Monday, January 31, 2011

Energy saving light bulbs 'could trigger breast cancer'

This is highly speculative. They didn't actually have any data on CFL usage. But it might jar the know-alls a bit

Energy saving light bulbs could result in higher breast cancer rates if used late at night, an academic has claimed. Abraham Haim, a professor of biology at Haifa University in Israel, said that the bluer light that compact flourescent lamps (CFLs) emitted closely mimicked daylight, disrupting the body's production of the hormone melatonin more than older-style filament bulbs, which cast a yellower light.

Melatonin, thought to protect against some breast and prostate cancers, is produced and secreted by the brain's pineal gland around the clock. Highest secretion levels are at night but light depresses production, even if one's eyes are shut.

A possible link between night time light exposure and breast cancer risk has been known for over a decade, since a study was published showing female shift workers were more likely to develop the disease.

Prof Haim explained that a recent study by himself and fellow colleagues had found a much stronger association than previous research between night-time bedroom light levels and breast cancer rates.

Their study, published in the journal Chronobiology International, found breast cancer rates were up to 22 per cent higher in women who slept with a light on, compared to those who slept in total darkness. They thought one of the reasons for this stronger link could be that people had switched to using energy saving lightbulbs. They wrote: "In the past decade, light bulbs emitting bluer light waves (~460 nm) have been widely introduced to save energy consumption and reduce CO2 emission."

They quoted another study which showed that exposure to bluer, shorter wavelength light for two hours in the late evening suppressed melatonin production more than the same exposure to yellower light (~550nm), which is more typical of filament bulbs.

The bluer light also made people more alert and increased their body temperature and heart rate. Prof Haim thought this was because the bluer light from eco-lightbulbs mimicked the stronger light of midday closer than filament bulbs did.

Speaking to The Daily Telegraph, he said he had subsequently removed eco-friendly lightbulbs from his house, as he thought they caused "light pollution". He said: "Around the world the advice is to change the lights to 'green' bulbs - but they are not really green. They pollute much more light." Because people thought they were so cheap to run, they were turning on more lights at home, he explained.

He emphasised that the study did not prove that using eco-friendly light bulbs late at night or overnight resulted in higher breast cancer rates than using filament bulbs, and that it remained an unproven theory.

British cancer charities echoed that point. Jessica Harris, senior health information officer at Cancer Research UK, said: "As this study didn’t investigate low energy ‘eco’ light bulbs and there isn’t any other evidence that they have an effect on breast cancer risk we can’t draw any conclusions about the risk of breast cancer from low energy light bulbs.

"Although it’s far from settled, the evidence that light at night – from any source - could affect breast cancer risk is strengthening and the World Health Organisation classify shift working as a 'probable' cause of cancer."

Dr Sarah Rawlings, head of policy at Breakthrough Breast Cancer, said the link was "purely speculative". "We know there are a number of lifestyle, genetic and environmental risk factors associated with breast cancer, which require more research," she said.


Waiting to take HRT 'lessens breast cancer effect'

The risk is tiny in absolute magnitude anyway so there is no point bothering about it in any case. It would make more sense to avoid crossing the road

Waiting to take hormone replacement therapy (HRT) after the menopause can lessen its effect on raising breast cancer risk, a new study has found.

Eight years ago Oxford University research based on data from the Million Women study, which had 1.13 million volunteers, found that taking combined HRT (oestrogen and progesterone), doubled the risk of developing breast cancer. Taking oestrogen-only therapy increased the risk by 30 per cent.

Now Prof Valerie Beral, the same Oxford epidemiologist who spearheaded the 2003 study, has found that the increased risk is highly dependent on when HRT is begun.

For those who took combined-therapy, the additional risk dropped to 53 per cent higher than 'normal' among those who waited at least five years after the onset of menopause. For those on oestrogen-only therapy, waiting five years appeared to negate the additional risk altogether.

The authors wrote: "A new finding of this study, which has been little investigated previously, is that the interval between menopause and starting hormonal therapy has a substantial effect on breast cancer risk."

Ed Yong, Cancer Research UK’s head of health information, commented: "We’ve known for a while that HRT can increase the risk of breast cancer. This study suggests that there might be some situations in which that risk is small or negligible."


Sunday, January 30, 2011

Nanny-staters think that people read labels

The few who do are probably careful about what they eat and drink anyway. The New York experience shows that the sort of labelling advocated below will achieve nothing. Do the brainiacs below think Australians are more sophisticated than New Yorkers? Good luck with that assumption

FOOD police would enforce labels showing nutritional value on packaging and cigarette-style health warnings on alcohol under changes recommended for national laws.

A report released yesterday to improve food labelling laws in Australia and New Zealand contains 61 recommendations, including dropping mandatory "per serve" columns while explicitly stating the inclusion of trans-fats and salt content.

The report, Labelling Logic, was commissioned by the Australia and New Zealand Food Regulation Ministerial Council in October 2009 and compiled by a panel of independent experts, led by former federal health minister Dr Neal Blewett.

Information about food safety would be of primary importance followed by preventative health, new technologies such as genetic modification and lastly consumer values like "free range".

"The crux of the review was to address the tensions between competing interests that drive food labelling policy and seek to resolve them," Dr Blewett said.

Some of the recommendations call for food manufacturers to voluntarily adopt proposals such as a traffic light front-of-pack labelling system before they are legislated.

Food manufacturers attacked the traffic light recommendation, arguing there was a lack of consensus on the best way to label food. "The industry rejects traffic light labelling on the basis that it's badly understood by consumers and the system has been rejected by countries around the world," Australian Food and Grocery Council CEO Kate Carnell said.

The Federal Government has until December to respond to the recommendations.

The State Government has welcomed the review, which recommends fast food chains and vending machines declare energy (kilojoule) content - a move introduced in New South Wales last November which takes effect from February 1.

Under the recommendations, country-of-origin labelling would be tightened along with mandatory identification of any food prepared or treated with new technologies.

Alcoholic beverages would have generic health warnings including specific messages about the risks of drinking while pregnant. Alcoholic drink labels would also have to reveal their energy content.


Demonizing Bisphenol-A

Alan Caruba

In July 2010 I wrote a commentary about Bisphenol-A, more commonly called BPA. It is a chemical that has been in wide, safe use for over 50 years, but has come under a horrendous and unrelenting attack by a variety of specious environmental and consumer groups.

Out of curiosity mostly, I initiated a Google Alert earlier this month to inform me whenever BPA was mentioned in a news story on the Web. Within three weeks I received 20 alerts, almost one a day, and each contained notifications on 15 – 25 different article references. That’s just nuts!

Why are Americans being bombarded in the space of a single month with more than 400 articles in magazines, newspapers, and on the Internet that are designed to frighten them into thinking that a good, safe thing is a bad thing? It piqued my curiosity and prompted me to dig deeper. It seems that finding out who is behind these attacks on BPA, none of which has any credible science to support their claims, is proving to be a real detective game.

The result is that I have decided to follow the BPA story on a periodic basis in order to track and report how this classic scare campaign is maintained and spread. My research and writings will appear in “The BPA File”, a series that will ultimately be published on the website of The National Anxiety Center. It will appear monthly and elsewhere in places where readers have grown accustomed to seeing my writings.

I founded the National Anxiety Center in 1990 as a clearinghouse for information about just such scare campaigns and this fresh examination of BPA will be published alongside previous works including, “The Subversion of Education in America” and “The Enemies of Meat,” as well as the archive of commentaries written before I began my daily blog, “Warning Signs.”

The reason for this new series is that we have already seen any number of beneficial chemicals and products targeted in this fashion, often to be driven from the marketplace by class action lawsuits or banned by federal agencies and states.

Classic examples range from Alar and DDT to saccharine, all of which came under withering criticism from questionable sources using junk science, yet all of which have been proved over time to be perfectly safe and harmless when properly used. The same is happening today with BPA.

When the American Council on Science and Health, a consumer advocate group, listed “The Top Ten Unfounded Health Scares of 2010”, number one on its list was BPA. The ACSH wrote, “Bisphenol-A has been in use for over five decades in the manufacturing of certain life-saving medical devices as well as in baby and water bottles, dental devices, eyeglass lenses, DVDs and CDs and other electronics.”

BPA also plays an important role in maintaining a healthy food supply. “In addition,” said the ACSH, “it (BPA) has been used to coat the inside of nearly all metal food cans to protect consumers against deadly diseases like botulism.” If activists are successful in their pressure campaigns to ban BPA, my fear is that less-tested and less-safe alternatives will be forced upon unsuspecting consumers.

Here’s a simple question. If any of the charges against BPA are true, why then – in more than 50 year’s time! – has there been no direct connection drawn between BPA and the disease conditions claimed by anti-chemical activists? Answer: because none has ever been established through reliable scientific testing.

Human beings are chemical-processing machines. That’s what our bodies do all day, every day. We live longer, healthier lives precisely because of the discovery and use of chemicals, many of which exist solely to enhance our health and well-being.

Ultimately, as any chemist, pharmacist, or physician will tell you, “The poison is in the dose.” It is the amount of exposure and the route of exposure that determines whether something is harmful or not. Perhaps the best example of this ancient axiom is water. Too much and you can drown in it. Too little and you will suffer dehydration.

