Saturday, August 23, 2008

HRT 'boosts quality of life'

Nice to see an admission of how vanishingly small any risk is

Six years after widespread panic about hormone replacement therapy causing cancer and strokes, research suggests it improves quality of life. One of the world's longest and largest trials of hormone replacement therapy has found it can improve sleep, sexuality and joint pain in post-menopausal women. Published today by the British Medical Journal, the results are from a study by the WISDOM research team (Women's international study of long duration oestrogen after menopause). The study involved 2130 post-menopausal women in Britain, Australia and New Zealand, and assessed the impact of combined oestrogen and progestogen hormone therapy on the quality of life.

The average age of women in the study was 63, and 70 per cent of participants did not have menopausal symptoms of hot flushes and night sweats. University of Adelaide obstetrics and gynaecology Professor Alastair MacLennan, who led the Australian arm of the research, said the results were interesting but he was not recommending that women with no symptoms use HRT. "Our results show that hot flushes, night sweats, sleeplessness and joint pains were less common in women on HRT in this age group," he said yesterday. "Sexuality was also improved. Overall, quality of life measures improved. Even when women did not have hot flushes and were well past menopause, there was a small but measurable improvement in quality of life and a noted improvement in sleep, sexuality and joint pains."

Professor MacLennan said studies such as those conducted by WISDOM enabled the risks of HRT to be reduced and benefits maximised when the treatment was tailored to the individual. Early side effects could usually be eased by adjusting the treatment, he said. For most women with significant menopausal symptoms, the benefits of HRT outweigh the risks.

In 2002, an eight-year HRT trial was stopped after five years because researchers concluded the risks were too great, with evidence of more cancers and strokes. The news caused women around the world to abandon HRT, with Australian women reacting more strongly than most. In Europe, about 5 per cent of women stopped treatment, compared with up to 40 per cent in Australia, although many have since returned.

Professor MacLennan said the most recent analyses of the main long-term randomised control trial of HRT - the Women's Health Initiative - showed breast cancer incidence did not increase with oestrogen-only HRT and was only increased in women using combined oestrogen and progestogen HRT after seven years of use. This increased risk was less than 0.1 per cent [That's one tenth of one percent] per year of use. If a woman feels that HRT is needed for quality of life, then doctors can find the safest regimen for her, Professor MacLennan said. She can try going off HRT every four to five years, and can then make an informed choice about whether she takes and continues HRT.

The WISDOM research is independent of the pharmaceutical industry and has been funded by UK, Australian and New Zealand government research bodies. Australian Medical Association state president Dr Peter Ford said women should weigh up the known risks and benefits of HRT. Those with acute menopausal symptoms could gain considerable relief from the therapy. When people are really in distress from those symptoms, its a godsend, quite frankly, to be able to offer it, he said.


A disgusting example of `junk television'

BBC3 has given us yet another helping of mechanically-generated TV designed to scare us about what we eat.

Cheap food is often not very good. Sometimes it might look the part, but the content is frequently sickly and leaves a nasty taste in the mouth. How appropriate, then, that a programme `revealing' this fact should have been shown on BBC3 - the Beeb's yoof TV channel which produces documentaries that seem like a tasty treat on the outside but are actually stuffed with crap.

Britain's Really Disgusting Foods, presented by the mildly amusing Alex Riley, was the search for the worst thing you could eat that is legally available in shops. Riley has thick, black-rimmed glasses and could probably do with a haircut. He looks like a dork and has a vaguely northern accent, but his management calls him `tall, sleek and unconventionally handsome'. Whatever.

He went in search of foods that had the most `stuff' added to them. Unsurprisingly, this didn't mean organic parsnips, but the kind of food churned out by big food processors and sold in your local cash-and-carry.

His first target was something called `cheese alternative'. This is an `analogue', a substance that contains some of the qualities of cheese - it even contains some skimmed milk - but isn't actually produced in the same way as cheese. Instead, it is created by the block load to pad out cheap supermarket food and takeaway pizzas and is packed full of `E' numbers - that is, artificial additives. And it doesn't taste of anything very much, never mind cheese.

