Study Heart attack death rate declines
Wed, 02 May 2007 03:14:04 GMTBy LINDSEY TANNER, AP Medical Writer
CHICAGO - In just six years, death rates and heart failure in hospitalized heart attack patients have fallen sharply, most likely because of better treatment, the largest international study of its kind suggests. The promising trend parallels the growing use of cholesterol-lowering drugs, powerful blood thinners, and angioplasty, the procedure that opens clogged arteries, the researchers said.
"These results are really dramatic, because, in fact, they're the first time anybody has demonstrated a reduction in the development of new heart failure," said lead author Dr. Keith Fox, a cardiology professor at the University of Edinburgh.
The six-year study involved nearly 45,000 patients in 14 countries who had major heart attacks or dangerous partial artery blockages. The percentage of patients who died in the hospital or who developed heart failure was nearly cut in half from 1999 to 2005.
And the heart attack patients treated most recently were far less likely to have another attack within six months of being hospitalized when compared to the patients treated six years earlier — a sign that the more aggressive efforts of doctors in the last few years are working.
There have been other signs that better treatment of heart patients has been saving lives, but not on a scale as large as this international study, the researchers said.
"It's much more dramatic than we expected, in the course of six years," Fox said.
The new study follows landmark research results in March that showed angioplasty is being overused on people who have chest pain but are not in immediate danger of a heart attack. But this popular procedure, which typically uses stents to keep an unclogged vessel open, is still a powerful tool for saving those who are having a heart attack or are at high risk of one.
Patients for the study enrolled between July 1999 through December 2005 and were followed for up to six months after hospitalization. Besides the United States, they were in hospitals in Argentina, Australia, Austria, Belgium, Brazil, Canada, France, Germany, Italy, New Zealand, Poland, Spain and the United Kingdom.
The research showed that in 2005, 4.6 percent of the heart attack patients died in the hospital, compared with 8.4 percent in 1999. Heart failure developed in 11 percent of heart attack patients in 2005, versus nearly 20 percent in 1999. And just 2 percent had subsequent heart attacks in 2005, compared to 4.8 percent previously.
Improved outcomes also were found in those with partial blockages, which include less severe heart attacks.
The researchers said these marked improvements are probably a "direct consequence" of new practices that followed updated guidelines from key organizations of heart doctors in the United States and Europe.
The study "is the first report of what's actually going on in the real world," said Dr. Joel Gore, a co-author and cardiologist at the University of Massachusetts Medical Center.
Recommendations in those guidelines include quick use of aspirin or more potent blood thinners; beta blockers to reduce the damaged heart's oxygen needs, statins to lower cholesterol; ACE inhibitors to relax blood vessels; and angioplasty to open blocked vessels soon after hospital arrival.
Use of each of these treatments climbed during the study and in some cases more than doubled. For example, 85 percent of heart patients studied got cholesterol drugs in 2005 versus just 37 percent in 1999; 78 percent got potent blood thinners including Plavix versus 30 percent in 1999; and 53 percent had quick angioplasty, compared to just 16 percent six years earlier.
The study appears in Wednesday's http://jama.ama-assn.org
American Heart Association: http://www.americanheart.org
Guide touts Latin American Diet Pyramid
Wed, 02 May 2007 02:07:45 GMTBy MONICA RHOR, Associated Press Writer
HOUSTON - A new food pyramid, designed to encourage Latinos to eat healthier, touts the staples of traditional Latin-American cooking as the path to better nutrition.
The Latin American Diet Pyramid emphasizes the benefits of grains and tubers such as maize, quinoa and plantains, and tropical fruits such as mangos and papayas. It's featured in a pocket-sized bilingual shopping guide set for distribution nationwide.
The 16-page pamphlet, called "Camino Magico" or Magic Road, is the centerpiece of a campaign launched Tuesday by the Latino Nutrition Coalition, a Boston-based nonprofit dedicated to improving Latino eating habits.
The basic message is: The old ways are the best ways.
The pamphlet teaches shoppers to choose fresh fruits and vegetables and whole grains over processed or prepared foods. It also offers a shopping list and meal ideas that incorporate healthier versions of traditional dishes, such as a bean tortilla melt, arroz con pollo and Mexican chicken soup.
