Aug
01
2003

Newly Detected Hormone May Help Obesity

At a recent meeting of the Endocrine Society in Philadelphia new findings by British researchers were presented regarding hormone interactions with weight problems.

Dr. Simon Aylwin, a consultant from the King’s College Hospital in London, England, presented data showing that peptide hormone PYY levels were much lower in patients who were significantly obese versus normal weight controls.

As Dr. Stephen Bloom’s research group from Imperial College, London, UK had shown earlier, with a meal rich in calories the gut produces the PYY hormone in a way that with higher amounts of calories in food consumed more of the hormone PYY is secreted into the blood stream. The new information that was discussed at the meeting of the Endocrine Society was the fact that these hormone signals are registered in the hypothalamic tissue, a part of the brain situated just above the pituitary gland. It has been known for a long time that weight is regulated by a satiety centre in the hypothalamus. Now it has been appreciated that there are at least two or more pathways of registering weight related hormone signals: one being the gut related PYY hormone that tells the brain that enough food was consumed in a meal, and secondly leptin hormone signals where the hormone leptin is secreted from the fatty tissues in the body, which tells the satiety centre of the brain that not as much food needs to be consumed when our weight has reached a certain threshold.

Newly Detected Hormone May Help Obesity

Newly Detected Hormone May Help Obesity

Dr. Aylwin measured PYY hormone levels in a number of different groups of patients such as in patients who were obese, in patients who had gastric bypass surgery done and in a group who only had gastric banding done. They observed that the group who had bypass surgery done had a higher than normal response of PYY hormone release as a response to a meal. This enabled them to adhere to low calorie meals without any hunger pangs and this group of patients did well in terms of weight control on the longterm.

In contrast to this the group with gastric banding had a flat response curve to the stimulus of a meal with respect to the PYY hormone as did patients with obesity. The low PYY levels in response to meals likely explains why these patients continue to eat too much making their weight loss efforts more difficult.

Dr. Aylwin explained that with future research efforts new forms of medications could be developped that mimic the effects of the PYY hormone leading to satiety and allowing patients to control their weight easier. Dr. Linda Fish, an endocrinologist from the University of Minnesota, mentioned that for excessive obesity with a body mass index of more than 45 the only effective therapy right now would be the invasive gastric bypass procedure. With an anologue type medication that would have the same effect as the PYY hormone, many patients might be able to have persistent weight loss with these new medications allowing them to lose weight persistently without bypass surgery. However, results of this type of research likely would take about 10 years before a new drug would be available to the public.

This summary is based on an article in the July 15, 2003 issue of the Medical Post (page 50) as well as on the newsdesk article entitled “Obesity-is it all in the mind?” in The Lancet Neurology Volume 2, Number 1, January 2003.
Link to related topic (nasal spray for obesity).

Last edited December 9, 2012

Aug
01
2003

Modify Risk Factors For Erectile Dysfunction (ED) In Elderly Men

Erectile dysfunction (ED, impotence) is a subject that is difficult to research because of its personal nature. Very few good studies are available regarding the question as to how common it would be among older men.

A team of medical experts under Dr. Constance G. Bacon from the Harvard School of Public Health and other institutions have investigated this problem in men older than 50 years and published the results in the August 5, 2003 issue of the Annals of Internal Medicine.

31,724 men aged 53 to 90 years were taking part in the Health Professionals Follow-up Study. Since 1986 they had been filling out detailed questionaires biennially. In 2000 detailed questions about sexual function were also included. Erectile dysfunction was defined as “having poor or very poor ability to have and maintain an erection sufficient for intercourse without treatment during the past 3 months”. The investigators found that about 1/3 of the men above the age of 50 had a sexual dysfunction. Such factors as orgasm, ability to have intercourse, sexual desire and overall sexual function were all affected more and more with every year after the age of 50. When this was further analyzed using multivariate analyses an interesting pattern of reasons for this emerged. The following factors were identified to be independent risk factors for the development of erectile dysfunction.

