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Low Vitamin D Levels, Shorter Life?

By Amy Norton
HealthDay Reporter

FRIDAY, Sept. 20, 2019 (HealthDay News) — Young and middle-aged adults with low vitamin D levels may live shorter lives, a large study suggests.

The findings come from a 20-year follow-up of more than 78,000 Austrian adults. Researchers found that those with low vitamin D levels in their blood were nearly three times more likely to die during the study period than those with adequate levels.

When it came to the cause of death, vitamin D levels were most clearly linked to deaths from diabetes complications.

The findings were to be presented Friday at the annual meeting of the European Association for the Study of Diabetes, in Barcelona — and are considered preliminary. Experts said they do not prove that low vitamin D levels, per se, cut people’s lives short.

But the results add to a large body of evidence tying inadequate vitamin D to various health effects — beyond the long-recognized consequence of thinner, weaker bones. Studies have also pointed to higher risks of conditions like diabetes and high blood pressure, certain cancers, and autoimmune diseases such as multiple sclerosis.

“The role of vitamin D in the body appears to be more than simply assisting calcium absorption and bone health,” said Connie Diekman, a registered dietitian who was not involved in the study.

However, the research is “still evolving,” noted Diekman, who has served as president of the nonprofit Academy of Nutrition and Dietetics. That means it’s still unclear whether boosting your vitamin D intake — through food or pills — will prevent various diseases or lengthen your life.

In fact, a recent study, published in the New England Journal of Medicine, yielded disappointing results: Researchers found that vitamin D supplements did not help prevent type 2 diabetes in people at high risk of the disease.

But that may be in part because supplements later in life might not be enough to prevent a disease, according to Dr. Rodrig Marculescu, the lead researcher on the current study.

Many health conditions, including type 2 diabetes, get their start earlier in life, said Marculescu, of the Medical University of Vienna in Austria.

Continued

On the other hand, he said, vitamin D supplements might have more of an impact on the odds of dying from a disease.

His team found a clear relationship between blood vitamin D levels and the risk of early death — especially among people who were younger than 60: Those with levels of 10 nmol/L (nanomoles per liter) or less had almost a three-times higher risk of dying during the study, versus those with adequate levels (50 nmol/L).

In contrast, middle-aged and younger people with vitamin D levels at or above 90 nmol/L had a lower death risk than those at the 50 mark.

In general, vitamin D concentrations of 50 nmol/L or higher are considered to be high enough for overall health, according to the U.S. National Institutes of Health.

When the researchers zeroed in on causes of death, it turned out that vitamin D levels showed only weak connections to heart disease and cancer. Instead, people with low levels (below 50) had a more than fourfold higher risk of dying from diabetes complications, versus those with adequate levels.

It’s not clear why. But, Marculescu said, there are plausible reasons that vitamin D levels would be particularly linked to diabetes: The vitamin, which acts as a hormone in the body, helps regulate the immune system. That’s relevant to type 1 diabetes, Marculescu noted, because it is an autoimmune disease.

Vitamin D is also important to the cells that produce the hormone insulin — which regulates blood sugar — and to the body’s sensitivity to insulin. That’s relevant to type 2 diabetes, Marculescu pointed out.

For now, he said, the findings “further strengthen the already very strong rationale for intensifying vitamin D supplementation, especially during childhood and at younger ages.”

Specifically, he pointed to recommendations from the Endocrine Society. They suggest that adults get 1,500 to 2,000 IU of vitamin D per day, while children and teenagers get 600 to 1,000 IU.

The body naturally synthesizes vitamin D when sunlight hits the skin, but cold climates — and concerns about sun exposure — can limit that source.

Diekman suggested that people have their blood vitamin D level checked. If it’s low, she said, talk to your doctor about how to boost it — whether through supplements or foods such as vitamin D-fortified dairy products, juice or cereal.

WebMD News from HealthDay

Sources

SOURCES: Rodrig Marculescu, M.D., associate professor, Medical University of Vienna, Austria; Connie Diekman, M.Ed., R.D., food and nutrition consultant, St. Louis, Mo.; Sept. 20, 2019, presentation, European Association for the Study of Diabetes annual meeting, Barcelona, Spain

Copyright © 2013-2018 HealthDay. All rights reserved.

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Are Shorter Days Linked to Postpartum Depression?

By Mary Elizabeth Dallas

       

         HealthDay Reporter        

FRIDAY, Oct. 12, 2018 (HealthDay News) — Women whose final stages of pregnancy occur during the short, dark days of winter may be at increased risk for postpartum depression, a new study suggests.

It has to do with reduced exposure to sunlight — the same culprit that contributes to seasonal affective disorder, or SAD. That’s a type of depression that usually starts in fall and winter and disappears in spring and summer.