"We're trying to get people talking about what we should be eating, and to focus on more traditional and healthier foods rather than big quantities of cheap food," said Liz Mintz, manager of the Latino Nutrition Coalition. "We wanted to create awareness in the community and inspire people to eat healthy."
The supermarket guide, which is now available in some stores and churches in Dallas and Houston, will eventually be distributed in Chicago, New York, Los Angeles, Miami and Boston, Mintz said.
The coalition, whose parent company Oldways Preservation Trust created the Mediterranean Diet, developed the Latin American Diet Pyramid as a way to combat high rates of obesity, diabetes, and heart disease in the Hispanic community.
Obesity rates among Latinos in the U.S. doubled between 1991 and 2001, from 11.6 percent to 23.7 percent. About 23 percent of Hispanic men are obese, while 27.5 percent of women are obese — higher rates than those of non-Hispanics.
Latinos are also two times more likely to have diabetes, and to suffer from diabetes-related illness such as kidney and eye disease.
The ailments, like poor eating habits, seem to increase with immigration, studies have found.
"Five years after people immigrate, their weight goes up drastically," Mintz said. "The more acculturated Hispanics are, the more problems we are seeing."
The trend can be reversed, said John Foreyt, director of the Behavorial Medicine Research Center at Baylor College of Medicine.
"This is a quick, sensible way of helping Latinos. It's getting back to the old ways, and maintaining their culture, rather than shifting to something else," he said. "It's not just a diet, but the Latino lifestyle — eating with your family, eating home-cooked meals."
FDA Tainted feed minor threat to humans
Tue, 01 May 2007 23:16:27 GMTBy KEVIN FREKING, Associated Press Writer
WASHINGTON - Federal health investigators suspect that they will find more farms that received tainted animal feed but stressed Tuesday that the threat to people is minimal.
The investigators are trying to get a handle on just how much pet food tainted with an industrial chemical called melamine made its way into products consumed by pets as well as by hogs and chickens.
On Monday, they announced that byproducts from tainted pet food had been used in chicken feed on some farms in Indiana. A few days earlier, they said that hog farms in six states may have received tainted pet food for use as feed.
The pet food in question could be to blame for a wave of dog and cat deaths in March due to kidney failure. However, Dr. David Acheson, an assistant commissioner for the Food and Drug Administration, said the threat level to pets is greater than to livestock or humans.
"It was only a small portion of what the poultry was fed, and human consumers will only use poultry as a small portion of their diet," Acheson said.
By contrast, pets often eat the same product exclusively, he said.
"The dilution factors here are enormous," he said.
Officials said that as many as 3 million young chickens out of 9 billion slaughtered annually may have eaten feed that potentially included an ingredient containing the melamine. They have already been slaughtered for human consumption, but because there is no evidence that consumption is unsafe, no recall has been issued.
Acheson said that the investigation tracking contaminated pet food is complex and sweeping, which is why it could lead to the discovery of new states that are affected.
"There is a distinct possibility that it will broaden," Acheson said. "I'm not saying that it will, but we need to be prepared for that to happen."
The pet food scare as well as earlier discoveries of E. coli in spinach and salmonella in peanut butter has led to concerns about the safety of the nation's food supply.
The FDA reacted to that concern Tuesday by naming Acheson as assistant commissioner for food protection. One of his first projects will be to develop a strategy that identifies potential gaps in the food safety system and what is necessary to address those gaps.
Meanwhile, Democratic lawmakers announced their own plans Tuesday for addressing food safety. Two lawmakers introduced legislation that would give the FDA the power to order mandatory recalls of adulterated food products, plus establish fines for companies that don't promptly report contaminated products.
"The evidence is clear our food safety system is collapsing and one of the main agencies charged with protecting it, is asleep," said Rep. Rosa DeLauro , the Connecticut Democrat and sponsor of the bill in the House. "This needs to change immediately. It is time to transform the FDA from the toothless agency it has become to one that takes the proactive steps necessary to protect our food supply and the public health."
Sen. Dick Durbin, D-Ill., is the lead sponsor of the bill in the Senate.
Lawmakers' concerns about the FDA also led to another hearing on Capitol Hill Tuesday as three former commissioners testified that the agency needs more money for inspectors and more regulatory authority over producers and suppliers.
"The fact is that food is a second-tier priority within the FDA," said Dr. David Kessler, who served as FDA commissioner in the administrations of the first President Bush and President Clinton.
