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Overreaction in gut noted in study of people with type 1 version of disease
(HealthDay News) — An abnormal immune response to wheat proteins may contribute to type 1 diabetes, Canadian researchers say.
Their study of 42 people with type 1 diabetes found that nearly half had immune system T-cells that overreacted to wheat. The researchers also identified genes associated with this abnormal immune response.
“The immune system has to find the perfect balance to defend the body against foreign invaders without hurting itself or overreacting to the environment, and this can be particularly challenging in the gut, where there is an abundance of food and bacteria,” study author Dr. Fraser Scott, a senior scientist at the Ottawa Hospital Research Institute and professor of medicine at the University of Ottawa, said in a hospital news release.
“Our research suggests that people with certain genes may be more likely to develop an overreaction to wheat and possibly other foods in the gut, and this may tip the balance with the immune system and make the body more likely to develop other immune problems, such as type 1 diabetes,” he explained.
The study appears in the August issue of Diabetes.
“These observations add to the accumulating evidence that the gut is an active player in the diabetes disease process,” Dr. Mikael Knip of Finland wrote in an accompanying editorial.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about diabetes.
– Robert Preidt
SOURCE: Ottawa Hospital Research Institute, news release, Aug. 20, 2009
From the Johns Hopkins Health Alert
The most recent study on glucosamine chondroitin supplements seriously challenges their effectiveness at providing relief from osteoarthritis pain.
In 2006, the National Institutes of Health’s Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) showed that these popular arthritis supplements don’t help. But many patients held out hope that an ongoing second GAIT would uncover some benefit.
Now results are in for the second part of this landmark trial, and the final analysis suggests more of the same: Glucosamine and chondroitin supplements do not effectively treat osteoarthritis.
Cartilage cushions and protects joints. As osteoarthritis progresses, this cushion wears away, causing joint pain and disability. Glucosamine/chondroitin supplements (they are sold both as a combination pill and separately) contain compounds found in cartilage and are touted to help repair and slow joint deterioration. But it’s unknown how the body processes these compounds or if they ever make it to the cartilage.
The first GAIT analysis included 1,600 participants and measured how well glucosamine/chondroitin supplements reduced pain compared with a placebo and the proven pain reliever celecoxib (Celebrex). After six months researchers reported that, overall, these supplements were no more effective than placebo at relieving pain. As was expected, people taking celecoxib reported the greatest improvement.
Among a small group of participants with moderate to severe knee pain, those taking the combination supplement reported greater pain relief than people taking placebo, but this group was too small for researchers to say for sure that the combo works. Moreover, within this small group, placebo users reported as much pain relief as those taking celecoxib, which casts further doubt on the purported benefits of supplements.
Researchers hoped that the second GAIT analysis, which used x-rays to measure the physical effects of these supplements on knee joints, would clarify matters. Knee images from 357 people with osteoarthritis were analyzed to see if daily glucosamine/chondroitin supplements prevented a loss of joint space — the distance between the ends of bones in the joint. (Bones get closer together as cartilage wears away.) There were no meaningful differences among people taking glucosamine/chondroitin, celecoxib, or placebo.
Glucosamine and chondroitin together did worse than when each was taken alone, but again, these differences were insignificant and no better than placebo. As in the first trial, a small subgroup of patients showed a trend toward improvement. This time, however, the trend was seen in patients with less severe osteoarthritis pain who were taking glucosamine alone — not a combination supplement.
Many people will probably continue to take these supplements despite the new data — osteoarthritis hurts, relief is hard to find, and the small group of participants who benefited is still a nagging issue. About 1,500 mg a day of glucosamine alone is the most promising dosage.
But be aware that well-designed trials done independent of supplement manufacturers have not been able to prove these supplements work, despite their enormous popularity. Moreover, pills can cost more than $30 a month; this is a lot of money to spend on what might be a placebo effect.
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Clinical question
Can vitamin D prevent important fractures related to osteoporosis?
Bottom line
Vitamin D at dosages greater than 400 IU per day is effective in decreasing nonvertebral fractures, including hip fractures. The effect is dose dependent; dosages less than 400 IU per day are ineffective. A practical way to implement this low-cost approach is to suggest nonprescription vitamin D supplements at dosages of 800 IU per day; that way, missed doses will still keep the average daily dose in the range of effectiveness. (LOE = 1a)
Reference
Bischoff-Ferrari HA, Willett WC, Wong JB, et al. Prevention of nonvertebral fractures with oral vitamin D dose dependency. A meta-analysis of randomized controlled trials. Arch Intern Med 2009;169(6):551-561. [PubMed Abstract]
Study design: Meta-analysis (randomized controlled trials)
Setting: Various (meta-analysis)
Synopsis
This meta-analysis, now the fourth on this topic in the past 5 years, went further than the other ones and looked at the relationship of dose and effectiveness of vitamin D in preventing nonvertebral fractures, especially hip fracture. To identify articles, the authors searched 3 databases, including the Cochrane Controlled Trials Register, and searched meeting abstracts and reference lists of identified articles, and contacted experts in the field. They identified 12 double-blind randomized controlled trials (enrolling a total of 42,279 patients with an average age of 78 years) that included data on how the fractures happened and data regarding adherence so they could calculate the received dosage of vitamin D. Data from the studies were independently abstracted by 3 researchers, then compared. Combining all trials, vitamin D supplementation produced a small decrease in nonvertebral fractures (relative risk = .86; 95% CI, .77 – .96). However, the results across studies were heterogeneous until they stratified study results by dosage. Dosages of 400 IU per day or less did not reduce nonvertebral fracture risk. Dosages of greater than 400 IU per day significantly reduced nonvertebral fractures, with 1 fracture prevented for every 93 patients treated with vitamin D instead of placebo for 12 months to 84 months (number needed to treat [NNT] = 93; 66-160). The effect was more pronounced with cholecalciferol (vitamin D3) than with erogocalciferol (vitamin D2) . Similarly, hip fractures were also prevented by higher dosages of vitamin D (NNT = 202; 114-823). The addition of calcium supplementation did not improve results.
