Wednesday, September 12, 2012



Just a little breast-feeding in infancy 'lowers the risk' of a child suffering from depression in adulthood

Retrospective self-report data and a small sample of ill people.  Thin grounds for generalization

Adults are less likely to suffer from depression if they were breast-fed as infants, according to scientists.  However, the amount of time a person was breast-fed has no bearing on the severity of later depression.

German researchers studied 52 people with an average age of 44 who were being treated for severe depression at an inpatient facility.

The patients were considered to have been breast-fed if they, or their mothers, stated that they been nursed for more than two weeks.

They then contrasted these results with those gathered from 106 people without mental health problems.

The study revealed that some 73 per cent of those who didn't suffer from depression had been breast-fed, compared to just 46 per cent of people with depression.

Despite these results, the scientists said that there is no cause-and-effect relationship between breast-feeding, or lack thereof, and depression, reports MyHealthNewsDaily.

Firstly, a mother who breastfeeds might be more likely to go on to provide her child with a more loving environment growing up, thus lowering the chance of a child suffering from depression in adulthood.

Secondly, breastfeeding could be linked to an increase in the hormone oxytocin being released in mothers, which protects against stress.

Thirdly, the researchers said, breast milk could contain components that help prevent against depression.

Lastly, breast-feeding may lower the risk for diseases, like hypertension, which have been shown to be associated with an increased risk for depression.

The study is published in the journal Psychotherapy and Psychosomatics.

Its authors claim it is the first report showing an association between breast-feeding and the occurrence of depression later on in adulthood. However, they admit that the limited sample size and the inevitably retrospective nature of this analysis are limitations.

SOURCE





Another Stilnox/Ambien miracle

I take the stuff myself as a mild sleeping pill and have no problems with it

A South African man who had been in a coma for seven years was 'woken up' after being given a sleeping pill.

Ayanda Nqinana, from Johannseburg, was left with severe brain injuries after his car crashed along an Eastern Cape road in 2005.   His doctors said the father-of-one would most likely never recover.

But his wife Nomfundo recently read a newspaper article about other long-term coma patients who had woken up after being fed sleeping pill Stilnox.

She insisted her husband be given the tablets and, just five days later, Mr Nqinana was awake and able to talk.

He even recognised relatives, including his son Ayavuya, and could recall conversations from before his crash.

Mrs Nqinana told TimesLive.co.za: 'Ayavuya was so excited that he kept running to me saying: "Mum! Daddy knows my name."   'I will never forget the day Ayanda woke up; it was the happiest day of my life.
WHAT IS STILNOX?

Stilnox, also known as Ambien, is a prescription medicine used to treat insomnia by initiating sleep.

It contains Zolpidem, which studies have found increases blood flow in the brain, particularly in areas involved in language comprehension - allowing improved function.

Studies into the connection between stroke rehabilitation and Stilnox are ongoing.

John White at Moss Rehabilitation Center in Philadelphia is leading a study into the connection.

So far he has found that fewer than 10 per cent of stroke victims respond to the drug.  'We’re not able to yet advise families on how to use this drug clinically because the research is in the very early stages,' he said last year.

'The very first request he made was to see his son, and that moved me.'

Although Mr Nqinana is unable to hold a proper conversation, he can say the odd word and respond using sign language such as a thumbs-up gesture.

But his doctor, Siyabulela Bungana, remains unconvinced about Stilnox's ability to rouse patients out of a coma. He said: 'He has not spoken to me. I have not seen any evidence of improvement.'

The case is not the first time that Stilnox has woken up somebody in a coma.

Last December, it is believed to have roused Sam Goddard, 23, after he suffered a series of strokes that left him in a coma.

Mr Goddard, from Brisbane, Australia, was playing football in February 2010 when his head began to pound so severely he screamed for an ambulance.  Doctors told his fiancĂ©e Sally Jane Nielson that he had suffered a staggering eight strokes, leaving him with permanent brain damage, and would never be able to walk, talk or recognise his loved ones, and would likely be blind.

But after 45 days in a coma in the Intensive Care Unit at Royal Brisbane Hospital – where he also contracted pneumonia – Mr Goddard woke up and began making slow progress after he was given Stilnox.

SOURCE



Tuesday, September 11, 2012



Taking Omega-3 every day could help children who have poor reading skills

No overall effect but by careful dredging through the data they found something they liked.  You can usually do that but replicating it is the problem

Children with poor reading skills could have their performance boosted by taking daily supplements of fatty acids found in seafood and some algae, according to new research.

Scientists at Oxford University gave 600mg omega-3 fatty acid pills to 362 children aged seven to nine daily for 16 weeks.

Although there was no significant effect in the overall study sample, they found those whose reading skills were in the lowest fifth of the normal range improved their reading age by three weeks more that a group taking a placebo.

And in the group of children whose initial reading skills were in the lowest 10 per cent their reading age was improved by 1.9 months.

The study was funded by DSM Nutritional Lipids which makes omega-3 supplements but carried out independently by Oxford University.

Dr Alex Richardson, a senior research fellow at the Centre for Evidence-Based Intervention at Oxford University, said: ‘Our results showed that taking daily supplements of omega-3 DHA improved reading performance for the poorest readers (those in the lowest fifth of the normal range) and helped these children to catch up with their peer group.’

Paul Montgomery, Professor of Psychosocial Intervention at the Centre for Evidence-Based Intervention at Oxford University, said: ‘Previous studies have shown benefits from dietary supplementation with omega-3 in children with conditions such as ADHD, Dyslexia and Developmental Coordination Disorder, but this is the first study to show such positive results in children from the general school population.’

However, while parents said their children had fewer behavioural problems, their teachers did not report similar improvements such as less hyperactivity and 'opposition-defiant behaviour'.

And Michael Crawford at Imperial College London warned: 'People working with children, on the brain, expect the brain to be manipulated in a period of 16 weeks. It's a fundamental flaw.'

SOURCE





An end to the flu? Oral spray 'kills 99.9% of infectious airborne germs'

The only real tests of this stuff appear to have been in laboratory glassware -- which is pretty unconvincing

The influenza season is a thorn in the side of both employees and employers alike.  But a first-of-its-kind oral antiseptic spray promises to end the annual misery endured by millions of flu sufferers, and thousands of lives, around the world. Or so its manufacturer claims.

The Halo Oral Antiseptic has been found to be 99.9 per cent effective in killing infectious airborne germs.

Lead author Dr Frank Esper, from the University Hospitals Case Medical Center in Cleveland, Ohio, said: 'Respiratory tract disease is a major cause of morbidity and mortality throughout the world. Yet there has been limited progress in the prevention of respiratory virus infections.  'Halo is unique in that it offers protection from airborne germs such as influenza and rhinovirus.'

The scientists used glycerine and xanthan gum as a microbial barrier combined with cetylpyridinium chloride (CPC) as a broad-spectrum anti-infective agent to fight respiratory illnesses.

To test this, clinical strains of 2009 pandemic H1N1 were used as a prototype virus to demonstrate Halo's anti-infective activity in cell culture assays.

Dr Esper said: 'The glycerine and xanthan gum prevent the germs from entering a person's system and the CPC kills the germs once they're trapped there.'

He said Halo will have clear benefit to aid against infection and reduce disease from epidemic, sporadic or pandemic respiratory viral infections, particularly helping people at risk for severe respiratory illness including immune-compromised individuals with chronic lung disease, and military personnel.

The study findings were presented yesterday at the Interscience Conference on Antimicrobial Agents and Chemotherapy in San Francisco.

Another study on Halo will be presented by Dr Mahmoud Ghannoum of UH Case Medical Center, also in Cleveland, showing Halo's effectiveness against disease-causing pathogenic germs.

That study asserts that respiratory and/or systemic infections through airborne and manually transmitted pathogenic microbes often enter the system through the mouth, making Halo, an oral spray that targets these pathogens, an effective way to prevent infections.

Additionally, preliminary data from the researchers found that Halo completely kills all 11 clinical strains of whooping cough against which the spray was tested.

The results showed that when a person used three sprays of Halo, it destroyed airborne germs breathed in for up to six hours, even when people were eating and drinking.

The concept of coating the back of the oral cavity to prevent germs from entering and then providing sustained antiseptic action to kill airborne germs was developed by a Cleveland company, Oasis Consumer Healthcare.

Dr Ghannoum said: 'Exposure to airborne germs is inevitable - especially in crowded environments and when travelling. Unlike other products that support the immune system or protect from germs on surfaces or hands, Halo is the first and only product of its kind to offer protection from airborne germs.'

The Halo Oral Antiseptic is on sale in the U.S. now.

SOURCE

Monday, September 10, 2012



Drinkers in soft water areas at higher risk of liver disease, warns  surgeon

In the absence of a journal reference, the report below is hard to evaluate   -- but given that a previous large and well-controlled study ("Magnesium in drinking water supplies and mortality from acute myocardial infarction in north west England") showed NO protective effect of magnesium, the speculations and proposals  below would seem incautious

People who live in areas with soft water are more likely to develop  alcoholic liver disease (ALD) than those elsewhere, according to one of the world’s most eminent specialists.

Professor Roger Williams wants the Government to medicate the water supply to combat the effects after his research revealed the danger.

A paper co-authored by Prof Williams, who helped carry out the  UK’s first liver transplant in 1968 and was George Best’s surgeon, found those living in soft-water areas may be more at risk because of lower levels of magnesium. The mineral can help to protect the liver from alcohol.

It is the first time a link between water softness and the disease has been established.