If the `cheese' is full of additives, the chicken breasts are full of water. Riley managed to find some in his local Booker cash-and-carry store (yes, bizarrely, it is the same Booker that sponsors Britain's most famous literary prize) which contained just 60 per cent chicken and lots of water. You won't find chicken breasts like this in the local supermarket, but you might find them in your restaurant-bought chicken fried rice or chicken vindaloo. A trader in Smithfield, London's main meat market, told Britain's Really Disgusting Foods that chicken breasts stuffed full of water are popular with Chinese and Indian takeaways.

Another unsurprising target were sausages. They're absolutely full of rubbish, right? Well, actually, not as much as you might think. Riley was most disappointed to find that eyelids, scrotums, anuses and ears aren't allowed into any product labelled `sausage'. In fact, sausages must be 32 per cent meat at least, and most good-quality sausages contain 80 per cent or more.

However there's lots of other stuff you can put into meat products - like connective tissue - which might otherwise be thrown away. You'd have thought in an era of waste-not-want-not eco-frugality that the efficiency of the meat industry in this respect would have been praised. Many processed products are also bulked out with ingredients that are a hell of a lot cheaper than real meat: rusk, soya, colouring, etc. Confront people with the raw ingredients and they will turn their noses up. Offer samples of such a sausage at the posh nosh exhibition the Good Food Show, as Riley did, and people seem to think they're actually quite nice. Just don't mention what's in them.

This only goes to show the pragmatic attitude we Brits have to our food. As long as someone can assure us that what we eat isn't harmful, we'll happily munch away. Restaurants perform much the same trick. It doesn't really matter what you're eating - if it's cooked with half a pack of butter and seasoned well, it's going to taste good. We just love salt and fat, whether it's fine dining or the local takeaway after a heavy session.

As is often the way with this kind of TV show, Riley pulled in an expert or two to suggest that eating this kind of rubbish is responsible for the `wave of degenerative disease' in Britain, without actually detailing why that might be the case (or even proving that it is true). Like the pies he created to show off the worst of British processed food practices, Riley's film didn't have a lot of meat in it.

He did, however, manage one good thing. Booker's magazine for the Good Food Show featured a column by potty-mouthed celebrity chef Gordon Ramsay, which apparently extolled the virtues of Booker's wares to the catering trade. No doubt Ramsay was mortified to be featured in a programme on crap sausages and dodgy chicken; these are the type of catering practices he attacks in shows like Ramsay's Kitchen Nightmares. But that's what you risk if you whore your reputation as a multi-Michelin starred chef to all-comers - just the kind of thing that a young, up-and-coming chef called Gordon Ramsay was railing against 10 years ago.

Britain's Really Disgusting Foods was another prime cut of the kind of no-need-to-watch factual programming mechanically generated by BBC3 and, indeed, by every other channel these days. From Honey, We're Killing the Kids to It's Shit Being an Indian Sweatshop Worker (okay, I made the last one up), factual television has been reduced to junk telly, as obvious and unsatisfying as a Pot Noodle. Yummy!


Century-old drug might cure Parkinson's

A study with mice suggests a century-old drug, methylene blue, could slow or even cure Alzheimer's and Parkinson's disease in small doses, researchers say. "To find that such a common and inexpensive drug can be used to increase and prolong the quality of life by treating such serious diseases is truly exciting," said Bruce Ames, a coauthor of the study at Children's Hospital & Research Center Oakland, in California.

Led by Hani Atamna at the center, researchers studied the drug's effects on laboratory-cultured cells and mice. In very low concentrations -- the equivalent of a few raindrops in four Olympicsized swimming pools -- the drug slows cellular aging and enhances the function of cellular "power plants" called mitochondria, the experimenters said. Their results appeared in the March issue of the Federation of American Societies for Experimental Biology Journal.

The group found methylene blue could prevent or slow mitochondrial decline, specifically that of an important enzyme called complex IV. Mitochondria are the main energy suppliers to animal and human cells.

"The results are very encouraging," said Atamna. "One of the key aspects of Alzheimer's disease is mitochondrial dysfunction, specifically complex IV dysfunction," he went on. Methylene blue seems to expand the brain's "mitochondrial reserve," he added, "essential for preventing age-related disorders."

Discovered in 1891, methylene blue is used to treat methemoglobinemia, a blood disorder. But because high concentrations of methylene blue were known to damage the brain, no one thought to experiment with low concentrations, Atamna's group said. Also, drugs such as methylene blue don't easily reach the brain.

Atamna said methylene blue could become another commonplace lowcost treatment like aspirin, prescribed as a blood thinner for people with heart disorders.


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