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Nutritional Research Possibly Biased

Influential articles about nutritional research are widely publicized. What is not so well known to consumers is the fact that a number of the research is funded by industry, which introduces test bias into the results, which can have far reaching implications. These results influence dietary recommendations, the department of public health, or regulations by the Food and Drug administration. The articles are widely publicized and also influence consumers' choices.
Dr. Daniel Ludwig, author and director of the Optimal Weight For Life program at the Children's' Hospital in Boston, which is a Harvard medical institution, looked at 206 interventional and observational studies as well as scientific reviews. All of them were related to milk, soft drinks and juices. All the material was published between 1999 and 2003. The category was chosen, because these drinks are widely consumed by children and adolescents. There has been a considerable amount of controversy about the health risks and health benefit of these drinks. The soft drink industry is large and highly profitable, and the authors concluded that in this environment scientific bias could likely occur.
Of the206 studies only 111 submitted the source of financial sponsorship. One third of them had mixed sponsorships, half of them were not sponsored by the industry and one in five was industry sponsored. Results showed, that industry sponsored research was 4 to 8 times more likely to be in favor of the companies' products than those where the studies had independent financial funding. During the study period the researchers who declared the source of funding or a conflict of interest rose from 50 to 80 %.
Dr. Ludwig and his team suggested that there is the potential to public health harm, unless there is increased government funding available for nutritional research through a peer review process such as that at the National Institute of Health.

BMJ 2007; 334:62, 13 January

Mechanical Heart As Transplant Alternative

The device called HeartMate II (see image) is comparable in size and weight to a D-size battery, and it is the latest development to assist the left side of the heart. Older models were pulsating in nature, whereas the HeartMate II produces a continuous flow of blood. As a result of this, recipients of the device no longer have a discernible pulse, nor can their blood pressures be taken with the cuff around the arm. The leg muscles can naturally produce a surrogate pulse, and in the three years of human testing there have not been any problems related to the lack of pulse. It has been implanted at selected American test sites, and recently a 65 year old male patient has become the first Canadian to be implanted with the device at McGill University Health Center. Dr. Renzo Cecere, the heart surgeon involved, is very enthusiastic with the outcome. The patient made an exemplary recovery and stated that he feels more alive than he has in years, which is impressive, as in the past he could hardly take a step. He suffered of end stage left ventricular failure, and at this point only patients with this condition can enroll in the HeartMate II clinical trials.

Dr.Cecere foresees the device being appropriate for many Canadians. The longevity of the "mechanical heart"-it is good for 10 years) will make it a true alternative to a heart transplant. Some patients cannot receive a transplant because of age or medical conditions. Patients with a history of cancer would be the ones who could not be treated successfully with a heart transplant. The anti rejection drugs that have to be taken on an ongoing basis produce immunosuppression, and this can revive a cancer in remission.
So far the biggest known risk factors are bleeding, as patients have to take small amounts of blood thinners. Another risk is infection.
At this point the cost for the HeartMate II amounts to about $100, 000, and it does not have the Health Canada approval for general use.

National Review of Medicine, January 15, 2007, page 36-37

Lycopene Benefits Backed By Science

Lately a lot of attention has been directed to the health benefits of vegetables and fruit. Vitamin C has long been an accepted household term, and nobody questions the benefits. Newer buzz words are the terms "bioflavonoids" and "antioxidants". Some products are aggressively marketed extolling the above named beneficial substances, but often the consumer is left mildly bewildered by exaggerated claims. Often the sale prices of these miracle foods are as lofty as the bold statements that go along with them.
For any shopper it is important to know that some of the most beneficial foods are not high priced items, but very common staples. Take tomatoes, for instance. They are a significant source for the substance lycopene, which lately has received a lot of attention. Lycopene and its dietary sources as well as its benefits have been researched world wide, and the results are now in. It is responsible for the red color in fruit or vegetables, such as tomatoes, and its isomeric form 5-cis-lycopene is the most stable form having the highest antioxidant properties. Common dietary sources are tomatoes, watermelons, pink guava, pink grapefruit, papaya, apricot and other fruit. In the Western diet tomato-based foods account for about 85% of dietary sources of Lycopene. Studies have shown that lycopene is more efficiently absorbed from processed tomato products compared to raw tomatoes. Once it is absorbed it is distributed throughout the body. The highest levels showed up in the testes, the adrenal glands, prostate, breast and liver.