Modify Risk Factors For Erectile Dysfunction (ED) In Elderly Men

Modify Risk Factors For Erectile Dysfunction (ED) In Elderly Men

Each of the factors from this table is an independent risk factor and can be managed separately. For instance, the investigators found that a higher level of physical activity was associated with much less ED. The best group (men with no ED) was found among those who were always conscious about disease prevention and who had none of the conditions listed in this table or other chronic medical conditions. Leanness and physical activity were associated with good sexual functioning in this study.

Risk factors leading to erectile dysfunction (ED)
Symptoms: Comments:
increasing age
aging likely affects the blood supply to the swelling bodies of the penis; it also clamps down on testosterone production of the testicles
smoking accelerates aging and hardening of arteries
diabetes mellitus affects circulation and nerve impulse transmission
stroke
interferes with brain centers of arousal
antidepressant medication anticholinergic side-effect interferes with penile erection
beta-blocker medication reduction of libido (likely at the brain level from sympathetic nerve block)
alcohol consumption alcohol is a nerve poison that interferes with pudendus nerve function (lack of erections)
TV viewing time due to prolonged sitting there is a chronic lack of exercise that leads to nerve conduction and circulatory problems resulting in ED

This summary is based on a paper published in the medical journal of Annals of Internal Medicine 2003;139:161-168 by Dr. Constance G. Bacon and co-workers.

Here is a brief chapter on erectile dysfunction from Dr. Schilling’s web-based free Net Health Book.

Last edited October 26, 2014

Jul
01
2003

Beware Of Binges

In the June 16, 2003 issue of Time (page 73) an article appeared under the heading “Summertime booze”. A study from the Buffalo University showed that women, in particular, have to be conscious that drinking 3 or 4 drinks at one time on the weekend is not the same as drinking the same 3 to 4 drinks over the course of one week.

A study looking at the frequency of breast cancer in relation to drinking patterns found that the binge drinking women had a 80% higher breast cancer risk than the controls who drank 3 to 4 drinks at a time (but only one drink per day). Jo Freudenheim, the epidemiologist involved in this study, suggested that perhaps with the binge drinking alcohol’s toxic potential for breast cancer cells had been reached whereas with one drink at a time over one week this level was never encountered.

In another study from the Buffalo University liver toxicity as a result of alcohol exposure was examined. These researchers used blood tests to measure liver enzymes, which were leaking from the liver cells as a result of the toxic effect of alcohol. Both men and women were tested and various drinking patterns were also studied. Men who drink several drinks daily had the highest liver enzyme counts (reflecting the toxic effect of alcohol on the liver). However, women who drink only on weekends had even higher counts of the liver enzymes than men! Women who drank on an empty stomach had much higher liver enzymes in these studies than men where this effect did not show (with men it did not matter whether they drank with food or on an empty stomach).

Beware Of Binges

Beware Of Binges

The researchers concluded that binge drinking appears to affect women more than men. Generally speaking the higher the amount of alcohol consumed, the more toxic the effects on body cells and on the liver. Moderation may be in order.

Comments: These type of studies are particularly important in view of the fact of marketing techniques of the wine industry. Wine and alcoholic beverages are being portrayed as being a good source of bioflavonoids that are lowering cholesterol and would prevent or postpone heart attacks. Some of the data on cancer indicates that for ovarian cancer and colorectal cancer there may not be a safe low dose as even one drink per day can have a measurable effect on cancer risk. On the other hand, bioflavonoids are abundantly present in raw vegetables and fruit, so there is no panic about not getting enough heart attack preventing foods. Finally, a bit of common sense does not harm: alcohol is a cell toxin, so it should be diluted (nothing stronger than wine) and if you desire a drink, use it in moderation.

Link to chapter on alcoholism in Net Health Book:

http://nethealthbook.com/drug-addiction/alcoholism/

Last edited October 26, 2014

 

Jul
01
2003

Obesity And Metabolic Syndrome

In the June 10, 2003 edition, following page24, of The Medical Post there was a minisymposium on obesity and the metabolic syndrome (also known as the “syndrome of hyperinsulinism”).

