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World Diabetes Day – 14 November

World Diabetes Day – 14 November
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Australian diabetes organisations are participating in the World Diabetes Day monument challenge, where over 600 buildings will light up across the world to raise awareness of diabetes and reflect the International Diabetes Federation theme: Diabetes education and prevention.

World Diabetes Day (WDD) is celebrated every year on 14th November.  The World Diabetes Day campaign is led by the International Diabetes Federation (IDF) and its member associations.  WDD engages millions of people worldwide in diabetes advocacy and awareness. World Diabetes Day was created in 1991 by the International Diabetes Federation and the World Health Organization in response to growing concerns about the escalating health threat that diabetes now poses.  WDD became an official United Nations Day in 2007 with the passage of United Nation Resolution 61/255.  The campaign draws attention to issues of paramount importance to the diabetes world and keeps diabetes firmly in the public spotlight.

For more information visit www.worlddiabetesday.org

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Possible link between pesticides in water and allergies

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A new study has suggested that allergies may be linked to pesticides found in tap water.

Researchers at the American College of Allergy, Asthma and Immunology used existing government data to see whether people with more dichlorophenols in their urine were more likely to have food allergies. Dichlorophenols are a kind of chlorine in certain pesticides that are known to kill bacteria, and in theory, they could be killing the naturally occurring bacteria in humans’ digestive systems, causing food allergies.

“We wanted to see if there was an association between certain pesticides and food allergies, and we were specifically interested in dichlorophenols because those were the ones that had this antibacterial effect,” said lead researcher Dr. Elina Jerschow. “When researchers have compared bacteria from the bowel in healthy kids versus bacteria in the bowel for kids that have lot of allergies, they’ve noticed a big difference.”

The number of children and teens with food or digestive allergies in the United States has increased 18 percent between 1997 and 2007, according to a 2008 study by the Centers for Disease Control and Prevention. That’s about 3 million people under 18 years old.

Eggs, fish, milk, peanuts, shellfish, soy, tree nuts, and wheat make up 90 percent of food allergies, according to the CDC report. Symptoms can range from mouth tingling to anaphylaxis, which is the swelling of the throat and tongue and can lead to death.

Jerschow clarified that the researchers were only looking for a statistical association, meaning they were not able to examine patients to see how these chemicals physically caused their allergies. Because it’s only an association, these findings could mean that the chemicals caused the food allergies, or it could mean the food allergies caused the chemicals in the urine. That part is not yet clear.

“While the study does not allow concluding that pesticides are responsible for the allergies, it certainly raises the possibility and justifies pursuing the kinds of studies that can help sort of if these pesticides are, indeed, the cause,” said Dr. Kenneth Spaeth, who directs the Occupational and Environmental Medicine Center at North Shore University Hospital. He was not a researcher involved in the study.

Spaeth said the study findings fit in with a growing evidence that pesticide exposure can damage the immune system, which could increase allergies as well.

Researchers were surprised to find that dichlorophenol levels in urine didn’t vary between urban and rural areas, Jerschow said. They concluded that even those who opted for bottled water instead of tap water could ingest the pesticide chemical from eating fruit, fruit juices and foods with cocoa powder, like chocolate.

As such, Jerschow said the research is still too preliminary to suggest that people should change their eating or drinking habits.

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Most Brits are “replete’ in iron

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A UK report has found most Brits gain adequate levels of iron, but warned that the elderly, small children, girls, some women and the poor may be susceptible to deficiencies and should consider iron supplementation among other measures. “While most people in the UK are iron replete, health professionals need to be alert to increased risk of iron deficiency anaemia in toddlers, girls and women of reproductive age (particularly those from low income groups) and some adults aged over 65 years,” wrote the Scientific Advisory Committee on Nutrition’s Committee on Medical Aspects of Food and Nutrition Policy (COMA).

“Those with symptoms suggesting iron deficiency anaemia should receive appropriate clinical assessment and advice, including dietary advice on how to increase their iron intakes and to consider use of iron supplements if required.” The report updated COMA’s 1998 finding that high levels of red meat consumption were linked to colorectal cancer and also investigated the effects of reduced iron-rich red meat consumption. COMA concluded that a, “healthy balanced diet, which includes a variety of foods containing iron” is the best way to attain, “adequate iron status”.