The study authors said their findings should prompt doctors to encourage pregnant women who are at high risk for postpartum depression to increase their exposure to daylight and boost their levels of vitamin D.

The study was led by Deepika Goyal, a professor of nursing at San Jose State University. She and her team reviewed data on nearly 300 first-time mothers who took part in randomized controlled sleep trials before and after pregnancy.

The researchers looked at the amount of daylight during the women’s last trimester of pregnancy and other risk factors for postpartum depression, such as medical history, age, socioeconomic status and sleep quality.

Overall, participants had a 30 percent risk for depression. Their odds were strongly influenced by the number of daylight hours during the last month of pregnancy and immediately after delivery.

Women who were in the late stages of pregnancy during winter had a 35 percent risk — the highest scores — for postpartum depression. And their symptoms were more severe, the study found.

Women whose third trimester coincided with longer hours of daylight had a 26 percent risk for depression, the study showed.

“Among first-time mothers, the length of day in the third trimester, specifically day lengths that are shortening compared to day lengths that are short, long or lengthening, were associated with concurrent depressive symptom severity,” Goyal said.

The study was published recently in a special issue of the Journal of Behavioral Medicine focused on postpartum health.

Researchers said that women in their third trimester may benefit from exposure to artificial light during months with the shortest days. This treatment, which could reduce their depression risk, should continue for three months after delivery.

Continued

Pregnant women with a history of mental health issues and those who have signs of depression should spend more time outdoors during the final months of pregnancy or use therapeutic devices such as light boxes to increase their exposure to light, the researchers said.

“Women should be encouraged to get frequent exposure to daylight throughout their pregnancies to enhance their vitamin D levels and to suppress the hormone melatonin,” Goyal said in a journal news release.

Doctors should urge pregnant women to get more outdoor physical activity if the weather permits and it’s safe for them to do so, the researchers added.

“Daily walks during daylight hours may be more effective in improving mood than walking inside a shopping mall or using a treadmill in a gym,” Goyal said. “Likewise, early morning or late evening walks may be relaxing but would be less effective in increasing vitamin D exposure or suppressing melatonin.”

WebMD News from HealthDay

Sources

SOURCE:Journal of Behavioral Medicine, news release, September 2018

Copyright © 2013-2018 HealthDay. All rights reserved.


WebMD Health

Blacks Have Shorter Life Spans After Surviving Heart Stoppage: Study

MONDAY, July 9, 2018 — Black patients who survive cardiac arrest during a U.S. hospital stay have poorer long-term survival odds than their white peers, new research suggests.

The study included data from patients aged 65 and older who survived at least until they were discharged from the hospital. The investigators found that, compared with white people, black people were 28 percent less likely to live one year and 33 percent less likely to survive five years.

The black patients in the study were more often female and younger, were sicker, had higher rates of kidney and respiratory problems and pneumonia, and were more likely to have been on dialysis before their cardiac arrest, the findings showed.

“Notably, black patients were less likely to have had a heart attack during hospital admission or a prior history of heart attack,” said study lead author Dr. Lena Chen, an assistant professor of internal medicine at the University of Michigan.

“As a result, they were more likely to have a non-shockable initial heart rhythm of pulseless electrical activity and to have experienced their heart stoppage in an unmonitored hospital unit,” said Chen.

The researchers did not examine differences in caregiving, social support, or income between black and white patients.

The study was published July 9 in the journal Circulation.

“Our study’s findings suggest a need to examine to what degree differences in post-discharge care explain racial differences in long-term survival after heart stoppages,” Chen concluded in a journal news release.

More information

The American Heart Association has more on cardiac arrest.

© 2018 HealthDay. All rights reserved.

Posted: July 2018

Drugs.com – Daily MedNews

Toddlers Who Drink Milk Alternatives May Be Shorter

       

By Amy Norton

       

         HealthDay Reporter        

     

WEDNESDAY, June 7, 2017 (HealthDay News) — Young children who drink soy, almond or other milk “alternatives” may be a bit shorter than kids who drink cow’s milk, a new study suggests.

Researchers found that among more than 5,000 Canadian children, a 3-year-old who drank three cups of non-cow’s milk each day was, typically, a half inch shorter than a child who drank the same amount of cow’s milk.

The study — which was funded by the Canadian government and St. Michael’s Hospital Foundation — doesn’t prove that parents’ milk choices were the culprit.

For one, there could have been differences in the children’s overall diets, too, said lead researcher Dr. Jonathon Maguire.

But, he said, the nutritional content in different milk substitutes vary widely. And it’s “reasonable to hypothesize” that some shortchange children on protein, fat and other nutrients, said Maguire, a pediatrician at St. Michael’s Hospital in Toronto.