The same holds true for other chemicals, many of which are found in nature. Most crops produce their own pesticides to protect against natural predators and the human race has been ingesting trace elements of these chemicals since the dawn of humanity, along with the fruits and vegetables we know to be healthy elements of our diet. The amounts, however, are so miniscule – parts per billion – that they pose no threat.

This exact pattern exists with BPA as well; the so-called ‘endocrine disruptor’ we’re so breathlessly warned about in BPA is identical to a chemical found in soy products like tofu and soy sauce, soy milk and other related products. Strangely, we’re not hearing panicked cries to banish vegetarian food, Chinese carry-out and alternative dairy products for the lactose-intolerant from American society.


Saturday, January 29, 2011

Marriage is good for men's bodies and women's minds

This is an old, old story with the usual speculative inferences. Do the findings show that marriage makes you healthier or do they show that healthy people are more likely to be married? There is no way of telling but I would be inclined to think that the latter generalization accounts for at least part of the findings.

That older ladies are more sane if married rather fits what I have seen. Single ladies over 50 are in my observation often "spiritual", in a way suggesting low-grade mental illness. They feel forces that are not there etc. That such females have relationship difficulties is rather to be expected. Lack of reality contact is generally destructive

Marriage keeps men fit but boosts women’s mental health, according to an academic article. A study published in the Student BMJ says that committed couples live longer than singletons, with the health benefits of companionship increasing over time.

Meanwhile having lots of sexual partners can shorten lifespan and divorce can have a devastating impact, the editorial claims.

But spouses benefit from marriage in different ways. Married men are kept physically fit because their wives ensure they lead a healthy lifestyle, while women’s emotional health benefits because they value being in a relationship.

David Gallacher, a trainee at University Hospital of Wales, Cardiff, and John Gallacher, a reader at Cardiff University’s School of Medicine, write: “Love is a voyage of discovery from dopamine drenched romance to oxytocin induced attachment. Making this journey can be fraught with hazards and lead many to question the value of romance and commitment.

“Nevertheless, the impact of stable long term exclusive relationships on longevity is well established. In a study of one billion person years across seven European countries the married persons had age adjusted mortality rates that were 10-15 per cent lower than the population as a whole. So, on balance, it probably is worth making the effort.”

They cite evidence that romances among teenagers are linked to “increased depressive symptoms”, while relationships among young adults do not improve physical health. “So it seems that a degree of maturity is required before Cupid is likely to bring a net health benefit.”

The optimal time for women to establish a committed relationship in terms of health is said to be between 19 and 25, whereas for men it is after 25.

The students believe that being in a committed relationship leads to better social support - from one’s partner, their friends and family – which improves mental health and lifestyle choices. Marriage is thought to provide the largest benefits, because it involves “deeper commitment” than merely living together. Longer relationships are also said to lead to greater benefits to mental health and lower mortality rates.

On the different benefits received by brides and grooms, the authors write: “In terms of physical health, men benefit more from being in a relationship than women, but in terms of mental health women benefit more than men. “The physical health premium for men is likely to be caused by their partner’s positive influence on lifestyle. The mental health bonus for women may be due to a greater emphasis on the importance of the relationship in women.”

However they concede that “not all relationships are beneficial”, and it is better to be single than in a strained relationship.

Splitting up is distressing but less so for women, “because they have more supportive social networks”. However the authors conclude: “Although failure of a relationship can harm health, that is an argument for avoiding a bad relationship rather than not getting into a relationship at all.”


The £1-a-day red wine wonder pill to combat heart disease and cancer

This farce is getting a bit old now. There is evidence (see sidebar) that antioxidants SHORTEN your life. So if that doesn't put people off them, I don't know what would

A £1-a-day red wine wonder pill that claims to ward off heart ­disease, cancer and diabetes is to go on sale in Britain for the first time. Makers Biotivia claim the resveratrol supplement – derived from an anti­oxidant found in grape skins and ­naturally present in red wine – is as ­beneficial as exercise.

They say the drug can also protect against Alzheimer’s as well as delaying the ageing process and tackling ­obesity-related health problems.

But other experts warn that the benefits are unproven in humans and that it should not be used as a replacement for regular exercise and a healthy diet. Wine lovers, meanwhile, might argue that there is more enjoyment in cracking open a bottle of the real thing

Some studies have indicated that ­resveratrol could work by preventing the build up of fatty deposits in the arteries caused by high cholesterol. The pill goes on sale at Nutri Centre health stores next month. On Biotivia’s website it costs just over £30 for a month’s supply. It is already one of the most popular supplements in the U.S. but until now had been available in Britain only over the internet.

However, although some positive results have been found in animal studies, there has been no published research to show it works in humans. Even the animal studies used doses equivalent to 2,000mg a day, while doctors advise that humans should take a daily dose of no more than 50mg. And they warn that it can cause unpleasant side effects such as insomnia, joint pain, diarrhoea and acne.

Biotivia claims the pill can help prevent cancer by triggering the death of malignant cells. They say it effectively protects against a high-fat, high-calorie diet and even though people would still be overweight they would be less likely to suffer from related health risks.

Some studies have shown it can help reduce inflammation inside the ­arteries and prevent blood cells ­sticking together and forming a clot. Dr Alex Barber, a GP in Hampshire said: ‘The benefits are widespread and it effectively protects against a high-fat, high-calorie diet. It protects against cardiovascular disease by ­lowering cholesterol and reducing blood pressure. ‘If you can afford it, it’s got to be a good gamble.’

Other claims made by Biotivia are that it enables the body to function on less sleep and that animal studies have shown that it improves stamina. Studies on mice which were fed the pill have also shown that they didn’t gain weight despite eating fatty foods.

Scientists stumbled on the drug 20 years ago when trying to establish why France has low rates of heart ­disease. Some theories suggested that by drinking comparatively high quantities of red wine, the French were ­protected from the build-up of fatty deposits.

Research in 2009 showed the benefits of resveratrol, which is also found in raspberries, blueberries, cranberries and peanuts, extended to helping ­people to think clearer. Northumbria University researchers found adults given the supplement performed better in mental arithmetic tests.


Friday, January 28, 2011

Big discovery: Children like sugary, fatty and salty food! Just like people!

That seems to be the only actual finding revealed below but great castles in the air are built on it

CHILDREN as young as three are getting hooked on sugar, salt and fat and the more they are exposed to junk food the more they want, a new study reveals.

The findings come as a leading Australian nutritionist attacks parents after a disturbing poll revealed as many as one in three children skip breakfast at least once a week.

The US study findings have prompted a warning from the researchers for parents to step in early and feed their toddlers a healthy diet to help turn the tide in the war against childhood obesity.

Lead researcher Professor Bettina Cornwell said fighting childhood obesity should begin at home. "First families should focus on reducing the consumption of low-nutrient 'junk' foods, replacing them with increased servings of healthy foods," Prof Cornwell said. "Salt, sugar and fat have been repeatedly linked to obesity, so parents should not wait for their children to begin school to learn how to make wise food choices."

Nearly 200 youngsters aged three to five participated in the study, published in journal Appetite, which found children both preferred salt, sugar and fat, and knew which fast food and soft drink brands satisfied their cravings.

"Our findings present a public policy message if we want to pursue intervention, we probably need to start earlier," Prof Cornwell said. "Parents need to seriously consider the types of foods they expose their young children to at home and in restaurants, as repeated exposure builds taste preferences."

Sally Shaw, of Hawthorn, said it was important her children, Grace, 7, and Felix Ricketts, 5, ate a healthy diet rich in fruit and vegetables. "Sweet and salty foods are very addictive and I'd rather not have them be addicted to that sort of thing, I'd rather them get their sugars from fruit," Ms Shaw said.


Bread is good for you

And making it is a pleasure too


Dr Atkins must be ­spinning in his grave. After years of demonisation by the diet police, bread — crust, crumb and optional thick layer of golden butter — is back.

Sales of bread are rising for the first time in 36 years: Tesco, Asda and the Co-op have each reported an overall increase of up to 10 per cent, while speciality bakeries are mushrooming, their shelves groaning with ever more inventive breads, studded with everything from chocolate to potato.

And this week nutritionists have declared that far from being a food to avoid, bread is positively beneficial. It’s full of essential nutrients, ­vitamins and minerals, especially if you opt for wholegrain varieties with added nuts, seeds or dried fruit.

But even white sliced ‘mother’s shame’ has some nutritional value, as it’s a great source of calcium (essential if you’ve cut out that other modern dietary bogey, dairy).

Meanwhile, a new American diet book, The Carb Lover’s Diet, insists that bread, far from being fattening, actually helps to burn calories: wholegrain bread is rich in ‘resistant starch’, a type of ­carbohydrate that leaves you ­feeling fuller for longer because it’s hard to digest.

‘Studies show that resistant starch can help to curb cravings, control blood sugar levels and boost metabolism,’ say authors Ellen Kunes and Frances Largeman-Roth.

As it has only 80-100 calories a slice, bread can be a positive aid to weight loss rather than a diet-buster, as long as you don’t slather it with prawn mayo.

Bread is one of the earliest ­prepared foods known to man, dating back to the Neolithic era. It carries a heavy weight of ­symbolic value as the staff of life, an offering to the gods in ancient civilisations and a ­fundamental part of many ­religious rituals today.

A couple of years ago, worried by the presence of chemical additives in mass-produced bread, I bought a breadmaker to ensure my children ate as healthily as possible. I was worried it would end up in my great appliance graveyard at the back of a ­cupboard.