The study examined hospital admissions in 28 English regions between 2003 and 2006.

The six areas with soft water – Lancashire, Birmingham, Merseyside, Greater Manchester, the South West and County Durham – had rates of alcoholic liver disease 21 per cent above the national average.

But the 13 areas with hard water – including South London, Essex, Shropshire and Staffordshire – had rates 13 per cent below the average.

The research may also explain why rates of the disease in Scotland are almost double those in England, despite average alcohol consumption being approximately the same. Most water is soft north of the border.

While the call to add protective magnesium to the water supply will be controversial, there is increasing concern at a deteriorating health  situation.

Liver-disease deaths in England as a whole have risen to record levels. Prof Williams, director of the Institute of Hepatology, said: ‘We have never understood why some people will consume large amounts of alcohol and be unscathed while others drink more moderately and develop ALD.

‘These results suggest for the first time that the water supply may be a significant factor in explaining this anomaly. Perhaps we should supplement the water supply with magnesium.’

Andrew Langford, chief executive of the British Liver Trust charity, said: ‘Treating the water supply would be controversial but, if explained properly to the population, I think most people would say, “If it’s protecting the health of my liver then what’s the problem?” ’

However, campaigners who have opposed adding fluoride to the water supply are likely to oppose any proposed new measure.

John Graham, spokesman for the National Pure Water Association, said: ‘This sounds like nonsense. Why would we want to dose all of the water and all of the population for a tiny number of people who have a problem with alcohol?

‘Recommending supplements for those at risk seems much more sensible.’

The content of drinking water is affected by local geology and the minerals that seep into it.

SOURCE




Evolution could explain the placebo effect: Human immune system has developed on-off mechanism to save energy

The explanation below does not seem to acknowledge the power of suggestion generally

Scientists have discovered a possible evolutionary explanation for the placebo effect with new evidence suggesting the immune system has an on-off switch to save energy.

People who suffer from a weak infection often recover whether they take a medicinal drug or a simple sugar pill - which suggests humans can heal themselves.

But this has begged the question why people need to wait for the placebo before the recovery process from an infection begins.

According to the New Scientist, researchers have now found that something similar to the placebo effect occurs in animals, after studying Siberian hamsters.

If lights above the hamsters laboratory cages mimicked winter, they found the hamsters would not fight the infection.   However, if the lighting was changed to replicate summer conditions, the hamsters mounted a full immune response.

Similar to this, people who think they are taking medicine to treat an illness, but are actually receiving a placebo, can see a response from their immune system twice that than people who take no pills.  The evidence shows that intervention causes a mental response which kicks the immune system into action.

According to Peter Trimmer, a biologist at the University of Bristol, there is an explanation for this.

He suggests that the immune system uses up lots of energy when it is in action. So an animal's energy reserves could be severely depleted if the immune system launches a long response to an illness.

If the infection is not likely to causes death, it could be better to wait and see that fighting the illness will not put the animal in other dangers.

Evidence from a computer model designed by Mr Trimmer and his colleagues now supports this evidence.

It found those animals which live in more challenging environments were food was harder to find, they lived longer if they put up with infections rather than launch a response from their immune system.

However, for those animals living in much more favourable conditions, it was better for them to launch a response from their immune systems so they return to health quicker.

This is because in better conditions they have more access to food which provides energy to sustain an immune response.

SOURCE




Sunday, September 09, 2012



Fit fatties live longer than unfit fatties

And it's only the unfit fatties who die earlier.  The authors below seem surprised by their findings.  I guess it blows away the "fat is bad" gospel

The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fitness

Francisco B. Ortega et al.

Abstract

Aims: Current knowledge on the prognosis of metabolically healthy but obese phenotype is limited due to the exclusive use of the body mass index to define obesity and the lack of information on cardiorespiratory fitness. We aimed to test the following hypotheses: (i) metabolically healthy but obese individuals have a higher fitness level than their metabolically abnormal and obese peers; (ii) after accounting for fitness, metabolically healthy but obese phenotype is a benign condition, in terms of cardiovascular disease and mortality.

Methods and results: Fitness was assessed by a maximal exercise test on a treadmill and body fat per cent (BF%) by hydrostatic weighing or skinfolds (obesity = BF% ≥25 or ≥30%, men or women, respectively) in 43 265 adults (24.3% women). Metabolically healthy was considered if meeting 0 or 1 of the criteria for metabolic syndrome. Metabolically healthy but obese participants (46% of the obese subsample) had a better fitness than metabolically abnormal obese participants (P < 0.001). When adjusting for fitness and other confounders, metabolically healthy but obese individuals had lower risk (30–50%, estimated by hazard ratios) of all-cause mortality, non-fatal and fatal cardiovascular disease, and cancer mortality than their metabolically unhealthy obese peers; while no significant differences were observed between metabolically healthy but obese and metabolically healthy normal-fat participants.

Conclusions: (i) Higher fitness should be considered a characteristic of metabolically healthy but obese phenotype.

(ii) Once fitness is accounted for, the metabolically healthy but obese phenotype is a benign condition, with a better prognosis for mortality and morbidity than metabolically abnormal obese individuals.

SOURCE







Secret weapon in fight against lung cancer... is being MARRIED: Singles less likely to survive after treatment

They fail below to ask WHY people might be unmarried.  In some  cases it may be because they are in less than robust mental and physical health to start with.  Even a small minority of unmarrieds of that sort would produce the findings below

Being married can make a big difference in how long people survive after undergoing treatment for lung cancer, a study has found.

Researchers studied 168 patients with locally advanced lung cancer, who were treated with chemotherapy and radiation over a 10-year-period, from January 2000 and December 2010.

They found that 33 per cent of married patients were still alive after three years compared to 10 percent of the single patients, with women faring better than men.

Married women had the best three-year survival rate (46 per cent), and single men had the worst rate (3 per cent).

Single women and married men had the same survival rate. White married patients had a better survival rate than married African-Americans.

The study’s lead author, Elizabeth Nichols, a radiation oncology resident at the University of Maryland Greenebaum Cancer Center said: 'Marital status appears to be an important independent predictor of survival in patients with locally advanced non-small cell lung cancer.

'The reason for this is unclear, but our findings suggest the importance of social support in managing and treating our lung cancer patients. Patients may need help with day-to-day activities, getting to treatment and making sure they receive proper follow-up care.

'We believe that better supportive care and support mechanisms for cancer patients can have a greater impact on increasing survival than many new cancer therapy techniques.

'Not only do we need to continue to focus on finding new drugs and cancer therapies, but also on ways to better support our cancer patients.'

Further research is now being planned to determine if the findings can be corroborated on a wider basis.

E. Albert Reece, vice president for medical affairs at the University of Maryland, said: 'Lung cancer is the number one cause of cancer death in both men and women, and this study by researchers at the University of Maryland School of Medicine suggests that having a spouse who can act as a caregiver may improve survival for patients with this type of cancer.

'We must figure out ways to help all of our cancer patients live longer, with a better quality of life, regardless of their marital status.'

SOURCE


Friday, September 07, 2012



Greek diet may protect against melanoma

Everything they say below may be true but there is also lots of evidence that antioxidants shorten your life.  Is it worth it?

A DIET rich in antioxidants and omega-3 fats could help protect against skin cancer, research suggests.

Dr Niva Shapira said the Greek-style Mediterranean diet could play a role in contributing to that country's low rates of melanoma compared to Europe and other sunny countries such as Australia.

"It's more than their olive skin," said Dr Shapira, a researcher from Tel Aviv who is presenting her findings this week at the International Congress of Dietetics in Sydney.

"We think the difference in skin cancer rates may be partially due to the different eating habits in these countries," she said.

Dr Shapira studied two groups of women exposed to the sun for four to six hours a day over two weeks, with one group drinking an antioxidant-enriched beverage and the other drinking water or soft drinks.

Levels of malondialdehyde, an indicator of oxidative stress in the body linked to cancer risk, increased by about 55 per cent in those drinking water but dropped by 16 per cent in the women who had the fortified beverage.

Dr Shapira conducted further studies that found tomato paste, a Greek staple containing antioxidants such as lycopene, reduced and delayed UV-induced skin redness.

She said antioxidants accumulate in the skin and form a first line of protection against UV radiation and cell damage.

Antioxidants are plentiful in other foods that form the traditional Mediterranean diet, including omega-3 fats from fish, omega-9 in olive oil, fruit, vegetables, herbs and tea, Dr Shapira said.

An antioxidant-rich diet may be useful along with current sun-smart advice, she said.

Dietitians Association of Australia spokesperson Dr Catherine Itsiopoulos said the research was promising.

Such a diet could be especially useful during childhood, when the risk of inducing melanoma was high, she said.

Israel once had the world's third-highest rate of skin cancer after Australia and New Zealand but recently dropped back to 18th.

In 2010 the Israeli Cancer Association recommended that sun smart behaviour should include the right nutrition.

SOURCE





Traffic pollution linked to pre-eclampsia

Just correlations.  No causal data

Exposure to traffic pollution can increase the risk of pregnant women suffering pre-eclampsia by as much as a third, an Australian study suggests.

And the effect of traffic-related air pollution is even greater for women deemed to be at-risk of developing the disorder, such as Indigenous women and women with diabetes.

"Modest increases in exposure were associated with a 30 per cent increase in risk, and more-so among women with other major risk factors for pre-eclampsia," says lead author Dr Gavin Pereira, who did the research while at the Telethon Institute for Child Health Research.

