balk: The new drugs do slash LDL levels -- by as much as 60 percent -- but they haven't been studied long enough to know whether they actually prevent heart attacks and strokes.

"What we don't have yet is evidence that these drugs save lives," Hoadley said.

Plus, it's not entirely clear which people with high cholesterol would fare better with a PCSK9 inhibitor rather than a statin or other standard medication.

"There will be some ambiguity about which patients are the right candidates," Hoadley said.

And that will be a "real challenge" when the medications hit the market, said Brent Reed, an assistant professor of pharmacy practice and science at the University of Maryland, in Baltimore.

"I think the first patients to receive this drug will be those with familial hypercholesterolemia," Reed said, referring to a genetic condition that causes very high LDL levels that often resist statin treatment.

Beyond that group, though, things get murkier.

People who are "statin-intolerant," because of side effects such as muscle pain, seem like obvious candidates. But, Reed said, statin intolerance is not simply defined: Studies show that people who have, or perceive, statin side effects often do much better if they try again -- with a different statin or a different drug dose.

Reed said he wouldn't be surprised if insurers required proof of true statin intolerance before they would approve a PCSK9 inhibitor.

Whayne pointed to another group that could benefit from the new drugs: People at high risk of heart attack or stroke -- because of multiple risk factors, like diabetes and high blood pressure -- whose LDL levels do not respond adequately to statins.

But again, that's a gray area. If a doctor wants to further reduce a patient's LDL, an insurer can question the necessity. The latest guidelines from the American College of Cardiology and the American Heart Association say it's the statin treatment that is important, but downplay the need for getting LDL to a "target" number.

Whayne said he can foresee doctors "battling" insurers in such cases.

Still, Whayne also stressed that doctors will have to be selective about PCSK9 drugs. "This should not be a casual prescription," he said.

For his part, Reed said the unknowns about PCSK9 inhibitors -- not only their long-term effectiveness, but their safety -- will make him cautious. "Until I see compelling evidence that they improve patients' outcomes, I can't really see choosing them over a statin in most cases," he said.

Hoadley noted: "The FDA will probably approve them, but the FDA process does not look at whether these drugs are any better than the alternatives." That, he said, will require studies that compare PCSK9 inhibitors with statins.

SOURCES: Thomas Whayne, M.D., Ph.D., director, Lipid Management Clinic, University of Kentucky, Gill Heart Institute, Lexington; Jack Hoadley, Ph.D., research professor, Georgetown University Health Policy Institute, Washington, D.C.; Brent Reed, PharmD., assistant professor, pharmacy practice and science, University of Maryland School of Pharmacy, Baltimore.

http://www.nlm.nih.gov/medlineplus/news/fullstory_153148.html

Most Physical Activity Helps You Sleep Better

FRIDAY, June 12, 2015 (HealthDay News) -- Certain types of physical activity help you sleep better, while others might leave you tossing and turning, a new study finds.

Researchers looked at data from a survey of more than 429,000 American adults. They found that activities such as walking, bicycling, running, weight lifting, aerobics/calisthenics, gardening, yoga/Pilates and golfing were all linked to better odds of a good night's slumber.

But, people who got physical activity from household chores and child care had a greater risk of poor sleep, according to the study.

Results of the study were presented this week at the annual meeting of the Associated Professional Sleep Societies, in Seattle. Findings presented at meetings are generally viewed as preliminary until they've been published in a peer-reviewed journal.

The results of this study were surprising, according to study leader Michael Grandner, a psychiatry instructor at the Center for Sleep and Circadian Neurobiology at the University of Pennsylvania in Philadelphia.

"Not only does this study show that those who get exercise simply by walking are more likely to have better sleep habits, but these effects are even stronger for more purposeful activities, such as running and yoga, and even gardening and golf," Grandner said in a university news release.

"It was also interesting that people who receive most of their activity from housework and child care were more likely to experience insufficient sleep -- we know that home and work demands are some of the main reasons people lose sleep," Grandner added.

"These results are consistent with the growing scientific literature on the role of sleep in human performance. Lab studies show that lack of sleep is associated with poor physical and mental performance, and this study shows us that this is consistent with real-world data as well," he explained.

But since the study design only allowed the researchers to find associations between activity and sleep, instead of proof of a cause-and-effect relationship, more studies are needed, according to Grandner.

