Dr. Bray Links

Monday, December 10, 2018

Even When Not In Rome, Eat A Mediterranean Diet To Cut Heart Disease Risk | Kaiser Health News

Once again, your mother was right. You really do need to eat your vegetables. And while you are at it, put down the bacon and pick up the olive oil, because new research supports the contention that switching to a Mediterranean diet could significantly decrease the risk of heart disease.

According to a study published Friday in JAMA Network Open, people who followed this type of diet had 25 percent less risk of developing cardiovascular disease over the course of 12 years.

https://khn.org/news/even-when-not-in-rome-eat-a-mediterranean-diet-to-cut-heart-disease-risk/

Saturday, December 8, 2018

Association of Frequency of Organic Food Consumption With Cancer Risk

Results  Among 68 946 participants (78.0% female; mean [SD] age at baseline, 44.2 [14.5] years), 1340 first incident cancer cases were identified during follow-up, with the most prevalent being 459 breast cancers, 180 prostate cancers, 135 skin cancers, 99 colorectal cancers, 47 non-Hodgkin lymphomas, and 15 other lymphomas. High organic food scores were inversely associated with the overall risk of cancer (hazard ratio for quartile 4 vs quartile 1, 0.75; 95% CI, 0.63-0.88; P for trend = .001; absolute risk reduction, 0.6%; hazard ratio for a 5-point increase, 0.92; 95% CI, 0.88-0.96).

Conclusions and Relevance  A higher frequency of organic food consumption was associated with a reduced risk of cancer. If these findings are confirmed, further research is necessary to determine the underlying factors involved in this association.

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2707948

Ultraviolet and Vitamin D

Reptiles need UVB for biosynthesis of vitamin D, and other metabolic processes. Specifically cholecalciferol (vitamin D3), which is needed to for basic cellular / neural functioning as well as the utilization calcium for bone and egg production. The UVA wavelength is also visible to many reptiles and might play a signifiant role in their ability survive in the wild as well as visual communication between individuals. Therefore, in a typical reptile enclosure, a fluorescent UV a/b source (at the proper strength / spectrum for the species), must be available for many captive species to survive. Simple supplementation with cholecalciferol (Vitamin D3) will not be enough as there's a complete biosynthetic pathway that is "leapfrogged" (risks of possible overdoses), the intermediate molecules and metabolites also place important functions in the animals health. Natural sunlight in the right levels is always going to be superior to artificial sources, but this might be possible for keepers in different parts of the world. 

https://en.m.wikipedia.org/wiki/Ultraviolet

Tuesday, December 4, 2018

The acute and chronic effects of hot water immersion on inflammation and metabolism in sedentary, overweight adults

Regular exercise-induced acute inflammatory responses are suggested to improve the inflammatory profile and insulin sensitivity. As body temperature elevations partly mediate this response, passive heating might be a viable tool to improve the inflammatory profile. This study investigated the acute, and chronic effects of hot water immersion on inflammatory and metabolic markers. Ten sedentary, overweight males (BMI: 31.0±4.2 kg/m2) were immersed in water set at 39°C for 1 h (HWI) or rested for 1 h at ambient temperature (AMB). Venous blood was obtained prior to, immediately post and 2 h post-session for assessment of monocyte intracellular heat shock protein 72 (iHsp72) and plasma concentrations of extracelullar heat shock protein 72 (eHsp72), interleukin-6 (IL-6), fasting glucose, insulin and nitrite. Thereafter, participants underwent a 2-week intervention period, consisting of 10 hot water immersion sessions (INT). Eight BMI-matched participants (BMI: 30.0±2.5 kg/m2) were included as control (CON). Plasma IL-6 and nitrite concentrations were higher immediately following HWI compared to AMB (IL-6 p<0.001, HWI: 1.37±0.94 to 2.51±1.49 pg/ml; nitrite p=0.04, HWI: 271±52 to 391±72 nM), while iHsp72 expression was unchanged (p=0.57). In contrast to resting iHsp72 expression (p=0.59), fasting glucose (p=0.04, INT: 4.44±0.93 to 3.98±0.98 mmol/l), insulin (p=0.04, INT: 68.1±44.6 to 55.0±29.9 pmol/l) and eHsp72 (p=0.03, INT: 17±41% reduction) concentrations were lowered after INT compared to CON. HWI induced an acute inflammatory response and increased nitric oxide bioavailability. The reductions in fasting glucose and insulin concentrations following the chronic intervention suggest that hot water immersion may serve as a tool to improve glucose metabolism.