On the contrary, it’s been the best investment I’ve ever made. Every third evening, before I go to bed, I chuck in flour, water, honey, olive oil, salt, yeast and a few little extras now I’m an amateur expert and can go off-recipe — a handful of oats, maybe, or a sprinkling of pine nuts.

When the going gets really tough, a proper breadmaking session by hand is called for. If I’ve had a row with my husband, I grab a bag of flour and get mixing.

Just the silky feel of the flour trickling through your fingers is enough to calm shredded nerves. Then there’s the sensual pleasure of squishing up the flour, oil and warm water. The kneading is an enjoyably exhausting ­process that will leave your dough smooth and you slightly breathless.

My favourite bit, though, is when the dough has risen for the first time and you get to punch your fist into the centre of its satiny billows and squash it back down to size. It’s childishly satisfying.

By this stage of the process, any residual resentment has always dissipated, and I’m free to plump, plait or decorate my loaves before putting them in the oven and waiting for the rich smell of ­baking to permeate the house. And that’s even before you get to taste your handiwork and bask in the ­compliments from your family.

The whole breadmaking process seems calculated to put one in a good mood. It doesn’t surprise me to ­discover that a new social enterprise, ­Virtuous Bread, has been going into prisons and teaching inmates how to bake bread as a confidence-building exercise (not to mention a new skill).

In my experience, it’s worth hours on the therapist’s couch. So I’m off to cut myself a thick slice of home-made happiness.


Thursday, January 27, 2011

Breast implants may pose cancer risk, experts warn

The condition discussed is so rare that even if the association were proven, there would be no sense worrying about it: Just another attempt to stigmatize anything popular

US federal health officials say they are investigating a possible link between breast implants and a very rare form of cancer, raising new questions about the safety of devices which have been scrutinised for decades.

The cancer, known as anaplastic large cell lymphoma, attacks lymph nodes and the skin and has been reported in the scar tissue which grows around an implant.

The Food and Drug Administration is asking doctors to report all cases of the cancer so the agency can better understand the association. The agency has learned of just 60 cases of the disease worldwide, among the estimated five million to 10 million women with breast implants.

The agency reviewed the scientific literature going back to 1997 along with information provided by international governments and manufacturers. Most of the cases were reported after patients sought medical care for pain, lumps, swelling and other problems around the surgical site.

"We are very interested in trying to understand more specifically which patients may be at more risk and which breast implants may present a higher risk," said Dr William Maisel, FDA's chief scientist for devices.

The agency saw no difference in cancer rates between patients with saline versus silicone implants. There was also no difference between patients who got the implants for cosmetic reasons versus those who underwent reconstructive surgery after breast cancer.

Because the disease is so rare, FDA researchers suggested the issue may never be completely resolved. "A definitive study would need to collect data on hundreds of thousands of women for more than 10 years. Even then, causality may not be conclusively established," the agency said.

Still, the FDA said it is working with the American Society of Plastic Surgeons to register patients with the cancer and track them over time.

Breast implants are marketed in the US by Allergan Inc and Johnson & Johnson's Mentor Corp. Those companies will be required to update the labelling for their products to reflect the cancer reports.

A handful of researchers have published papers on instances of the lymphoma in breast implant patients over the past three years, prompting FDA's review.

Some research suggests bits of silicone can leak into skin and lymph node cells, triggering the cancer. Even saline implants include trace amounts of silicone to help them maintain shape.

The lymphoma is an aggressive form of cancer though it is often curable, according to experts. Treatments include radiation, chemotherapy and a bone marrow transplant, if the disease returns.

Reports of the cancer among women with breast implants have been reported anecdotally for years, according to Dr Jasmine Zain, a lymphoma specialist at New York University's Langone Medical Centre. "We've seen it from time to time over the years but this is the first time the FDA actually looked at all the case reports and made a statement," Zain said.

The FDA pulled silicone breast implants off the market in 1992, saying manufacturers had not provided medical data showing their safety and effectiveness. At the time, there were worries about a connection to a variety of diseases, including cancer and lupus. Alarming cases of ruptures added to the concern.

But in 2006 the agency returned the implants to the market after most studies failed to find a link between silicone breast implants and disease.

The approval came with conditions, including a requirement that the companies complete 10-year studies on women who have already received the implants to study leaks, as well conduct new decade-long studies of the safety of the devices in 40,000 women.

The FDA said the companies have continued to pursue those studies, though several of them have enrolled less than half of the patients needed to make them statistically useful.

Dr Diana Zuckerman said the studies "will be completely useless unless the FDA can convince the companies to do more to keep women in their studies". Zuckerman's group, National Research Centre for Women and Families, opposed the FDA's decision to re-approve silicone implants.

Wells Fargo analyst Larry Biegelsen, who covers the medical device industry, said the negative media coverage over the issue could hurt implant sales. "At this point, we do not expect breast implants to be removed from the market, but sales growth could be negatively impacted by the media coverage," Biegelsen wrote in a note to investors.


Scientists find key chemical that could boost memory and end the misery of Alzheimer's

Scientists have pinpointed a brain chemical that boosts memory, raising hope of new treatments for Alzheimer's. Scientists have shown that the brain chemical IGF-II plays a key role in the laying down and the strengthening of memories. Learning more about the process could lead to new memory-boosting drugs for Alzheimer’s, stroke and other conditions that rob people of their ability to remember even the simplest things.

The reverse may also be possible, with pills that wipe painful memories being used to help soldiers erase the horrors of battle, as well as those haunted by memories of car crashes and sufferers of crippling phobia.

In a series of experiments the US government-funded researchers showed IGF-II to play a key role in memory. The chemical occurs naturally in the body, and is found in relatively high levels in the hippocampus, the brain’s memory hub. However, levels decline with age.

To find out how it affects memory, rats were given mild electric shocks when they entered the darker side of a box. As the creatures normally like shaded spots, any reluctance to re-enter the area was taken to mean they remembered the painful consequences. So, the more the animal avoided the darkness, the better it was at remembering where not to go.

Tests showed that levels of IGF-II rose as the animals learnt to avoid the dark spot – and that giving them an injection of the substance boosted memory even further. New memories were strengthened and were slower to break down. In other words, the creatures found it harder to forget, the journal Nature reports.

Examination of the animals’ brains reviled that IGF-II had strengthened the cellular connections and mechanisms underlying long-term memory.

Researcher Cristina Alberini, of Mount Sinai School of Medicine in New York, said: ‘The implications of these data are far-reaching and give us new clues about how to investigate memory loss and forgetfulness in people with cognitive impairment, like those with Alzheimer’s disease, stroke or dementia.

‘This study is the first step to understanding the benefits of IGF-II. We have identified some of the mechanisms associated with this effect and look forward to studying them further and exploring the clinical relevance of IGF-II.’

With other experiments showing that blocking IGF-II stops long-lasting memories from forming, the research could also lead to pills that erase bad memories – a process known to medics as extinction.

Dr Thomas Insel, of the National Institutes of Health, which funded the research, said: ‘As we learn more about such mechanisms of fear memory formation and extinction we hope to apply this knowledge to address clinical problems, including post-traumatic stress disorder.’

The ability to erase painful memories has been the stuff of science fiction and Hollywood blockbusters for decades. In the film Eternal Sunshine of the Spotless Mind, a couple, played by Kate Winslet and Jim Carrey, undergo a procedure known as 'targeted memory erasure' to wipe out all recollection of each other after their relationship turns sour.

Dutch researchers recently discovered that beta-blocker drugs used to treat heart disease may also help patients to banish bad memories.

And scientists have shown that maintaining a stiff upper lip in times of crisis can stop bad memories from being laid down. Those who refuse to panic during moments of trauma remember less about what they saw than people who are more emotional.

It is thought that by concentrating so hard on keeping their emotions in check, they overload their brain, stopping it from taking in what is happening.

But the field is not without its critics, with some claiming that holding on to and reviewing bad memories is essential if we are to learn from our mistakes.


Wednesday, January 26, 2011

Traffic noise boosts risk of stroke - study

Findings of this nature are common and it usually transpires that controls for income and wealth have not been applied. Since poor people have worse health and tend to live in less salubrious locations, the findings can be seen as nothing more than another demonstration that poorer people have worse health. People tend to live by busy roads only if they can afford nothing better. The abstract below mentions no controls for income so would appear to fall into that category

As old people tend to be poorer in income terms, the fact that the association was found only among the elderly may reinforce the suspicion that we are looking at an income or wealth effect only.

A complication is that income and wealth are not strongly associated among the elderly and both could affect how well the person could afford to live.

Exposure to road traffic noise boosts the risk of stroke for those 65 or older, according to research published online today in the European Heart Journal.

In a survey of more than 50,000 people, every 10 additional decibels of road noise led to an increase of 14 per cent in the probability of a stroke when averaged for all age groups. For those under 65, the risk was not statistically significant. But the risk was weighted hugely in the over-65 group, where it rose 27 per cent for each 10 decibel increment. Above 60 decibels or so, the danger of stroke increased even more, the researchers found.

A busy street can easily generate noise levels of 70 or 80 decibels. By comparison, a lawnmower or a chainsaw gives off 90 or 100 decibels, while a nearby jet plane taking off typically measures 120 decibels.