SOURCE: University of Pennsylvania, news release, June 4, 2015

HealthDay

http://www.nlm.nih.gov/medlineplus/news/fullstory_153056.html

Chamomile Tea Tied to Longer Lives for Mexican-American Women

SATURDAY, June 13, 2015 (HealthDay News) -- Consumption of chamomile may be linked to a longer lifespan for older Mexican-American women, new research suggests.

The study, funded by the U.S. National Institutes of Health, found that among Mexican-American women who consumed chamomile, the risk of death during the study period was reduced by about 28 percent.

"Drinking chamomile tea is beneficial to the health of Mexican-American women," said the study's lead author, Bret Howrey, assistant professor of family medicine at the University of Texas Medical Branch in Galveston.

However, the study only showed evidence of a possible link between chamomile and longer lifespan. It didn't prove a cause-and-effect relationship.

And at least one nutritionist questioned the validity of the study's findings.

The herb chamomile is a mainstay of alternative medicine, and practitioners often recommend it to treat conditions like stomach problems and cramps, according to the study. But "few well-designed and controlled human studies have been conducted on the effects of herbal teas or herbal preparations," said Diane McKay, an assistant professor with the Friedman School of Nutrition Science and Policy at Tufts University, who's familiar with the study findings.

Researchers examined the findings from almost 1,700 Mexican-American people from the southwest United States. They were all 65 and older, and were tracked from 2000 to 2007. About 14 percent of the participants reported using chamomile, according to the study.

Using chamomile didn't seem to affect lifespan in men, the study found.

When researchers adjusted the statistics to account for factors such as age, smoking and chronic health conditions, they found the odds of dying during the study period were reduced by just over one-quarter in women who used chamomile.

Why might chamomile affect lifespan and health in general? It's unclear. "Our understanding of chamomile is still really in its infancy," Howrey said.

He added that the study itself has limitations: It's based entirely on research into a Mexican-American community. Only 26 percent of those in the study had a normal weight. Also, there's no information on the overall diet of the participants. Those who consumed chamomile could have healthier diets overall, although the researchers did try to take factors such as fitness and weight into account.

The study also says nothing about people who aren't Mexican-American, Howrey said. And he noted that the study doesn't eliminate the possibility that men could benefit from chamomile. The study may not have picked up a benefit for them due to lower rates of chamomile consumption (just 8 percent of men reported using it) or worse health overall, he said.

McKay called the study "deeply flawed." She said the findings don't support the idea that chamomile affects lifespan.

Among other weaknesses, she said, the study doesn't explain how participants consumed chamomile: "We can't say for sure whether these folks actually drank the same chamomile tea we find on our store shelves, or even how much they drank and how often. No information was collected on the actual form of chamomile used, i.e., whether it was tea, pill or other type of preparation, or whether it was actually consumed rather than used as a lotion or inhaled oil, for example."

Howrey acknowledged that the study says nothing about how much chamomile to take. Still, he recommends consuming chamomile, especially since it's "generally non-toxic, relatively inexpensive, and widely available."

He mentioned one caveat -- some people may be allergic to chamomile, especially if they're allergic to related plants such ragweed.

Howrey said the researchers are continuing to track the older Mexican-Americans. However, "if the effects of brewed chamomile are very subtle and benefits slow to manifest," a more extensive study would be needed, he said.

The study was published recently in the journal The Gerontologist.

SOURCES: Bret Howrey, Ph.D., assistant professor, Department of Family Medicine, University of Texas Medical Branch, Galveston; Diane McKay, Ph.D., director, Graduate Certificate Program, and assistant professor, Friedman School of Nutrition Science and Policy, Tufts University, Boston; April 29, 2015, The Gerontologist

HealthDay

http://www.nlm.nih.gov/medlineplus/news/fullstory_153075.html

FDA Ban on Harmful Trans Fats Expected Soon

SUNDAY, June 14, 2015 (HealthDay News) -- Harmful trans fats may soon be banished from America's food supply, following a U.S. Food and Drug Administration announcement expected any day now.

The move could prevent as many as 20,000 heart attacks and 7,000 deaths from heart disease a year, the FDA says.

Most trans fats in food come from partially hydrogenated oils. Up to now, the FDA has designated these oils with "generally recognized as safe" status. That allows manufacturers to use the oils in food without prior FDA approval.

But under the proposed rule on the verge of finalization, the FDA would reclassify partially hydrogenated oils as food additives. This means companies would need federal approval before including them in food products.