A pediatric nutrition specialist who wasn’t involved in the study agreed.

“With the exception of soy milk, other (non-dairy) products contain almost no protein,” said Erin Corrigan, a registered dietitian at Nicklaus Children’s Hospital, in Miami.

When it comes to fat, she said, coconut milk has a relatively higher amount. But many cow’s milk alternatives contain little fat — which may be fine for an adult, but not for a toddler, Corrigan said.

Plus, she added, the calcium from milk alternatives is generally not as well-absorbed as the calcium in cow’s milk.

No one argued that young children must have cow’s milk.

But, Maguire said, parents who choose alternative products should be “savvy” about reading nutrition labels. And they should be sure their child’s overall diet has adequate protein, fat and other nutrients, he said.

The study findings are based on more than 5,000 children between the ages of 2 and 6. In all, 13 percent drank non-cow’s milk every day, while 92 percent drank cow’s milk daily.

Overall, Maguire’s team found, there was a correlation between the type of milk kids drank and their height at age 3: For each daily cup of non-cow’s milk, children were 0.4 centimeters — or 0.15 inches — shorter than the norm for their age, on average.

Continued

On the other hand, for each daily cup of cow’s milk, kids were 0.2 centimeters (0.08 inches) taller than the norm.

The study did not ask about the specific type of cow’s milk alternative, or about overall diet. Those are two important gaps in the research, according to Corrigan.

“We don’t know why kids were drinking non-cow’s milk,” she said. “We don’t know whether the family was vegetarian or vegan, for instance.”

In at least some cases, a child’s overall diet might have been lacking, according to Corrigan.

It’s possible for vegetarian diets to be healthy for young children, she said — though vegan diets (which exclude all animal products, including eggs and dairy) are trickier.

“It depends on the child and their acceptance of the diet,” Corrigan said. “There’s a difference between a child who’s only eating bagels and pasta, and a child who’s eating a variety of foods like quinoa, legumes, tempeh and avocados.”

But does it matter if a 3-year-old is a bit shorter than his or her peers?

According to Maguire, height is an indicator of overall “nutritional status” and development. He acknowledged, though, that it is only one measure of development.

It’s also possible, Maguire added, that kids who drink milk alternatives “catch up” in height later in childhood.

But, he said, the bottom line is that parents should not assume the alternative products are “healthier” than cow’s milk — no matter what the advertising claims.

Corrigan made another point: Non-dairy milks come in sugar-sweetened varieties, with flavors such as chocolate and vanilla that appeal to young children. She cautioned parents to avoid any products with added sugar.

In general, Corrigan said, if parents want their children to a follow a more-restricted diet — vegan or otherwise — it’s a good idea to talk to a pediatric nutrition specialist if possible.

The study was published June 7 in the American Journal of Clinical Nutrition.

WebMD News from HealthDay

Sources

SOURCES: Jonathon Maguire, M.D., pediatrician, St. Michael’s Hospital, Toronto, Canada; Erin Corrigan, R.D.N., clinical nutrition manager, Nicklaus Children’s Hospital, Miami; June 7, 2017, American Journal of Clinical Nutrition online

Copyright © 2013-2017 HealthDay. All rights reserved.

WebMD Health

Toddlers Who Drink Cow’s Milk Alternatives May Be Shorter

WEDNESDAY, June 7, 2017 — Young children who drink soy, almond or other milk “alternatives” may be a bit shorter than kids who drink cow’s milk, a new study suggests.

Researchers found that among more than 5,000 Canadian children, a 3-year-old who drank three cups of non-cow’s milk each day was, typically, a half inch shorter than a child who drank the same amount of cow’s milk.

The study — which was funded by the Canadian government and St. Michael’s Hospital Foundation — doesn’t prove that parents’ milk choices were the culprit.

For one, there could have been differences in the children’s overall diets, too, said lead researcher Dr. Jonathon Maguire.

But, he said, the nutritional content in different milk substitutes vary widely. And it’s “reasonable to hypothesize” that some shortchange children on protein, fat and other nutrients, said Maguire, a pediatrician at St. Michael’s Hospital in Toronto.

A pediatric nutrition specialist who wasn’t involved in the study agreed.

“With the exception of soy milk, other (non-dairy) products contain almost no protein,” said Erin Corrigan, a registered dietitian at Nicklaus Children’s Hospital, in Miami.

When it comes to fat, she said, coconut milk has a relatively higher amount. But many cow’s milk alternatives contain little fat — which may be fine for an adult, but not for a toddler, Corrigan said.

Plus, she added, the calcium from milk alternatives is generally not as well-absorbed as the calcium in cow’s milk.

No one argued that young children must have cow’s milk.