"Previous studies have linked traffic noise with raised blood pressure and heart attacks," said lead researcher Mette Sorensena of the Danish Cancer Society. "Our study shows that exposure to road traffic noise seems to increase the risk of stroke."

The study reviewed the medical and residency histories of 51,485 people who had participated in the Danish Diet, Cancer and Health survey, conducted in and around Copenhagen between 1993 and 1997. A total of 1881 people suffered a stroke during this period.

Eight per cent of all stroke cases, and 19 per cent of cases in those aged over 65, could be attributed to road traffic noise, according to the paper.

The researchers suggest noise acts as a stressor and disturbs sleep, which results in increased blood pressure and heart rate, as well as increased level of stress hormones. The study factored in the effect of air pollution, exposure to railway and aircraft noise, and a range of potentially confounding lifestyle factors such as smoking, diet and alcohol consumption.

The survey cohort lived mainly in urban areas and was thus not representative of the whole population in terms of exposure to road traffic noise. Proximity to road noise is also related to social class, as wealthier people can afford to live in quieter areas.


Road traffic noise and stroke: a prospective cohort study

Mette Sørensen et al.


Aims: Epidemiological studies suggest that long-term exposure to road traffic noise increases the risk of cardiovascular disorders. The aim of this study was to investigate the relation between exposure to road traffic noise and risk for stroke, which has not been studied before.

Methods and results: In a population-based cohort of 57 053 people, we identified 1881 cases of first-ever stroke in a national hospital register between 1993–1997 and 2006. Exposure to road traffic noise and air pollution during the same period was estimated for all cohort members from residential address history. Associations between exposure to road traffic noise and stroke incidence were analysed in a Cox regression model with stratification for gender and calendar-year and adjustment for air pollution and other potential confounders. We found an incidence rate ratio (IRR) of 1.14 for stroke [95% confidence interval (CI): 1.03–1.25] per 10 dB higher level of road traffic noise (Lden). There was a statistically significant interaction with age (P < 0.001), with a strong association between road traffic noise and stroke among cases over 64.5 years (IRR: 1.27; 95% CI: 1.13–1.43) and no association for those under 64.5 years (IRR: 1.02; 95% CI: 0.91–1.14).

Conclusion: Exposure to residential road traffic noise was associated with a higher risk for stroke among people older than 64.5 years of age.


Fatty Footprints: A Modest Proposal Based on Liberal GroupThink

Fact: The USA is in the midst of a obesity epidemic.

Fact: Fat people are more likely to need health services, work fewer years, and pay less in taxes. They “free ride” by consuming scarce health care resources paid for by those who are healthy and thin.


For their own good, and for the Public Good, the Departments of Health (state and federal) will calculate the “fat footprint” of every product that enters the stream of interstate commerce (by definition, everything in the universe). A new value added tax (VAT) will be added to all food items to cover health care costs and encourage healthy behavior on the part of those “irresponsible” fat people.

The government will also require all state and federal workers to work out at their local gym, eat food from an approved list, and reduce their weight to a level deemed adequate by F.A.T.S. (Federal Agency for Trimming and Slimming America).

This regulation will also extend to employees of businesses that contract with the federal government. Currently. F.A.T.S. is working to devise universal coverage beyond those groups. After all, one reason why children are “left behind” is that they are too fat to catch up with their peers. This must change.

Civil rights laws will be revised to add thin-to-normal weight people to the list of protected classes for affirmative action purposes. Employers must seek out thin-to-normal weight employees by casting a wide net in their recruitment. These workers will boost the bottom line of companies and make for a more socially just distribution of resources. The EEOC will supervise the formulation of goals and timetables to achieve real progress.

The tax code will extend credits to those who can document weight loss. Other candidates for tax subsidies: those with reduced cholesterol levels, lower blood pressure, and other markers of good health.

A half century ago, normal-weight president John F. Kennedy said, “Ask not what your country can do for you, ask what you can do for your country.” His promise lays unfulfilled next to the potato chips on millions of American couches.

Fifty years is too long, we know what you can, should, and must do for your count


Tuesday, January 25, 2011

Statistical significance

Below is the first part of an article in the NYT that looks at why we use tests of statistical significance in scientific research. The issue is a relevant one for medical research as every medical journal article one looks at does use and report tests of statistical significance for the findings described in it.

The discussion below is quite right in reporting that many statisticians think we are too lenient in what we accept as statistically significant. I think that too. Accepting a 5% chance that a correlation may be due to chance alone seems risky in medical research. Medical research should surely observe high standards of proof before conclusions are drawn.

What the article overlooks, however, is that statistically aware researchers have never been much impressed by the 5% standard. It is quite common for results significant by that standard to be seen as preliminary or tentative. For researchers to report their results with any confidence about the reality of what they report, a 1% standard has long been the informal criterion. And to the extent to which that is so, the criticisms below rather fall by the wayside: There is already a stronger standard in informal use.

I taught statistical analysis in a major Australian university for a number of years so have had some opportunity to reflect on why we use tests of statistical significance. And I think the major point that is rather overlooked below is that an effect can be significant in a statistical sense but not in any other sense. All a significance test does is exclude randomness. But even a tiny correlation can be shown as non-random if the sample size is large enough. But a tiny correlation may be of no practical importance or use at all.

So the function of significance testing is simply to act as a filter. Such a test enables us to say of some correlation: "This correlation is NOT EVEN statistically significant". And in that case its significance in any other sense is unlikely to be worth bothering about. It is, in other words, just a very preliminary filter which we use to help sort out which correlations may be worthy of our attention

In recent weeks, editors at a respected psychology journal have been taking heat from fellow scientists for deciding to accept a research report that claims to show the existence of extrasensory perception.

The report, to be published this year in The Journal of Personality and Social Psychology, is not likely to change many minds. And the scientific critiques of the research methods and data analysis of its author, Daryl J. Bem (and the peer reviewers who urged that his paper be accepted), are not winning over many hearts.

Yet the episode has inflamed one of the longest-running debates in science. For decades, some statisticians have argued that the standard technique used to analyze data in much of social science and medicine overstates many study findings — often by a lot. As a result, these experts say, the literature is littered with positive findings that do not pan out: “effective” therapies that are no better than a placebo; slight biases that do not affect behavior; brain-imaging correlations that are meaningless.

By incorporating statistical techniques that are now widely used in other sciences — genetics, economic modeling, even wildlife monitoring — social scientists can correct for such problems, saving themselves (and, ahem, science reporters) time, effort and embarrassment.

“I was delighted that this ESP paper was accepted in a mainstream science journal, because it brought this whole subject up again,” said James Berger, a statistician at Duke University. “I was on a mini-crusade about this 20 years ago and realized that I could devote my entire life to it and never make a dent in the problem.”

The statistical approach that has dominated the social sciences for almost a century is called significance testing. The idea is straightforward. A finding from any well-designed study — say, a correlation between a personality trait and the risk of depression — is considered “significant” if its probability of occurring by chance is less than 5 percent.

This arbitrary cutoff makes sense when the effect being studied is a large one — for example, when measuring the so-called Stroop effect. This effect predicts that naming the color of a word is faster and more accurate when the word and color match (“red” in red letters) than when they do not (“red” in blue letters), and is very strong in almost everyone.

“But if the true effect of what you are measuring is small,” said Andrew Gelman, a professor of statistics and political science at Columbia University, “then by necessity anything you discover is going to be an overestimate” of that effect.

More here

Can it really be true that statins won't stop heart attacks?

Cochrane reviews aim to be the most thorough and comprehensive in the medical literature so are generally regarded as highly authoritative

Confused about statins? Hardly surprising, when even the experts seem to disagree. Last week, a major report suggested that if you hadn’t had a heart attack or a stroke, ­taking one of the ­cholesterol-­lowering drugs was probably a waste of time. That’s because the chance of them preventing a heart attack was very small.

But other experts rejected the report by the respected Cochrane Library, saying it hadn’t included the latest studies. ‘The quality of the data showing the effectiveness and safety of statins is remarkably high,’ argued Dr Colin Baigent of the Cholesterol Treatment Trialists’ Collaboration in Oxford. ‘We now have a very large database of patients that show clear benefits.’

There are just over two and a half million people living with heart disease in the UK and there’s no doubt many will be ­benefiting from statins.

However, seven million Britons take them and the number is rising. While some of these people are at high risk of heart disease and may be helped by the drugs, several ­million others are taking them when the evidence for their benefits is conflicting.

And now to add to the confusion, an ­influential cardiology organisation known as The Joint British Societies is expected to announce even more people should be put on the drugs and given them earlier.

So who is right, why has it taken so long for these doubts to appear, and what else could you be doing? Good Health asks the experts.

I’ve never had a heart attack, do I need statins?

That depends on your age and how healthy you are. The latest report found little evidence that taking a statin would protect people from having a first heart attack unless their risk was high. This risk is calculated by your doctor according to a number of factors including your cholesterol levels.

But if you are female or over 65 and at low risk, the Cochrane review says it’s even less clear. That’s because most ­trials involve white, middle-aged males so the results don’t necessarily apply to anyone else.

But some experts say that I should take them . . .

These experts were probably ­relying on studies that some people now say were flawed. This is because they included patients who already had heart problems — there’s little doubt that statins help these patients, so their inclusion skews the results. Critics say you can’t use this evidence to justify treating healthy people with statins.

The evidence for statins can also be made to seem more favourable that it really is. One technique used by drug companies is ‘simply to not say very much about negative findings’, says Dr Shah Ebrahim, senior author of the latest review.