“Such an approach is more important than consuming iron-rich foods at the same time as foods/drinks that enhance iron absorption (e.g., fruit juice, meat) or not consuming iron rich foods with those that inhibit iron absorption (e.g., tea, coffee, milk),” the committee said.

On the issue or red meat consumption COMA found that reduced red meat consumption levels would not cause widespread iron deficiencies. “Adults with relatively high intakes of red and processed meat (around 90 g/day or more) should consider reducing their intakes. A reduction to the UK population average for adult consumers (70 g/day cooked weight) would have little impact on the proportion of the adult population with low iron intakes.”

Current UK guidelines state that 3.2 oz (90g) is a healthy daily portion of red meat, and that only those who eat more than 5oz (140g) need to cut back. However some research has challenged these levels. A 2005 European study found those who regularly eat more than 5.6oz (160g) of red meat daily increase their risk of contracting bowel cancer by a third. In 2007, the World Cancer Research Fund report in 2007 concluded that there was a link between red meat consumption and an increased risk of bowel cancer.

The COMA report follows research from the British Nutrition Foundation (BNF) which contradicts these recommendations

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Languages Protect from Memory Loss

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People who speak more than two languages may lower their risk of memory loss or developing other memory problems, according to a study released today that will be presented at the American Academy of Neurology’s 63rd Annual Meeting in Honolulu April 9 to April 16, 2011. “It appears speaking more than two languages has a protective effect on memory in seniors who practice foreign languages over their lifetime or at the time of the study,” said study author Magali Perquin, PhD, with the Center for Health Studies from the Public Research Center for Health (“CRP-Santé”) in Luxembourg. Perquin is helping to lead the MemoVie study which involves a consortium of partners from different hospitals and institutions.

The study involved 230 men and women with an average age of 73 who had spoken or currently spoke two to seven languages. Of the participants, 44 reported memory loss or cognitive problems; the rest of the group had no memory issues. Researchers discovered that those people who spoke four or more languages were five times less likely to develop memory loss or cognitive problems compared to those people who only spoke two languages. People who spoke three languages were three times less likely to have memory loss or cognitive problems compared to bilinguals. In addition, people who currently spoke more than two languages were also four times less likely to have memory loss or cognitive impairment. The results accounted for the age and the education of the participants.

“Further studies are needed to try to confirm these findings and determine whether the protection is limited to thinking skills related to language or if it also extends beyond that and benefits other areas of cognition,” said Perquin. The research was conducted in Luxembourg, where there is a dense population of people who speak more than two languages. The MemoVie study was supported by The National Research Fund (FNR) from Luxembourg.

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Soft drinks high blood pressure

Soft drinks high blood pressure
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Drinking soft drinks is associated with higher blood pressure, according to a study of over 2,500 people reported this week in the journal Hypertension. High blood pressure is a major risk factor for heart disease, which is the leading cause of death worldwide. Someone with a blood pressure level in millimetres of mercury (mmHg) of 135 over 85 is twice as likely to have a heart attack or stroke as someone with a reading of 115 over 75.

The new research shows that for every extra can of soft drink consumed per day, participants on average had a higher systolic blood pressure by 1.6 mmHg and a higher diastolic blood pressure by 0.8 mmHg. This difference was statistically significant even after adjusting for factors such as weight and height. The study did not examine the mechanism that might link soft drinks with blood pressure. However, the researchers suggest that raised uric acid, which has been linked to soft drink consumption, might raise blood pressure by reducing the levels of nitric oxide, a chemical that relaxes the lining of the blood vessels.

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The association between soft drinks and higher blood pressure was especially strong in people who consumed a lot of salt as well as sugar. Diet drinks were linked with lower blood pressure levels in some analyses, but the association was not consistent or strong. Professor Paul Elliott, senior author of the study, from the School of Public Health at Imperial College London, said: “It’s widely known that if you have too much salt in your diet, you’re more likely to develop high blood pressure. The results of this study suggest that people should be careful about how much sugar they consume as well.”