Four specialists had a discussion about this topic: Dr. Ehud Ur (endocrinologist, Dalhousie University, Halifax, N.S., Canada), Dr. Robert Dent (Director of the Weight Management Clinic, Ottawa Hospital, Ont.), Dr. Dominique Garrel (Director of Department of Nutrition and endocrinologist, University of Montreal, Quebec), and Dr. Arya Sharma (Prof. of Medicine, McMaster University, Hamilton, Ont.).

Introduction:

Obesity is now a health threat that about 25% of the North American population is suffering from. There is still a lot of discussion what the exact criteria should be, but the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) has simplified the detection of the metabolic syndrome.

Obesity And Metabolic Syndrome

Obesity And Metabolic Syndrome

The experts agree that when three or more of the criteria mentioned in this table are positive the person would be considered to have metabolic syndrome.

There is a wide age-related variety: in one study only 7% had metabolic syndrome in the age group of 20 to 29. The same study found 40% of study participants had the metabolic syndrome in the age group of 70 years and older. It is thought that too many calories coupled with too little activity over a longer period of time, perhaps coupled in some people with a genetic tendency to develop metabolic syndrome, leads to an accumulation of abdominal (so-called”visceral”) fat.

Because fat cells have their own hormone systems (leptins etc.) there is a change of metabolism including an elevation of the insulin level with associated loss of “insulin sensitivity”. So, the more obese a person becomes, the less effective insulin becomes in transporting blood sugar through cell walls. At the same time the liver metabolism is changing with the good cholesterol (HDL) being less produced and the bad cholesterol (LDL) being overproduced. The liver will produce a different mix of coagulation factors, which leads to a tendency to form clots in the veins of the legs and in the lungs. As the pancreatic capacity for insulin production gets exhausted over a period of time, the patient eventually develops type 2 diabetes mellitus. Due to the risk of the coronary arteries clogging up with the cholesterol changes and the accelerated hardening of arteries from diabetes, the risk for getting severe heart attacks in obese people with the metabolic syndrome when compared to a normal weight population is about 4-fold.

Elements leading to the diagnosis of “metabolic syndrome”
Finding: Comments:
abdominal obesity waist circumference more than 102 cm in men or more than 88 cm in women
elevated triglyceride level level of 150 mg/dl or higher
low HDL cholesterol level under 40 mg/dl in men or under 50 mg/dl in women
elevated blood pressure systolic or diastolic blood pressure exceeding 130/85 mm Hg
high fasting blood glucose level fasting glucose higher than 110 mg/dl

Treatment of metabolic syndrome:

The experts agreed that a reduction of only 5% to 10% of the body weight through a sensible combination of a mild exercise program (e.g. walking 30 to 45 minutes every day) and a calorie reduced food intake will make a significant difference in terms of normalization of the body chemistry. It is my estimate that perhaps 70% to 90% of all cases of obesity and metabolic syndrome can be treated this way.

However, the remaining cases should continue to see their physician and be followed like the doctor would follow someone who has high blood pressure. There are two types of medications available and they have nothing to do with the Phen-Fen diet pills from not too long ago that were found to cause pulmonary hypertension. These new diet pills are fairly safe and show weight loss results provided the patient co-operates with regard to a modified to low fat diet and some degree of regular exercise.

1. Sibutramine (brand name: Meridia) is a specific brain hormone inhibitor in the area where the appetite zone is located (serotonine and norepinephrine reuptake inhibitor). This medication helps the patient by experiencing satiety sooner so that the patient does not feel deprived despite less calorie consumption.

It is the medication of choice for those who tend to eat a lot. Like with other anti-depressants side-effects are a dry mouth, heart rate increases and sleep loss (insomnia).

2. Orlistat (brand name: Xenical) inhibits fat uptake at the level of the gastrointestinal wall (gastrointestinal lipase inhibitor). This leads to an inhibition of fat absorption by about 30%. The patient needs to keep the fat intake down to about 2 oz. (=60 gm) per day. If the patient consumes more fat, the side-effect of orlistat will be flatulence, abdominal cramps and diarrhea. If the patient is on a strict low fat diet, there would not be enough fat in the gut for the medication to be effective.