Pre-eclampsia is a disorder that occurs only in pregnancy and post-birth and can be life-threatening for the mother and unborn child.

The causes and origins of pre-eclampsia are not well understood, but it normally develops late in pregnancy and can impact on the mother's various body functions such as the cardiovascular system, liver and kidneys.

Pereira, now based at the Yale Centre for Perinatal, Pediatric and Environmental Epidemiology at Yale University, says exposure to traffic-related air pollution is practically unavoidable in an urban environment.

However he believes there is potential for decreases in the levels of pollution to prevent some cases of pre-eclampsia and associated deaths.

"It is infeasible for pregnant women to avoid this ubiquitous exposure," he says.  "Air pollution can be present even if you cannot see it or smell it. The obvious message for the public is to reduce your reliance on your car. Use public transit and switch to active modes of transport like walking and cycling."  [And spend even more time swimming through pollution?]

For the study, Pereira and colleagues took measurements of the nitrogen dioxide, as a marker for traffic-related air pollution around Western Australia's Perth metropolitan area in 2010.

They developed a model to predict these measurements based on the season of measurement and exposure to major roads near the measurement site.

They also undertook a retrospective study in the southwest area of Perth, which identified 23,452 pregnant women who had delivered children between 2001 and 2006.

Of this group 943, or 4 per cent, developed pre-eclampsia. Pereira used the modelling to predict the levels of the traffic-related pollutant at the residential addresses of the women in the year of their pregnancy.

The study, published recently in the Journal of Epidemiology Community Health, shows elevated exposure in the third trimester and higher average traffic-air pollutant levels across a whole pregnancy are associated with greater risk.

"Although I cannot fully explain why exposure seems more relevant in late pregnancy, it is this period when most cases of pre-eclampsia develop," says Pereira.

"My interpretation is that traffic-related air pollution is more of a precipitating or promoting cause than an initiating cause of pre-eclampsia."

"That is, some women develop pre-eclampsia independently of pollution levels, and some women don't develop pre-eclampsia irrespective of the pollution levels, but for some women air pollution could be the last straw."
Strongest link

He says the strongest link between traffic pollution and pre-eclampsia was for women with diabetes.

"Women with gestational diabetes have a higher risk of developing pre-eclampsia as their pregnancy progresses. So again there is suggestion that traffic-related pollution seems to promote or precipitate pre-eclampsia in already susceptible pregnancies," says Pereira.

He says the study did not pinpoint exactly which chemicals in traffic emissions was causing the adverse impact.

However he says he hopes to answer these types of questions while at Yale using chemical data from the US Environmental Protection Agency and a very large cohort of approximately half a million pregnancies.

SOURCE

Thursday, September 06, 2012



Study links high-sugar diet to brain shrinkage

Stupid logic.  Just because high blood sugar was correlated with brain shrinkage does not mean high blood sugar caused brain shrinkage.  If  "age, high blood pressure, smoking, alcohol use and other factors" were also correlated, there could have been many other factors as well.  Maybe it was just that poor people had more sugary diets, for instance

NEW research linking a diet high in sugar and processed foods to brain shrinkage has prompted a rethink on safe blood sugar levels.

People with blood sugar levels of 4ml-6.1ml were found to have a greater risk of the brain atrophy that occurs with ageing and dementia, researchers at the Australian National University's College of Medicine found.

These blood sugar levels are not high enough to meet the clinical definition for type 2 diabetes and are at the upper end of the normal range, which has surprised researchers.

The research may force doctors to redefine what blood glucose levels are dangerous.

The study found that the loss of brain volume affected mostly memory and cognitive skills.

Dr Nicolas Cherbuin, who conducted the study, said the research suggested long-term exposure to  foods like sugary drinks and white flour were responsible for the problem.

Previous medical research found higher levels of brain shrinkage among the obese and patients with type 2 diabetes.

"These findings suggest that even for people who do not have diabetes, higher blood sugar levels could have an impact on brain health," Dr Cherbuin said.

"More research is needed, but these findings may lead us to re-evaluate the concept of normal blood sugar levels and the definition of diabetes," he said.

After controlling for age, high blood pressure, smoking, alcohol use and other factors the study found blood sugar accounted for six to ten per cent of the brain shrinkage.

The study involved  249 Canberra residents aged 60-64 who had an MRI scan of the brain and a blood glucose test and  were then retested four years later.

The shrinkage of the brain was measured by comparing brain size in the two MRIS.

Dr Cherbuin says he is now undertaking new research to see whether people aged in their 40's and 50's experience the same brain shrinkage.

The best way to avoid brain shrinkage was to eat low- glycaemic foods and avoid sugary soft drinks and highly processed foods that used sugar, white flour and fat, he said. Physical activity also helped lower blood sugar levels.

SOURCE




Frozen embryos better for IVF treatment

Surprising but there's some logic to it

Using frozen embryos in all IVF treatments rather than as a last resort could lower the risk to both mother and baby, a study claims.

Babies which grow from frozen embryos are less likely to be born preterm or underweight and have a lower risk of dying in the days after their birth, a study found.

Using embryos which have been frozen and then thawed, rather than being implanted shortly after being created, also reduced the risk of bleeding in the mother during pregnancy.

Researchers said the increased reliability of frozen embryos could be down to the delay between removing the eggs from the mother and implanting it back in the mother after fertilisation.

In IVF treatment, doctors stimulate the ovaries to produce a number of eggs, and remove and fertilise them all. The healthiest-looking ones are implanted three to six days later, and the remainder are frozen for future use.

Fresh embryos can be implanted a matter of days after they are removed from the mother, meaning the lining her womb may not have fully recovered from the invasive procedure and could be damaged, researchers said.

The fact that only the healthiest embryos survive the freezing and thawing process could also increase the likelihood of the pregnancy going according to plan, it was claimed.

Previous studies have suggested that drugs used to stimulate egg production which would still be circulating in the mother's body at that stage could have a harmful effect on the pregnancy.

Existing research has also shown there is no difference in pregnancy rate whether fresh or frozen embryos are used.

Experts from Aberdeen University reviewed 11 previous studies which followed more than 37,000 pregnancies from implantation of either fresh or thawed embryos to birth.

When frozen embryos were used, there was a 30 per cent lower risk of bleeding during pregnancy, 30 to 40 per cent less chance of the baby being born underweight, 20 per smaller risk of it being born preterm and 20 per cent less likelihood of it dying shortly after birth.

The study by Dr Abha Maheshwari of Aberdeen University was published in the Fertility Sterility journal and will be presented at the British Science Festival in Aberdeen today (TUES).

Speaking ahead of the festival Dr Maheshwari said: "We found pregnancies arising from the transfer of frozen thawed embryos seem to have better outcomes both for mothers and babies when compared to those after fresh embryo transfer."

Although no changes in fertility practice should be made until the study's findings have been backed up by a controlled trial, the findings could one day lead to a shift in clinical practice to improve the chance of success at the first attempt, she added.

"Our results question whether one should consider freezing all embryos and transfer them at a later date rather than transferring fresh embryos. This represents a major paradigm shift in assisted reproduction.

"We are all very aware that a postcode lottery still exists [in NHS fertility treatment]. Most clinics only provide one cycle and that does not include the frozen treatment, only the fresh treatment."

SOURCE



Wednesday, September 05, 2012



Stanford Scientists Cast Doubt on Advantages of Organic Meat and Produce

The NYT below takes a very cautious approach to the findings and for once I agree with them.  Meta-analyses are sometimes just GIGO but, more importantly, what is termed organic is one huge fudge.  There are standards but very little enforcement.  You mainly just have the word of the grower that something is organic.  Still, it is clear that any health advantage of anything organic has yet to be demonstrated in any kind of scientific way.  Health nuts mostly seem to rely on intuition or an interpretation of some personal experience rather than science

Stanford University scientists have weighed in on the “maybe not” side of the debate after an extensive examination of four decades of research comparing organic and conventional foods.

They concluded that fruits and vegetables labeled organic were, on average, no more nutritious than their conventional counterparts, which tend to be far less expensive. Nor were they any less likely to be contaminated by dangerous bacteria like E. coli.

The researchers also found no obvious health advantages to organic meats.

Conventional fruits and vegetables did have more pesticide residue, but the levels were almost always under the allowed safety limits, the scientists said. The Environmental Protection Agency sets the limits at levels that it says do not harm humans.

“When we began this project, we thought that there would likely be some findings that would support the superiority of organics over conventional food,” said Dr. Dena Bravata, a senior affiliate with Stanford’s Center for Health Policy and the senior author of the paper, which appears in Tuesday’s issue of the Annals of Internal Medicine. “I think we were definitely surprised.”

The conclusions will almost certainly fuel the debate over whether organic foods are a smart choice for healthier living or a marketing tool that gulls people into overpaying. The production of organic food is governed by a raft of regulations that generally prohibit the use of synthetic pesticides, hormones and additives.

The organic produce market in the United States has grown quickly, up 12 percent last year, to $12.4 billion, compared with 2010, according to the Organic Trade Association. Organic meat has a smaller share of the American market, at $538 million last year, the trade group said.

The findings seem unlikely to sway many fans of organic food. Advocates for organic farming said the Stanford researchers failed to appreciate the differences they did find between the two types of food — differences that validated the reasons people usually cite for buying organic. Organic produce, as expected, was much less likely to retain traces of pesticides.

Organic chicken and pork were less likely to be contaminated by antibiotic-resistant bacteria.

“Those are the big motivators for the organic consumer,” said Christine Bushway, the executive director of the trade association.