Kessler said the federal government has more authority to halt the distribution of dangerous toys than it has over unsafe food products. And, the agency has no ability to impose fines on companies that are slow to remove unsafe foods.
Energyinfused sunflower seeds on market
Tue, 01 May 2007 20:45:12 GMTBy DIRK LAMMERS, Associated Press Writer
SIOUX FALLS, S.D. - Baseball players and truck drivers who chew sunflower seeds at work no longer have to down a cup of black coffee or a Red Bull for an extra energy jolt. A South Dakota company is infusing sunflower seeds with caffeine and other boosters commonly found in energy drinks.
"A lot of people chew sunflower seeds to stay awake and give them energy, and we just thought we'd combine the two of them," said Tim Walter, president of Carpenter-based Dakota Valley Products.
Sumseeds, so-named because they add ingredients to seeds, have been in development for about a year. The seeds are grown in North Dakota and Kansas and shipped to the company's Willow Lake plant, where caffeine, taurine, lysine and ginseng are added.
The 3.5-ounce bags sell for $1.99, about twice the price of normal sunflower seeds. The company is working to get them into nationwide distribution.
Sumseeds are being sold at a Sioux Falls drug store chain and should soon begin appearing on shelves in Minneapolis and the Southeast. A major convenience store chain is testing the snack in 10 of its stores, and Dakota Valley Products also is getting international interest from as far away as New Zealand, Walter said.
John Sandbakken, international marketing director for the National Sunflower Association, said he hasn't yet tried Sumseeds. But any new product is good for the industry, he said.
"Any way that there's more products on the market, obviously that's a plus for us and for farmers," Sandbakken said.
Eighteen- to 30-year-old males make up the largest market for in-shell sunflower seeds, and many of them chew and spit while playing outdoor activities or watching television, he said. They're also a favorite of truckers, who eat them during long trips.
Sunflower seeds became more popular in baseball in the 1990s when the minor leagues banned tobacco products from clubhouses.
The new supercharged seeds will be the official sunflower seed of the Sioux Falls Canaries, which begins its American Association season in early May.
Matt Meola of the Canaries said the juiced-up snack, which will be sold at concession stands, is a good fit for a team that likes its promotions on the quirky side.
"We're a team that is based on having fun and being a little over the top at times," said Meola, the Canaries' director of media and public relations. "A caffeinated sunflower seed is over the top and has got a lot of energy, too."
Sunflower seeds have long been touted as a healthy snack that's high in protein and fiber and contains vitamins and minerals.
And while energy drinks pack in the sugar, a bag of Sumseeds contains just 5 grams to give snackers a longer-lasting boost in lieu of a high carbohydrate rush, Walter said.
"Our angle is that you can't consume a sunflower seed as fast as say you could guzzle a 10-ounce or a 12-ounce can of a beverage and you also don't have that sugar," he said. "So it will be more of a sustained energy boost."
Dakota Valley Products has two patents pending, one for the way it roasts and cools the seeds and another for its method of getting the ingredients through the shell and into the kernel, which helps avoid the bitter taste caffeine can add, Walter said.
"If you would coat it on the surface of the kernel or shell, caffeine is extremely bitter you'd either have to try to hide that taste or you'd have to put up with it," he said.
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On the Net:
Sumseeds: http://www.sumseeds.com/
39Rubber band39 obesity surgery cuts diabetes risk
Wed, 02 May 2007 16:29:09 GMTBy Anne Harding
NEW YORK - After having &;lap band&; surgery for weight loss, men and women show large increases in sensitivity to the blood-sugar-regulating hormone insulin -- even if they remain obese -- a new study shows.
&;They don't have to reach their ideal weight in order to make some pretty significant health improvements,&; Dr. Joan F. Carroll of the University of North Texas Health Science Center in Fort Worth, one of the study's authors, told Reuters Health.
Carroll reported the findings this week at the American Physiological Society's annual meeting in Washington, DC.
In the operation Carroll and her team are investigating, known medically as laparoscopic gastric banding surgery, an elastic band is placed around the stomach, restricting the amount of food the stomach can comfortably hold. Another procedure, surgical gastric bypass, has been shown to help reduce the body's resistance to insulin -- often a prelude to full-blown diabetes -- before major weight loss has taken place, but less is known about how lap band surgery affects insulin resistance.