At this point it is not known how long the patient should be on such weight loss medication, if this was the chosen route. The experts felt that 1 year would be reasonable, but that the patient should be observed by the treating physician and it may be necessary after some intermission to go for another year of therapy all the way attempting to permanently change eating and exercise habits as an ongoing maintenance program.

Here is a link to another reference about the metabolic syndrome (syndrome of insulin resistance).

Last edited December 9, 2012

 

Jul
01
2003

Food And Mood

“Food affects your mood” is the heading of an article by Dr.Susan Biali (practising family physician with a degree in dietetics) in the June 24, 2003 edition of The Medical Post (page 24). According to her there is good evidence in the medical literature to indicate that a number of biologically active brain hormones depend on what we eat. There are 5 major items that she pointed out, which I summarized below in tabular form.

The medical literature points to the importance of these various food factors to allow us to have a balanced brain metabolism. When these ingredients are present our mood is more likely to be normal with more resilience to depression.

The literature centers around various population groups in comparison with the North American population. For instance, in an article of the Dec. 2000 issue of Psychiatric Clinics of North America a study was reported that found that Taiwanese and Chinese people consume a lot more omega-3 fatty acid rich foods such as fish than North Americans.

In the same study the rate of major depression was found to be 10-times more frequent in North Americans and the investigators felt that this was so because of the brain hormone stabilizing effect of the omega-3 fatty acids. Other researchers suggest that chronic stress might lead to a depletion of omega-3 fatty acids in the brain through an oxydation process, which eventually results in depression.

Food And Mood

Food And Mood

Several nutritional factors appear to have caused deficiency states of essential brain nutrients, one being the junk foods like candy bars, French fries, hamburgers etc. leading to a dysbalance of the omega-6 fatty acid to omega-3 fatty acid ratio. Another factor is the increase of consumption of highly refined carbohydrates (sugar and starch), often also called high glycemic foods. This is known to lead to the metabolic syndrome, also called syndrome of insulin resistance. Finally many people still have too much fat in their diets with a high amount of hydrogenated vegetable oils (see link). It is also important to note that folate, Vit. B6 and Vit.B12 are required for prevention of hardening of the arteries by lowering homocysteine levels.

Brain food components that affect your mood
Food item: Comments:
omega-3-fatty acids Chinese and Taiwanese eat much more of these and have 10 times less depression than North Americans
DHA, a long-chain omega-3-fatty acid our daily intake is 100mg less per day than 50 years ago due to our diet being based on commercial livestock; lack of DHA leads to depression
too much
omega-6-arachidonic acid in “junk foods”
ratio of
omega-6 to omega-3 arachidonic acid has increased from fast food consumption; this
leads to depression
folate and Vit.B12 deficiency associated with depression
tryptophan
an essential amino acid that is needed to make serotonin, a brain hormone without
which we experience depression

So what is “brain food” ? Dr. Biali pointed out in her article that it is always best to start with a low fat, well balanced food plan where junk foods are avoided and where vegetables and fruit provide the low to medium glycemic index carbohydrates. Fish should be eaten at least three times per week to provide the brain with the essential omega-3 fatty acids.

It is probably not recommendable to take tryptophan as a supplement: in 1989 several fatalities occurred from impurities in commercial tryptophan and many researchers are concerned about dysbalancing the network of brain hormones by giving an overdose of only one amino acid, but not giving enough of the others. It is much safer to simply eat enough protein (meat, soy protein, milk products) and the body can pick and choose what it needs in terms of amino acids including tryptophan. With folates one needs to be careful not to exceed 0.8 mg per day as with mega-doses of folate in the 15 mg range toxic symptoms of vivid dreams, disturbed sleep patterns and even occasional seizures developped. A good multivitamin supplement will not only provide the right folate dose, but also Vit. B12, which is also needed to prevent depression.

Last edited December 9, 2012

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Jun
01
2003

Exercise Saves Lives In Women Over 65

A recent study released in the Journal of the American Medical Association (JAMA Vol. 289 No. 18, May 14, 2003) has found a profound effect of exercise on the survivial of elderly women. Dr. Gregg et al. have followed 9518 women aged 65 or older for a total of 12.5 years with a follow-up visit in between at about the 6 year point. They found that women who exercised (walking, aerobics etc.) and who were compared with a control group who was sedentary (no form of exercise), had the following improved survival rates.

