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Healthnotes Newswire (July 31, 2008)—Premature babies are at risk for complications in their mental development, but new evidence shows that their brains may get a boost from fatty acids: A study in Pediatrics reports that breast milk supplemented with omega-3 DHA (docosahexaenoic acid) and omega-6 AA (arachidonic acid) may improve brain development in premature infants.DHA and AA are two types of fatty acids essential for many bodily functions including brain, eye, and nervous system development. The optimal amounts of these fatty acids for premature infants has not been determined, but researchers suggest that increasing the amounts in early infancy may reduce the risk of developmental problems later in life.

Learning disabilities and school-related problems are more common among premature infants than full-term infants. Prior studies, however, have shown that premature infants who are breast-fed have higher IQs than babies receiving formula milk. This finding was attributed to higher concentrations of DHA found in human milk compared with formula milk. The authors of the new study considered the possibility that increasing the DHA content of human milk and adding AA could further improve preemies’ brain development.

Study results encouraging

In the study, 141 premature infants weighing less than 1,500 grams (about 3 pounds) were randomly assigned to receive human breast milk supplemented with either 32 mg of DHA and 31 mg of AA per 100 ml of milk, or breast milk supplemented with soy oil and medium-chain triglyceride oil. Infants received more than 100 ml of human milk per kilogram of body weight per day beginning on the first or second day of birth and continuing until discharge from the hospital (an average of nine weeks).

At six months of age, infants who received the human milk supplemented with DHA and AA were better at problem-solving and were better able to discriminate between familiar and unfamiliar objects compared with infants in the control group.

“There is growing evidence that DHA and AA have specific functions related to memory and problem-solving,” said Christine Henriksen, PhD, lead author of the study from the Department of Nutrition at the University of Oslo, Norway. Dr. Henriksen and her colleagues point out that these functions are critical for being able to focus, be attentive, learn, and process information. Further research is needed to understand the long-term impact of supplementing with fatty acids on school performance and attention capacity later in life.

Ensure you eat your EFAs

Babies are dependent on breast milk and/or fortified formula milk for DHA and AA, but there are other important sources of essential fatty acids (EFAs) to consider as the child grows older. In addition, recent research has shown that it is important for pregnant women to eat plenty of fatty acids in order to help optimize their baby’s brain function. You can find them in these sources:

• Fatty fish such as salmon, halibut, and tuna are good sources of DHA, which is also found in smaller amounts in eggs. Pregnant women should balance the need for fatty acids from fish with reducing exposure to mercury by limiting the amount of fish they eat and avoiding fish high in mercury content.

• AA is found in meat, chicken, and eggs.

• Some people may benefit from supplements that contain fatty acids. Check with your doctor about the appropriateness of using supplements to further enrich your diet.

(Pediatrics 2008;121:1137–45)

Healthnotes Newswire (July 31, 2008)—Women over 50 are usually reminded to have their bone density evaluated every couple of years, but many healthcare providers don’t know when to recommend this screening to men. To help pinpoint the right time for testing men’s bone density, a new review has identified the major factors that put men at risk for fracture from osteoporosis. The review, published in the Annals of Internal Medicine, analyzed the findings from 177 studies performed between 1990 and 2007 that assessed risk factors for osteoporosis-related fracture in men, and 20 studies that evaluated various screening tests for osteoporosis. The findings from a previous review were also included in the analysis.

What puts men at risk

It comes as little surprise that the two most important risk factors identified for men were the same as those for women: being over 70 years old and being thin (having a low body mass index). Other risk factors included sedentary lifestyle, having taken prolonged courses of steroid medications, weight loss, and having had a previous fracture due to osteoporosis. Androgen deprivation therapy, a prostate cancer therapy that reduces testosterone levels, was also found to significantly increase fracture risk.

Smoking was found to slightly increase fracture risk, while low dietary calcium from milk was not consistently associated with fracture risk. Drinking alcohol had no apparent effect on fracture risk or bone mineral density.