The study also found that organic milk contained more omega-3 fatty acids, which are considered beneficial for the heart.

“We feel organic food is living up to its promise,” said Sonya Lunder, a senior analyst with the Environmental Working Group, which publishes lists highlighting the fruits and vegetables with the lowest and highest amounts of pesticide residues.

The Stanford researchers said that by providing an objective review of the current science of organic foods, their goal was to allow people to make informed choices.

In the study — known as a meta-analysis, in which previous findings are aggregated but no new laboratory work is conducted — researchers combined data from 237 studies, examining a wide variety of fruits, vegetables and meats. For four years, they performed statistical analyses looking for signs of health benefits from adding organic foods to the diet.

The researchers did not use any outside financing for their research. “I really wanted us to have no perception of bias,” Dr. Bravata said.

One finding of the study was that organic produce, over all, contained higher levels of phosphorus than conventional produce. But because almost everyone gets adequate phosphorus from a wide variety of foods, they said, the higher levels in the organic produce is unlikely to confer any health benefit.

The organic produce also contained more compounds known as phenols, believed to help prevent cancer, than conventional produce. While the difference was statistically significant, the size of the difference varied widely from study to study, and the data was based on the testing of small numbers of samples. “I interpret that result with caution,” Dr. Bravata said.

Other variables, like ripeness, had a greater influence on nutrient content. Thus, a lush peach grown with the use of pesticides could easily contain more vitamins than an unripe organic one.

The study’s conclusions about pesticides did seem likely to please organic food customers. Over all, the Stanford researchers concluded that 38 percent of conventional produce tested in the studies contained detectable residues, compared with 7 percent for the organic produce. (Even produce grown organically can be tainted by pesticides wafting over from a neighboring field or during processing and transport.) They also noted a couple of studies that showed that children who ate organic produce had fewer pesticide fragments in their urine.

The scientists sidestepped the debate over whether the current limits are too high. “Some of my patients take solace in knowing that the pesticide levels are below safety thresholds,” Dr. Bravata said. “Others have questioned whether these standards are sufficiently rigorous.”

Similarly, organic meat contained considerably lower levels of antibiotic-resistant bacteria than conventionally raised animals did, but bacteria, antibiotic-resistant or otherwise, would be killed during cooking.

Dr. Bravata agreed that people bought organic food for a variety of reasons — concerns about the effects of pesticides on young children, the environmental impact of large-scale conventional farming and the potential public health threat if antibiotic-resistant bacterial genes jumped to human pathogens. “Those are perfectly valid,” she said.

The analysis also did not take factors like taste into account.

But if the choice were based mainly on the hope that organic foods would provide more nutrients, “I would say there is not robust evidence to choose one or the other,” Dr. Bravata said.

The argument that organic produce is more nutritious “has never been major driver” in why people choose to pay more, said Ms. Lunder, the Environmental Working Group analyst.

Rather, the motivation is to reduce exposure to pesticides, especially for pregnant women and their young children. Organic food advocates point to, for example, three studies published last year, by scientists at Columbia University, the University of California, Berkeley, and Mount Sinai Hospital in Manhattan. The studies identified pregnant women exposed to higher amounts of pesticides known as organophosphates and then followed their children for years. In elementary school, those children had, on average, I.Q.’s several points lower than those of their peers.

Critics of the Stanford study also argue that lumping all organic foods into one analysis misses the greater benefits of certain foods. For example, a 2010 study by scientists at Washington State University did find that organic strawberries contained more vitamin C than conventional ones. [Big deal!  Lots of things have vitamin C.  Eat an orange if in doubt]

Dr. Crystal Smith-Spangler, another member of the Stanford team, said that the strawberry study was erroneously left out but that she doubted it would have changed the conclusions when combined with 31 other studies that also measured vitamin C.

SOURCE





How taking exercise can trigger a deadly food allergy

Eating vegetables and taking exercise are the cornerstones of healthy living advice.  But for Traton Steven, these two innocuous sounding activities have a far from positive effect.  In fact, he’s allergic to them.

Traton, 18, is one of half a million Britons who suffer from a condition called food-dependent exercise-induced anaphylaxis (FDEIA), where physical exercise sparks a severe and potentially fatal allergic reaction.

Indeed, it was only because of his father’s quick thinking that Traton survived his first attack at the age of 14.  He was helping out at his parents’ garden centre two hours after eating a meal of cannelloni.

‘I’d always had hay fever and allergies to horses, but I suddenly got what I can only describe as really bad hay fever, terrible stomach ache and, without being too dramatic, a sense of doom,’ says Traton.  ‘I went to wash my hands and change my clothes, which usually helps with my hay fever, but it got worse.’

Traton’s father put him in the car and rushed him to nearby Maidstone hospital.

By the time he arrived, 20 minutes after the reaction had started, the teenager’s face and eyes were so swollen he couldn’t see, his tongue was lolling out and he was having severe breathing problems.

He was suffering from anaphylaxis, a severe allergic reaction where the body’s immune system over-reacts to an allergen, triggering the release of the chemical histamine, which can affect the airways and mucous membranes (lips and eyes) and cardiovascular system.

The hospital administered adrenaline, steroids and oxygen, kept him in overnight and ran tests for peanut allergy, which came back clear.

Puzzled doctors released the teenager with an EpiPen — an adrenaline shot he can administer himself when the next reaction starts — and told him to be cautious.

Over the next three years, Traton had several more severe reactions, but allergy specialists could not explain why.

Finally, he was referred to Dr Stephen Till, a consultant in adult allergy at Guy’s and St Thomas’ NHS Foundation Trust in London, who diagnosed him as having FDEIA, brought on by a substance in green vegetables and salad called lipid-transfer protein.

Around 750,000 Britons are thought to have suffered an anaphylactic reaction — and a food allergy is one of the most common causes.

But in an estimated ten to 20 per cent of people with a food allergy, the reaction is only sparked when they exercise.

It typically occurs two to four hours after ingesting food, but in some people it can be as much as 12 hours later.  Wheat and prawns are the most common culprits, but fruit, vegetables and nuts can also cause anaphylaxis.

The patient may go through life eating the food they are allergic to without any reaction, and it’s only when they exercise afterwards that the anaphylaxis strikes.

‘The exercise involved can be moderate — one patient suffered anaphylaxis when pushing her baby’s pram up a hill — and in many different forms, from labouring on a building site or dancing in a nightclub to taking a walk or going for a run,’ says Dr Till.

But it’s thought that the more the person exerts themselves, the stronger the reaction.

Diagnosis is based on a patient’s history, what they ate and when they ate it before exercise, plus blood tests commonly used to detect food allergies.

‘Classically, anaphylaxis will occur if the patient exercises two hours after eating the food, but sometimes it can be much longer,’ he says.  ‘One patient, a triathlete, reacted to something she had eaten the night before a race.’

Allergy consultants estimate they see one or two patients with FDEIA a month, but all agree the number of undiagnosed sufferers is likely to be much higher.

Why exercise should spark anaphylaxis is unknown, but there are theories that it increases the permeability of the gut, changes the way the blood vessels react to allergens or has an effect on the body’s neuroendocrine cells (specialised nerve cells that produce hormones such as adrenaline).

Heat, alcohol, anxiety and mental stress are also thought to exacerbate the problem.

The first case of FDEIA was recorded in a marathon runner in 1979, who collapsed when he ran after eating prawns.

However, there has been no other research into the condition — due, in part, to the danger of inducing a potentially fatal condition.

But this year, doctors will begin a three-year study, funded by the Food Standards Agency, looking at the effects of exercise on food allergies.

Dr Andrew Clark, a consultant in paediatric allergy at Addenbrooke’s hospital in Cambridge, is leading the study that will involve 100 people with a peanut allergy.  ‘Each will eat peanuts on four occasions and, under strictly controlled conditions, exercise on a static bike,’ he says. The researchers expect exercise to lower the threshold at which patients can tolerate peanuts before suffering a reaction.

They think that even people with a food allergy who do not have full-blown FDEIA, exercise may make reactions worse.

‘We will take blood tests to see if there are changes in the blood vessels, gut or allergy cells during exercise,’ says Dr Clark.

Whatever the causes, once a diagnosis is made, avoiding the food causing the reaction is often all that’s necessary for cure.

Alastair Lockhart, 70, from Oban, avoids wheat after an attack earlier this year.   ‘For many years I would sometimes get “the itches” — hives and red blotches around my mouth — but thought nothing of it, until the day I walked a mile to the nearby village in the sunshine after a meal,’ he says.

‘I started to get itchy, so I stopped at the local shop to buy antihistamine.  'But soon I was shaking and shivering and couldn’t keep still. I felt as if I was losing consciousness.’

Luckily, a builder in the shop spotted the signs of anaphylaxis and called the local GP, who administered adrenaline.

Alastair was referred to Professor Jonathan Brostoff at King’s College London, and was diagnosed with FDEIA with an allergy to wheat.  ‘Working out what foods contain wheat has been tricky — even some whiskies do,’ he says.

As well as food avoidance, patients must have adrenaline with them at all times.  If anaphylaxis strikes, Professor Brostoff advises them to lie down and raise their legs so blood goes back to the heart.

‘Take an antihistamine or adrenaline as soon as possible, call the doctor and, when you are better, ask your GP for a referral to an allergist,’ he says.

Some patients also need to work with a dietitian so they can identify the culprit food.

