Health and Medicine – Page 28

A sweet little fairy story

The fairies at the bottom of my garden have been digging up the pot of gold at the end of the rainbow. A spokesdog for the Society of Wolves tells me that Canis Lupus is no longer dining on geriatric homeowners nor juvenile females in crimson headgear. Oh, and there is no link between sugar in the diet and diabetes.

The first two statements may seem a little far-fetched but that last one, surely it’s a fairy story…

Well, apparently not. In a press release posted on AlphaGalileo by the UK’s Sugar Bureau, new evidence from researchers at the Royal Victoria Hospital and Queen’s University Belfast suggests that receiving a quarter of daily calories from sucrose (sugar) as part of a balanced, weight-maintaining diet does not result in any difference in insulin resistance compared to getting 10% of the same number of calories from sucrose.

The press release states, that “It has long been suspected that a high sugar diet over a long term period may lead to an increased risk of developing diabetes. But there has been little or no evidence to support this idea, with studies on the role of any aspect of the diet in the development of diabetes difficult to conduct.”

So, is this the evidence we’ve all been waiting for?

The research, published by Steven Hunter and colleagues in the journal Diabetes points to sugar’s innocence. “Sugar has traditionally been linked to the development of diabetes,” he says, “These findings challenge that thinking, and show that intakes of more than double that currently recommended do not appear to have an adverse effect on markers of diabetes risk.”

But, let’s take a closer look at this little story from the Sugar Bureau. The trial studied the effects of different amounts of sucrose in the diets of 13 healthy men without diabetes over a period of six weeks.

Thirteen volunteers? Six weeks?

How can they draw any serious conclusions from such a tiny sample tested over such an incredibly short period? Where is the data on sucrose intake for hundreds if not thousands of people over several years of sucrose abuse? While there is evidence that saturated fat intake and obesity are closely linked to diabetes risk, this single very small study cannot seriously claim that sugar intake has no effect on diabetes risk. How can they tell in a month and a half with just 6 or 7 men being fed a larger amount of sugar in their diet?

I don’t doubt the researchers’ integrity, but this news, coming as it does from the Sugar Bureau, does smack of sickly sweet spin to my cynical eye. It doesn’t tell us anything about the long-term effect of repeated blood sugar spikes caused by excessive intake nor about the effects of aging on sucrose processing and the harmful cross-links it can form with body proteins.

It’s a story that will have the tooth fairy rubbing its hands in glee as well as giving anyone with a penchant for two desserts the impression that they can get away with a large amount of sugar in their diet without having to worry about diabetes. I find it hard to imagine a happy ever after for this story.

What do you think? Should organisations or companies that promote a particular product be allowed to fund scientific research into the benefits or otherwise of that product?

Too much protein increases cancer risk

Earlier this week scientists reported a strong correlation between obesity and the risk of common cancers, such as cancer of the colon and breast cancer. Today, initial findings from a US study suggest that eating less protein could be a way to protect some people from cancers that are not directly associated with obesity.

The research is published in the December issue of the American Journal of Clinical Nutrition (2006, 84, 1456), shows that lean people on a long-term, low-protein, low-calorie diet or participating in regular endurance exercise training have lower levels of plasma growth factors and certain hormones linked to cancer risk. “However, people on a low-protein, low-calorie diet had considerably lower levels of a particular plasma growth factor called IGF-1 than equally lean endurance runners,” says Luigi Fontana of Washington University, “That suggests to us that a diet lower in protein may have a greater protective effect against cancer than endurance exercise, independently of body fat mass.”

“Our findings show that in normal weight people IGF-1 levels are related to protein intake, independent of body weight and fat mass,” Fontana says. “I believe our findings suggest that protein intake may be very important in regulating cancer risk.”

Fontana says most of us don’t eat nearly enough fruits and vegetables or enough whole-grains, cereals or beans. “Many people are eating too many animal products – such as meat, cheese, eggs and butter – as well as refined grains and free sugars,” he says. “Our intake of vegetables and fruits is low, and beans are vastly underconsumed in the U.S. and Europe these days.”

He believes diets would be healthier if we ate more whole grains, beans, fruits and vegetables and far fewer animal products. He recommends mostly fish, low-fat dairy products and, occasionally, some red meat. Such a diet would both cut total calories and reduce the amount of protein we consume to healthier levels.

“Eating too many calories increases our risk of developing obesity, diabetes, cardiovascular disease and of certain types of cancer related to obesity,” Fontana adds, “We hope to further clarify what happens to cancer risk when we are chronically eating more protein than we need.”

Cholesterol drug withdrawal

According to the FierceBiotech pharma newsletter, Pfizer has been forced to halt development of its cholesterol drug Torcetrapib. The report says that the Data Safety Monitoring Board recommended the withdrawal of the drug from trials because of an “imbalance of mortality and cardiovascular events”.

