Added Sugar Associated with Increased Risk for Death from Cardiovascular Disease

General Posted by anthony Date March 10, 2014

More of this puts you at risk for cardiac death!

Many U.S. adults consume more added sugar (added in processing or preparing of foods, not naturally occurring as in fruits and fruit juices) than expert panels recommend for a healthy diet, and consumption of added sugar was associated with increased risk for death from cardiovascular disease (CVD), according to a study published by JAMA Internal Medicine, a JAMA Network publication. Recommendations for added sugar consumption vary and there is no universally accepted threshold for unhealthy levels. For example, the Institute of Medicine recommends that added sugar make up less than 25 percent of total calories, the World Health Organization recommends less than 10 percent, and the American Heart Association recommends limiting added sugars to less than 100 calories daily for women and 150 calories daily for men, according to the study background. Major sources of added sugar in AmericansÛª diets are:

sugar-sweetened beverages
grain-based desserts
fruit drinks
dairy desserts
candy.
A can of regular soda contains about 35g of sugar (about 140 calories).

Quanhe Yang, Ph.D., of the Centers for Disease Control and Prevention, Atlanta, and colleagues used national health survey data to examine added sugar consumption as a percentage of daily calories and to estimate association between consumption and CVD. Study results indicate that the average percentage of daily calories from added sugar increased from 15.7 percent in 1988-1994 to 16.8 percent in 1999 to 2004 and decreased to 14.9 percent in 2005-2010. In 2005-2010, most adults (71.4 percent) consumed 10 percent of more of their calories from added sugar and about 10 percent of adults consumed 25 percent or more of their calories from added sugar. The authors note the risk of death from CVD increased with a higher percentage of calories from added sugar. Regular consumption of sugar-sweetened beverages (seven servings or more per week) was associated with increased risk of dying from CVD. ÛÏOur results support current recommendations to limit the intake of calories from added sugars in U.S. diets,Û the authors conclude. Be warned.

Want the Best Geriatric Care? Go for providers that do a high volume of geriatric patients.

General Posted by anthony Date March 7, 2014

The higher the volume, the better the results.

Want the best geriatric care? Go for providers that do a high volume of geriatric patients. According to a study in JAMA, older trauma patients were less likely to die or have a major complication at hospitals with high volumes of geriatric trauma patients, and the chance of major complications increased for geriatric patients in hospitals with high volumes of younger patients, according to a study by Kazuhide Matsushima, M.D., of the University of Southern California, and colleagues. The association between higher hospital volume and lower mortality rates in complex surgical procedures has been well documented, according to the study background. In this study, researchers used a statewide registry of trauma centers in Pennsylvania to examine differences in trauma care outcomes for geriatric patients based on how many geriatric and nongeriatric trauma patients were cared for at the hospitals. Between 2001 and 2010, there were 39,431 geriatric trauma patients and 105,046 younger patients in a review of outcomes at 20 level 1 and 2 trauma centers. Odds of in-hospital death, major complications (such as respiratory failure, kidney failure and heart attack), and failure to rescue (death after a surgical complication) were lower in hospitals with higher volumes of geriatric trauma patients. Larger volumes of nongeriatric patients at hospitals were associated with higher odds of major complications in geriatric patients, according to the results. ÛÏThese results should help focus the discussion about how to allocate geriatric trauma patients to appropriate receiving centers,Û the authors conclude. No duh I say. This seems to be a study that did not need a study. Nonetheless, it probably is wise to research health care providers and understand the populations in which they specialize.

Mediterranean Diet Associated With Lower Risk of Peripheral Artery Disease

General Posted by anthony Date March 5, 2014

Frankly I rather be in the Mediterranean when enjoying the diet!