https://www.physiology.org/doi/abs/10.1152/japplphysiol.00407.2018

Sunday, December 2, 2018

Patients Often Withhold Information From Providers

The most common situations in which information was withheld were not agreeing with the clinician's recommendation (MTurk, 45.7%; SSI, 31.4%) and not understanding the clinician's instructions (MTurk, 31.8%; SSI, 24.3%).

The five reasons most commonly indicated for participants not disclosing information were not wanting to be judged or lectured (MTurk, 81.8%; SSI, 64.1%), not wanting to hear how harmful their behavior is (MTurk, 75.7%; SSI, 61.1%), embarrassment (MTurk, 60.9%; SSI, 49.9%), not wanting the clinician to think they were difficult patients (MTurk, 50.8%; SSI, 38.1%), and not wanting to take up more of the clinician's time (MTurk, 45.2%; SSI, 35.9%).

"If patients are withholding information from clinicians as frequently as this research suggests, then clinicians are routinely not receiving the information that they need to provide high quality care to patients, especially sicker patients," the researchers conclude. They note that sicker patients were more likely to withhold information.

https://www.medscape.com/viewarticle/905825

Saturday, December 1, 2018

A novel hypothesis for atherosclerosis as a cholesterol sulfate deficiency syndrome

Worldwide geographical data show an inverse relationship between cardiovascular disease and annual sunlight availability [18]. In a study conducted in the British Isles, 49 % of the variance in mortality from coronary heart disease was accounted for by mean annual sunshine hours as measured by the Meteorological Office [19]. However, placebo-controlled trials failed to show any benefit from vitamin D3 supplementation [20]. We propose that the benefit comes from Ch-S synthesis instead. In [16], it was proposed that the protein endothelial nitric oxide synthase (eNOS), along with sunlight, catalyzes sulfate production in erythrocytes, endothelial cells, platelets and keratinocytes in the skin. Thus, eNOS is a dual-purpose enzyme, producing sulfate when it is membrane–bound and producing nitric oxide when it is free in the cytoplasm. We hypothesize that the overuse of sunscreen has played a dual damaging role not only because sunlight catalysis is suppressed but also because the aluminum found in high-SPF sunscreens as an emulsifier actively disrupts eNOS' function [21]. eNOS is an orphan cytochrome P450 (CYP) enzyme [22], and aluminum is a known disruptor of CYP enzyme function through its displacement of the iron in the heme group [23]. Many other environmental toxicants also disrupt CYP enzymes, including mercury [24, 25], arsenic [26], cadmium [24], glyphosate [27, 28], and lead [25, 29].

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4456713/

Wednesday, November 28, 2018

Can Diet Reverse Type 2 Diabetes?

Unlike in DiRECT, patients were allowed to take insulin at study onset (30% in the low-carbohydrate group and 46% in the usual care group). After 1 year, patients in the usual care group had no significant changes in study biomarkers.

Conversely, 60% of those in the low-carbohydrate group achieved an A1c level < 6.5 while taking no diabetes medications or metformin only. There was also a 12% weight loss, 24% reduction in triglyceride level, 18% increase in high-density lipoprotein cholesterol level, and 39% reduction in C-reactive protein level.