Although some studies identified rheumatoid arthritis, respiratory diseases such as asthma, and gastrointestinal disorders such as celiac disease as risk factors for low bone density and fracture, the evidence was not strong.

Are you a good candidate for screening?

Dual-energy x-ray absorptiometry (DEXA) is the current gold standard for diagnosing low bone density and osteoporosis in men and women. It is regularly recommended for women but less commonly for men, despite the fact that 25% of men over age 60 will have a fracture due to osteoporosis sometime in their lifetime.

A simple osteoporosis screening questionnaire involving age and weight as the only variables was found to be an accurate predictor of osteoporosis in men, and one study found that the strongest predictor for hip fracture risk was weight under about 150 pounds (70 kilograms).

“Osteoporosis in men is substantially underdiagnosed and undertreated in the United States and worldwide,” said lead study author Dr. Hau Liu of the Santa Clara Valley Medical Center in San Jose, California. “We determined that men of advanced age and low body weight are the best candidates for osteoporosis screening. Identifying other important risk factors, particularly weight loss, physical inactivity, corticosteroid use, previous osteoporotic fracture, and androgen deprivation therapy, can help healthcare providers select other men who are good candidates for screening.”

(Ann Intern Med 2008;148:685–701)

Healthnotes Newswire (July 24, 2008)—People with type 2 diabetes are more likely to suffer from memory problems, especially right after eating. A new study in Nutrition Research found that taking antioxidant vitamins with food can help people with diabetes offset the memory-robbing effects of a heavy meal.

Putting antioxidants to the test

Diabetes is characterized by higher than normal blood sugar (glucose) levels. Long-term elevations in blood sugar increase the body’s production of free radicals—tissue-damaging compounds that cause many of the complications of diabetes including eye and kidney damage, heart disease, and memory impairment. Eating a meal increases free radical production in the body, and people with diabetes are particularly prone to the negative effects of this sudden rise.

In the new study, 16 adults with diabetes, on separate occasions, were given a high-fat high-carbohydrate meal or the same meal plus 1,000 mg of vitamin C and 800 IU of vitamin E. After eating, they took a series of tests to measure memory capacity.

After eating the test meal alone, the people had a harder time remembering words and information presented to them. Taking antioxidant vitamins with the meal prevented this from happening. “In adults with type 2 diabetes, co-consumption of antioxidant vitamins minimizes meal-induced memory impairment, implicating oxidative stress as a potential contributor to these decrements,” said the study’s authors.

Upgrade your diet for better health and sharper memory

While taking supplements can be useful in the short term, it’s a good idea to eat healthful foods that are naturally rich in antioxidants and other substances known to combat diabetes like fiber, magnesium, and chromium.

• Eat lower-fat meals. Limit packaged and snack foods, and cook foods at home to control the amount of fat, sugar, and other processed ingredients that go into a meal.

• Use unprocessed foods in meal preparation. Skip “white foods” like flour, rice, bread, potatoes, and sugar. Whole grains may be substituted for processed ones; these will not have the same detrimental effects on blood sugar and memory function.

• Focus on antioxidant-rich foods. Great choices include berries, winter squash, cantaloupe, sweet potato, broccoli, tomatoes, oranges, pomegranate, artichoke, red grapes, nuts and seeds, sweet peppers, mango, legumes, whole grains, and dark green leafy veggies (kale, collards, chard).

(Nutr Res 2008;28:423–9)

Healthnotes Newswire (July 24, 2008)—The Journal of the American Medical Association reports that bright light may help improve symptoms caused by dementia such as altered moods, disturbed sleep, and the inability to carry out activities of daily living.

Dementia is a common condition worldwide, and Alzheimer’s disease is its most common form. Dementia impairs a person’s memory and ability to think normally and is often associated with changes in behavior, mood, sleep, and the ability to carry out activities of daily living such as bathing or eating. With few simple remedies available, these symptoms create challenges for people with dementia and their caregivers.