But, Maguire said, parents who choose alternative products should be “savvy” about reading nutrition labels. And they should be sure their child’s overall diet has adequate protein, fat and other nutrients, he said.

The study findings are based on more than 5,000 children between the ages of 2 and 6. In all, 13 percent drank non-cow’s milk every day, while 92 percent drank cow’s milk daily.

Overall, Maguire’s team found, there was a correlation between the type of milk kids drank and their height at age 3: For each daily cup of non-cow’s milk, children were 0.4 centimeters — or 0.15 inches — shorter than the norm for their age, on average.

On the other hand, for each daily cup of cow’s milk, kids were 0.2 centimeters (0.08 inches) taller than the norm.

The study did not ask about the specific type of cow’s milk alternative, or about overall diet. Those are two important gaps in the research, according to Corrigan.

“We don’t know why kids were drinking non-cow’s milk,” she said. “We don’t know whether the family was vegetarian or vegan, for instance.”

In at least some cases, a child’s overall diet might have been lacking, according to Corrigan.

It’s possible for vegetarian diets to be healthy for young children, she said — though vegan diets (which exclude all animal products, including eggs and dairy) are trickier.

“It depends on the child and their acceptance of the diet,” Corrigan said. “There’s a difference between a child who’s only eating bagels and pasta, and a child who’s eating a variety of foods like quinoa, legumes, tempeh and avocados.”

But does it matter if a 3-year-old is a bit shorter than his or her peers?

According to Maguire, height is an indicator of overall “nutritional status” and development. He acknowledged, though, that it is only one measure of development.

It’s also possible, Maguire added, that kids who drink milk alternatives “catch up” in height later in childhood.

But, he said, the bottom line is that parents should not assume the alternative products are “healthier” than cow’s milk — no matter what the advertising claims.

Corrigan made another point: Non-dairy milks come in sugar-sweetened varieties, with flavors such as chocolate and vanilla that appeal to young children. She cautioned parents to avoid any products with added sugar.

In general, Corrigan said, if parents want their children to a follow a more-restricted diet — vegan or otherwise — it’s a good idea to talk to a pediatric nutrition specialist if possible.

The study was published June 7 in the American Journal of Clinical Nutrition.

More information

The Academy of Nutrition and Dietetics has advice on dairy alternatives for kids.

Posted: June 2017

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Sperm, Semen Defects May Be Linked to Shorter Life Spans


Sperm, Semen Defects May Be Tied to Shorter Lives

Men with 2 or more defects have more than double the risk of dying early, study suggests

WebMD News from HealthDay

Meanwhile, other research saw no fertility

By Dennis Thompson

HealthDay Reporter

FRIDAY, May 16, 2014 (HealthDay News) — Men rendered infertile due to defects in their semen and sperm are more likely to die early than men with normal semen, new research suggests.

Over a period of about eight years, men with two or more abnormalities in their semen had a risk of death that was more than double that of men with healthy semen, researchers reported in the May 16 online issue of Human Reproduction.

Knowing this, doctors who treat men for infertility should advise them to adopt healthy habits that might boost their survival, said lead author Dr. Michael Eisenberg, assistant professor of urology and Stanford University School of Medicine’s director of male reproductive medicine and surgery.

“There may be a window of opportunity here. When they see their doctor they could do some other things that might benefit them,” Eisenberg said. “I see this as an opportunity to pay more attention to your health and be more proactive.”

For the study, Eisenberg and his colleagues reviewed the medical records of about 12,000 men aged 20 to 50 who had visited either the Stanford University School of Medicine or the Baylor College of Medicine in Houston to be evaluated for possible infertility.

At both clinics, doctors had recorded information on patients’ semen quality, such as total semen volume, sperm counts, sperm movement and shape. The researchers compared patient data with death records to track the men’s death rates, while taking into account for underlying health issues that could compromise semen quality.

While no single semen abnormality in itself predicted early death, men with two or more such abnormalities had 2.3 times the risk of death during the study period than those with no semen abnormalities. The greater the number of abnormalities, the higher the risk of death, the study found.

Low semen volume, sperm concentration, sperm activity, total sperm count and the total count of active sperm specifically were associated with a higher risk. Abnormally shaped sperm did not appear to be linked to increased risk of death during the study follow-up.

“This striking increased death rate in men with abnormal semen parameters highlights the urgency and need to investigate the causes of male infertility and not to just proceed with assisted reproductive technologies,” said Dr. Natan Bar-Chama, director of male reproductive medicine and surgery at the Icahn School of Medicine at Mount Sinai in New York City.

Bar-Chama, who was not involved with the study, added that “it is equally important to identify potential modifiable causes of male infertility that could be acted upon and subsequently decrease this increased mortality rate.”