According to Sarah Hallberg, DO, the study's principal investigator and medical director of Virta Health and Indiana University Arnett's Medically Supervised Weight Loss Program, the 94% rate of reduction or outright cessation of insulin in this group is particularly noteworthy.

https://www.medscape.com/viewarticle/905409

Sunday, November 25, 2018

Report: Toxic herbicide found in many Texans' drinking water | The Texas Tribune


Nearly 500 water utilities across the state tested positive for atrazine — a weed killer — which can lead to harmful health effects, according to a new report. The Environmental Working Group also found that utilities are testing water during times when the herbicide isn't being used as much — and that they may be lowballing the results.


https://www.texastribune.org/2018/11/15/report-toxic-herbicide-found-many-texans-drinking-water/

The Real Scoop on the Latest Low-Carb Diet Study

Those in the low-carb-diet group had significantly higher total energy expenditure than those in the other groups. They were burning about 209 calories per day more than the high-carb group.

https://www.medscape.com/viewarticle/904963

Tuesday, November 20, 2018

This Inventor May Have Cured Motion Sickness Without Drugs. And That Could Mean a Lot to the US Military - Defense One

The vibrations emanating from the OtoTech gently target two of the four fibers that carry data about body motion to the brain via a system of inner ear sensors called the vestibulocochlear nerve. "Two [of the four vestibulocochlear nerve fibers] go to the brain, two go to your reflexes," Owen said. The trick is to affect the former and not the latter.

"The working hypothesis is that [the vibration] causes a chaotic and noninformative stimulus to go to the brain. Somewhere, probably the cerebellum, there's a filtering mechanism that filters out noninformative sensed information. It's the reason you don't notice the shirt on your back right now," he said.

https://www.defenseone.com/technology/2018/11/inventor-may-have-cured-motion-sickness-without-drugs-and-could-mean-lot-us-military/152960/

Sunday, November 18, 2018

Death of HHS official Daniel Best is ruled a suicide

The Nov. 1 death of Daniel Best, a pharmaceutical executive from Bay Village who led U.S. Department of Health and Human Services efforts to lower prescription drug prices, has been ruled a suicide, officials in Washington, D.C., said Thursday.

Police say Best was found "unresponsive" near the garage door exit of an apartment building in Washington, D.C.'s Navy Yard neighborhood at 5:25 a.m. on Nov. 1, and was pronounced dead by medical personnel who responded to the scene.

The city's Office of the Chief Medical Examiner on Thursday said Best died from "multiple blunt force injuries" and it ruled his death a suicide. It would not release further information.

http://12160.info/m/discussion?id=2649739%3ATopic%3A1847383

Eating More Organic Food Tied to Lower Cancer Risk

A higher frequency of eating organic food was associated with a reduced risk for cancer, according to results from a large population-based observational study published online October 22 in JAMA Internal Medicine.

"Promoting organic food consumption in the general population could be a promising preventive strategy against cancer," conclude the authors, led by Julia Baudry, PhD, of the Center of Research in Epidemiology and Statistics Sorbonne Paris Cité.


https://www.medscape.com/viewarticle/903742

The High Cost of Pesticides: Human and Animal Diseases | OMICS International

A significant degradation in the health of wild animals in Montana has been recorded over the past two decades. We surmise that the health issues are related to pesticide exposure. We present some of the evidence of the deterioration of the health in wildlife, which we used to inspire investigations on human health in the US population. While the animals' exposure is through food, water and air, we believe that human exposure is predominantly through food, as the majority of the population does not reside near agricultural fields and forests. We have obtained US government data on pesticide usage and on human disease patterns over time from the 1998-2010 hospital discharge data. Since glyphosate is by far the most widely used herbicide, we believe it to be a major source of contamination for humans. Correlations between glyphosate usage and specific health issues, along with the known toxicology profile of glyphosate obtained from the literature, reflect a plausible causal relationship. Because much of the wildlife data is from deer fawns, most of the human data presented here involve newborn infants, but we also present some data for children 0-15 years old and for the full population (except newborn). We found many diseases and conditions whose hospital discharge rates match remarkably well with the rate of glyphosate usage on corn, soy, and wheat crops. These include head and face anomalies (R=0.95), newborn eye disorders, newborn blood disorders (R=0.92), newborn skin disorders (R=0.96), lymph disorders in children 0-15 (R=0.86) and in the general population except newborn (R=0.89), congenital heart conditions in newborns (R= 0.98), enlarged right ventricle in all age groups except newborn (R=0.96), newborn lung problems (R=0.95), pulmonary bleeding and edema for all age groups except newborn (R=0.97), liver cancer for all age groups except newborn (R=0.93), newborn metabolic disorders (R=0.95) and newborn genitourinary disorders (R=0.96).