Testing showed some clear improvements

In this study, 189 elderly people with Alzheimer’s or other types of dementia were randomly assigned to receive bright light (indirect, ceiling-mounted, whole-day bright light), melatonin (2.5 mg per day), a combination of bright light and melatonin, or neither melatonin nor bright light. Treatments were given daily for an average of 15 months.

When compared with other treatments or no treatments, bright light was associated with no worsening of mental status, an improvement in depressive symptoms, and improved functioning. Melatonin alone improved the ability to fall asleep earlier and increased sleep duration but had an adverse effect on behavior and mood, and increased withdrawn behavior. Bright light plus melatonin improved sleep disturbances, improved agitated behavior and restlessness during sleep, and decreased the duration of awakenings during sleep.

The study’s authors concluded, “The simple measure of increasing the illumination level in group care facilities ameliorated symptoms of disturbed cognition, mood, behavior, functional abilities and sleep. Melatonin improved sleep, but its long-term use by elderly individuals can only be recommended in combination with light to suppress adverse effects on mood.”

People with dementia need structure and safety

Caring for a person with dementia can be challenging, but the following tips may help make it easier:

• It is important for caregivers to work closely with people who are highly trained and familiar with the specific challenges of dementia, such as geriatricians and/or social workers. These professionals can educate caregivers about ways to improve symptoms and keep a person with dementia safe from harming themselves or others. Medications may help improve symptoms or slow the condition’s progression, but many needed changes are often behavioral or environmental.

• A structured, supervised environment is important for people with moderate to severe dementia who cannot care for themselves. A stimulating and caring environment can help them stay active and functional for a longer period of time.

• Consider the following safety precautious if you are caring for someone with dementia: lock doors so that he or she cannot leave the house unsupervised and get lost; keep car keys in an inaccessible place; and put safety latches on appliances such as ovens. It is also a good idea to get a medical alert bracelet for the person under your care to wear.

(JAMA 2008;299:2642–55)

Healthnotes Newswire (July 17, 2008)—Everyone knows that fish is good for you, but it turns out that some is better than others for certain health needs and goals.

A new study, published in the Journal of the American Dietetic Association, analyzed 30 species of wild and farmed fish and found that while wild fish is generally more healthful than farm-grown, fish such as salmon and trout still maintain a beneficial fatty acid profile. Other farmed fish, such as talapia, do not, so while these may be incorporated into a regular diet as an occasional inexpensive, low-fat protein source, people wanting to maximize disease-fighting health benefits from fish will opt in favor of those with a better balance of fatty acids.

The ratio is the real measure of risk

A wealth of research shows that eating fish rich in omega-3 fatty acids may help prevent and treat diseases such as heart disease, diabetes, inflammatory and autoimmune diseases, and some cancers. However evidence increasingly points to the ratio of omega-3 to the less discussed omega-6 fatty acids in the diet as the indicator of disease risk.

• Fish with an omega-3 to omega-6 ratio of greater than one are considered beneficial because of their effect on the fatty acid profile of the entire diet.

• Fish with a ratio of 0.5 or lower are considered not protective against disease.

As a polyunsaturated fat, omega-6 also plays a role in supporting health, as long as it is consumed in moderation.

The best fish for fending off disease

The authors of the study collected samples of commonly eaten fish—including tuna, snapper, mahi-mahi, cod, sole, halibut, haddock, talapia, swordfish, catfish, salmon, and trout—from distributors in the US and Chile, from fish farms in the US, Chile, Canada, Ecuador, Honduras, Norway, and New Zealand, and from supermarkets in the US. Some highlights of their findings include:

• Sockeye salmon, Coho salmon, Copper River salmon, and farmed rainbow trout had a beneficial fatty acid pattern—in other words, a high ratio of omega-3 to omega-6 fatty acids.