It’s important to keep in mind that this study wasn’t designed to prove that semen abnormalities lead to a higher rate of death, only to show there is an association between these factors.

WebMD Health

Too Much Running Tied to Shorter Lifespan, Studies Find

TUESDAY April 1, 2014 — Running regularly has long been linked to a host of health benefits, including weight control, stress reduction, better blood pressure and cholesterol.

However, recent research suggests there may a point of diminishing returns with running.

A number of studies have suggested that a “moderate” running regimen — a total of two to three hours per week, according to one expert — appears best for longevity, refuting the typical “more is better” mantra for physical activity.

The researchers behind the newest study on the issue say people who get either no exercise or high-mileage runners both tend to have shorter lifespans than moderate runners. But the reasons why remain unclear, they added.

The new study seems to rule out cardiac risk or the use of certain medications as factors.

“Our study didn’t find any differences that could explain these longevity differences,” said Dr. Martin Matsumura, co-director of the Cardiovascular Research Institute at the Lehigh Valley Health Network in Allentown, Pa.

Matsumura presented the findings Sunday at the American College of Cardiology’s annual meeting in Washington, D.C. Studies presented at medical meetings are typically viewed as preliminary until published in a peer-reviewed journal.

Matsumura and his colleagues evaluated data from more than 3,800 men and women runners, average age 46. They were involved in the Masters Running Study, a web-based study of training and health information on runners aged 35 and above. Nearly 70 percent reported running more than 20 miles a week.

The runners supplied information on their use of common painkillers called NSAIDs (nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen/Aleve), which have been linked with heart problems, as well as aspirin, known to be heart-protective. The runners also reported on known heart risk factors such as high blood pressure, high cholesterol, diabetes, family history of heart disease and smoking history.

None of these factors explained the shorter lives of high-mileage runners, the researchers said. Use of NSAIDs was actually more common in runners who ran less than 20 miles weekly, Matsumura’s team noted. “The study negates the theory that excessive use of NSAIDs may be causing this loss of longevity among high-mileage runners,” Matsumura said.

So what’s the advice to fitness-oriented Americans?

“I certainly don’t tell patients ‘Don’t run,’ ” Matsumura said. But, he does tell high-mileage runners to stay informed about new research into the mileage-lifespan link as more becomes known.

“What we still don’t understand is defining the optimal dose of running for health and longevity,” he said.

Even though the heart disease risk factors couldn’t explain the shorter longevity of high-mileage runners, there do seem to be potentially life-shortening ill effects from that amount of running, said Dr. James O’Keefe, director of preventive cardiology at the Mid-American Heart Institute in Kansas City.

O’Keefe, who reviewed the findings, believes there may simply be “too much wear and tear” on the bodies of high-mileage runners. He has researched the issue and is an advocate of moderate running for the best health benefits. Chronic extreme exercise, O’Keefe said, may induce a “remodeling” of the heart, and that could undermine some of the benefits that moderate activity provides.

In O’Keefe’s view, the “sweet spot” for jogging for health benefits is a slow to moderate pace, about two or three times per week, for a total of one to 2.5 hours.

“If you want to run a marathon,” he said, “run one and cross it off your bucket list.” But as a general rule, O’Keefe advises runners to avoid strenuous exercise for more than an hour at a time.

More information

To learn more about this field of research, head to the Masters Running Study.

Posted: April 2014

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Wider Waistline May Mean Shorter Lifespan: Study


Wider Waistline May Mean Shorter Lifespan: Study

Evidence review suggests extra inches raise risk of dying younger, regardless of body weight

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

FRIDAY, March 14, 2014 (HealthDay News) — Having a big belly means big trouble when it comes to your health, researchers warn.

They analyzed data from 11 studies that included more than 600,000 people worldwide and found that people with large waist circumferences were at increased risk of dying younger and dying from conditions such as heart disease, lung problems and cancer.

Men with waists of 43 inches or more had a 50 percent higher risk of death than those with waists less than 35 inches. This equated to a three-year lower life expectancy after age 40, according to the study.

Women with waists of 37 inches or more had an 80 percent higher risk of death than those with waists of 27 inches or less, which equated to a five-year lower life expectancy after age 40.

The larger the waist, the greater the risk, the researchers said. For every 2 inches of increased waist circumference, the risk of death increased 7 percent in men and 9 percent in women, according to the study, which was published in the March issue of the journal Mayo Clinic Proceedings.

Although the review found an association between larger waist size and risk of death at a younger age, it didn’t prove a cause-and-effect relationship.

The link between a big belly and increased risk of death was seen even among people whose body-mass index (BMI) was within the healthy range, the researchers found. BMI is an estimate of body fat based on height and weight.