https://www.omicsonline.org/open-access/the-high-cost-of-pesticides-human-and-animal-diseases-2375-446X-1000132.php?aid=56471

Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT: Cell


Murine gut mucosal probiotic colonization is only mildly enhanced by antibiotics
Human gut mucosal probiotic colonization is significantly enhanced by antibiotics
Post antibiotics, probiotics delay gut microbiome and transcriptome reconstitution
In contrast, aFMT restores mucosal microbiome and gut transcriptome reconstitution

https://www.cell.com/cell/fulltext/S0092-8674%2818%2931108-5?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867418311085%3Fshowall%3Dtrue

Saturday, November 17, 2018

EMA Curtails Use of Fluoroquinolone, Quinolone Antibiotics

Fluoroquinolones "should be used with special caution in the elderly, patients with kidney disease and those who have had an organ transplantation because these patients are at a higher risk of tendon injury. Since the use of a corticosteroid with a fluoroquinolone also increases this risk, combined use of these medicines should be avoided," the EMA advised.

On the basis of available evidence, the EMA concluded that fluoroquinolones are associated with prolonged (up to months or years), serious, disabling, and potentially irreversible drug reactions affecting more than one and sometimes multiple systems, organ classes, and senses.

The adverse effects include tendonitis, tendon rupture, arthralgia, pain in the extremities, gait disturbance, neuropathies associated with paraesthesia, depression, fatigue, memory impairment, sleep disorders, and impaired hearing, vision, taste, and smell.

Tendon damage (especially to the Achilles tendon but also other tendons) can occur within 48 hours of starting a fluoroquinolone, but the damage may be delayed several months after stopping treatment, the EMA said.

https://www.medscape.com/viewarticle/905023

Worse than opioids: Alcohol deaths soar among the middle-aged, women

From 2007 to 2017, the number of deaths attributable to alcohol increased 35 percent, according to a new analysis by the Institute for Health Metrics and Evaluation at the University of Washington. The death rate rose 24 percent.

One alarming statistic: Deaths among women rose 67 percent. Women once drank far less than men, and their more moderate drinking helped prevent heart disease, offsetting some of the harm.

https://www.usatoday.com/story/news/health/2018/11/16/alcohol-deaths-emergency-room-increase-middle-aged-women-addiction-opioids/1593347002/

Thursday, November 15, 2018

Novel Agent Lowers Lp(a), Meets All End Points in Phase 2

A novel antisense agent is relatively safe and highly effective in lowering levels of lipoprotein(a) in patients with both elevated Lp(a) and established cardiovascular disease (CVD), new research suggests.

In a dose-finding phase 2b trial that examined five regimens in more than 200 patients with CVD and Lp(a) levels of 60 mg/dL or higher. Treatment with the subcutaneous injectable drug known as AKCEA-APO(a)-LRX (Akcea Therapeutics/Ionis Pharmaceuticals) was associated with a dose-dependent effect on these levels from baseline to week 25 to 27, meeting the primary end point.

In addition, for the patients receiving the highest active dose evaluated, 20 mg/week, there was a mean 80% reduction in Lp(a) from baseline.

Lead author Sotirios Tsimikas, MD, vice president of Global Cardiovascular Development at Ionis Pharmaceuticals and professor of medicine at the University of California, San Diego, noted that this is especially dramatic compared with currently available treatments, including proprotein convertase subtilisin/kexin type 9 (PCSK-9) inhibitors.

"Looking at current therapies, PCSK-9 inhibitors lower Lp[a] by about 15% to 25% and niacin can lower it by 20% to 30%. So this is two to three times more potent than what's currently available to lower Lp(a)," Tsimikas told theheart.org | Medscape Cardiology.

Results also showed that 98% of the participants "got to goal," defined as Lp(a) less than 50 mg/dL. "This means almost everybody who got on the drug got to a level that we think has very low risk," Tsimikas said.