• Farm-raised Atlantic salmon had high levels of omega-3 fatty acids but their levels of omega-6 fatty acids were higher than those of the wild salmon, making their ratio slightly less favorable, though still healthy.

• Tuna, one of the most commonly eaten fish in the US, had a low level of omega-3 fatty acids, but it also had a low omega-6 level, so its ratio remained favorable.

• On the other end of the spectrum, farmed talapia and catfish had low levels of omega-3 and poor ratios of omega-3 to omega-6 fatty acids.

Balancing factors besides fatty acids also important

Of all the fish reviewed in this study, tilapia has received the most attention for its unfavorable fatty acid content. “All other nutritional content aside, the inflammatory potential of hamburger and pork bacon is lower than the average serving of farmed tilapia,” the article cautions. However, keep in mind that a fish not being highly protective against heart disease does not mean it needs to be avoided entirely. Other health factors, such as heavy metal contamination—which are high in otherwise healthful fatty fish like tuna, but low in less heart-healthy fish like tilapia—should also be taken into account.

To give the pros and cons of fish consumption some real world perpective, consider that eating moderate amounts of farmed tilapia is roughly equivalent to other staples of the average diet, and may be a reasonable option for some people. For those at risk for inflammatory diseases such as heart disease, fish with a good omega-3 to -6 ratio such as salmon or trout are the best choice.

(J Am Diet Assoc 2008;108:1178–85)

Healthnotes Newswire (July 17, 2008)—If you are chronically tired, getting moving might be just the thing to put some pep in your step. A new study has found that exercise can improve energy and lessen feelings of tiredness in people who suffer from persistent fatigue.

The effects of exercise on people with certain chronic medical conditions (heart disease and cancer, for example) are well documented, but less is known about its role in improving stamina in people suffering from fatigue without an underlying disease. The new study aimed to determine how exercise affects feelings of fatigue and energy in young people with fatigue unrelated to a medical condition.

In the study, published in Psychotherapy and Psychosomatics, 36 sedentary people with persistent fatigue ranging in age from 18 to 35 were assigned to a low- or moderate-intensity exercise group, or to a no-treatment control group. The low-intensity group worked out on a stationary bicycle at 40% of their peak oxygen consumption (roughly equivalent to walking at a leisurely pace) and the moderate intensity group at 75% of their peak oxygen consumption (about the same as walking at a fast pace), for 30 minutes three times per week for six weeks.

Slow and steady the best bet for persistent fatigue

People in the low- and moderate-intensity exercise groups had a 20% improvement in energy levels after six weeks compared with levels at the beginning of the study. Low-intensity exercise decreased feelings of fatigue by 65%, compared with 49% in the moderate-intensity group. The changes in fatigue and energy levels were unrelated to changes in aerobic fitness. The authors suggested that energy and fatigue improvements are due to the direct effects of exercise on the central nervous system.

Exercise professionals agree

“I have found that maintaining a consistent exercise routine keeps me feeling well balanced and energized,” says Rachel Weisz-Nesshoever, Aerobic and Fitness Association of America certified group exercise instructor in Narragansett, Rhode Island. “Exercise has a way of lifting the spirits and combating fatigue. Sometimes people who are chronically tired tend to avoid exercising. What they don’t realize is that—if it’s done right—exercise can actually give you more stamina and energy to do the things you want to do.”

(Psychother Psychosom 2008;77:167–74)

Healthnotes Newswire (July 10, 2008)—When applied to the skin, honey may help prevent and treat skin diseases caused by bacteria, according to a new study published in Clinical Infectious Diseases. As the number of antibiotic-resistant infections increases, alternative solutions are needed for infections.

Some research has already demonstrated that honey may help with wound healing. In the new study, Revamil, a medical-grade honey, was effective in killing or reducing many types of bacteria on the skin of healthy volunteers, including bacteria that are susceptible to or resistant to antibiotics.