To investigate, Carroll and her team have been following 37 lap band patients for up to one year. Those followed for six months have lost 23 kilograms , on average, while average weight loss for those who have been followed for a year is 34 kg .
Their level of insulin resistance had fallen by 60 percent after six months, she told Reuters Health, even though the patients remained clinically obese.
Given that resistance to insulin greatly increases the risk of developing type 2 diabetes, which has a number of other health consequences including heart disease and even amputations, &;over the long term it's really a benefit for all the body systems,&; Carroll said.
Alarming rates of unsafe sex among HIVinfected British gays study
Tue, 01 May 2007 07:49:34 GMTLONDON - More than a third of British homosexuals who are infected with the AIDS virus continue to have unprotected sex, according to a survey published on Tuesday.
The investigation was carried out in 2003 and 2004 among 2,640 men in London, Manchester and Brighton who filled out questionnaires.
Most of the volunteers also provided a saliva sample for HIV testing, and the results showed that among those with the AIDS virus, only a third knew they had been infected.
Thirty-seven percent of HIV-positive men said they had had unprotected sex with more than one partner in the past year, while the rate among HIV-negative men was 18 percent.
The survey appears in the latest issue of the journal Sexually Transmitted Infections, published by the British Medical Association .
The authors, led by Julie Dodds of the Centre for Sexual Health and HIV Research at University College London, say they are worried.
The high rates of unsafe sex and ignorance about HIV status occurred despite an awareness campaign and access to condoms, virus testing and antiretroviral drugs, they note.
US warns of suicide link to antidepressants
Wed, 02 May 2007 18:37:57 GMTWASHINGTON - The US Food and Drug Administration raised concerns Wednesday about the link between antidepressant medications and suicidal behavior in young adults.
The government drug regulator recommended that producers of some three dozen antidepressants add warnings to labels pointing out the increased risks of &;suicidality&; -- suicidal thinking and behavior -- in people 18-24, in the first stages of their treatment.
An announcement from the agency cited studies showing &;a slight increase in suicidality for patients taking antidepressants in early treatment for most of the medications.&;
In 2005 the FDA asked drug manufacturers to add a similar warning regarding children and adolescents prescribed antidepressants.
However, it said in the statement Wednesday that the same drugs do not increase suicidal behavior in people over 24 and, indeed, among those over 65, the tendency is reduced.
High calcium vitamin D intake may have a down side
Wed, 02 May 2007 12:41:37 GMTBy Megan Rauscher
NEW YORK - In one of the first studies to examine the relationship between diet and brain lesions, researchers observed that elderly people who reported higher calcium and vitamin D intake were much more likely to have greater volumes of brain lesions -- regions of damage that can increase risk of cognitive impairment.
&;Our finding of a relationship between brain lesions and consumption of both calcium and vitamin D raises the question about a possible down side to high intakes of these nutrients,&; Dr. Martha E. Payne of Duke University, Durham, North Carolina, told Reuters Health.
Higher intakes of calcium and vitamin D have been promoted in recent years as a way to prevent bone loss with aging. &;We are concerned that some of this extra calcium may end up in the blood vessel walls rather than the bone. This may be a particular problem for individuals with renal disease since calcium excretion may be impaired,&; Payne said.
The research team assessed calcium and vitamin D intakes and magnetic resonance imaging brain scans in 232 elderly men and women.
All of the subjects displayed some brain lesions of varying sizes but those reporting the highest intakes of calcium and vitamin D were significantly more likely to have higher total volume of brain lesions as measured across several MRI scans.
These positive associations remained significant in two separate &;multivariable models&; controlling for age, high blood pressure, diabetes, heart disease, and depression. In one model containing both calcium and vitamin D, only vitamin D remained significantly positively associated with brain lesion volume.
&;We cannot conclude that calcium or vitamin D caused the brain lesions that we found,&; Payne said. &;However, we hypothesize that our findings may be due to vascular calcification, whereby calcium is taken up into the blood vessel walls.&;
&;A longitudinal study,&; Payne concludes, &;is urgently needed in order to determine if calcium and vitamin D lead to vascular calcification and brain lesions in the long term.&;
She reported the study findings at a meeting of the American Society for Nutrition, part of Experimental Biology 2007 in Washington, DC.