The researchers analysed data from 2,696 volunteers aged between 40 and 59, in eight areas of the US and two areas of the UK. On four separate occasions over a period of three weeks on average, the participants reported what they had eaten in the preceding 24 hours, as well as giving urine samples and having their blood pressure measured. The volunteers were taking part in INTERMAP, the International Study of Macronutrients, Micronutrients and Blood Pressure.

The researchers also found that people who drink more soft drinks tended to have more unhealthy diets in general. As well as consuming more sugar, those consuming more than one soft drink a day consumed more calories by 397 kilocalories per day on average, and less fibre and minerals. Those who did not consume soft drinks had a lower body mass index (BMI) on average than those who consumed more than one drink per day. “Individuals who drink a lot of sugar-sweetened beverages appear to have less healthy diets,” said Dr Ian Brown, the study’s first author, also from the School of Public Health at Imperial College London. “They are consuming empty calories without the nutritional benefits of real food. They consume less potassium, magnesium and calcium.” “This is a population study,” Dr Brown added. “It can’t say definitively that sugary drinks raise your blood pressure, but it’s one piece of the evidence in a jigsaw puzzle that needs to be completed. In the meantime, we would advise people who want to drink sugar-sweetened beverages should do so only in moderation.”

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Food Allergies Anxiety And Loneliness

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Children who are allergic to food are found to be suffering from anxiety and are increasingly more lonely; One allergic child out of five never attends peers’ parties, while one in four always brings along “safe” food. The burden of food allergies and the risk they can escalate to life-threatening diseases is particularly heavy on children, whose normally active and sociable lifestyle can be severely limited and frustrated by the effort to keep them away from potentially dangerous food.

According to a study presented at the 2011 Food Allergy and Anaphylaxis Meeting by the European Academy of Allergy and Clinical Immunology (EAACI), held Feb 17-19 in Venice, Italy, 23 percent of allergic children are no longer curious to try new food to vary their diet, considered too monotonous by most of them. A child out of ten also gives up crucial physical activity for fear of anaphylactic shock triggered by exercise.

“About 17 percent of allergic children, regardless of their age, never go to a party or a picnic with friends, while 24 percent are forced to bring along something to eat,” says Prof. Maria Antonella Muraro, Chair of the EAACI Meeting. The study, headed by Prof. Muraro, was carried out by the Center for the study and treatment of allergies and food intolerances at the hospital of the University of Padua, Italy on 107 young patients and their mothers.

“Also, 5 to 15 per cent of cases of anaphylactic shock can be triggered by physical activity following the consumption of small amounts of allergenic food that would otherwise be harmless, so one allergic child out of ten also stops every kind of exercise,” Prof. Muraro added. “Allergies are often downplayed as a minor problem, but the life of an allergic person can be hell. Allergic children show to be more afraid of being sick and a higher level of anxiety about food than children with diabetes. The constant alarm surrounding them is taking a toll on their development and well-being.”

Another worrisome problem adding to the poor quality of life of allergic patients, especially the younger ones, is the need to carry life-saving devices at all times, such as epinephrine auto-injectors, “loaded” with enough drug to prevent death in case of severe anaphylactic shock. They are easy to use, light to carry and discreet, but one out of three patients still leaves home without them.

“Within 8 or 10 minutes the shot reverses the symptoms, ranging from urticaria to respiratory distress, cardiovascular collapse and gastrointestinal problems including vomiting and diarrhoea,” explains Prof. Muraro. “It can cause minor side effects, such as irritability or tremors that end as soon as the adrenaline is processed by the body, generally within a couple of hours. Patients should not be scared, even those who have a heart disease: the possible side effects are negligible in comparison to the opportunity to save your life.”

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Alternative allergy tests are misleading

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There is no scientific evidence that complementary therapies or kits sold through websites can identify allergies, the UK NHS watchdog NICE says. It says sites for services such as hair analysis use plausible stories but are not backed up by scientific evidence.  It is publishing new guidance to help doctors in England and Wales identify when a child may have allergy problems. NICE says some parents end up turning to alternative therapies after a perceived lack of help from their GPs.