Compared with the control group, bacteria on the forearm were reduced 100-fold after honey was applied for two days, and more than 80% of the honey-treated skin patches showed no evidence of bacteria compared with only 21% of the control patches. Test tube studies also showed that within 24 hours honey killed all antibiotic-resistant and -susceptible strains of Staphylococcus aureus, Staphylococcus epidermis, Enterococcus faecium, Escherichia coli, Pseudomonas aeruginosa, Enterobacter cloacae, and Klebsiella oxytoca.

The study’s authors commented that since very few new antibiotics are being developed, alternative solutions are needed. Honey, they said, could be helpful in treating wound infections and in preventing infection at skin sites where bacteria are likely to thrive, such as catheter sites in ill patients. Further research is needed to understand the potential role of medical-grade honey in preventing and treating skin infections.

Honey may kill or suppress bacteria growth because of its high sugar content, high acid content, natural production of hydrogen peroxide, or because of other actions related to flower or bee components. Though the authors warn that pulling a jar of honey off of the shelf to treat skin infections may not get the job done (Revamil is produced in a greenhouse under standardized conditions), evidence from other studies suggests that raw, unprocessed honey may be effective.

(Clin Infect Dis 2008;46:1677–82)

Healthnotes Newswire (July 3, 2008)—Reishi, shitake, and maitake are among the mushrooms long known to contain medicinal properties that help with health and healing, but the Journal of the Science of Food and Agriculture reports that a mushroom doesn’t need to be exotic to pack a healthy punch. It turns out that common white button mushrooms are rich in antioxidants, making them a wise choice for healthy eating.

Whitecoats study white button mushrooms

In the study, extracts from two wild strains and one cultivated strain of button mushrooms (Agaricus bisporus) were tested for their antioxidant activity. The cultivated strain had the highest, quenching more free radicals than either of the wild strains. In all of the mushrooms, the gills had stronger antioxidant effects than the stems and caps.

Some extracts were tested in the lab for their effects on replenishing glutathione, a molecule sometimes referred to as the body’s “master antioxidant.” All of the mushrooms were strong promoters of restoring glutathione to its beneficial active form. Other tests demonstrated their ability to preserve other important antioxidant enzymes.

Eating your favorite fungus may have health benefits

Button mushrooms are the most commonly eaten mushrooms in the United States. Preliminary studies have found that these mushrooms can stimulate the immune system and block cancer growth in test tubes. Several recent studies have linked eating high amounts of button mushrooms with lower risk of breast and stomach cancers.

The degree of antioxidant activity measured in the white button mushroom extracts was similar to that seen in extracts of other Asian mushrooms that have historically been used as food and medicine, such as himematsutake, basket stinkhorn, maitake, lion’s mane, white matsutake, and poplar fieldcap. Studies of these mushrooms and two other well-known medicinal mushrooms, reishi and shitake, suggest that they have immune-enhancing and anticancer properties.

Research shows that dietary antioxidants are important nutrients for preventing chronic diseases including heart disease and cancer. Eating lots of colorful fruits and vegetables is the best way to support a healthy immune system and prevent cancer, and adding more white button mushrooms to your meals may be one easy way to do so.

“The results presented here indicate that the premier cultivated mushroom, the white button mushroom, might be an important source of dietary antioxidants that could have protective effects in the body,” said Dr. Jean–Michel Savoie of the French National Institute for Agricultural Research, Laboratory Mycology and Food Safety in Bordeaux, France. “This common mushroom could be included in the growing group of mushrooms that have demonstrated excellent antioxidant activity.”

(J Sci Food Agric 2008;88:970–5)

Healthnotes Newswire (June 26, 2008)—Yet more proof points to the importance of exercise and healthy eating to reduce the chance of developing diabetes in people at risk for the disease. With the onset of type 2 diabetes, the body’s ability to keep blood sugar (glucose) levels in check begins to diminish. Losing weight, exercising regularly, and eating well can help improve insulin sensitivity, protecting against diabetes or possibly halting its progression.