It has been reported that a Mediterranean Diet could help reduce heart attack and stroke. Now comes word from a study in JAMA that a Mediterranean Diet is associated with a lower risk of Peripheral Artery Disease. Peripheral arterial disease (P.A.D.) is a disease in which plaque (plak) builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. When plaque builds up in the body’s arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis). Over time, plaque can harden and narrow the arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. The multicenter study that previously reported a reduction in heart attack and stroke with a Mediterranean diet supplemented with extra-virgin olive oil or with nuts now also reports a lower risk of peripheral artery disease. The hypothesis that a Mediterranean diet may reduce the risk of peripheral artery disease (PAD) has never been tested in a randomized trial. Miguel Ruiz-Canela, Ph.D., of the University of Navarra, Pamplona, Spain, and colleagues assessed the association of Mediterranean diets with the occurrence of symptomatic PAD in a randomized trial conducted from October 2003 and December 2010. Eligible participants were men 55 to 80 years of age and women 60 to 80 years of age without clinical PAD or baseline cardiovascular disease but with type 2 diabetes mellitus or at least 3 cardiovascular risk factors. Participants were randomized to 1 of 3 groups: a Mediterranean diet supplemented with extra-virgin olive oil; a Mediterranean diet supplemented with nuts; or counseling on a low-fat diet (control group). All participants received a comprehensive dietary educational program on a quarterly basis. The trial included 7,477 participants, with an average age of 67 years, and 58 percent of whom were women. There were 89 confirmed new cases of clinical PAD after a median (midpoint) follow-up of 4.8 years. Both Mediterranean diet interventions were associated with a lower risk of PAD compared with the control group. ÛÏTo our knowledge, this is the first randomized primary prevention trial to suggest an association between a dietary intervention and [reduction in] PAD. These results are consistent with previous observational studies and relevant from a public health perspective,Û the authors write. So forget the clinical mumbo jumbo. The bottom line is we should change our diets. Check with your physician and dietitian.

Mindfulness Meditation May Help Reduce Anxiety, Depression and Pain

General Posted by anthony Date March 3, 2014

Ummmmmmmmmm

According to a report in JAMA, Mindfulness Meditation programs may help reduce anxiety, depression and pain in some individuals, according to a review of medical literature by Madhav Goyal, M.D., M.P.H., of The Johns Hopkins University, Baltimore, and colleagues. Many people meditate to cope with stress and promote good health. To counsel patients, clinicians need to know more about meditation programs and how they might affect health outcomes, according to the study background. The review by researchers included 47 randomized clinical trials with 3,515 participants. Study findings indicate moderate evidence in the medical literature that mindfulness meditation programs show small improvements in anxiety, depression and pain. For example, the effect size for the effect on depression was 0.3, which is what would be expected with the use of an anti-depressant. There was low evidence of small improvements in stress/distress and the mental health component of health-related quality of life. Researchers also found little or no evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep and weight. There was no evidence of harms of meditation programs, although few trials reported on harms. ÛÏClinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior,Û the study concludes. Pretty interesting when you think how many people swear by meditation as a guiding force in their lives. This study seems to suggest otherwise. But I guess if it works for you, there is no harm in continuing!

Use of Vitamin E By Patients With Mild to Moderate Alzheimer Disease Slows Functional Decline

General Posted by anthony Date February 28, 2014

Among patients with mild to moderate Alzheimer disease, a daily dosage of 2,000 IUs of vitamin E was effective in slowing functional decline and in reducing caregiver time in assisting patients, according to a study appearing in the January 1 issue of JAMA. Alpha tocopherol, a fat-soluble vitamin (E) and antioxidant, has been studied in patients with moderately severe Alzheimer disease (AD) and in participants with mild cognitive impairment (MCI) but has not been studied in patients with mild to moderate AD. In patients with moderately severe AD, vitamin E was shown to be effective in slowing clinical progression. The drug memantine has been shown to be effective in patients with AD and moderately severe dementia, according to background information in the article. Maurice W. Dysken, M.D., of the Minneapolis VA Health Care System conducted a trial of 613 patients at 14 Veterans Affairs medical centers. Participants received either 2,000 IU/day of vitamin E (n = 152), 20 mg/d of memantine (n = 155), the combination (n = 154), or placebo (n = 152). Change in functional decline was gauged via the Alzheimer’s Disease Cooperative Study/Activities of Daily Living (ADCS-ADL) Inventory score (range, 0-78). Over the average follow-up time of 2.3 years, participants receiving vitamin E had slower functional decline than those receiving placebo, with the annual rate of decline in ADLs reduced by 19 percent. This treatment effect translates into a clinically meaningful delay in progression in the vitamin E group of 6.2 months. Neither memantine nor the combination of vitamin E and memantine showed clinical benefit in this trial. In addition, caregiver time was reduced by about 2 hours per day in the vitamin E group. The authors write that the current study is one of the largest and longest treatment trials in patients with mild to moderate AD. The researchers note that decline in functioning in AD is increasingly recognized as an important determinant of both patient quality of life and social and economic costs. Check with your physician.