The Cochrane review, carried out by researchers from the London School of Hygiene & Tropical Medicine and the University of Bristol, closely analysed 14 controlled trials that involved 34,272 primary prevention patients — that is, people who’d never had a heart attack.

It found ‘only limited evidence that primary prevention with ­statins may be cost-effective and improve patient quality of life’. The small size of the benefit is vividly illustrated by this fact: out of 1,000 primary patients taking a statin, only one death from heart disease would be avoided.

If benefits are that small then it becomes more important to balance them against the side-effects.

So what are the side-effects?

On the positive side, the review didn’t find any evidence that the drugs cause some of the adverse reactions that people have worried about in the past, such as cancer, low mood or anger or increased deaths from violence or suicide.

But that still leaves quite a number that you have to weigh against a small benefit. Statins are well known to cause muscle problems, including muscle pain, fatigue and weakness. Estimates of how common they are vary widely — from 1 per cent to 20 per cent.

Other potential ­reactions include cataracts, acute kidney failure, and moderate or severe liver dysfunction, said to be rare. Recently the Medicines and Healthcare products Regulatory Agency warned about some ­additional risks — sleep ­disturbances, memory loss, sexual dysfunction, depression, and (very rarely) interstitial lung disease.

However the review points out that the trials don’t give nearly enough information about side-effects. Over half the trials didn’t report on adverse effects, and there has been no attempt to assess the risk of some potentially serious side-effects such as ­cognitive impairment or the risk of diabetes when cholesterol is ­lowered too much.

What if I’m only ‘at risk’ of a heart attack?

The Nice guidelines say that if you have some of the familiar risk factors for heart disease — are male and over 55 (65 for a woman), have high cholesterol, smoke or are overweight — which gives you a 20 per cent or more chance of a heart attack in the next ten years, you should be prescribed statins.

The Cochrane report doesn’t change that advice. It says ‘it is likely the benefits of statins with a raised risk of heart disease are greater than potential short-term harms’, but warns: ‘Long-term effects (over decades) remain unknown’.

Dr David Tovey, head of the Cochrane Editorial Unit, says: ‘This report is a warning against expanding statin use further to ­people below that level of risk. [This expanded use] is not supported by existing evidence.’

So will GPs stop giving out so many statins?

Despite the latest research, your GP may well start prescribing more. That’s because in a few months’ time the Joint British Societies will issue new guidelines.

This will mean that instead of calculating your risk of heart attack within ten years, your GP will calculate it for your lifetime and start treating you as soon as possible.

But as the doctors’ magazine Pulse recently warned, this means GPs faced with younger patients will inevitably reach for the statins. An editorial decries this ­‘latest step on the road to mass medicalisation’.

Are there other ways to protect my heart?

Last year Kausik Ray, professor of cardiovascular disease prevention at St George’s, University of London, published a review that, like the Cochrane Review, also found ­virtually no benefit from statins in primary prevention. He encourages patients to look at alternatives.

‘The data is very clear that statins can save some lives,’ he says. ‘But we need to get better at predicting who is going to benefit. ‘GPs have been pushed into a ­tick-box culture that means you get statins if you have certain risk ­factors,’ says Professor Ray. ‘But ideally you should discuss concerns, like how to handle long-term issues such as ­side-effects. Statins are unlikely to kill you but they can affect your quality of life.

‘You may want to try other treatments such as the B vitamin niacin, which has proved effective in trials recently. There are lots of options.’ Several trials have shown that niacin can bring down the ‘bad’ LDL cholesterol and raise the ‘good’ HDL. It does have a brief flushing effect on the skin, which some ­people find unpleasant.


Monday, January 24, 2011

Drinking Milk in Childhood Cuts Risks of Cancer (?)

That may be true but the report below is a weak basis for saying so. It is retrospective self-report of unknown reliability and may simply show that people believe milk to be good for them

Good habits of childhood, no matter how resentful they were always end up paying well, it seems. According to a new study, the people who took part in the milk drinking programme during their schooling are at the lower risk of cancer today.

A survey published in the American Journal of Epidemiology recruited around 1000 people, which also included patients with pre-existing bowel cancer. The questionnaire prepared asked them about their milk drinking habits, summing up the total quantity they had per week.

Associate Professor Dr. Brian Cox and Dr. Mary Jane Snyed, who led the study found that there was 30% reduced risk of bowel cancer for those who took drank milk regularly. The results were more significant for those who were the biggest milk drinkers. They reported of being at 38% lowered cancer risk.

The findings of the study are looked up with the great expectations for New Zealand, which has currently the highest number of Cancer cases. It is estimated that approximately 3000 people are diagnosed with the disease, out of which 1200 people die every year.

The researchers claim that the presence of calcium in the milk accounts for healthier bones thereby also contributing towards the negative effect on the growth of bowel adenomas.


Drug may guard against lung cancer death

A very poorly controlled study. How did the women getting and not getting the drug differ?

Tamoxifen, a drug commonly used to treat breast cancer, may also help reduce the risk of death from lung cancer, says a study published in the US peer-reviewed journal Cancer today.

Tamoxifen works by blocking oestrogen. Previous studies have shown that women undergoing hormone replacement therapy to boost oestrogen during menopause showed an increased risk of dying from lung cancer.

Based on the hypothesis that blocking oestrogen might also cut lung cancer death risk, researchers examined data from 6655 women diagnosed with breast cancer between 1980 and 2003 in Switzerland's Geneva Cancer Registry. Close to half of those women, 3066 (46 per cent), were given anti-oestrogen drugs.

The registry's Elisabetta Rapiti, lead author of the study in Cancer, followed all those subjects until December 2007 and looked at how many developed lung cancer and how many died from lung cancer. Rapiti found that among those taking anti-oestrogen drugs, there were 87 per cent fewer deaths from lung cancer when compared with the general population.

When she looked simply at how many women in the study were diagnosed with lung cancer, she found no significant difference between those taking anti-oestrogen therapy and those who were not. "Our results support the hypothesis that there is a hormonal influence on lung cancer which has been suggested by findings such as the presence of oestrogen and progesterone receptors in a substantial proportion of lung cancers," said Rapiti.

"If prospective studies confirm our results and find that anti-oestrogen agents improve lung cancer outcomes, this could have substantial implications for clinical practice," she added.


Sunday, January 23, 2011

Will this nonsense never die?

A well-known effect demonstrated yet again and the same fallacious explanation given again. What they overlook: People living beside main roads are POOR. Rich people wouldn't want to live there. And poor people have worse health anyway

Residential Proximity to Major Roads and Preterm Births

By Yorifuji, Takashia et al.


Background: Preterm births cause a large public-health burden, and air pollution is considered to be a potential risk factor. We evaluated the association between proximity to major roads (as an index for air pollution) and preterm births, classified by gestational age and specific clinical manifestations.

Methods: Data on parental information and birth outcomes were extracted from the database maintained by the perinatal hospital in Shizuoka, Japan. We restricted the analysis to mothers who delivered liveborn single births from 1997 to 2008 (n = 14,226). Using the geocoded residential information, each birth was classified on its proximity to major roads. We estimated the multivariate-adjusted odds ratios and their 95% confidence intervals (CIs) for the association of proximity to major roads with preterm births, using logistic regression.

Results: We found positive associations between proximity to major roads and preterm births at all gestational ages. Living within 200 m increased the risk of births before 37 weeks by 1.5 times (95% CI = 1.2–1.8), birth before 32 weeks by 1.6 times (1.1–2.4), and births before 28 weeks by 1.8 times (1.0–3.2). Proximity specifically increased the risk of preterm births with preterm premature rupture of the membranes and with pregnancy hypertension.

Conclusions: This study demonstrates that exposure to traffic-related air pollution increases even the risk of preterm births of less than 30 weeks' gestational age and proposes a possible mechanism.


Daily pill for people with MS 'in months'

The first daily pill for multiple sclerosis (MS) could be available in Britain within a few months. At the moment people whose MS returns frequently have to inject themselves with a drug as often as every day to control their symptoms, or travel to hospital for treatment.

But now a committee of the European Medicines Agency (EMA) has recommended that the drugs regulator approves the pill, called Gilenya, to be marketed across the EU. It is already approved for sale in Russia and the US.

Novartis, which makes Gilenya, said a licence allowing Gilenya to be marketed in the UK was expected "in the next few months".

Dr Jayne Spink, policy and research director of the MS Society, welcomed the news as "great for people with MS".

She said: "The availability of a tablet to treat the condition will give people more choice and for many will come as a welcome relief from frequent injections."

Besides from being more convenient and less painful, a trial has also showed Gilenya to be twice as effective at stopping relapses as one of the injectable drugs, called interferon beta 1a.

However, the EMA's Committee for Medicinal Products for Human Use has only recommended the pill for use by patients with highly active relapsing-remitting multiple sclerosis (RRMS) who fail to respond adequately to interferon beta, or who have rapidly evolving severe relapsing-remitting MS.

Once Gilenya receives a UK licence, the National Institute for Health and Clinical Excellence (Nice) will decide if and to whom it should be prescribed on the NHS.

A rival to Gilenya, the brand name for the drug fingolimod, is expected to be granted approval later this year. Cladribine, which only has to be taken between eight and 20 times a year, has shown to be similarly effective.