“BMI is not a perfect measure,” study lead author Dr. James Cerhan, an epidemiologist at the Mayo Clinic, said in a journal news release. “It doesn’t discriminate lean mass from fat mass, and it also doesn’t say anything about where your weight is located. We worry about that because extra fat in your belly has a metabolic profile that is associated with diseases such as diabetes and heart disease.”

When assessing patients, doctors need to consider both waist size and BMI.

“The primary goal should be preventing both a high BMI and a large waist circumference,” Cerhan said. “For those patients who have a large waist, trimming down even a few inches — through exercise and diet — could have important health benefits.”

WebMD Health

Obese Patients With Pancreatic Cancer Have Shorter Survival, Study Finds

TUESDAY Oct. 22, 2013 — A diagnosis of pancreatic cancer usually carries with it a poor prognosis, and the news may be even worse for those who are obese: It could mean dying two to three months sooner than pancreatic cancer patients of normal weight, new research shows.

Prior studies have tied obesity to a higher chance of getting pancreatic cancer, but the new study asked whether the disease affects the tumor’s aggressiveness and the patient’s overall survival.

“[The new research] adds to the growing body of evidence that obesity is linked to cancer,” said Dr. Smitha Krishnamurthi, an associate professor of medicine at the Case Western Reserve University School of Medicine.

The study was published Oct. 21 in the Journal of Clinical Oncology. Krishnamurthi was not involved in the new study, but did write a related journal commentary.

Because it is so often asymptomatic and is detected late, pancreatic cancer remains one of the most deadly tumor types. According to the American Cancer Society, more than 45,000 people will be diagnosed with the disease this year, and it will claim over 38,000 lives.

In the new study, a team led by Dr. Brian Wolpin, an assistant professor of medicine at the Dana-Farber Cancer Institute and Harvard Medical School, collected data on more than 900 patients with pancreatic cancer who took part in either the Nurses’ Health Study or the Health Professionals Follow-Up Study. These patients were diagnosed during a 24-year period, the researchers said.

After diagnosis, the patients lived for an average of only five months. Normal-weight patients, however, lived two to three months longer than obese patients, the researchers found.

This association remained strong even after the researchers took into account factors such as age, sex, race, ethnicity, smoking and the stage of the cancer at diagnosis. The study did not, however, prove a cause-and-effect relationship between weight and length of survival.

In addition, obese patients were more likely to have more advanced cancer at the time they were diagnosed compared with normal-weight patients. Overall, the cancer had already showed signs of spreading in 72 percent of obese patients at the time of diagnosis, compared with 59 percent of normal-weight patients.

It also seemed to matter how long the patient had been obese — the association between weight and survival was strongest for the 202 patients who were obese 18 to 20 years before being diagnosed with pancreatic cancer.

Krishnamurthi said the reasons for the link aren’t clear. She said the study can’t tell us whether shorter survival in obese patients “was due to biologic changes that can occur in obesity, such as increased inflammation in the body, or whether the obesity caused other conditions that interfered with the treatment of pancreatic cancer.”

“We need more research into how obesity may increase cancer rates and/or aggressiveness,” she said.

In a statement from the journal, lead author Wolpin said the research “reinforces the importance of maintaining a healthy weight throughout your life, which may lead to better outcomes after diagnosis and help prevent pancreatic cancer from developing.”

“While our findings will not affect the way we treat patients today, they provide new leads for investigating the molecular pathways that may be responsible for the survival difference between obese and healthy-weight patients,” Wolpin said. “Hopefully, in the future, that research will bring new approaches for treatment of pancreatic cancer.”

Another expert agreed.

“This finding may provide clues about the biology of pancreatic cancer that could eventually be useful in treating patients,” said Eric Jacobs, strategic director of pharmacoepidemiology at the American Cancer Society.

“At this point, however, the great majority of pancreatic cancer patients, regardless of their weight, will die of their disease within a few years,” Jacobs said. “The most important thing to know about obesity and pancreatic cancer is that maintaining a healthy weight throughout life can help lower the risk of ever developing this highly fatal cancer.”

More information

For more information on pancreatic cancer, visit the American Cancer Society.

Posted: October 2013

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Shorter Radiation Course Appears Effective for Early Breast Cancer


Shorter Radiation Course for Early Breast Cancer?

New protocol could replace current standard, experts say

WebMD News from HealthDay

Repeat tests cause anxiety and additional costs

By Steven Reinberg

HealthDay Reporter

WEDNESDAY, Sept. 18 (HealthDay News) — In women with early breast cancer, three weeks of high-dose radiation is as effective as the current standard — five weeks of lower-dose treatment, British researchers say.

A short course of radiation given in larger doses — an approach called hypofractionated radiation — is safe and effective and causes less damage to healthy surrounding tissue, according to the 10-year results of two British trials. The short course is also more convenient and less expensive.