In addition, the 20 mg/week dose met all secondary outcomes, including mean change from baseline in low-density-lipoprotein cholesterol (LDL-C), ApoB, and oxidized phospholipids on apoB particles (OxPL-apoB and OxPl-apo[a]).

https://www.medscape.com/viewarticle/904891

Low-Carbohydrate Diets May Increase Energy Expenditure

 Lowering dietary carbohydrate intake could help in maintaining weight loss, new research suggests. However, some experts say the trial methodology makes drawing conclusions difficult.

Findings from a randomized trial comparing the metabolic effects of diets of varying carbohydrate-to-fat ratio were presented November 14 here at Obesity Week 2018 by David S. Ludwig, MD, and Cara B. Ebbeling, MD, both of the New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts. The findings were simultaneously published in BMJ.

The study found that lowering dietary carbohydrate increased energy expenditure during weight loss maintenance, especially among those with high insulin secretion. However, the investigators' use of doubly labeled water to measure energy expenditure was called into question during the Obesity Week symposium by Kevin Hall, PhD, a senior investigator at the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.

The bottom line, symposium chair and Obesity Society president Caroline M. Apovian, MD, told Medscape Medical News, is, "We need to do more studies to show that this is actually the case. There's controversy...This may mean that we haven't yet figured out how to find out what each individual person needs to eat for better health."

https://www.medscape.com/viewarticle/904956

Wednesday, November 14, 2018

Effect of Amla fruit (Emblica officinalis Gaertn.) on blood glucose and lipid profile of normal subjects and type 2 diabetic patients

Overall, the results of the present study suggest that Amla fruit (E. officinalis, Gaertn.) has both anti-hyperglycemic and lipid-lowering properties and might be used as an ideal plant food supplement in developing successful alternative therapies in the prevention and treatment of diabetes, dyslipidemia, obesity and cancers in general population. 

https://www.tandfonline.com/doi/full/10.3109/09637486.2011.560565?scroll=top&needAccess=true

Efficacy and safety of Amla (Phyllanthus emblica L.) in non-erosive reflux disease: a double-blind, randomized, placebo-controlled clinical trial. - PubMed - NCBI

BACKGROUND:

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal complaints. GERD, caused by the reflux of stomach contents into the esophagus, leads to troublesome symptoms such as heartburn and regurgitation. It is classified into two types: erosive esophagitis, characterized by visible esophageal mucosa erosion in endoscopy, and non-erosive reflux disease (NERD). GERD is a chronic and recurrent disease that impairs the quality of life and imposes socioeconomic and therapeutic burdens to both patients and society.
OBJECTIVE:

Due to the failure of the conventional treatments for GERD and to the traditional use of Amla (Phyllanthus emblica L.), in addition to beneficial effects shown in recent studies, we evaluated the safety and efficacy of Amla tablet for improvement of symptoms of patients with NERD.
DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS:

We designed a double-arm, randomized, double-blind, placebo-controlled clinical trial. Sixty-eight patients who had classic symptoms of GERD (heartburn, regurgitation and epigastralgia) for at least three months before the start of the trial were randomized in two parallel groups. Patients in the Amla group received two 500 mg Amla tablets twice a day, after meals, for 4 weeks. In the control group, patients received placebo tablets similar to the Amla prescription.
MAIN OUTCOME MEASURES:

The patients were visited at baseline, and at the end of the 2nd and 4th weeks of intervention; their symptoms were measured on a frequency and severity scale for the symptoms of NERD, according to the quality of life in reflux-associated disease questionnaire.
RESULTS:

Frequencies of heartburn and regurgitation in both groups of the study were significantly reduced after intervention (P < 0.001). Repeated measures logistic regression analysis showed that, in the Amla group, there was a more significant reduction in regurgitation frequency, heartburn frequency, regurgitation severity and heartburn severity during the study period, compared with the placebo group (P < 0.001).
CONCLUSION:

This randomized double-blind, placebo-controlled clinical trial demonstrated that Amla could reduce frequencies of heartburn and regurgitation and improve heartburn and regurgitation severity in patients with NERD.

https://www.ncbi.nlm.nih.gov/pubmed/2952623