Since Traton was diagnosed, he avoids greens and salad. He feels healthy and works at the family garden centre part-time. ‘I can eat cauliflower, carrots and red cabbage as well as fruit,’ he says.  ‘Luckily for me, I’m a meat and potatoes person, so I don’t mind.’

SOURCE



Tuesday, September 04, 2012



Report: Chocolate may lower risk of stroke in men

Self-report data!

Chocolate – often touted for aiding heart health – may have another benefit up its sleeve.  Men who eat a moderate amount of chocolate per week can possibly lower their risk of stroke, according to new research published in the journal Neurology.

Study author Susanna Larsson, from the Karolinska Institute in Stockholm, Sweden, said it was natural to examine chocolate’s effects on stroke, given its other healthy properties.

“Chocolate consumption has been shown to reduce blood pressure, which is a strong risk factor for stroke,” Larsson told FoxNews.com.  “Chocolate also reduces LDL cholesterol, which is also a risk factor for stroke.  So it made sense to look at stroke.”

Larsson and her team conducted a study of over 37,000 Swedish men between the ages of 49 and 75.  Each participant filled out a food questionnaire detailing the different foods and drinks they consumed, as well as discussing how often they ate chocolate.  The scientists then identified how many men suffered from strokes over a 10 year period – recording close to 2,000 cases.

Upon analyzing the questionnaires, the researchers found that the men who consumed the most chocolate – 63 grams or one-third of a cup of chocolate chips – had the lowest risk of stroke compared to the men who did not eat any chocolate.  Overall, the highest chocolate consumers decreased their risk of stroke by 17 percent.

In previous research, dark chocolate has often been hyped for its heart health benefits.  But an interesting aspect of the study revealed that 90 percent of the participants actually ate milk chocolate.  Larsson said that both types of would most likely provide the same benefits, but dark chocolate may still be the better option.

“If you eat dark chocolate, you need to eat only 30 grams instead of 60 grams, so you don’t need as much,” Larsson said.  “Then there’s less of a risk that you gain weight if you consume smaller amounts.

From previous research, the scientists have a few ideas as to why chocolate has such beneficial properties.

“There are possible antioxidant effects because chocolate contains flavanoids,” which have been found to be protective of cardiovascular health, Larsson said.  However, she noted they don’t know exactly why chocolate is so protective against stroke.  “There are several potential mechanisms,” she said.

While the results are encouraging, Larsson doesn’t want people to significantly increase the chocolate consumption.

“I think, it’s too early to give a recommendation about chocolate,” Larsson said.  “People can continue to consume, and if other people start to consume chocolate, they have to reduce the consumption of something else, because too much could lead to overweight or obesity.  So consume in moderation.”

Larsson agreed, however, that the association between chocolate and a lower risk of stroke has been concretely proven.

“We have examined the association in women previously,” Larsson said.  “And we have the same combined results in both men and women.  This was the last study of this relationship, and now it’s in men.  So there’s definitely an association."

SOURCE





For Diabetics, a Steady Job Is Good for Your Health

Sounds like some social class factors at work.  Middle class people more likely to hold down a job

 If you're diabetic or prone to diabetes, having a steady job appears to be good for your health, and not just because of the insurance coverage.

A new University of Michigan study found that that jobless working-age people with diabetes are less likely to adhere to their oral anti-diabetic medications than diabetics who are employed. Further, people of working age with diabetes are more likely to be unemployed than those who do not have diabetes.

The lack of a clear-cut, cause-and-effect relationship between insurance and medication adherence surprised lead researcher Rajesh Balkrishnan of the U-M College of Pharmacy and School of Public Health.

"Improved use of medications is more than just a facet of having medical insurance. It is linked to bigger issues such as being employed, periods of joblessness or a personal financial strain," said Balkrishnan, who believes that a healthier, active lifestyle and access to medical care resources through employers that want employees to remain productive play a big role in adherence.

Other factors that account for lack of medication adherence include lack of financial resources, stress due to unemployment and lack of access to health care.

Researchers looked at diabetes because it is one of the most commonly present chronic conditions in working-age adults in the United States, Balkrishnan said. And globally, diabetes is the seventh-leading cause of death and the eighth-most costly disease to treat. In 2007, total health care costs for diabetes were estimated at $174 billion.

Policy changes would help, Balkrishnan said.  "Workforce participation for adults with diabetes and other chronic conditions command the attention of public policymakers, particularly when prioritizing resource allocation," he said. "As a starting position, health care providers and systems need standard processes to identify individuals facing financial pressure and their vulnerability to lower medication adherence."

SOURCE



Monday, September 03, 2012




The Miracle Cure That’s Hiding in Plain Sight

You've maybe never heard of Bacillus Calmette–GuĂ©rin—it sounds kinda French after all, so why would you? But scratch a little deeper and you'll find that BCG, as it's commonly known, is one of the most overlooked wonder-drugs of our time.

BCG is first and foremost the world's most common tuberculosis vaccine, and was first used in humans all the way back in 1921. Made from a weakened strain of live bovine tuberculosis bacteria, it's been show to be up to 80 percent effective in preventing TB for a duration of 15 years, depending on geographical location. That's pretty impressive, which is why—US aside—it's shoved into many a childhood arm around the world. But that's just the beginning.

Cancer killer

Jumping from TB to cancer is quite a leap, but it's one BCG has made time and again. As far back as 1979, a clinical trial declared that "BCG is beneficial in the treatment of lung cancer". Then, in 1991, a study published in the new England Journal of Medicine suggested that the BCG vaccine offered strong protection against the recurrence of bladder cancer.

There followed a 1994 trial which provided evidence that BCG increased survival time and reduced risk of recurrence in those suffering from malignant melanoma; reports that it was beneficial in the treatment of colorectal cancer; and, most recently, concrete examples of its beneficial effects in bladder cancer treatment.

TB, dead. Four disparate types of cancer kept in check. That alone would make for a pretty impressive scorecard.

But wait, there's more

But BCG has plenty more up its sleeve. Take multiple sclerosis, a disease in which the fatty sheaths around axons in the brain become damaged, in turn leading to scarring and, over time, cognitive disability. In 1999, it was demonstrated that BCG reduced the incidence of MS symptoms. In a later study, it was shown that this effect was likely due to the fact the vaccineattenuated the scarring of nerve cells by up to 50 percent—an effect that was observed on MRI scans. While it's not commonly used as a treatment, it was deemed a safe and sensible use of the vaccine in the journal Neurology.

The list keeps going. A 2006 paper in the Lancet explained how BCG has a protective effect on leprosy, while another pointed out that it delayed the onset of Buruli ulcers—nasty growths beneath the surface of the skin. There are also a host of animal experiments which promise even more positive news: in particular, a mouse model of Parkinson's disease has shown that BCG provides a mild neuroprotective effect, and it's hoped it can be replicated in humans.  Not bad for a 90-year old treatment.

Old drug, new tricks

BCG's latest feat, though, is perhaps its most unexpected. Several years ago, Harvard professor Denise Faustman showed that BCG could be used to treat diabetes in mice. She demonstrated that the vaccine helped mice to produce a protein which kills off T-cells, which are responsible for type 1 diabetes. With bated breath, the scientific community waited while the same experiments were replicated in humans. What was at stake? A positive finding could mean that diabetes patients no longer had to inject themselves with insulin.

Four years later, Fausmtan and her colleagues have published results from a very small-scale trial in PLoS One. Their work is limited and caveat-laden—the study looked at three patients for just 20 weeks—but the researchers observed the same protein production and T-cell death as they saw in mice. While it's not quite time for diabetes sufferers to pop the champagne corks and stop injecting insulin just yet, it's certainly a major finding that promises a great deal.

Perplexingly, we don't even really know quite what makes BCG so successful. There are hypotheses that suggest that it activates a protein called the "tumor necrosis factor-alpha"—and the diabetes study lends some weight to that idea—but the research community isn't 100 percent sure yet. Put simply, though it seems to be helpful across many conditions, we don't yet know exactly why.

Ignore at your own risk

Given the success of BCG against so many disease, you might wonder why it's not more common. It's certainly not unsafe: outside the US, it's one of the most widely used vaccines in the world, and has few adverse effects other than a little scarring where the injection is given. It's certainly not prohibitively expensive, either, as it's used throughout vast swathes of Asia and South America.

Perhaps more likely is that the US—usually the pioneer in cutting-edge treatments—has never really embraced BCG. Instead, it's always shunned the vaccine as a TB preventative, instead preferring to opt for programs of detection and treatment of latent tuberculosis. In turn, BCG is less commonplace in the States: medical professionals aren't as generally aware of it as in other parts of the world and, as a result, it sometimes goes overlooked.

Given what a panacea it's proven to be, though? Perhaps it's time that changed.

SOURCE





Scientists close to creating single-dose cure for all strains of malaria

Scientists believe they are close to creating a single-dose cure for all strains of malaria.  A team from the University of Cape Town said a recently discovered compound, called MMV390048, may also be able to block transmission of the parasite from person to person.

Conventional multidrug malaria treatments only work for a short period of time as the malaria parasite becomes resistant to them.

However, the UCT team led by Professor Kelly Chibale said their new treatment 'killed these resistant parasites instantly' in more than 18months worth of trials.

Naledi Pandor, the Minister of Science & Technology in South Africa, said: 'This is a significant victory in the battle to alleviate the burden of disease in the subcontinent.

'Clearly the war on this disease is not yet won, but I am excited by the role that our excellent scientists have played in this milestone in finding a potential cure for malaria and possibly preventing its transmission.'