Copyright © 2009 John Wiley & Sons, Inc. www.essentialevidenceplus.com
Posted on June 3, 2009 by childhealthsafety
Just months following the US Court of Federal Claims rejection of the claim that the MMR vaccine causes autism, here you will see data from formal peer refereed medical papers showing that vaccines caused autism in Japanese children and will be doing the same to children around the world. The number of Japanese children developing autism rose and fell in direct proportion to the number of children vaccinated each year [click image for larger graph in new window]:-
For the full article click here
Breaking News
In a recently published study, green tea extract was investigated in an experimental model of spinal cord injury.
In this study, mice were subjected to spinal cord trauma by a spinal operation called a laminectomy, in which the area of the vertabrae called the lamina is removed. This operation resulted in increased measures of inflammation and edema, infiltration of white blood cells called neutrophils, and programmed cell death, also known as apoptosis. There were also significantly increased levels of nitrotyrosine, which is used as a marker of cell damage, inflammation, and nitric oxide production. Green tea extract was administered one and six hours after the spinal cord injury.
The mice receiving green tea extract demonstrated a reduction in all of the measures of inflammation. There was a significant decrease in the degree of spinal cord inflammation and reductions in levels of nitrotyrosine, less infiltration by neutrophils, and lower levels of poly ADP-ribosyl synthetase, which is an enzyme involved in apoptosis and DNA repair. Additionally, the recovery of limb function was significantly ameliorated by green tea extract.
The study authors stated, “Taken together, our results clearly demonstrate that green tea extract treatment ameliorates spinal cord injury oxidative stress.”
Reference:
Paterniti I, Genovese T, Crisafulli C, Mazzon E, Di Paola R, Galuppo M, Bramanti P, Cuzzocrea S. Treatment with green tea extract attenuates secondary inflammatory response in an experimental model of spinal cord trauma. Naunyn Schmiedebergs Arch Pharmacol. 2009 Apr 1. Published Online Ahead of Print.
Individuals who do not want to consume large amounts of green tea as a beverage can take green tea extract capsules
Association Between Serum 25-Hydroxyvitamin D Level and Upper Respiratory Tract Infection in the Third National Health and Nutrition Examination Survey
Adit A. Ginde, MD, MPH; Jonathan M. Mansbach, MD; Carlos A. Camargo Jr, MD, DrPH
Arch Intern Med. 2009;169(4):384-390.
Background Recent studies suggest a role for vitamin D in innate immunity, including the prevention of respiratory tract infections (RTIs). We hypothesize that serum 25-hydroxyvitamin D (25[OH]D) levels are inversely associated with self-reported recent upper RTI (URTI).
Methods We performed a secondary analysis of the Third National Health and Nutrition Examination Survey, a probability survey of the US population conducted between 1988 and 1994. We examined the association between 25(OH)D level and recent URTI in 18 883 participants 12 years and older. The analysis adjusted for demographics and clinical factors (season, body mass index, smoking history, asthma, and chronic obstructive pulmonary disease).
Results The median serum 25(OH)D level was 29 ng/mL (to convert to nanomoles per liter, multiply by 2.496) (interquartile range, 21-37 ng/mL), and 19% (95% confidence interval [CI], 18%-20%) of participants reported a recent URTI. Recent URTI was reported by 24% of participants with 25(OH)D levels less than 10 ng/mL, by 20% with levels of 10 to less than 30 ng/mL, and by 17% with levels of 30 ng/mL or more (P < .001). Even after adjusting for demographic and clinical characteristics, lower 25(OH)D levels were independently associated with recent URTI (compared with 25[OH]D levels of ?30 ng/mL: odds ratio [OR], 1.36; 95% CI, 1.01-1.84 for <10 ng/mL and 1.24; 1.07-1.43 for 10 to <30 ng/mL). The association between 25(OH)D level and URTI seemed to be stronger in individuals with asthma and chronic obstructive pulmonary disease (OR, 5.67 and 2.26, respectively).
Conclusions Serum 25(OH)D levels are inversely associated with recent URTI. This association may be stronger in those with respiratory tract diseases. Randomized controlled trials are warranted to explore the effects of vitamin D supplementation on RTI.
