Category Archives: Uncategorized

Should Adults Decrease Their Consumption Of Milk?

High milk consumption in adults is associated with increased mortality and, among women, increased fracture risk, according to an observational study in BMJ.

Women who reported drinking 3 or more glasses of milk daily had a near doubling of risk for total mortality relative to those who drank less than a glass daily. Men drinking 3 or more glasses daily had a smaller, but still significant, increase in mortality.

Among women, high milk consumption was also associated with increased risk for any fracture and hip fracture.

The authors note that D-galactose, found in milk, has been shown to induce oxidative stress damage and chronic inflammation in animals, and such changes have been associated with cardiovascular disease, cancer, bone loss, and sarcopenia in humans. Nonetheless, the authors caution that their findings “merit independent replication before they can be used for dietary recommendations.”

BMJ

ACP Offers New Guidelines for Preventing Recurrent Kidney Stones

The American College of Physicians has issued a new set of recommendations to prevent recurrent kidney stones.

Published in the Annals of Internal Medicine, the guidelines recommend the following:

Patients with a history of kidney stones should be encouraged to increase their fluid intake, with a goal of producing at least 2 liters of urine a day.
In patients with active disease in whom higher fluid intake is not sufficient, treatment with a thiazide diuretic, citrate, or allopurinol is recommended.
Patients should also be encouraged to avoid colas, which are acidified with phosphoric acid. The recommendation does not apply to fruit-flavored soft drinks, which are often acidified with citric acid.

Annals of Internal Medicine article

Banned Ingredients Still Being Sold In Supplements

According to a research letter in JAMA, dietary supplements recalled because of the presence of pharmaceutical adulterants still contain the banned ingredients months after the recall.
They looked at 27 dietary supplements that were recalled between 2009 and 2012 because of pharmaceutical adulterants. Researchers purchased the supplements at least 6 months after recall for analysis of banned ingredients.

Roughly two thirds of the products tested positive for at least one pharmaceutical adulterant — usually the same ingredient identified at the time of the recall. One fifth of all products contained additional banned ingredients. Among the adulterants identified were sibutramine (wt loss agent), sildenafil (Viagra), fluoxetine (antidepressant), and anabolic steroids.

The researchers conclude: “Action by the FDA has not been completely effective in eliminating all potentially dangerous adulterated supplements from the US marketplace.” They call for “more aggressive enforcement of the law, changes to the law to increase the FDA’s enforcement powers, or both.”

JAMA

False Weight-Loss Claims related to Green Coffee Extract

Applied Food Sciences, Inc. of Austin, Texas has settled Federal Trade
Commission charges that it “… used the results of a flawed study to
make baseless weight-loss claims about its green coffee extract to
retailers, who repeated those claims in marketing finished products to
consumers …” – The settlement requires the company to “… pay $3.5
million, and to have scientific substantiation for any future weight-
loss claims it makes, including at least two adequate and well-
controlled human clinical tests …”

PALB2- Another Breast Cancer Gene

Mutations in the PALB2 gene confer as much increased risk for breast
cancer as BRCA2 mutations, according to a New England Journal of
Medicine study. The PALB2 protein is key to several BRCA2 functions,
including limiting cellular DNA damage.

U.K. researchers examined breast cancer risk among some 360 members of
154 families in which at least one person had breast cancer and a loss-
of-function mutation in PALB2 (but no BRCA mutations). They found that
breast cancer risk was 9.5 times higher among mutation carriers than
in the general population. The absolute breast cancer risk by age 70
among women with PALB2 mutations ranged from 33% among those with no
family history of breast cancer to 58% among those with at least two
first-degree relatives with breast cancer at age 50. PALB2 mutations
also increased risk among men.

The researchers say the level of risk conferred by PALB2 mutations
would be considered high according to American Cancer Society and
other guidelines. “This level of risk,” they write, “may justify
adding PALB2 to genetic testing for BRCA1 and BRCA2.”

New England Journal of Medicine

Low-Carb Dietiers Lose More Weight Than Low-Fat Diet

According to a study published in the Annals of Internal Medicine,
looking at 150 otherwise healthy adults, at 12 months, the low-carb
group had lost 3.5 kilograms more than the low-fat group, even though
caloric intakes were similar. The low-carb group also saw greater
improvements in body composition, CRP levels, HDL cholesterol, and
triglycerides.

Annals of Internal Medicine

Low D levels linked to Dementia

A new study in Neurology adds to the mounting evidence linking vitamin
D deficiency with increased risk for dementia and Alzheimer disease.

In this study, participants with deficient levels (25-50 nmol/L) had
significantly increased risks for dementia and AD, than participants
with sufficient baseline vitamin D levels (50 nmol/L or higher).

The researchers conclude, “Our results confirm that vitamin D
deficiency is associated with a substantially increased risk of all-
cause dementia and Alzheimer disease. This adds to the ongoing debate
about the role of vitamin D in nonskeletal conditions.”

-Neurology

FDA Recalls Another Batch of Generic Metoprolol

The FDA has recalled more than 13,000 bottles of metoprolol succinate
extended-release tablets manufactured by Dr. Reddy’s Laboratories,
Reuters reported. In addition, the agency recently recalled another
lot of generic metoprolol from a different company, Wockhardt. Both
recalls were for medicines manufactured at facilities in India.

The recalls were categorized as Class II, which the FDA says “may
cause temporary or medically reversible adverse health consequences or
where the probability of serious adverse health consequences is remote.”

If you are prescribed metoprolol, a beta blocker, please talk with your doctor.

New York Times story

Fish Consumption Advice –

FDA and EPA have issued a draft updated advice which recommends that
“… pregnant women eat at least 8 ounces and up to 12 ounces (2-3
servings) per week of a variety of fish that are lower in mercury to
support fetal growth and development … The draft updated advice
cautions pregnant or breastfeeding women to avoid four types of fish
that are associated with high mercury levels:
tilefish from the Gulf of Mexico
shark
swordfish
king mackerel.
In addition, the draft updated advice recommends limiting consumption
of white (albacore) tuna to 6 ounces a week … When eating fish
caught from local streams, rivers and lakes, follow fish advisories
from local authorities. If advice isn’t available, limit your total
intake of such fish to 6 ounces a week and 1-3 ounces for children …”