Author Archives: Menon Medical Center

And The Winner is The DASH Diet

The DASH Diet (Dietary Approaches to Stop Hypertension) was the winner in the U.S. News & World Report’s 2015 Best Diet rankings, for best overall diet. To do well in this category, a regimen “had to be relatively easy to follow, nutritious, safe, effective for weight loss and protective against diabetes and heart disease.”

Runners-up include the TLC Diet, the Mayo Clinic Diet, Weight Watchers, and the Mediterranean Diet. Coming in last place is the Paleo Diet.

Diets were also ranked in seven sub-categories. Weight Watchers earned the top slot for Best Weight-Loss Diet, the Biggest Loser Diet and DASH tied for first for Best Diabetes Diet, and the Ornish Diet won for Best Heart-Healthy Diet.

Deaths from Influenza Crosses Epidemic Threshold in the U.S.

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Death from pneumonia and influenza in the U.S. has reached an epidemic level, according to CDC data released last week. Pneumonia and influenza accounted for 6.9% of all deaths. Twenty- six pediatric deaths have been reported to date.

The CDC previously warned that this flu season is likely to be severe because the predominant virus in circulation, H3N2, is known for being particularly virulent, especially in children under five and adults over sixty-five; in addition, the circulating H3N2 strains are not well matched to the H3N2 strain included in this season’s flu vaccine. However, all flu samples tested thus far have been susceptible to the antiviral treatment options available like Tamiflu and Relenza. On December 19, 2014, the FDA approved a third antiviral, Rapivab, to treat influenza infection in adults.

For more information on the flu, click on this link, or copy and paste to your browser. CDC FluView

Whole Grains Decrease Overall Mortality

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According to an article recently published in the JAMA, higher intake of whole grains is associated with reduced overall mortality and especially cardiovascular mortality. The study looked at both men and women over twenty five years. Participants were free of cancer and cardiovascular disease at baseline; they completed dietary questionnaires every 2 to 4 years.

After adjustment for confounders (e.g., age, smoking, BMI), higher whole grain intake was associated with lower total mortality. In particular, cardiovascular mortality was reduced — especially with high intake of brans. Whole grain intake did not reduce cancer mortality.

Which Treatment Is Best For Knee Pain

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The Annals of Internal Medicine published a meta- analysis comparing the various treatment options available for patients with knee osteoarthritis (OA) suffering from pain. The winner was an injection of hyaluronic acid into the affected knee, followed closely by corticosteroids knee injections. They compared knee injections with oral pain medications like acetaminophen, diclofenac, ibuprofen, naproxen and celebrex. As expected oral acetaminophen, which is not an anti-inflammatory, offered the least benefit.

The analysis included nearly 140 randomized trials involving some 33,000 adults with primary knee OA.

In terms of pain, all active treatments were statistically significantly better than oral placebo, with acetaminophen providing the least benefit and hyaluronic acid providing the greatest.

What does “being healthy” mean in Women?

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An interesting article about young women and their habits– according to a study done by the Journal of the American College of Cardiology, young women with healthy habits are less likely to develop coronary heart disease or cardiovascular risk factors as they age,

They looked at six criteria in women aged 27-44 years of age

nonsmoker

normal body mass index

physical activity of at least 2.5 hours weekly

television viewing of 7 hours or less weekly

moderate alcohol consumption

and a healthy diet —

These women had almost no heart disease and low rates of type 2 diabetes, hypertension, and high cholesterol after 20 years’ follow-up.

Compared with women who met none of the criteria, those meeting all six had a 92% reduction in risk for coronary heart disease and a 66% reduction in CV risk factors. Of note, only about 5% of study participants met all six criteria.

Nearly 500,000 Cancers in 2012 Attributable to Obesity

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High body mass index (BMI) may be to blame for nearly 4% of all cancer cases, a Lancet Oncology study finds. These cancers include colon, rectal, esophageal, ovarian, uterine, and breast. This link seems to be higher among women than men. Highly developed nations had the most high-BMI-related cancers: North America accounted for about a quarter of all such cases.

Lancet Oncology

Cytisine a Better Choice for Smoking Cessation

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Cytisine, a partial agonist of nicotinic acetylcholine receptors, helps smokers quit tobacco more effectively than nicotine-replacement therapy (NRT), according to a New England Journal of Medicine study. The plant-based agent has been used for smoking cessation in Eastern Europe for decades but is largely unavailable elsewhere.

Some 1300 adult daily smokers who were motivated to quit smoking were randomized to receive cytisine tablets for roughly 3.5 weeks or NRT (patches plus gum or lozenges) for 8 weeks. Both groups also received behavioral support via three brief telephone calls over 8 weeks.

The primary outcome — self-reported continuous abstinence at 1 month — was higher with cytisine than with NRT. Similarly, abstinence rates favored cytisine at 2 and 6 months. Cytisine was associated with more adverse events (mostly nausea, vomiting, and sleep disorders), but only 5% of participants discontinued the drug because of side effects.

An editorialist notes that cytisine is inexpensive and, if made widely available, could make smoking cessation pharmacotherapy affordable for many smokers.

NEJM

Blood Test to Help Predict Heart Disease

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The FDA has cleared for marketing a test that could help predict risk for coronary heart disease events in people with no history of heart disease. The PLAC Test for Lp-PLA2 Activity assesses the level of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) — a marker of vascular inflammation.
Researchers used the test to measure Lp-PLA2 levels in 4600 people aged 45 to 92 who were free of CHD at baseline. After a median follow-up of 5 years, people with Lp-PLA2 levels above 225 nmol/min/mL had a higher rate of CHD events than those with lower levels (7.0% vs. 3.3%). The FDA said that the test predicts risk most accurately in black women.

FDA news release

Belly Fat an Independent Risk Factor for Sudden Cardiac Death

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The association of general obesity with sudden cardiac death appears to be mediated through traditional cardiovascular risk factors, whereas abdominal obesity may pose an independent risk for sudden death, a Heart study suggests.
The findings, according to editorialists, suggest that waist-to-hip ratio might be better than BMI for predicting sudden cardiac death. The mechanisms responsible for the association remain speculative, however.
The recommended waist circumference for men is less than 102 cm, and for women is less than 88 cm.

Heart

Obesity in Young Adults Linked To Early Death

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Obese young adults can expect to live about 6 years less than their normal-weight peers, according to a modeling study in the Lancet Diabetes & Endocrinology.
Researchers created and validated a model to estimate the annual risks for diabetes, cardiovascular disease, and mortality in overweight and obese adults.
Compared with normal-weight men aged 20–39, overweight men lived an estimated 2.7 fewer years; obese men, 5.9 fewer years; and very obese men, 8.4 fewer years. Findings generally were similar for women. Overall, the number of years lost attributable to excess weight decreased with increasing age.

The researchers say their findings “might provide a useful health measure for discussions between health professionals and their patients.”

Lancet Diabetes & Endocrinology