It is estimated that one in 20 young children has a food allergy. Dr Adam Fox, an allergy specialist based at the Evelina Children's Hospital in London, says not all children suffer immediate and obvious symptoms. “Food allergies can actually be extremely subtle. Lots of children have eczema, colic or spit up more food than usual. For some of those children the underlying problem is an allergy to something within their diet.”

The guidelines include detailed advice about how to recognise symptoms and when to refer to specialists. Dr Fox, who helped write the guidelines for National Institute for Health and Clinical Excellence (NICE), says he often sees parents in his specialist clinic who have wasted money on complementary or alternative tests.

The review by NICE looked for any scientific research of the usefulness of approaches including hair analysis and Vega testing, which uses mild electric currents, or kinesiology, in diagnosing allergies in children. “The websites are very well put together, the stories behind them are plausible, but we were unable to find any evidence to support them,” says Dr Fox. He says there are two types of testing used in NHS clinics – skin prick and blood sample – which are backed by scientific research. NICE is warning that parents sometimes turn to alternative tests when they have failed to convince their family doctor to listen to their concerns.

It took Alison Berthelson more than two years to get an allergy diagnosis for her first son Harris. She had been to the local surgery several times when he suffered rashes and stomach upsets without any particular cause being identified. After Harris ate a small piece of chocolate containing nuts he suffered a more extreme reaction, becoming agitated, with an extreme rash covering his entire body. The out-of-hours GP gave her son a medicine to reduce swelling, but did not send him on to hospital as an emergency. “It was really very terrifying, terrifying at the time because we didn't know what was happening, and terrifying later when we did know what had happened and how lucky we were.” A new GP correctly diagnosed possible food allergies, and sent Harris for testing at a specialist NHS clinic. He now has to avoid nuts, sesame and some other ingredients used in prepared foods.

Allergies on rise The number of children suffering from food allergies appears to be increasing, although experts are at a loss to understand exactly why. Family doctors are now more likely to see very young children suffering allergic reactions. Dr Joanne Walsh, a GP involved in drafting the advice, says she now sees several children a week with suspected allergic reactions. Some are babies just a couple of weeks old. By gradually eliminating, and reintroducing different foods, she can help parents manage the allergy without the need for hospital visits. “There's nothing more rewarding than a parent coming back and saying it's like having a different child.”

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Antioxidants lower stroke risk

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Eating a diet high in antioxidants may protect against ischemic stroke, an Italian cohort study showed.

People who had a diet high in total antioxidant capacity — an index that takes into account several different antioxidants and their interactions — had a 59% reduced relative risk of ischemic stroke (HR 0.41, 95% CI 0.23 to 0.74), according to Nicoletta Pellegrini, PhD, of the University of Parma in Italy, and colleagues. But there was no such relationship with hemorrhagic stroke, they reported in the January issue of the Journal of Nutrition. In fact, the highest intake of the antioxidant vitamin E was associated with a greater risk of hemorrhagic stroke (HR 2.94, 95% CI 1.13 to 7.62).
Considering evidence suggesting that oxidative stress and systemic inflammation are involved in the pathogenesis of ischemic stroke, the researchers noted that “a high-total antioxidant capacity diet could be protective as a consequence of its ability to deliver compounds with antioxidant activity and with a demonstrated anti-inflammatory effect.” But, they acknowledged that the mechanism for such activity was unclear may “go beyond the antioxidant activity of the numerous total antioxidant capacity contributors present in foods and beverages.”