“In people with impaired glucose tolerance, group-based interventions targeting lifestyle changes such as diet and exercise produce a durable and long-lasting reduction in incidence of type 2 diabetes,” said the authors of a new study in the Lancet.

As part of the 20-year study, 577 people with impaired glucose tolerance (a prediabetic condition) were assigned to a control group (no intervention), or to one of three lifestyle intervention groups (diet, exercise, or diet plus exercise). The dietary intervention focused on eating more vegetables and consuming less sugar and alcohol. The exercise intervention concentrated on increasing leisure time physical activity.

The interventions lasted for 6 years; then the people were followed for 14 more to determine the long-term effects of the lifestyle changes on the risk of developing diabetes and related complications, including heart disease.

During the first 6 years, the people in the intervention groups had a 51% lower incidence of diabetes than did people in the control group. After 20 years, the intervention groups sustained a 43% lower diabetes incidence, and people in the intervention groups were diabetes-free for almost 4 years longer than people in the control group. The interventions did not seem to affect the risk of cardiovascular disease and other diabetic complications.

The World Health Organization estimates that at least 180 million people worldwide are living with diabetes. The risk of type 2 diabetes is higher in people with a family history of the disease; being overweight, having high triglycerides (a fat in the blood), and high blood pressure also raise risk.

Simple steps to protect your blood sugar

Dr. Leon Hecht, a New Hampshire naturopathic doctor specializing in diabetes, offers these tips for stabilizing blood sugar and avoiding diabetes and related problems.

• Focus your diet on whole foods, including vegetables, fruits, whole grains, lean animal proteins, legumes, nuts, and seeds.

• Eat a larger breakfast and a smaller dinner.

• Each day, make one meal a large salad with all the fixings.

• Decrease foods with flour in them—this means all cakes, cookies, and breads—as these foods will raise your need for insulin, causing you to store fat.

• Aim to lose abdominal fat, as weight in this area is a principal risk factor for type 2 diabetes.

(Lancet 2008;371:1783–9)

Healthnotes Newswire (June 19, 2008)—Older women with low back pain might benefit by getting some extra vitamin D, reports a study in the Journal of the American Geriatrics Society. Low levels of vitamin D can lead to weakened bones, lowered immune function, and sometimes pain.

The new study included 958 people over age 65 who gave information about the location of their pain, from their midback to their feet. Blood samples were taken to measure vitamin D levels.

Women were more likely than men to have moderate or severe pain in some part of their bodies, and women who were vitamin D deficient were almost twice as likely to suffer from low back pain as were people with normal vitamin D levels. Vitamin D status didn’t seem to affect low back pain in men, nor did it influence pain in other parts of the bodies of men or women.

How (and how much) do you D?

The “sunshine vitamin” is produced in the body after exposure of the skin to sunlight. Exposing the face, arms, and hands to sunlight for 15 minutes three times per week year-round can help boost vitamin D levels. Vitamin D also occurs naturally in a few foods like egg yolks and fatty fish such as salmon and mackerel. Dairy products, juices, and cereal products are often fortified with vitamin D.

Just how much vitamin D is best for optimal health is a hot topic. A growing body of evidence suggests that 400 IU per day, the amount found in many multivitamin products, is not enough to maintain optimal levels. Many people appear to need 1,000 IU per day and in some cases even more. The body’s ability to synthesize vitamin D diminishes with age, putting older people at increased risk for deficiency.

The Institute of Medicine has concluded that long-term intake of 2,000 IU per day is safe for most people. Some doctors recommend even more, such as 2,000 to 4,000 IU per day depending on the season, but people taking those amounts should be monitored by a doctor.

Along with the many other benefits adequate D offers the body, such as supporting calcium absorption that keeps bones strong, the authors of the new study conclude that the new study’s “findings suggest it may be worthwhile to question older adults about their pain and screen older women with significant back pain for vitamin D deficiency.”

(J Am Geriatr Soc 2008;56:785–91)