“For most indications, a three-week course of postoperative radiotherapy can be recommended as standard of care for women with early breast cancer following breast conservation surgery or mastectomy,” said study researcher Dr. John Yarnold, a professor of clinical oncology at the Institute of Cancer Research in London.

“Three weeks of treatment is gentler on the healthy tissues without loss of anti-cancer effect, so it represents an improvement for women with early breast cancer,” he added.

The report, published Sept. 19 in The Lancet Oncology, may not change current practice immediately, however, said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City.

The short course is “a great alternative and may eventually replace long-term radiation,” Bernik said. But she thinks studies conducted in the United States are needed to convince U.S. oncologists of the benefits.

“They want a little experience with it before they start doing it automatically,” she added. “But you will probably see it more and more.”

Already, some places in the United States use the three-week course, she said, adding, “we have been waiting for the results of a long-term study.”

In this case, between 1999 and 2002, researchers conducted two trials — U.K. Standardization of Breast Radiotherapy, known as START A and B. The trials tested different radiation doses and timing schedules among 4,451 women treated at 35 centers across the United Kingdom.

START A compared the international standard — a total of 50 Gy given in 25 small doses over five weeks — with two other schedules: 41.6 Gy and 39 Gy, each given in 13 treatments over five weeks.

START B compared the international standard with 40 Gy given in 15 doses of 2.67 Gy over three weeks.

Over 10 years of follow-up, the results of START A were similar regardless of the dose of radiation. In all three cases, the cancer relapse rate was about the same, ranging from 6.3 percent to 8.8 percent. Damage to surrounding tissue was also similar regardless of the dose of radiation, the researchers noted.

In START B, similar results were also seen after 10 years, with relapses ranging from 5.5 percent to 4.3 percent. Damage to surrounding tissue, however, was significantly less than in START A, the researchers found.

The outcomes of the two trials were independent of age, tumor grade, stage, chemotherapy use, or use of tumor bed boost — additional radiation therapy, the study authors pointed out.

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COPD Patients May Do Fine With Shorter Course of Steroids

TUESDAY May 21, 2013 — Less is more when it comes to steroid therapy for patients having severe bouts of chronic obstructive pulmonary disease (COPD), according to Swiss investigators.

Five days of glucocorticoid treatment with prednisone to treat COPD flare-ups was as good as the standard 14 days, but with fewer chances for adverse side effects, they said.

“We wanted to show that a shorter period of treatment was not less effective than 14 days,” said lead researcher Dr. Jorg Leuppi, with the department of medicine at the University Hospital of Basel.

The shorter course of treatment had the same outcome as the longer course of treatment, the study found. “There is exactly the same time to recovery and exactly the same number of re-exacerbations,” Leuppi said.

In addition, the shorter course of treatment meant fewer side effects from the drug, such as increased blood pressure and elevated blood sugar, he said.

The report was published May 21 in the online edition of the Journal of the American Medical Association to coincide with its Tuesday presentation at the American Thoracic Society meeting in Philadelphia.

COPD is a progressive disease involving bronchitis and emphysema — often tied to smoking — that makes it hard for patients to breathe. Patients periodically have flare-ups or exacerbations, when symptoms are at their worst.

Prednisone is a glucocorticoid pill that acts as an anti-inflammatory. Since a generic version is available, it is a relatively low-cost therapy.

“COPD exacerbations, which are the leading cause of medical hospitalization in the U.S. and elsewhere, can be treated with a five-day course of prednisone, which is a corticosteroid, not 10 to 14 days as recommended by most national and international guidelines,” said Dr. Don Sin, a professor of medicine at the University of British Columbia, in Vancouver, and co-author of an accompanying journal editorial.

Corticosteroids are highly toxic drugs, he said. “Thus, by using a five-day versus a 10- to 14-day [course], we will prevent many steroid-related complications — such as diabetes, osteoporosis and adrenal insufficiency — without sacrificing any of the benefits of steroids for management of COPD exacerbations,” he said. “There is no rationale for giving more steroids than this.”

For the study, Leuppi’s team randomly assigned more than 300 patients suffering from an acute COPD exacerbation to daily doses of prednisone for either five or 14 days.

The goal of the study was to see whether either treatment resulted in fewer new exacerbations of COPD over six months.

The researchers found that prednisone treatment resulted in about the same number of patients having new bouts of COPD. Among those who got five days of therapy, 56 had a new bout within six months; 57 patients given 14 days of therapy had a new flare-up.

The average time to a new exacerbation of COPD was 43.5 days in the short-term treatment group and 29 days in the standard treatment group, the researchers said.

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, said that “while treatment with corticosteroids is often necessary in exacerbations of COPD, it has not been clear how long the treatment should be given.”