Pellegrini and her colleagues set out to explore the relationship between dietary total antioxidant capacity and the risk of stroke among 41,620 people participating in EPICOR, the Italian segment of the European Prospective Investigation into Cancer and Nutrition (EPIC). None had a history of stroke or MI at baseline. Dietary intake was assessed with a food frequency questionnaire. In the study population, more than half of the total antioxidants consumed came from coffee, wine, and fruit. Through a mean follow-up of 7.9 years, there were 112 ischemic strokes, 48 hemorrhagic strokes, and 34 other types of strokes. After adjustment for energy intake, hypertension, smoking status, education, nonalcoholic energy intake at recruitment, alcohol intake, waist circumference, body mass index, and total physical activity, individuals eating a diet in the highest tertile of total antioxidant capacity had a reduced risk of ischemic — but not hemorrhagic — stroke.

Looking at individual antioxidants, the researchers found that participants consuming the highest amounts of vitamin C had a reduced risk of ischemic stroke (HR 0.58, 95% CI 0.34 to 0.99). Controlling for vitamin C intake did not negate the overall association between antioxidants and ischemic stroke, which ruled out the nutrient as the sole driver of the relationship. High intake of vitamin E, on the other hand, was associated with nearly triple the relative risk of hemorrhagic stroke. However, “it must be stressed that the small number of cases observed in this population strongly limits the validity of statistical observations on hemorrhagic stroke,” noted the researchers, who called for further studies.

Aside from anti-inflammatory effects, it is possible that the association between antioxidants and ischemic stroke risk can be explained by the interaction between polyphenols — the major contributors to total antioxidant capacity — and the generation of nitric oxide from the vascular endothelium. That interaction leads to the vasodilation and expression of genes that may be protective for the vascular system, according to the researchers. In addition, coffee — the main source of antioxidants in the study population — reduces blood pressure, which is a recognized risk factor for ischemic stroke, the researchers wrote.

They noted some limitations of the study, including the low numbers of cases when different types of stroke were analyzed, the measurement of total antioxidant capacity at baseline only, and the inability to rule out confounding effects of other dietary components, like sodium and potassium.

Source: Del Rio D, et al “Total antioxidant capacity of the diet is associated with lower risk of ischemic stroke in a large Italian cohort” J Nutr 2011; 141: 118-123.

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Fructose Intolerance

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Researchers have a new theory on why some kids get unexplained tummy aches.

In some people, the small intestine is unable to efficiently break down fructose (and sometimes other forms of sugar). This problem is sometimes referred to as fructose intolerance. The undigested fructose passes into the large intestine, where it is broken down by bacteria. A by-product of this process is the creation of carbon dioxide and hydrogen. These two gases build up in the intestine, causing bloating, gas, pain and diarrhea. In some cases, the problem can affect absorption of important nutrients, like calcium and iron.

Researchers estimate about 33 percent of Americans have some level of sensitivity to sugar, most commonly to fructose, but the symptoms are often vague. Some people with fructose intolerance can eat small amounts of the sugar and not have any problems, making diagnosis even trickier.

Daniel Lustig, M.D., Pediatric Gastroenterologist at Mary Bridge Children’s Health Center in Tacoma, WA, says patients with chronic digestive problems should have a physician’s evaluation to rule out other possible causes of the symptoms, like Celiac disease or Crohn’s disease. Once those conditions have been ruled out, he recommends a diagnostic tool called the breath hydrogen test.

A patient is given a dose of fructose. Then, periodically, he/she breathes into an air collection bag. The gases from the bag are retrieved and analyzed for the presence of hydrogen (one of the gases given off when fructose is broken down in the large intestine). Patients whose hydrogen levels exceed 20 points beyond a baseline reading are likely to be fructose intolerant.

Lustig explains the main treatment of fructose intolerance is avoidance of foods containing fructose. That includes fruits, fruit juices, sodas and processed foods and drinks with high fructose corn syrup. Since fructose is in so many foods, it can be tricky to find and hard to avoid.

Lustig recently performed a study to look at possible fructose intolerance in 245 children and adolescents (ages 2 to 18) with unexplained chronic abdominal pain, gas or bloating. The breath hydrogen test found that nearly 54 percent of the participants tested positive for fructose intolerance. Lustig says the problem appeared to be especially high among teen girls.

Those who were judged to be fructose intolerant were given advice on using a low-fructose diet. The investigators found that nearly 68 percent of those who followed the recommended diet had an improvement or resolution in their symptoms.

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