The promising new compound shows potent activity against multiple points in the malaria parasite's lifecycle, which is why it could stop the parasite from spreading between human populations.

In 2010, malaria caused an estimated 655 000 deaths - mostly among African children.

Symptoms of malaria include fever, headache, and vomiting, and usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs.

The compound is being developed by scientists at the University of Cape Town in collaboration with the Medicines for Malaria Venture based in Switzerland.

So far it has displayed a complete cure of animals infected with malaria parasites in a single dose given orally, and thus has the potential to cure millions of people. It is also active against a wide panel of resistant strains.

'We are very excited that this promising compound, researched by African scientists, has been selected by MMV for further development,' said Dr Chibale.

'Our team is hopeful that the compound will emerge from rigorous testing as an extremely effective medicine for malaria - a disease that accounts for 24 per cent of total child deaths in sub-Saharan Africa.'

SOURCE




Sunday, September 02, 2012



Calorie restriction doesn't help in primates

This is a big blow to the conventional wisdom.  The conventional wisdom was however mainly founded on rodent studies and I have always said that generalizing lifespan effects from short-lived creatures, such as rodents, to long-lived creatures, such as humans,  is absurd.  Things that help rodents are probably already embedded in human physiology

To those who enjoy the pleasures of the dining table, the news may come as a relief: drastically cutting back on calories does not seem to lengthen lifespan in primates.

The verdict, from a 25-year study in rhesus monkeys fed 30% less than control animals, represents another setback for the notion that a simple, diet-triggered switch can slow ageing. Instead, the findings, published this week in Nature, suggest that genetics and dietary composition matter more for longevity than a simple calorie count.

“To think that a simple decrease in calories caused such a widespread change, that was remarkable,” says Don Ingram, a gerontologist at Louisiana State University in Baton Rouge, who designed the study almost three decades ago while at the National Institute on Aging (NIA) in Bethesda, Maryland.

When the NIA-funded monkey study began, however, studies of caloric restriction in short-lived animals were hinting at a connection. Experiments had showed that starvation made roundworms live longer. Other studies had showed that rats fed fewer calories than their slow and balding brethren maintained their shiny coats and a youthful vigour. And more recently, molecular studies had suggested that caloric restriction — or compounds that mimicked it — might trigger a cascade of changes in gene expression that had the net effect of slowing ageing.

In 2009, another study, which began in 1989 at the Wisconsin National Primate Research Center (WNPRC) in Madison, concluded that caloric restriction did extend life in rhesus monkeys. The investigators found that 13% of the dieting group died from age-related causes, compared with 37% of the control group.

One reason for that difference could be that the WNPRC monkeys were fed an unhealthy diet, which made the calorie-restricted monkeys seem healthier by comparison simply because they ate less of it. The WNPRC monkeys’ diets contained 28.5% sucrose, compared with 3.9% sucrose at the NIA. Meanwhile, the NIA meals included fish oil and antioxidants, whereas the WNPRC meals did not. Rick Weindruch, a gerontologist at the WNPRC who led the study, admits: “Overall, our diet was probably not as healthy.”

Further, the WNPRC control group probably ate more overall, because their meals were unlimited, whereas NIA monkeys were fed fixed amounts. As adults, control monkeys in the WNPRC study weighed more than their NIA counterparts. Overall, the WNPRC results might have reflected an unhealthy control group rather than a long-lived treatment group. “When we began these studies, the dogma was that a calorie is a calorie,” Ingram says. “I think it’s clear that the types of calories the monkeys ate made a profound difference.”

Researchers studying caloric restriction in mice have become accustomed to mixed results, which they attribute to genetic diversity among strains. Genetics probably explains part of the variation between the monkey studies, too, as the NIA monkeys were descended from lines from India and China, whereas the Wisconsin monkeys were all from India.

The molecular effects of caloric restriction have also turned out to be complicated. Using compounds such as resveratrol, found in red wine, scientists have triggered the stress response that caloric restriction activates, which shuts down non-vital processes in favour of those that ward off disease. But hopes that ageing could be delayed by targeting a single gene or protein in a single molecular pathway have faded, as researchers have learned that the key pathways vary according to the animal.“It may take us a decade to sort out longevity networks,” says David Sinclair, a geneticist at Harvard Medical School in Boston, Massachusetts.

Meanwhile, there is a dearth of evidence that caloric restriction slows ageing in humans. Observational studies have found that people of average weight tend to live longest [by a small margin]. Nir Barzilai, a gerontologist at Albert Einstein College of Medicine in New York, says that the centenarians he studies have led him to believe that genetics is more important than diet and lifestyle. “They’re a chubby bunch,” he says.

A more nuanced picture would suit Ingram, who enjoys an occasional feast of Louisiana crawfish. Ingram says that he looks forward to studies of how diet composition, rather than caloric intake, affects ageing. “Is the human lifespan fixed?” he asks. “I still don’t believe that for a minute.”

SOURCE






Statin fanatic ignores issues of therapeutic compliance (discontinuing treatment)

It seems very easy to find people who have had bad side-effects from statins but clinical trials report very few side-effects.  Why?  Because people enrolled in clinical trials are embarrassed to tell the researchers that they have flushed the garbage down the toilet because they couldn't tolerate it.  "I'd rather risk a heart attack" is one comment I have head

Statins should be given to all over-50s, regardless of their health history, because they dramatically cut the risk of heart attacks and strokes in later life, one of the UK's leading experts has said.

Currently statins are given only to high-risk patients, around eight million people, who have high cholesterol or have a risk of heart disease.

But there is 'clear evidence' that healthy people can also benefit based on their age alone, says Professor Sir Rory Collins.

He led the world's largest study to investigate statins in the prevention of cardiovascular disease which proved that cutting levels of 'bad' LDL cholesterol in the blood saved lives.

The risk of having a major vascular event such as a heart attack is cut by one-fifth for each 1.0mmol/L (millimoles per litre) fall in LDL, whether in high or low risk patients.

But current guidelines on their use - and misguided safety fears about muscle pain and memory loss - are restricting the range of people who can take them, he said.

'At 50 you should be considering it and whether you should be taking them at an earlier age is an open question' he said.

'If you start treatment earlier and continue for longer the benefits will be much greater, you're not trying to unfur the arteries, you're preventing them from furring in the first place' he said.

Prof Collins, who was giving a keynote lecture at the European Cardiology Congress in Munich, said evidence from 130,000 patients taking statins in trials show they are safe.

Yet drug safety watchdogs here and in the US have insisted on flagging up relatively minor side effects which are putting patients off the drugs, he said.

These include memory loss, depression, sexual difficulties and depression, while recent research suggests cataracts and diabetes may be more common in patients taking statins.

Trial data shows only one significant side effect, myopathy or muscle pain, which affects one in 10,000 patients, said Prof Collins.

He said: 'We need to look properly at the safety of statins. The reality is that these drugs are remarkably safe, but the problem is that high risk patients are getting the message that these drugs have side effects.'

Prof Collins, 57, went to his GP a fortnight ago to ask about taking statins despite a relatively low cholesterol level, and was dismayed to learn she could not get high risk patients to take them because of fears about side effects.

Research earlier this year co-ordinated by the Clinical Trial Service Unit Oxford University, where Prof Collins is co-director, reviewed findings from 27 statin trials involving 175,000 people, some of whom were at low risk of heart problems.

The drugs cut the risk of heart attacks, strokes and operations to unblock arteries by one third or more.

The benefits were gained no matter what level of cholesterol patients started out with. Healthier people who were given statins also had lower overall death rates than those who were given a placebo.

It concluded the positives greatly exceeded any side-effects from taking the drugs.

More than eight million adults are already taking statins, but it is estimated that routine use by the over 50s would lead to 10,000 fewer heart attacks and strokes a year, including 2,000 fewer deaths in the UK.

The small cost of the drugs - as low as £16 a year - would be outweighed by NHS savings due to the reduced number of heart attacks and strokes.

At present, statins are restricted to those with at least a 20 per cent risk of having a heart attack or stroke over the next five years.

But, said Prof Collins, trial data shows very low risk groups can benefit where individuals have just a five to 10 per cent chance of heart disease, and even lower.

He said there did not appear to be a threshold at which the drugs didn't work and the longer they were taken, the greater the benefit.

'We need to review the guidelines and the current thresholds should go,' said Prof Collins, who claimed medical tests such as liver function were also unnecessary.

Professor Peter Weissberg, medical director of the British Heart Foundation, said: 'The issue is where do you set the threshold between low, normal and high risk.

'The current arbitrary threshold was decided by cost but now statins are off patent (and much cheaper) it may be appropriate to see if there are benefits for more people - the threshold is a bit too high,' he added.

SOURCE


Friday, August 31, 2012



Marmite: the latest superfood?

Marmite -- and a similar Australian product -- Vegemite -- is a complete mystery to Americans, who generally find it revolting.  But in much of the British Commonwealth it has a huge and dedicated following.  I enjoy the stuff myself.  I always have a large jar of Vegemite in the fridge.  That's almost a patriotic duty in Australia.  And it has always been clear that it has some useful nutrients in it. I doubt that the concentration of niacin is high enough for relevance to the mouse study  mentioned below, however



Five months ago, crisis struck in New Zealand. Earthquake damage to a factory in Christchurch halted production of a staple foodstuff, crippling supply chains nationwide. Supermarket shelves were stripped bare and store cupboards emptied. Consumers started panic buying, hoarding secret supplies and auctioning half-full containers online for extortionate amounts.