These findings were independent of other factors up to an age of 75 years. In other words, age, smoking, weight and a number of pre-existing diseases did not influence these improved survival figures from the effect of exercise. However, when a woman had a significant chronic disease or was older than 75 years of age, the survival improval from exercise was not as strong as indicated in the table above. Also, the follow-up visits showed that those women who exercised continually, had the highest survival advantage.

Exercise Saves Lives In Women Over 65

Exercise Saves Lives In Women Over 65

The bottom line: increasing and maintaining a physical exercise program will likely lead to a longer life. At the same time the exercise program needs to be started early enough to be of benefit to those who are older than 75 years of age.

Disease and death rate reduction from exercise in women aged 65 and over
Reduction of:
Effect of risk reduction:
overall death rates 48%
cardiovascular disease 36%
cancer 51%

Some of the Associations that were contributing to this important study were: The National Center for Chronic Disease Prevention and Health Promotion (Atlanta, Ga), the Graduate School of Public Health, University of Pittsburgh (Pittsburgh, Pa), the Prevention Sciences Group, Departments of Medicine and Epidemiology and Biostatistics, University of California (San Francisco) and the University of Minnesota and Section of General Internal Medicine, Veterans Affairs Medical Center, Minneapolis.

Here is a fitness link: http://www.nethealthbook.com/articles/fitness.php

Last edited December 9, 2012

Apr
01
2003

Edible Vaccines From Lettuce, Tomatoes And Other Plants

Can vaccines be taken by mouth (orally)? Yes, we know this from the polio vaccine.

Can vaccines be produced by plants? This does not sound likely, but this is exactly what researchers have already achieved and what they are working on now. A group of researchers under Dr. Robert Rose from the University of Rochester in New York have been working on a number of vaccines with the help of genetic engineering.

The rationale is simple: in developing countries it can be difficult to keep vaccines refrigerated and to administer them by injection in a sterile manner through doctors and nurses. Also, the cost of production can be a major factor with regard to effectiveness of the vaccine on a population basis, if large parts of the community cannot afford the vaccine. For many vaccines to be effective more than 85% of the population have to be vaccinated. Newer research has shown that the protein envelope of a virus, which has a certain surface antigen associated with it, can be broken down into smaller subunits. According to a review article in The Medical Post ( March 4, 2003, page 29) Dr. Rose and his team have isolated the DNA sequence of the human papillomavirus (HPV) envelope in the early 1990’s. They were able to program potatoes to grow the protein subparticles that were immunologically active, but were not infective (no virus activity). In other words after genetic engineering the plant grows a vaccine, which can be safely consumed and the body mounts an immune response to this modified virus protein similar to the polio vaccine, but without a trace of virus.

Edible Vaccines From Lettuce, Tomatoes And Other Plants

Edible Vaccines From Lettuce, Tomatoes And Other Plants

As potatoes have to be cooked before consumption, some of the effectiveness of the vaccine gets lost. The researchers have since concentrated on other plants like apples, bananas, tomatoes and lettuce, which are eaten in the raw state. The various diseases that are being tested at the present time are: hepatitis B, respiratory syncytial virus (RSV), Norwalk virus, rotavirus and even the measles vaccine.

Dr. Charles Arntzen from the Arizona State University in Tempe, Arizona, has successfully applied the above technology to the production of plant vaccines against the Norwalk virus, the E.coli enterotoxin and hepatitis B in potatoes and tomatoes. He is taking this a step further as he is developing a technique of freeze-drying tomatoes containing the vaccine against the Norwalk virus, which allows the vaccine to be stored for long periods of time. When it is needed, it can be rehydrated and could also be delivered in pill form to vaccinate the population at risk at the time of an epidemic of enteritis the with Norwalk virus.