Author Affiliations: Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora (Dr Ginde); and Department of Medicine, Children’s Hospital Boston (Dr Mansbach), and Department of Emergency Medicine, Massachusetts General Hospital (Dr Camargo), Harvard Medical School, Boston.
Chronic Pain Linked to Low Vitamin D
Allison Gandey Medscape Medical News 2009. © 2009 Medscape
March 25, 2009 — Inadequate vitamin D may represent an underrecognized source of nociperception and impaired neuromuscular functioning, say researchers.
“Physicians who care for patients with chronic, diffuse pain that seems musculoskeletal — and involves many areas of tenderness to palpation — should strongly consider checking vitamin-D level,” Michael Turner, MD, from the Mayo Clinic in Rochester, Minnesota, said in a news release issued Friday.
“For example,” he added, “many patients who have been labeled with fibromyalgia are, in fact, suffering from symptomatic vitamin-D inadequacy. Vigilance is especially required when risk factors are present, such as obesity, darker pigmented skin, or limited exposure to sunlight.”
Dr. Turner was lead investigator of a study published in the journal Pain Medicine in November 2008. The work suggests a correlation between inadequate vitamin-D levels and the amount of narcotic medication taken by chronic pain patients. Continue reading Chronic Pain Linked to Low Vitamin D
(HealthDay News) — Consuming more vitamin C may help reduce a man’s risk of gout, according to researchers who studied almost 47,000 men over a 20-year span.
During that time, more than 1,300 of the men developed gout. Compared with those whose vitamin C intake through food and supplements was less than 250 milligrams a day, the risk for gout was 17 percent lower among men with a daily intake of 500 to 999 milligrams, 34 percent lower for those who took in 1,000 to 1,499 milligrams, and 45 percent lower with a daily intake of 1,500 milligrams or more.
For every 500 mg increase in vitamin C intake, the risk for gout fell 17 percent, the researchers calculated.
Risks were similar when comparing men who did and did not take supplements. Those who took 1,000 to 1,499 supplemental milligrams a day had a 34 percent lower risk of gout than men who did not take vitamin C supplements. The risk was 45 percent lower with 1,500 supplemental milligrams daily.
The researchers said it appears that vitamin C reduces levels of uric acid, which can form crystal deposits that cause the pain, inflammation and swelling associated with gout. Vitamin C may affect reabsorption of uric acid by the kidneys, increase the speed at which the kidneys work or protect against inflammation, all of which might reduce the likelihood of developing gout.
The study is published in the March 9 issue of Archives of Internal Medicine.
“Given the general safety profile associated with vitamin C intake, particularly in the generally consumed ranges as in the present study (e.g. tolerable upper intake level of vitamin C of less than 2,000 milligrams in adults, according to the Food and Nutrition Board, Institute of Medicine), vitamin C intake may provide a useful option in the prevention of gout,” wrote Dr. Hyon K. Choi, who was with the University of British Columbia when the study was conducted and is now with the Boston University School of Medicine.
More information
The American Academy of Family Physicians has more about gout.
– Robert Preidt
SOURCE: JAMA/Archives journals, news release, March 9, 2009
ISSLS prize winner: Early predictors of chronic work disability: a prospective, population-based study of workers with back injuries
Turner JA, Franklin G, Fulton-Kehoe D, Sheppard L, Stover B, Wu R, Gluck JV, Wickizer TM. Spine. 2008 Dec 1;33(25):2809-18..
When investigators analyzed which health care providers patients saw first after their injury vs. disability at 1 year, “Clearly, patients whose first visit for the injury was to a chiropractor had reduced odds of chronic disability,” Turner said. “That at least raises the possibility that chiropractic care was more effective in improving pain and disability or promoting RTW [return to work].”
Twenty-nine percent initially saw a chiropractor, compared to 36% who saw a primary care physician.
The finding concerning chiropractors surprised the researchers who expected to see the best outcomes in the 7% of patients who initially saw an occupational medicine physician. “In fact, if anything, they had somewhat worse outcomes,” Turner said.
James Turner, the chairman of the national consumer education group Citizens for Health, has expressed shock and outrage after reading a new report from scientists outlining the dangers of the artificial sweetener Splenda (sucralose).
In animals examined for the study, Splenda reduced the amount of good bacteria in the intestines by 50 percent, increased the pH level in the intestines, contributed to increases in body weight and affected P-glycoprotein (P-gp) levels in such a way that crucial health-related drugs could be rejected.
The P-gp effect could result in medications used in chemotherapy, AIDS treatment and treatments for heart conditions being shunted back into the intestines, rather than being absorbed by the body.
According to Turner, “The report makes it clear that the artificial sweetener Splenda and its key component sucralose pose a threat to the people who consume the product. Hundreds of consumers have complained to us about side effects from using Splenda and this study … confirms that the chemicals in the little yellow package should carry a big red warning label.”
Sources:
Globe Newswire September 28, 2008
Journal of Toxicology and Environmental Health Part A 2008;71(21):1415-29
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