They called it “Marmageddon”. The foodstuff? Marmite. That sticky, gloopy, salty spread, made from yeast extract. It’s so popular on the other side of the world that when Sanitarium, its main manufacturer in New Zealand, shut down, the prime minister appeared on television urging the public to stay calm. Now, Marmite could become just as in demand in Britain, after scientists labelled it the latest “superfood”, capable of helping our bodies fight off life-threatening infections.

According to research in the Journal of Clinical Investigation, high doses of niacin (or vitamin B3), one of the main ingredients in Marmite, help boost the body’s defences against staphylococcus bacteria. In tests, concentrated niacin – which produces neutrophils, a white blood cell that fights bacteria – increased our immune system’s ability to kill different strains of the bugs by up to 1,000 times. This could mark a turning point in the battle against antibiotic-resistant superbugs, such as MRSA, the deadly strain that poses a threat in hospitals.

As the saying goes, you either love Marmite or you hate it. On one side are devoted fans who worship “black gold” and would pour it on their cornflakes if they could. On the other are those who hate its yeasty, bitter tang. I’m one of the latter: for me, Marmite has the taste of stale, acrid sardines and the texture of cold treacle. They say the best things for you often taste the worst – such as cabbage, lentils and green tea – but I’d need a lot more convincing before spreading Marmite on my toast.

This isn’t the first time it has been billed as a superfood. First produced in Burton-on-Trent in Staffordshire in 1902, Marmite contains concentrated brewer’s yeast, salt, spices and celery. Due to its high nutritional value, it was part of soldiers’ ration packs during the First World War, and in the Thirties, English scientist Lucy Wills found that the folic acid in Marmite could be used to treat anaemia. Its high vitamin B content also reportedly makes the spread an effective mosquito repellent.

“Marmite helps my pregnant clients get over morning sickness and it’s great for elderly people who have lost their sense of taste,” explains nutritionist Melanie Brown. “I would recommend it to vegetarians, who miss out on vitamin B12, and children who don’t eat much wholegrain bread.”

But not everyone agrees. Concerns have been raised over the high salt content of Marmite (11g per 100g), which led the local council in Ceredigion, Wales, to ban it in primary schools in 2008. More recently, the Danish Veterinary and Food Administration declared Marmite illegal because of its large quantities of additives – it hasn’t been sold in Denmark since May last year.

So before you start lathering yourself in the sticky spread, be warned: indeed, scientists from Oregon State University, who carried out the latest research, have urged people not to take high doses without medical supervision. Our recommended daily intake of niacin is 17mg (13mg for women), and excessive quantities can cause skin flushes and liver damage.

For all those Marmite obsessives out there, the experts recommend a spoonful at a time. “A thin layer is all you need, not piled on your toast like chocolate spread,” says Brown. “A little of what you love won’t do you any harm.”

SOURCE





Eating nuts in pregnancy 'reduces chance of childhood allergy'

Finally the word is getting out

Mothers-to-be should eat nuts because doing so reduces the chances of their children developing allergies, new research has found.
The study adds to evidence that most women should not fear eating nuts in pregnancy, or while breast feeding.

Children of women who eat peanuts and other nuts during pregnancy are a third less likely to suffer from asthma by the age of seven, compared to those whose mothers avoid them, researchers discovered.

For years pregnant women were advised against eating nuts of any kind, due to concerns that they could increase the risk of allergies in their offspring.

But in 2009, the Food Standards Agency revised its advice, stating there was “no clear evidence that eating or not eating peanuts during pregnancy, breastfeeding or early childhood has any effect on the chances of a child developing a peanut allergy”.

Now Danish researchers have gone a step further - finding that eating nuts while expecting has a protective effect on babies.

British experts said they hoped the “robust” study would help discredit the myth that foods containing nuts were somehow intrinsically dangerous for most children.

The new study looked at more than 60,000 mothers and their children, following them from early pregnancy until the children were seven.

Nut eating during pregnancy reduced the chance of a child being classes as asthmatic at 18 months by about a quarter, and a third at seven years.

Writing in the Journal of Allergy and Clinical Immunology, Ekaterina Maslova and colleagues from the Statens Serum Institute in Copenhagen, said: “We found that maternal peanut and tree nut intake one or more times per week during pregnancy decreases the risk of allergic disease in childhood. These results do not support avoidance of nuts during pregnancy.”

Colin Michie, chairman of nutrition at the Royal College of Paediatrics and Child Health, hoped women would take note of the findings, which mirrored others showing early exposure to nuts was beneficial for the developing immune system.

He said a rash of studies in the 1980s, that purported to find evidence of a link between nut eating during pregnancy and allergic response, had in fact been found to be weak.

Unfortunately public health officials had leapt on these and others, and advised against eating nuts. By invoking the ‘precautionary principle’ they had unwittingly done more harm than good, he said.

He went on: “Recent studies such as this robust research show the truth of granny’s wisdom, that a little bit of everything tends to be good for you.

“If your body has experienced something before, it’s not going to think that it’s an enemy and come out fighting against it, which is what happens with an allergic response.

“Scientifically speaking, if you have antigens that are present when you are building up your immune repertoire as a foetus and infant, you are less likely to regard something as foreign or dangerous when you encounter large quantities of it.”

This school of thought is exactly the same as that in the hygiene hypothesis, which contends that growing up in a home that is too clean is bad for a child, as it prevents exposure to bugs that stimulate the immune system.

Dr Michie cautioned that, while it was now largely accepted that most pregnant women and young children should not restrict their diets for fear of allergies, there were still clinical exceptions.

Women who had a “dreadful family history of allergy” to nuts should still avoid them, he said, while those unsure should consult their doctors.

Michael Walker, a food chemist, said two studies, called EAT and LEAP, were currently ongoing to determine if early introduction of potentially allergenic foods could help prevent food allergies.

SOURCE



Thursday, August 30, 2012



Whoops!   Chocolates and red wine may not be so good for you as scientists say there is no evidence they battle heart disease

Scientists claim there is no proof that chocolate and red wine cut heart disease – despite millions hoping they do.

The mechanisms by which they could make a difference have still to be explained, according to heart specialists.

The evidence that dark chocolate protects the heart remains elusive, even though a recent study showed a 37 per cent cut in risk for those eating a square a day.

This was only a 'sign', however, and not proof because the study was flawed, said Steffen Desch from the University of Leipzig Heart Centre in Germany.

He said a more conclusive trial could be difficult because the real thing would have to be tested against a 'dummy' substance that looked and tasted like chocolate.

Some small studies have claimed that chocolate lowers blood pressure and reduces inflammation in the body. But Dr Desch is unconvinced.  'Despite the studies I couldn't yet recommend dark chocolate as a prevention or treatment in cardiovascular disease,' he said.

'There's no strong evidence of a benefit and no clear explanation of an effective mechanism.' The calories contained in chocolate are likely to offset any protection to the heart, he added.

His reservations came as Dutch researchers dampened down speculation about the benefits of red wine on the heart.  Even though it is also supposed to help heart health, there is no single ingredient which appears to work, they said.

They have tested resveratrol, which is found in the skin of red grapes and is believed to have a range of life-enhancing properties.  Eric Sijbrands, of Erasmus University Medical Centre in Rotterdam, led a series of studies which failed to replicate the findings of heart benefits from taking resveratrol.

Using it in capsules for four weeks did not lower blood pressure in patients with hypertension, he said. 'Certainly I would never actively prescribe red wine for a heart condition and, even if I was asked about it, I would be cautious,' he added.

If red wine does work, the explanation is likely to be 'complex', he said. Any benefit from moderate consumption is likely to be small and outweighed by the adverse effects of drinking too much.

The scientists were speaking at the European Congress of Cardiology in Munich yesterday.

SOURCE





Cannabis smoking 'permanently lowers IQ'

Teenagers who regularly smoke cannabis are putting themselves at risk of permanently damaging their intelligence, according to a landmark study.  Researchers found persistent users of the drug, who started smoking it at school, had lower IQ scores as adults.

They were also significantly more likely to have attention and memory problems in later life, than their peers who abstained.

Furthermore, those who started as teenagers and used it heavily, but quit as adults, did not regain their full mental powers, found academics at King’s College London and Duke University in the US.

They looked at data from over 1,000 people from Dunedin in New Zealand, who have been followed through their lives since being born in 1972 or 1973.

Participants were asked about cannabis usage when they were 18, 21, 26, 32 and 38. Their IQ was tested at 13 and 38. In addition, each nominated a close friend or family member, who was asked about attention and memory problems.

About one in 20 admitted to starting cannabis use before the age of 18, while a further one in 10 took up the habit in the early or mid 20s.

Professor Terrie Moffitt, of KCL’s Institute of Psychiatry, who contributed to the study, published in the journal Proceedings of the National Academy of Sciences, said “persistent users” who started as teenagers suffered a drop of eight IQ points at the age of 38, compared to when they were 13.

Persistent users meant those who used it during at least three of the ages from 18 to 38, and who said at each occasion they were smoking it on at least four days a week.

She said: “Adolescent-onset cannabis users, but not adult-onset cannabis users, showed marked IQ decline from childhood to adulthood.  “For example, individuals who started using cannabis in adolescence and used it for years thereafter showed an average eight-point IQ decline.

“Quitting or reducing cannabis use did not appear to fully restore intellectual functioning among adolescent-onset former persistent cannabis users,” she said.

Although eight points did not sound much, it was not trivial, she warned.

It meant that an average person dropped far down the intelligence rankings, so that instead of 50 per cent of the population being more intelligent than them, 71 per cent were.