Research going back to 1995 showed an inverse relationship between the consumption of tomatoes and the risk of prostate cancer. A follow up publication in 1999 showed that the same inverse relation of lycopene intake and cancer also included breast, cervical, ovarian, liver and other organ sites. Further studies have followed these initial publications, and the great majority of them suggest that an increased intake of lycopene showed an association with a significant reduction in the risk of many cancers.
Coronary heart disease and lycopene benefits were also examined. The strongest population based evidence comes from a multi center case control study in Europe (EURAMIC). 662 Cases and 717 controls were recruited from 10 different European countries, and there was a significant relationship between levels of lycopene in fatty tissue and the risk of myocardial infarction. Lower lycopene levels were associated with a higher risk of heart attacks.Lycopene was also shown to decrease levels of oxidized LDL (LDL or low density lipoprotein is known as the "bad" cholesterol). Another small study showed that lycopene was reducing total cholesterol levels and as a result was lowering the risk of coronary heart disease (CHD).
The list of benefits does not end here: the dietary oxidant reduces oxidative stress and levels of bone turnover markers, meaning that it may contribute to the bone health, especially reducing the risk of osteoporosis in postmenopausal women.
For people with mild hypertension (high blood pressure), consumption of lycopene resulted in significant reductions of systolic and diastolic blood pressures.
Infertility in males was significantly helped by lycopene intake. In a study infertile man received 8 mg lycopene per day in capsule form. Laboratory tests confirmed an increased sperm density along with functional sperm concentration and mobility. This treatment protocol with lycopene supplementation resulted in a success rate of 36% pregnancies in their partners.
Pregnant women with pre-eclampsia who were treated with lycopene supplement significantly improved, which was shown by decreased diastolic blood pressure, the reduction of pre-eclampsia and a decrease of intrauterine growth retardation, resulting in a healthier mother and baby.
Future research is pending surrounding lycopene in metabolic and inflammatory diseases and in its role of possibly preventing neurodegenerative diseases such as Alzheimer's disease. Other inflammatory conditions such as arthritis and emphysema will likely also be shown to benefit from lycopene. Preliminary data has already indicated this.
The Food and Drug Administration (FDA) of USA has recently approved lycopene as a safe "natural coloring agent" and a Generally Recognized as a Safe (GRAS) component. The Department of Nutritional Sciences , Faculty of Medicine, University of Toronto, c/o Dr. A.V. Rao et al. who completed this meta analysis of the recent literature have recommended that we all consume a regular daily lycopene dose in our food and supplements as part of our diet for good health.

The Whitehall-Robins Report, December 2006, Volume 15, No.4

Avoiding Back Pain By Relaxed Sitting

Patents and educators are often heard telling their charges to "sit up straight". The results however are not that favorable, as the 90 degree angle in this position is causing the largest movement of the spinal disc and a lot of strain. This conventional wisdom of sitting up straight has important implications for a large population group that have work situations whith mostly sitting jobs. Consequences of bad posture are also quite visible: lower back pain is the leading cause of disability in the U.S. and Canada and a major cause for missed work days.
Investigators have presented evidence, that a 135 degree body/thigh sitting position, leaning back, is the optimal position to avoid back pain. The author of the study, Dr.W. Bashir from the department of radiology and diagnostic imaging at the University of Alberta Hospital in Edmonton emphasizes, that the angle of posture has been under question for some time, and improper posture and back pain are related. Positional MRI scans have shed more evidence on the spine. Special MRI machines are needed, as the patient needs to be examined not in a lying down position, but in a position that allows the patient free motion during the test. Spinal angles can be measured and spinal disk movement can be observed in various positions and angles.
The 90 degree angle showed most spinal disk movement, creating stress for the spine. Another unfavorable position is a slouching posture. Scan results showed a reduction in spinal disk height, signifying more wear and tear of the lumbar spine. Spinal disk movement was least pronounced with the 135 degree angle. This more relaxed position poses less strain on spinal disks and the associate muscles and tendons. Employees sitting comfortably versus sitting up straight can make the job place friendlier to people's backs.

The Medical Post, January 16, 2007, page17

King Tut's Death Demystified By CT Scan

CT scans are important diagnostic tools in medicine. They are generally performed in radiology departments or departments for diagnostic imaging in hospitals. They are extremely useful to get detailed information that surpasses the simple findings an x-ray can provide.
Recently CT scanning has been used as a tool by archeologists to examine a patient that has passed away 3,300 years ago. Tutankhamun, the Egyptian king, died very young. After an x-ray examination in 1968 which seemed to detect bone fragments in the boy king's skull, it was speculated that he had been a victim of foul play. Dr. Ashraf Selim, a radiologist at Cairo University and leader of the CT examination of King Tut, did not find any evidence of this. During the discovery of the mummy by the Englishman Howard Carter in 1922 Carter and his cronies were quite rough, when they tried to remove the pharaoh's golden mask, and as a result some bone fractured, which also matched a defect within the first cervical vertebra. This being an injury long time after death excluded foul play. What was obvious in the CT finding was a fracture to the femoral bone, which occurred before the death of the young king. While researchers cannot assess how this injury happened, the findings suggest that the injury was likely an open wound that became infected and led to the untimely death of the king.
It is rare that archeologists will draw on CT scans to uncover a mysterious death, but CT scans are not only tools for specialists like orthopedic surgeons or neurologists. They can be a helpful tool to assist in other areas of medicine such as forensic medicine to find valuable insights.

The Medical Post, January 16,2007, page 16

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