In summary, the new plant technology of vaccine production allows for much cheaper vaccine manufacturing. It eliminates the problems surrounding sterile injection techniques. The vaccine delivery by mouth allows for a much simpler distribution to a population at risk and can be done by lay persons. Also, a variety of vaccines will be able to be manufactured this way in future. The plant production is similar to the photocopying process where a template (the specific viral protein subparticle) is being copied by the plant. This allows for a number of vaccines against different strains of viruses to be programmed fairly quickly. It is an exciting new technique.

Here is a link to Influenza, which is one of the viral illnesses that can be significantly suppressed by vaccination.

Here is a link that explains the rationale of vaccinations and vaccination schedules.

Last edited October 25, 2014

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Feb
01
2003

Coffee — What’s The Scoop…

In a recent issue of The Medical Post, a weekly news magazine for Canadian Physicians (The Medical Post, Jan. 28, 2003), Dr. Suzan Biali has revisited what is medically known about the effects of coffee on health.

This doctor is a family physician in Vancouver/B.C., but also has a degree in dietetics. Here is a summary in table form of what this medical review found.

Dr. Biali also mentioned the recent publication in the November issue of the Lancet by the Dutch investigators that coffee consumption of more than 7 cups per day would cut diabetes in half.

Summary: It would appear that coffee consumption is better than previously thought of. Most people can benefit from it. But this is a personal preference issue. Some groups of patients should refrain from coffee consumption entirely such as patients with rheumatoid arthritis.

Coffee -- What's The Scoop...

Coffee — What’s The Scoop…

Others such as women in early pregnancy (particularly the first 3 to 4 months) should refrain from it. When infertility is a problem it is wiser to refrain completely from coffee as well. Patients with a tendency to ulcers likely should refrain or cut down the coffee consumption. The majority of the population likely could enjoy a cup of coffee and prevent degenerative neurological diseases (Alzheimers and Parkinsons disease). Some patients with psychiatric illnesses (phobias, anxiety disorders) likely should stay away from coffee as should patients with high blood pressure or heart rhythm irregularities.

Coffee — what’s the scoop?

Effects of coffee on: Comments:
first trimester pregnancy 5 or more cups a day can cause miscarriages
infertility women who drink 250 mg of caffeine per day (5 to 6 cups) experience infertility
no hip fractures a large Minnesota study showed in 2001 that there were NO hip fractures with coffee consumption
calcium in bones despite the rumors otherwise, there is NO link of coffee consumption to calcium loss
rheumatoid arthritis (RA) This is the patient group where osteoporosis has been found to be present with coffee consumption; a Finland study found a 2-fold risk with more than 4 cups per day, and a 15-fold risk with more than 11 cups per day (in RA patients only)
Alzheimers and Parkinsons the cells in the basal ganglia that produce dopamine get stimulated by coffee; this is also the seat of the addiction (though mild) to coffee and the cause for headaches when coffee is suddenly withdrawn. This effect  prevents Alzheimers and Parkinsons, both bad degenerative neurological disorders.
stomach problems anybody with a tendency for stomach ulcers or duodenal ulcers tends
to get worse with coffee. Arabian type coffee is less acidy than South American coffee. Coffee does not cause ulcers, but may stimulate existing acid production and in higher doses may stimulate
H.pylori growth.
panic attacks and insomnia more sensitive people tend to feel anxious with a single cup of coffee per day, others can tolerate many cups. When a patient complains about panic attacks or insomnia the physician will likely inquire about how much coffee the person drinks.
high blood pressure long term coffee users show almost no effect on blood pressure, it does not cause high blood pressure. Those with high blood pressure
or a history of a stroke still should refrain from drinking coffee

Last edited December 10, 2012

Jan
01
2003

Framingham Study…Obesity And Smoking Lead To Loss Of Life

The Netherlands Epidemiology and Demography Compression of Morbidity Research Group has published an important medical research paper in the Jan. 7, 2003 edition of the Annals of Internal Medicine (Ann Intern Med 2003;138:24-32).

The lead researcher, Dr. Anna Peeters, explained that the group has revisited the Framingham Heart Study 40 years later and analyzed survival statistics of the group of men and women who enrolled in this longterm study between 1948 and 1951. The population at the beginning of the study was aged between 30 and 49. The snap shot, after 40 years had elapsed, is the subject of this analysis. In order to make it easier to understand, I have tabulated the data as seen below.