MS, an auto-immune disease, affects around 100,000 people in Britain. It occurs when immune system cells attack the brain and spinal cord, causing the protective insulation around nerve fibres to be destroyed. The disease can lead to a wide variety of symptoms ranging from mild tingling to paralysis.


Saturday, January 22, 2011

Americans wait longer for life-saving drugs

The 1962 Kefauver-Harris Amendments have killed a lot of people

How could regulations, which were passed to protect the American public, actually do more harm than good? To answer that question, we must first examine what changes the amendments made in drug development.

A pivotal provision of the amendments concerned the approval process. Prior to 1962, a manufacturer would submit data on a new drug and the FDA had six months to respond. In the absence of FDA concern or questions, marketing could begin. However, the amendments required FDA examiners to actually sign off and approve each New Drug Application (NDA), as a testament to the safety and efficacy of the new drug.

Of course, since no drug is totally safe and efficacious, FDA personnel risked censure by Congress if unexpected side effects, which occur with all drugs, were severe enough to attract public attention. To protect themselves, therefore, regulators began demanding more and more testing, so that they could show “due diligence” in the event they were asked to defend an approval.

In addition, the FDA was given oversight of pharmaceutical advertising, manufacturing, and labeling. The FDA determined which animal safety studies had to be performed prior to testing a new drug in people. Consequently, manufacturers had to do more animal experimentation, perform more quality control work, negotiate every word of advertisements and labels with the FDA, and send literally truck loads of data to the FDA.

One of the primary provisions of the Kefauver-Harris amendments was, of course, the senator’s requirement for “substantial evidence of efficacy.” The FDA decided that giving doctors samples of drugs and getting their evaluation was not enough evidence of effectiveness. Based on the amendments, the FDA began requiring that drug companies perform two U.S. studies that were “double-blind, placebo-controlled.” In other words, some patients would receive the test drug and some would receive an identical “sugar” pill. The capsules or tablets would carry a number, not a name, so that neither patient nor doctor would know what was taken. When the study was done, the code would be broken.

Even if more patients were helped by the drug instead of placebo, it would only be considered effective if the results were “statistically significant.” Because we are not genetically identical, an inactive drug could appear effective simply because one group was going to heal faster naturally than the other.

Therefore, statisticians look for big differences between placebo groups and drug treated groups. When this difference is big enough to have 95% certainty that the drug effect isn’t simply due to chance, we call that “statistically significant.” By requiring two studies with 95% certainty, the FDA set a high standard for new drugs to meet.

Of course, meeting all of these new requirements took time. As you can see from Figure 2, drug development times, which were about 4 1/2 years between 1948 and 1961 started rising dramatically after the amendments were passed. Development times, as used here, are the years between the first time the drug is made (compound synthesis) and FDA approval. How do we know that the increase in development time was due to the 1962 amendments and not some other factor? The time for the FDA to review new drug applications went from about 7 months pre-amendment to an average of 29 months in the years 1963-1969. The extra time taken for the FDA to review the new studies it required was greater in the late 1960s than the time needed to do the studies themselves!

Clearly, the regulators were concerned about the new visibility that the 1962 amendments had given them. They were asked to do the impossible: approve only safe and effective drugs. They did the next best thing. They still approved new drugs, but required more and more expensive studies, driving the cost of development up and raising drug prices.

Figure 2. Average development time of new drugs (known as new chemical entities or NCEs) before (blue bars;) and after (red bars;) passage of the 1962 Kefauver-Harris Amendments. The time saved by passage of the 1992 Prescription Drug User Fee Act is shown (pink bar) for the 1990-1999 period.

In addition, the FDA took more and more time to evaluate the studies, shortening the patent life of the new product. Manufacturers, who have to recover most of their costs before a drug goes generic, had fewer years to do so. Consequently, they raised prices even more.

Meanwhile, in Europe, regulations had not changed as much, even after the thalidomide tragedy. Consequently new drugs, although invented predominantly in the United States, were marketed first in Europe. Europeans had twice as many drugs in their pharmacies as Americans had!

One of these new drugs was propranolol, the first beta-blocker for heart disease. Because of the “drug lag,” propranolol entered the American market in 1968, three years after it had been available in Europe. One study performed in the 1980s estimated that propranolol was saving approximately 10,000 American lives per year. Consequently, at least 30,000 Americans died prematurely during the three-year delay in propranolol approval. This estimate may be low, since propranolol was not approved for its major uses, angina and hypertension, until 1973 and 1976 respectively.

Instead of being complemented for finally approving propranolol, the FDA was criticized by a congressional committee for exposing the American public to a drug with potential side effects. Given this negative feedback, it’s hardly surprising that the FDA increased its regulatory demands even further.


Dieting while pregnant can lower your baby's IQ

For once I agree with the official advice -- at the end of the article below

Expectant mothers who diet during pregnancy are putting their babies at risk of low IQs and behavioural problems, scientists say. A new study found that cutting back on vital nutrients and calories in the first half of pregnancy stunts the development of an unborn child's brain.

Although the study was carried out on animals, researchers says the same findings are likely to be true for women - and highlight the lifelong dangers to babies if their mothers don't eat healthily. Author Dr Thomas McDonald said: 'This study is a further demonstration of the importance of good maternal health and diet.

'It supports the view that poor diets in pregnancy can alter development of foetal organs, in this case the brain, in ways that will have lifetime effects on offspring, potentially lowering IQ and predisposing to behavioural problems.'

Past studies have shown that severe diets, famines and food shortages during pregnancy can harm unborn babies. But the new study looked at the sort of 'moderate dieting' typical of women in Britain and America.

The researchers compared two groups of baboon mothers at the a primate research centre in San Antonio. One group was allowed to eat as much as they wanted during the first half of pregnancy - while the other group was fed 30 per cent less - 'a level of nutrition similar to what many prospective mothers' experience, the researchers said.

Cells did not divide as much as they should and connections between neurons were not made.

Lack of nutrients interfered with the way brain cells connected in the unborn babies and altered the expression of hundreds of genes - many involved in cell growth and development, the researchers report in the Proceedings of the National Academy of Sciences.

Dr McDonald said foetal nutrient deficiency was a special risk for both teenage mothers and women who get pregnant later in life.

In teenage pregnancies, the developing foetus can be deprived of nutrients by the needs of the growing mother, he said. And stiffer arteries in older women reduce blood flow to the womb, reducing the flow of nutrients to the growing baby.

The scientists called for more research into links between maternal diet and their children's risk of autism, depression and schizophrenia later in life.

The study also challenges the widely held view that mothers can protect their unborn babies from poor diets in pregnancy, he said.

The baboon's brain developmental stages are 'very close' to those of human fetuses, the researchers said.

Dr Peter Nathanielsz, of the University of Texas Health Science Centre in San Antonio said: 'This is a critical time window when many of the neurons as well as the supporting cells in the brain are born.'

Guidelines from the Royal College of Obstetricians and Gynaecologists state: 'There is little evidence of harm in the first half of pregnancy - but in the second half concerns arise.'

However, it still advises women not to diet if they find they are pregnant.

Dr Patrick O'Brien, consultant and spokesman for the Royal College of Obstetricians and Gynaecologists said the study might not apply to women. 'All the studies in humans have not suggested that moderate dieting in the first half of pregnancy causes any problems,' he said. 'Our guidance is unchanged - that pregnant women should eat a healthy mixed diet and should avoid dieting, but also avoid "eating for two",' he added.


Friday, January 21, 2011

Spread the word: medicinal margarine not worth the money

IF YOU struggle with high cholesterol, you are better off visiting your GP for a prescription than looking for a solution in the supermarket aisles, says a medical paper that casts doubt on the effectiveness of food products claiming to reduce cholesterol reabsorption.

Many margarines and spreads advertise an ability to reduce cholesterol levels in consumers by up to 15 per cent through the addition of plant-based sterol and stanol esters, which compete with cholesterol in the body and inhibit its reabsorption. High cholesterol is a main cause of cardiovascular disease, the leading cause of death in Australia.

But the author of the paper, Sheila Doggrell, a Queensland biomedical writer and pharmacologist, argues that this figure represents only the very top of the cholesterol-reducing capabilities of these products and that under normal consumption conditions they are unlikely to achieve reductions of above 1.3 to 3.8 per cent.

Under the same conditions, prescription treatments for abnormally high cholesterol were shown to reduce the cholesterol levels of participants by more than 20 per cent.

Unilever, which produces the sterol-enhanced spread Flora pro-activ, says that the product is not designed to be relied on as a comprehensive medical solution.

"Plant sterols are not a replacement for medication, however they are effective used in conjunction with some cholesterol-lowering medication," the company said, citing a statement issued by the National Heart Foundation in 2008.

Dr Doggrell argues that the products are not necessary at all. "If you have a problem with high cholesterol you are wasting your money paying extra for cholesterol-reducing products," she said.

Research done by the consumer advocacy group Choice shows that sterol-enhanced products can cost up to three times as much as the regular alternatives.

Dr Doggrell's advice is that the margarines and spreads on the market are simply not effective enough to make any difference to someone who has been diagnosed with abnormally high levels of cholesterol, and that the products provide no benefit to those whose cholesterol falls within the normal range.


Lounging on the couch is bad for your fitness health, experts claim

As far as I can see, the research showed only that unfit people watch a lot of TV. Causative inferences are speculative

FITNESS fanatics who reward themselves by lounging in front of the TV after a gym workout should think again.