"This is going to be a huge public health victory," said Jim O'Hara, director of health promotion for the Center for Science in the Public Interest, which petitioned the FDA to ban trans fats nine years ago. "It's time to get trans fats out of the food supply."

Food manufacturers use partially hydrogenated oils to improve the texture, shelf life and long-term flavor of foods, according to the FDA. They are created by pumping hydrogen into vegetable oil to make it more solid.

These oils most often are found in processed foods such as:

• baked goods like cakes, cookies and pies,
• nondairy creamers,
• microwave popcorn,
• frozen pizza,
• margarine and other spreads,
• vegetable shortening,
• refrigerated dough products such as biscuits and cinnamon rolls.

Trans fats are considered even worse than saturated fats such as butter because they simultaneously increase "bad" LDL cholesterol and reduce "good" HDL cholesterol in the body, said Sonya Angelone, a registered dietitian nutritionist in San Francisco.

"Trans fats don't do anything good for us, and they are in a lot of foods that people like eating," said Angelone, a spokesperson for the Academy of Nutrition and Dietetics. "If we get rid of them, it's going to help people reduce their risks for heart attacks and strokes."

Companies began cutting back on their use of partially hydrogenated oils in 2006, when the FDA added trans fats to the Nutrition Facts label contained on products, O'Hara said.

Food manufacturers have voluntarily lowered the amounts of partially hydrogenated oils in food products by 86 percent since 2003, and continue to remove them from products, according to a statement released last week by the Grocery Manufacturers Association.

"I think they've seen the handwriting on the wall," Angelone said. "A lot of large companies have already moved to get rid of trans fats."

In November 2013, the FDA released a tentative determination that partially hydrogenated oils are not generally recognized as safe. It opened the matter up for public comment and has since weighed input from consumers, industry, advocacy groups and academic researchers.

The FDA's latest statement, issued last week, said the agency "expects to make a final decision whether artificial trans fats, known as partially hydrogenated oils, are generally recognized as safe for use in food in the next several weeks."

Companies still would be able to petition the FDA to use partially hydrogenated oils as food additives, to help preserve flavor or colors in some foods. The Grocery Manufacturers Association is leading an industry working group that is developing a food additive petition for partially hydrogenated oils, the group said in its statement.

"We hope that the FDA will take a very rigorous and skeptical eye to these petitions," O'Hara said.

SOURCES: Jim O'Hara, director, health promotion, Center for Science in the Public Interest; Sonya Angelone, M.S., R.D.N., C.L.T., registered dietitian nutritionist, San Francisco, and spokesperson, Academy of Nutrition and Dietetics; June 11, 2015, statement, U.S. Food and Drug Administration; June 10, 2015, statement, Grocery Manufacturers Association

HealthDay

http://www.nlm.nih.gov/medlineplus/news/fullstory_153076.html

Growing interest: School-grown vegetables increase salad selection

If kids grow vegetables, they're more likely to eat them. A new Cornell study published in Acta Paediatrica shows that when garden grown vegetables were slipped into school salads, kids were over four times as likely to take a salad.

"This is a small study, but it suggests gardens can help children's diets -- even in the snow belt," said lead author Brian Wansink PhD, Director of the Cornell Food and Brand Lab and author of Slim by Design.

This pilot study, conducted in upstate New York, measured the change in vegetable selection and plate waste when school grown salad greens were incorporated in the cafeteria school lunch. The researchers measured the selections and plate waste of a total of 370 enrolled high school students over three separate days.

When the salad bar contained produce grown by students, the percentage of those who selected salads with their meals increased from 2% to 10% and on average, students ate two-thirds of their salads. Unfortunately, in addition to increased salad selection, the amount of plate waste also increased. Overall salad consumption for the entire student body increased from approximately 5 to 12 servings per day.

This study implies the larger potential benefits of the school garden programs. "We see great promise with this research. The first hurdle in increasing vegetable consumption is simply getting kids to put them on their plate," concluded co-author Drew Hanks of Ohio State University.

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Story Source:

The above story is based on materials provided by Cornell Food & Brand Lab. The original article was written by Brian Wansink. Note: Materials may be edited for content and length.

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Journal Reference:

1. Brian Wansink, Andrew S. Hanks, David R. Just. A plant to plate pilot: a cold-climate high school garden increased vegetable selection but also waste. Acta Paediatrica, 2015; DOI: 10.1111/apa.13028