This study shows that life style choices do matter: being overweight shortens your life by 3 years on average, being obese shortens it by 6 to 7 years.

Add the risk of smoking, and you end up shortening your life by 7 years in the case of being overweight (4 years more than without smoking) or more than 13 years, if you are obese.

Framingham Study...Obesity And Smoking Lead To Loss Of Life

Framingham Study…Obesity And Smoking Lead To Loss Of Life

This study was based on 3,457 participants who 40 years ago had a life expectancy of 85 years, if they were in the normal weight category and did not smoke.

The death rates were much higher than the researchers expected. The researchers from the Erasmus Medical Center in Rotterdam stated as a conclusion: ” just think about two things: Don’t get fat and don’t smoke”.

Years of life lost 40 years after Framingham Heart Study Was Started:
Non-smokers: Smokers:
  Male Female   Male Female
overweight *: 3.1 3.3 overweight*: 6.7 7.2
obese** : 5.8 7.1 obese ** : 13.7 13.3
* overweight:BMI25 to 29.9 ** obese:BMI = 30 and higher

Here are some links to my Internet based Healthbook regarding risks for heart attacks and strokes:

Heart disease: http://www.nethealthbook.com/articles/cardiovasculardisease_heartdisease.php

Strokes: http://www.nethealthbook.com/articles/cardiovasculardisease_strokeandcerebralaneurysm.php

Two things will lead to a normal weight (as you likely have heard before):

Proper nutrition…

http://www.nethealthbook.com/articles/nutrition.php

…and proper exercise (fitness):

http://www.nethealthbook.com/articles/fitness.php

Last edited December 10, 2012

 

Nov
01
2002

WAVE Trial Failed To Show Benefits Of Estrogen (Premarine) And Vitamins

Dr. David D. Waters of the University of California at San Francisco reported in Chicago at the American Heart Association’s Scientific Session 2002 about the WAVE trial. This stands for “Women’s Angiographic Vitamin and Estrogen” trial.

The results of this study were simultaneously published in the Journal of the American Medical Association(JAMA 2002;288:2432-2440). It was a “carefully designed randomized study” where 423 women with established blood vessel damage to their hearts (established by angiography) were put on a therapy and then followed for an average of 2.8 years. Essentially the question was whether or not estrogen (Premarine) and vitamins (Vit.E and C) would have a protective effect on the blood vessels. Surprisingly the worst outcome was in the group with estrogen replacement and vitamins. The placebo group (=no estrogen, only vitamins) had the lowest death rate. The authors felt that the beneficial effect of estrogen (speak “Premarine”) on heart vessels could not been verified in this study. The take home message to the physicians at the conference was that they should concentrate on lowering the known risk factors: weight reduction, blood pressure control, cholesterol lowering and increasing exercise. Estrogen should be given in low doses (Premarine 0.625mg per day) only to those women who are symptomatic with hot flashes, but not to every postmenopausal woman.

WAVE Trial Failed To Show Benefits Of Estrogen (Premarine) And Vitamins

WAVE Trial Failed To Show Benefits Of Estrogen (Premarine) And Vitamins

NOTE : This group of postmenopausal women is a selection of women more likely suffering from hyperinsulinism with a higher rate of cardiovascular disease (and also arthritis and possibly a higher risk for cancer as well). The most logical therapy for these women is to work on weight loss, to increase exercise and to change their diet to a zone diet as this is known to lower cholesterol. Hoping to cure these women with estrogen or vitamin manipulation alone does not make “medical common sense” to me. Also, those women who had not had a hysterectomy were not dealt with as a separate group, although they were put on medroxyprogesterone acetate (Prempro). This is called a “confounding bias” and should have been openly discussed, which it was not. This means the WAVE trial made waves, but it was not a properly designed randomized study.

You may want to read these useful related links to chapters of my free Internet based Nethealthbook: For links to arteriosclerosis, heart attacks and strokes see this link: http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/
For a link to hyperinsulinism follow this link:
http://www.nethealthbook.com/articles/hormonalproblems_diabetesmellitus.php

Last edited October 25, 2014