Researchers believe long bouts slumped in front of the idiot box or computer screen have an adverse affect on the heart's ability to recover from physical exertion.

The news is a worrying development for couch potatoes. Heart rate recovery is considered an important indicator of heart health, and its speed is associated with the risk of death.

Sitting in front of a screen uses less energy than other sedentary behaviour, such as reading, writing or driving.

Past studies have found that longer screen viewing time is associated with abnormal glucose metabolism, obesity and metabolic syndrome - a "constellation of chemical factors" associated with a higher risk of heart disease.

More than 2000 people in their 30s with no heart disease history and varying levels of cardiovascular fitness took part in the new study.

Researchers measured the speed at which heart rates returned to normal up to two minutes after peaking during eight minutes of exercise on a treadmill.

Participants were quizzed about factors, ranging from blood pressure levels and alcohol consumption to level of physical activity over the past month and the time devoted to watching TV and computer screens.

Researchers found that women who spent long periods in front of a screen had a slower heart rate recovery than men as well as unfavourable metabolic patterns.

Those who engaged in little or no exercise had the slowest heart rate recovery levels, according to the paper published in online journal Heart Asia.

Melbourne fitness trainer Donna Aston insisted it was all about balance. "I don't see a problem with relaxing after exercise. We all need to recuperate," the South Yarra trainer said. "Watching a little TV is fine, but if you are going to sit for hours on end in front of the screen, that's obviously not good for you."

With people spending more time sitting down, she said it was more important to get up and get physical.


Thursday, January 20, 2011

Forget five, now it's eight portions of fruit and veg a day for good health (?)

The Marmot's at it again. Epidemiogical rubbish, of course. International comparisons are very dicey. There could be many differences in different national populations other than their diets. Just let one fact sink in: Southern Europeans have a much more vegetarian diet than Australians do yet Australians live longer! If the Marmot reads this (unlikely) he would no doubt want to say: "Yes. But there are many other differences ...". To which I would say: "Precisely"

For years the advice has been clear: eating five portions a day of fruit and vegetables is the key to a healthy life. But five may no longer be enough.

A study has found that to get maximum defence against heart disease, you need to eat at least eight daily servings of fresh food.

The Government’s five-a-day advice has its roots in World Health Organisation guidelines to include 14oz of vegetables in a daily diet. But there have been doubts over whether eating more than this level of fruit and veg meant even greater health benefits. Now the new study suggests every extra portion provides added protection.

Significantly, those in the ­highest category – eating eight or more a day – have a 22 per cent lower chance of dying from heart disease than those who consume three ­portions, the UK average. A ‘portion’ weighs just under 3oz, equal to a small banana, a medium apple or a small carrot.

The findings come from an ongoing European investigation into diet and health, looking at 300,000 people in eight countries. Dr Francesca Crowe, of Oxford University, is working on the project. She said that although ischaemic heart disease (IHD) – the most common form – was less likely in those who ate lots of vegetables, it could be explained because these people might also have healthier lifestyles.

However, the study specifically showed a reduced risk of dying from IHD of around four per cent for each additional portion of fruit and veg consumed above the lowest category, which was those who ate two or fewer portions.

The average intake of fruit and vegetables across all the countries in the study was five portions. People in Greece, Italy and Spain ate more and those in Sweden less.

Professor Sir Michael Marmot, of the University College London, said the findings were of ‘huge practical importance’. He said: ‘Cardiovascular disease is the most common cause of death. A reduction of 22 per cent is huge. There would need to be big shift in dietary patterns to achieve this healthy consumption of eight portions a day. It is worth trying to move in that direction.’

Scientists have previously suggested 15,000 lives a year could be saved if everyone ate five a day.


Drug offers new hope in treatment of deadly form of skin cancer

SCIENTISTS have heralded a new therapy for one of the deadliest forms of cancer after trials showed a new drug can extend the lives of patients with advanced malignant melanoma.

Patients taking the new drug, which attacks a genetic mutation found in about half of all cases of the aggressive skin cancer, live significantly longer than those given standard treatment, a landmark study has found.

Preliminary results suggest that the drug, known as RG7204 or PLX4032, is the first melanoma therapy with a proven benefit on survival. Though the cancer is treatable if caught early, fewer than 10 per cent of patients survive for a year if it has spread.

The trial has been so successful that Roche, the drug company, has ended its control arm, so that participants who had received a placebo can now take the active drug.

While RG7204 is suitable for only the half of melanoma patients whose tumours carry the right mutation, and only 80 per cent of these respond, scientists said it would transform treatment of the disease.

Richard Marais, Professor of Molecular Oncology at the Institute of Cancer Research in London, said: “What this means is that now, for the first time in melanoma, we have a treatment that actually works for an appreciable proportion of patients.”

James Larkin, of the Royal Marsden Hospital in London, said: “This is an incredibly exciting breakthrough. Malignant melanoma is a very difficult disease to treat and with a growing incidence in younger people the results of this trial are very encouraging.”

The drug also marks a milestone in the development of personalised genetic medicine, as it was designed to target a genetic mutation that is found in about 50 per cent of melanoma patients. The mutated gene, called BRAF, was identified in 2002 by a British team led by Professor Mike Stratton, of the Wellcome Trust Sanger Institute near Cambridge.

The company is also developing a diagnostic test for the BRAF gene targeted by RG7204, to identify which patients can benefit. Such targeted treatment is considered to be the next frontier of cancer medicine.

In a separate study, published in the journal Nature, a team led by Dr Andy Futreal, of the Sanger Institute, has identified a gene that is mutated in one in three cases of kidney cancer.


Wednesday, January 19, 2011

We should stop putting blame on obese people

By Paul Zimmet (Professor Paul Zimmet AO is director emeritus of the Baker IDI Heart and Diabetes Institute, Australia, and an international authority in public health aspects of obesity and diabetes)

It is time to ask if we have the right strategies to fight the national and global obesity epidemics. Since the last Australian Diabetes and Lifestyle study in 2005, there has been no reliable national monitoring data and nothing to suggest we are winning the war. It could be 2013 or 2014 before new data are available.

While the government may be about to enact some of the easier recommendations of the 2009 Preventative Health Taskforce report, the strong message was that the recommendations needed to be implemented as a package. Otherwise, there is unlikely to be any real impact on obesity, which is by far the main driver of the Australian diabetes and heart disease epidemics.

The failure to respond aggressively is very disappointing. We need to challenge the myth that sloth and sedentary behaviour are largely responsible for obesity. We need to stop arguing that individuals and parents are solely responsible.

Politicians and health bureaucrats need to acknowledge the changed thinking of scientists and researchers about the underlying cause of obesity. A significant biological component drives the very behaviour we focus on.

A major part of obesity is hereditary. There are also lifelong consequences of poor or excessive maternal nutrition. Children who have poor nutrition before birth are predisposed to obesity, type 2 diabetes, heart disease and even mental disorders in adult life.

For indigenous Australians, this disadvantage predisposes them to chronic diseases in adulthood.

Maternal diabetes and obesity shape the way the foetus responds, making it more likely that a child will develop obesity and diabetes.

A mother's behaviour during pregnancy has profound effects on her baby's responses to the environment in adult life. Diabetes and obesity in the mother, malnutrition, smoking, alcohol and drug abuse all have an effect on the baby's genetic material.

So these changes create a vicious intergenerational pattern of susceptibility to chronic disease. But appropriate advice and education, intervention during pregnancy, and even before, can reverse this escalating obesity epidemic.

Two renowned Australian researchers, Boyd Swinburn and Garry Egger, have even described the world and our environment as "obesogenic".

Societal changes are so profound that parents can no longer control many of the behavioural, socio-cultural and economic changes that affect their children. Because of the rapid pace of change, many parents do not have the knowledge or skills.

We in the public health arena need to explain more effectively this new way of thinking and present the problem as a combination of individual and population vulnerabilities. Many factors are not the ''fault'' of the individual.

It is unfortunate that much of the media fuels the belief that obesity is primarily caused by sloth and gluttony. This invites a passive response and allows government to put the responsibility on individuals - particularly when it comes to intervening with children.

Intergenerational change and the lack of nutritional understanding mean that parents are ill equipped to deal with nutrition education and other lifestyle issues. Action needs to start before birth and rely on the new science of epigenetics.

Our governments and public health agencies need to work out how to engage meaningfully with the food industry and recruit it to the fight. We need to work out better ways to interact with these companies. Unlike smoking, we cannot live without eating, and we cannot win this battle without their co-operation.

An Access Economics report in 2008 put the cost of obesity in Australia and its impact from chronic disease and economically at $58 billion a year. The potential cost of implementing the recommendations of the Preventative Health Taskforce would seem an absolute bargain against this. It is time to stop the culture of blame. I hope our governments are listening.


Statins 'may cause loss of memory and depression'

And that's not half of it. Many people given statins decide that they would rather take the risk of a heart attack than continuing to take them

Cholesterol-lowering pills taken by millions of Britons may cause memory loss and depression, researchers warn. They say not enough is known about the level of harm posed by statins, prescribed to prevent heart disease and strokes. Leading doctors say that the drugs should only be taken by patients for whom the benefits of the drug outweigh any potential risks.