“Research has shown that IQ is a strong determinant of a person’s access to a college education, their lifelong total income, their access to a good job, their performance on the job, their tendency to develop heart disease, Alzheimer’s disease, and even early death,” she said.

“Individuals who lose eight IQ points in their teens and 20s may be disadvantaged, relative to their same-age peers, in most of the important aspects of life and for years to come.”

The cognitive abilities of the 10 per cent of people who started in their 20s - who could loosely be classed as college smokers - also suffered while they were still smoking.

However, if they gave up at least a year before their IQ test at 38, their intelligence recovered, suggesting their brains were more resilient and bounced back.

Prof Moffitt said adolescent brains appeared "more vulnerable to damage and disruption" from cannabis than those of fully mature adults.

Reliable figures on cannabis usage among today’s British teens and twentysomethings are hard to come by.

But Prof Moffitt said there was growing concern in the US that cannabis was increasingly being seen as a safe alternative to tobacco.  “This is the first year that more secondary school students in the US are using cannabis than tobacco, according to the Monitoring the Future project at the University of Michigan,” she noted.  “Fewer now think cannabis is damaging than tobacco. But cannabis is harmful for the very young.”

SOURCE

Wednesday, August 29, 2012



Middle class people more likely to do what the do-gooders tell them

Whether that is what makes them healthier is not establshed, however

The middle classes are getting healthier by giving up bad habits as the less well-off fail to get the message, a report has found.

The increasing social class divide in health will put ‘unavoidable pressure’ on an already hard-pressed NHS, it says.

The report, from the influential King’s Fund health think-tank, says many poorer people are failing to give up habits such as smoking and eating junk food.

Researchers analysed official data from England covering four behaviours linked to disease and early death: smoking; excess alcohol use; poor diet and sedentary lifestyles.

These bad habits account for almost half the burden of ill health in developed countries and are linked to everything from heart problems and diabetes to cancer.

They found the number of people engaging in three or four of these risky behaviours fell from 33 per cent in 2003 to 25 per cent in 2008.

But the ‘significant’ change was very different among the social classes.  The report found ‘these reductions have been seen mainly among those in higher socioeconomic and educational groups’.

Those with no educational qualifications were more than five times as likely as those with degrees to engage in four key damaging behaviours in 2008, compared with three times as likely in 2003.

‘The health of the overall population will improve as a result of the decline in these behaviours, but the poorest and those with the least education will benefit least, leading to widening health inequalities and unavoidable pressure on the NHS’, the report says.

It found the better off someone was, the more likely they were to have begun living a healthier life during 2003-08 – when the Labour government embarked on a campaign for healthier living.

David Buck, a senior fellow at the King’s Fund who was head of health inequalities at the Department of Health until 2010, led the research.  He said: ‘The widening... gap is due to the improvement in those at the top, and, to a lesser degree, those in the middle, not because those at the bottom have got worse per se. They’re stuck in a rut.’

Those from poorer backgrounds or with less education are more likely to develop long-term conditions such as cancer and diabetes earlier and to experience them more severely, Mr Buck said. He added: ‘As well as this being a  public health problem, this does also store up problems for the NHS in future.’

The report warns about 70 per cent of adults in England still engage in two of the four habits.

Health Secretary Andrew Lansley has pledged to ‘improve the health of the poorest fastest’, with the better-off currently living seven years longer on average.

A Department of Health spokesman said: ‘We are working hard to tackle health inequalities – from next year, local authorities will receive a specific public health budget for the first time, targeted at the areas that need it most.’

SOURCE






An aspirin a day could help in fight against depression among the elderly

The effects found below were slight in absolute terms but the evidence for benefit from aspirin intake does seem wide-ranging

Taking an aspirin pill a day could help combat depression in the elderly.  Trials found a regular dose reduced the risk in sufferers by around 40 per cent.

It seems to work by lowering levels of homocysteine, an acid in the blood thought to increase the chances of heart attacks and strokes when levels are too high.

Now some scientists think excess homocysteine may also be a factor in poor mental health and that nearly one in six cases of depression in the elderly could be avoided by using aspirin to lower levels in the blood.

Up to 20 per cent of us suffer depression at some point in our lives, with women affected more than men.

And the elderly are at high risk because of the effect from declining health, bereavements and loneliness.

To test whether lowering homocysteine levels prevented depression, scientists at the University of Western Australia in Perth studied 3,700 men aged between 69 and 87 and monitored their medical records to see which ones had a history of depression.

They were also tested to see if they had raised levels of homocysteine. The findings, published in the journal Translational Psychiatry, showed men with excessive homocysteine levels were 60 per cent more likely to suffer with depression.

The report said: 'This study showed, for the first time, that aspirin is associated with a significantly lower risk of depression among older men with high homocysteine.'

Researchers say it is still not clear how homocysteine makes someone more susceptible to depression, but the men with high homocysteine who took a daily aspirin saw their risk of depression drop 43 per cent.

Taking vitamin B supplements, which can also lower homocysteine, did not have the same effect. US scientists recently discovered daily aspirin users are 16 per cent less likely to die if they develop any type of cancer.

Other studies suggest the drug can also cut the risk of prostate cancer by almost 30 per cent and bowel cancer by up to 60 per cent.

However aspirin can cause stomach bleeding in around one in a thousand patients.

Emer O’Neill, chief executive of the Depression Alliance, said although the research was ‘interesting’, patients should not change their treatment because of the findings.

SOURCE




Tuesday, August 28, 2012



Could  drinking red wine help keep old people  steady on their feet?

Mouse study only  -- using gigantic doses

Red wine isn’t usually associated with being steady on your feet.  But a ‘miracle ingredient’ in it could have that effect on pensioners, scientists claim.  They say that resveratrol, which is already credited with a host of health benefits from cutting cholesterol to warding off cancer, boosts balance and improves mobility.

In tests, old mice that were given the plant chemical for a few weeks became just as sprightly as young animals.

If resveratrol has similar effects on the human body, it could help prevent the painful falls and fractures from which many pensioners struggle to recover.

Falls are one of the leading causes of death in the over-75s, and half of elderly women die within two years of a fall.

The US researchers said: ‘Our study suggests that a natural compound like resveratrol, which can be obtained through dietary supplementation or diet itself, could actually decrease some of the motor deficiencies that are seen in our ageing population.

‘That would therefore increase an ageing person’s quality of life and decrease their risk of hospitalisation due to slips and falls.’ The researchers, from Duquesne University in Pittsburgh, fed resveratrol to young and old mice for eight weeks and regularly tested their ability to walk along a rodent-sized beam.

Initially, the older mice struggled but, over time, they became just as deft on their paws as the younger animals.

An American Chemical Society conference heard that it is not entirely clear how resveratrol, which is found in the grape skins that give red wine its colour, improves balance.

But rather than it strengthening bones or muscles, studies on cells in a dish suggest it helps ailing brain cells survive.

But don’t reach for the wine bottle just yet – you would fall over long before you drank the required amount.

Despite its potential in lab tests, resveratrol is so poorly absorbed by the human body that someone would have to drink several hundred glasses of wine a day to get the benefits enjoyed by the mice.

The researchers are now looking for compounds that work just as well but at much lower quantities.

They say that while there are medicines available to help improve balance and co-ordination in people with diseases such as Parkinson's, there is nothing for otherwise healthy pensioners who are not as steady on their feet as they used to be.

SOURCE






Anorexia is genetically transmitted

As it is clearly a mental illness in the OCD category, this is what you would expect

Claire Vickery was not surprised when scientists announced that eating disorders have a genetic link, because she and her two daughters suffered from the illness.

Eating disorders specialist Professor Howard Steiger, of McGill University in Montreal, told a conference in Adelaide last week that new discoveries in epigenetics show mothers pass a genetic predisposition to eating disorders to their children.

"The science of epigenetics is relatively new," he said at the National Eating Disorders Collaboration National Workshop. "Epigenetics helps explain how adverse development, stress, malnutrition and other influences can affect development of mental-health problems - including eating disorders."

Ms Vickery, 56, said she had bulimia from the ages of 16 to 29. "I'm sure I'm carrying the gene."

However, the president of the Australian and New Zealand Academy for Eating Disorders, Dr Anthea Fursland, said that genes alone would not result in a child developing an eating disorder. "Genetic influences do play a part but they will not cause an eating disorder on their own," she said. "Eating disorders arise as result of a combination of factors but the common factor in every case is dieting."

Ms Vickery's two daughters, Anna and Laura, both had eating disorders when they were younger. They have all recovered but Ms Vickery's experience led her to set up the Butterfly Foundation, which encourages prevention, treatment and support of those affected by eating disorders.

Professor Steiger said epigenetics would play a large role in understanding eating disorders. "If eating disorders are about anything, they're about the ways in which environments switch on hereditary vulnerabilities," he said.

"It will give us a better understanding how it is that some people develop an eating disorder. It's not due to moral weakness or character flaws, but real susceptibilities, for which we can find real physical evidence."

By identifying the genes, he hopes to develop a test and even medication.

One of Ms Vickery's daughters, Anna Spraggett, who is 33 and has three children, said she was excited about the discovery. "It's a positive step forward to finding a cure and treatment," she said.

While she thinks that environmental factors play a part, Ms Vickery said if parents were aware their children were susceptible, they could be mindful of stressful triggers.

"This is not about guilt for mothers," she said. "But if there was a take-home message, it's to choose your words with children … no fat talk in the household - or ever, in fact."

SOURCE