“The authors found that a shorter duration of treatment with steroids was possible,” he said. “The accompanying side effects were less, and total dose of steroids was less long term.”

More information

To learn more about COPD, visit the American Lung Association.

Posted: May 2013

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Shorter Arms May Explain Why Women Need Glasses Sooner Than Men

FRIDAY June 29, 2012 — The reason why women tend to need reading glasses sooner than men has been unclear, but a new report may shed light on the issue.

Researchers say it isn’t because eyesight starts to deteriorate earlier in women than in men. Instead, they suggest that because women’s arms are shorter, they tend to hold reading materials closer to their eyes, which may affect focusing ability.

For the study, researchers from California and Texas performed a “meta-analysis” on nine studies about presbyopia, or aging-related vision loss. A meta-analysis pools the results of previous studies.

Although investigators found no significant gender-related difference in the ability to focus close up, the researchers found that compared with men, women needed higher-power lenses.

“These findings could impact global vision care in multiple ways,” Adam Hickenbotham, of the University of California Berkeley, said in a news release from the Association for Research in Vision and Ophthalmology.

“The findings reinforce the need for presbyopia correction programs for women — a group that often has greater unmet vision needs in developing countries. It also points out that presbyopia is a multi-factorial problem and requires solutions that are tailored to each individual,” he added.

The study was published in a recent issue of Investigative Ophthalmology and Visual Science.

More information

The U.S. National Library of Medicine has more about presbyopia.

Posted: June 2012

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Could Fertility Drugs Make Kids Shorter?

SATURDAY June 23, 2012 — For those who need help getting pregnant, the thought of having a child who’s a little shorter than other kids probably won’t be much of a worry. But the question of whether infertility treatment causes unanticipated consequences remains fertile ground for researchers.

In a study scheduled for presentation Saturday at the Endocrine Society annual meeting in Houston, researchers found full-term children conceived with fertility drugs were about one inch shorter than their peers.

The researchers wanted to find out whether there was a difference in height among children whose mothers used only ovarian stimulation by fertility drugs such as Clomid (clomiphene) without in-vitro fertilization (IVF).

Children conceived with the help of ovarian stimulation alone account for about 5 percent of all births in the developed world, according to the researchers.

Previous studies have suggested that children conceived by IVF may be taller than naturally conceived kids. The researchers wanted to know if something in the process of IVF, which includes fertilization and culture of embryos in a laboratory dish, could affect stature. So they studied children conceived without IVF, but with the assistance of fertility drugs that cause ovulation.

“The challenge in doing research like this is that in general the people who come to infertility clinics have been trying to get pregnant for multiple years,” said Dr. Valerie Baker, medical director at the Stanford Fertility and Reproductive Medical Center, in Palo Alto, Calif. “These people often have serious medical problems. So it’s possible that the issue is not the fertility treatment, but something going on with people who have been trying to get pregnant for more than a year without success,” she said. Baker was not involved in the study.

The researchers, led by Dr. Tim Savage, a pediatrician and research fellow at the Liggins Institute, University of Auckland, in New Zealand, studied 84 children conceived with the help of fertility drugs and 258 who were conceived naturally. All were between 3 and 10 years old and from a single-fetus, full-term pregnancy. None had low birth weight, a factor that can be associated with health problems.

The children conceived with the help of fertility drugs were nearly an inch shorter than the others, although still within the normal range, even with differences in their parents’ height taken into account. Parental height is considered the key factor in determining a child’s height.

The height difference was greater in boys, who were more than an inch shorter on average than naturally conceived boys.

There was no significant difference in general physical health between the two groups of children.

The authors speculated that the height difference may be due to something that happens around the point of conception. They suggested it could be caused by “imprinting” variations — changes in the way genes are expressed, which could be related to the process of ovarian stimulation. The appropriate expression of genes is important in normal development.

Other experts greeted the study findings with caution.

Dr. Edward Illions, an associate professor of obstetrics and gynecology at Albert Einstein College of Medicine and a reproductive endocrinologist at Montefiore Institute for Reproductive Medicine in Hartsdale, N.Y., said any number of mechanisms, including the act of stimulation, could affect imprinting.

Illions also expressed concern with the study’s limitations. “The researchers don’t tell us which particular drugs the women were on, what stimulation protocols were used or the number of treatment cycles rendered to these patients,” he said.

Dr. David Cohen, chief of reproductive endocrinology and infertility at the University of Chicago, said researchers need to continue studying children born with infertility technology to better understand any implications of fertility treatment. “As far as this study goes, there are no take-aways,” he said.

Data and conclusions of research presented at medical meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Library of Medicine sheds light on female infertility.

Posted: June 2012

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