More than seven million people in Britain now take statins – as many as one in three adults over the age of 40. They are extremely effective in lowering levels of cholesterol, the fatty substance in the blood that clogs up arteries leading to heart attacks and strokes. Many people over the age of 45 are routinely prescribed statins by their GPs if they have slightly high blood pressure or cholesterol.

In addition low-dose pills are increasingly bought over the counter without a prescription. Although they have been proven to be extremely effective – saving up to 10,000 lives a year – researchers warn that not enough is known about their risks.

They warn statins should only be prescribed to those with heart disease, or who have suffered the condition in the past. Researchers warn that unless a patient is at high risk of suffering a heart attack or stroke, statins may cause more harm than good.

The study, published in the Cochrane Library, which reviews drug trials, also points out that the vast majority of trials have been carried out by drugs companies who may play-down any possible risks. Some patients taking statins have suffered from short-term memory loss, depression and mood swings.

Previous studies have also linked the medication to a greater risk of liver dysfunction, acute kidney failure, cataracts and muscle damage known as myopathy.

The researchers examined data from 14 drugs trials involving 34,000 patients. They found that although the drugs did prevent heart attacks and strokes, there was not enough evidence to prescribe them to patients with no previous history of heart disease.

Professor Shah Ebrahim, from the London School of Hygiene and Tropical Medicine said: ‘When you put the evidence together you certainly find it supports the use of statins. But we found that evidence of potential harm is not being taken seriously. ‘The adverse effects are not included in the trials.’

Lead researcher Dr Fiona Taylor, added: ‘The decision to prescribe statins in this group [who have no history of heart disease] should not be taken lightly.’

Amy Thompson, senior cardiac nurse at the British Heart Foundation, said: ‘This systematic review echoes what we already know – that statins have huge benefits for people with heart and circulatory disease, or those who are high risk – they help to reduce the risk of heart disease including heart attacks.

‘It is still unclear whether statins provide any real benefits for people without heart and circulatory disease and who are at low risk.’


Tuesday, January 18, 2011

Congress affirms that regulations account for over 80% of drug development time

As a consequence of the increasing development times, new drugs often enter the marketplace with only a few years of patent life remaining. Consequently, manufacturers had to charge excessive prices for new drugs in order to make up their increasing research and development costs. To counter this trend, Congress passed the Waxman-Hatch Patent Restoration Act in 1984 to extend pharmaceutical patent life. Companies could recover up to half of the time lost to regulatory requirements, as long as their total patent life at time of marketing didn’t exceed 14 years. (Patents generally expire 17 years from the time of issuance or 20 years from date of patent filing, whichever is later.)

The Act estimated the “regulatory review time” as the number of years of clinical testing and FDA evaluation. When the Act was passed, the regulatory review time accounted for about 84% of drug development time. About two-thirds of the regulatory review time could be directly attributed to the 1962 amendments.

As a research scientist in drug discovery and development at the Upjohn Co., between 1976 and 1995, I was quite aware of the impact of increasing regulatory demands on drug development time. My colleagues and I joked that we spent so much time fulfilling the regulations that we had no time to discover new drugs to treat disease! However, as we’ll soon see, it’s no laughing matter: it’s a matter of life and death!

In 1992, the Prescription Drug User Fee Act was passed. This Act allowed pharmaceutical firms to pay “user fees” of hundreds of thousands of dollars to the FDA. The agency would then hire new examiners to expedite their review of the company’s new drug application. This process shaved about a year from the drug development process. As you can see from Figure 2, had this legislation not been passed, drug development times in the 1990s would have more than 15 years-greater than three times the average development time prior to amendment passage!


Hot flushes during menopause 'halves chances' of breast cancer

A dark cloud with a silver lining, apparently. The research methodolgy was a bit weak but the findings seem reasonable

Women who suffer hot flushes during the menopause may be half as likely to get breast cancer. Those whose lives are blighted by the symptoms of the ‘change’ seem to have significant protection against the disease later in life, say scientists.

The results of a study show the worse the hot flushes are, the lower a woman’s risk of developing the most common forms of breast cancer. It suggests the same hormone deficiency which causes severe menopausal symptoms also lowers the chances of developing a tumour.

It is estimated that women who suffer several hot flushes a day during the menopause have up to 40 per cent less oestradiol – a form of the hormone oestrogen. Oestrogen is known to play a central role in the development of some types of breast cancer.

The findings, by researchers from the University of Washington and the Fred Hutchinson Cancer Research Centre, both in Seattle, will bring some comfort to thousands of women who struggle to cope with the effects of the menopause.

It occurs when the ovaries stop producing oestrogen and progesterone, another female sex hormone, usually when a woman is in her early fifties. The most common symptoms are hot flushes and sweating attacks, affecting three in four women. Lasting three to six minutes at a time, these can happen dozens of times throughout the day.

At night, some women sweat so heavily they have to get up to change the sheets. Depression, mood swings, tiredness and headaches are also common symptoms.

The researchers, whose work was published in the journal Cancer Epidemiology Biomarkers and Prevention, recruited just over 1,000 women aged 55 to 74 who had been diagnosed with breast cancer.

Each volunteer was asked how badly they were affected by symptoms during the menopause and the results were compared with a similar sized group of cancer-free women.

Those who endured severe hot flushes, night sweats, depression and insomnia were up to 50 per cent less likely to go on to develop either an invasive lobular carcinoma or an invasive ductal carcinoma, the two most common forms of breast cancer.

In a report on their findings the researchers said: ‘This is the first study to report that women who experience menopausal symptoms have substantially reduced risk of breast cancer and that the severity of hot flushes is also inversely associated with risk. ‘A plausible explanation is that menopausal symptoms are a marker for hormonal changes relevant to the development of breast cancer.’

Every year, around 38,000 women in Britain are diagnosed with breast cancer, the equivalent of more than 100 a day. A woman has a one in nine chance of developing the disease at some point in her life.

A spokesman for Cancer Research UK said: ‘We already know hormones are linked to breast cancer risk. ‘Women who start their periods later, have more children, breastfeed, or have an early menopause have a lower risk. While it’s too soon to add menopausal symptoms to that list, more research will certainly help further our understanding of this area.’


Monday, January 17, 2011

Beauty and brains DO go together! Study claims good-looking men and women have higher IQs

Another of the many positive correlates of IQ

Handsome men and women often appear to be blessed with lucky lives. Now research has shown they are cleverer than most people as well. Studies in Britain and America have found they have IQs 14 points above average. The findings dispel the myth of the dumb blondes or good-looking men not being very bright.

It appears that those already physically blessed attract partners who are not just good looking but brainy too, according to research by the London School of Economics. The children of these couples will tend to inherit both qualities, building a genetic link over successive generations between them.

LSE researcher Satoshi Kanazawa told the Sunday Times: ''Physical attractiveness is significantly positively associated with general intelligence, both with and without controls for social class, body size and health. 'The association between attractiveness and general intelligence is also stronger among men than among women.'

In other research on social standing, he found that middle-class girls tended to have higher IQs than their working- class counterparts.

Among the millions of examples of beauty and brains, there's supermodel Lily Cole who went to Cambridge University, actress Kate Beckinsale, an Oxford graduate, and physicist Brian Cox, one-time keyboard player with D:ream.

In Britain, the study found that men who are physically attractive had IQs an average 13.6 points above the norm while women were about 11.4 points higher.

Kanazawa's findings were based on the National Child Development Study which followed 17,419 people since their birth in a single week in March, 1958. Throughout their childhood up to early adulthood, they were given a series of tests for academic progress, intelligence and marked on appearance.

The American research was taken from the National Longitudinal Study of Adolescent Health which involved a similar study of 35,000 young Americans.

Kanazawa, whose paper was published in the academic journal Intelligence, said: 'Our contention that beautiful people are more intelligent is purely scientific. It is not a prescription for how to treat or judge others.'


Brazilian mothers benefit from vitamin pills

Brazil is a poor country. The pills may have helped make up for nutritional deficiencies

A capsule containing a cocktail of ­essential oils and vitamins could make PMS less painful for millions of women – not to mention the men in their lives. In tests, the natural supplement cut monthly symptoms by up to two-thirds, with minimal side-effects.

It is thought the pills, which contain a mixture of healthy fats and vitamin E, make the body less sensitive to a hormone blamed for much of the misery of pre-menstrual syndrome.

In a study, 120 women were asked to rate the severity of the bloating, tiredness and aches and pains that often beset them in the days leading to menstruation.

Eighty were then prescribed pills containing varying doses of a trio of polyunsaturated fatty acids and vitamin E, which is found in nuts, seeds and green vegetables. Forty women were given packs of dummy pills.

All were told to take two capsules before bedtime each night leading up to their period and asked to rate their symptoms after three months and again at six months.

Those taking the essential oils experienced a clear easing of symptoms after three months. By six months the effects were dramatic, especially among those taking the highest doses.

In some of these cases the severity of ­symptoms fell by more than two-thirds, the journal Reproductive Health reports. Side-effects were rare, with one woman experiencing stomach ache and another’s period starting later than usual.

The researchers, from the Federal University of Pernambuco, in Brazil, believe the contents of the capsules make the body less sensitive to prolactin, a hormone blamed for fluid retention and breast tenderness.

Reacting to the study, Nick Panay, a consultant gynaecologist, questioned whether the capsules would relieve psychological symptoms such as mood swings or low self-esteem. But he added: ‘It sounds encouraging and it is good to see that people are doing proper trials.’