I presume that’s management speak for “too many patients were having heart attacks and dying”.

The drug was set to become a Pfizer blockbuster, although I’d have hoped the marketing people would have come up with a snappier name before it went to market. “Based on all the evidence we have seen regarding Torcetrapib and in light of prior study results, we were very surprised by the information received from the DSMB,” the company stated. The DSMB has privileged access to the blind trials information so that it can make such decisions in the public and patient interest, but Pfizer claims the announcement was “totally unexpected and disappointing”.

The drug was set to replace Lipitor, a $12b a year blockbuster the patent on which is soon to expire. The FB newsletter says, that Pfizer “continue to invest in a wide range of pipeline opportunities across a diverse range of therapeutic areas.” Which, I presume, is management speak for “back to the drawing board”.

Apparently, just two days before this withdrawal, the company was enthusing about its benefits? Should we be policing drug trials even more stringently than we are now to prevent products getting so far before it is discovered there are serious issues with a particular trial?

Raman best for breast cancer

Breast cancer remains the most common form of cancer among women but screening with mammography involves exposure to ionising radiation and suffers from a high rate of false positives that then require a definitive assay. In the December issue of the journal Biopolymers, researchers in India describe how Raman spectroscopy might be used to discriminate between normal, benign, and malignant breast tissue and so provide a simple and relatively non-invasive complement to a suspicious mammogram.

Murali Krishna of the Center for Laser Spectroscopy at Manipal Academy of Higher Education, in Karnataka and a visiting scientist at the University of Reims, France, and colleagues at Department of Surgical Oncology, Shirdi Sai Baba Cancer Hospital and Research Center and the Department of General Surgery at Kasturba Medical College, both part of Manipal, explain that, as with most cancers, survival rates depend on the stage at which diagnosis is made. More reliable screening and diagnosis methodology could thus improve survival rates.

Read on…

Double heart trouble

US researchers have demonstrated that MRI is twice as sensitive as other techniques at detecting early heart damage in patients with the immune system disorder sarcoidosis.

The early detection of heart problems in patients with sarcoidosis is imperative if the risk of dying from heart failure is to be reduced for such patients. Sarcoidosis is characterized by tiny inflammatory growths, granulomas, that cluster in the lungs, lymph nodes and under the skin, but can also form in the heart. Conventional techniques cannot differentiate between which patients who have cardiac granulomas will suffer long-term heart damage and those who will not.

Now, caridiologists at Duke University Medical Center have shown how MRI can reveal minute areas of heart damage before they reach a critical size. The earlier diagnosis might allow physicians to reduce the incidence of sudden cardiac death, a leading cause of death in patients with sarcoidosis.

The full story is available in my science news column on SpectroscopyNOW

Smoking ban

Geordie Boffin Asthma sufferers, non-smokers, and those who really just don’t care for passive-smoking-induced lung cancer can breathe a long sigh of relief as England follows other enlightened states and places a ban on smoking in enclosed public places, such as pubs, clubs, and restaurants, from July 1, 2007.

There’s sure to be an enormous backlash from those addicted to the Nicotiana vapours, but it can only be good for the rest of us who prefer not to partake of the various chemical congeners that accompany tobacco smoke: carcinogenic polyaromatic hydrocarbons, arsenic, carbon monoxide, hydrogen cyanide, lead, formaldehyde, phenol, butadiene, etc etc etc.

The ban in England will follow those in the Irish Republic and Scotland. Wales ban begins April 2, 2007.

Anyway, for those who simply cannot resist, there’s always those little patches, chewing tobacco, or what about the Victorians’ favourite, snuff? All the artificial benefits with none of the smoke. Oh, but regular use will increase your risk of nasal, oral, or throat cancer. You may even want to consider getting an e-cig with an Aspire tank for sale as these can reduce your nicotine intake and do not contain vapors that are as harmful.

UPDATE: 2021-12-20 Who knew that “vaping” would be such a big thing so many years later?

Hangover Cures

Hangover culprit

Hangover cures…don’t work. And, that’s official. So you’re stuck with that thumping headache, the sick feeling in your stomach, and the mouth that feels like the bottom of a parrot (or parrot’s cage depending on what you were drinking.

According to a report published in the British Medical Journal some time ago, but timely once again given the imminent holiday season, the only way to reduce the risk of waking up with a stinking hangover the morning after the night before is to not drink alcohol or at the least to avoid imbibing copious amounts of this natural poison.

There is, says the report, “No compelling evidence to suggest that any complementary or conventional intervention is effective for treating or preventing alcohol hangover.”

Apparently, hangovers waste something like Â£2billlion (almost $4b) in lost earnings every year because of sufferers taking a sickie and forfeiting their pay for the day. Add to that the cost of the various “hangover cures” those drinkers often turn to. They usually do so in the hope that they will be able to get out of bed and stand up straight without feeling sick or as if someone has hit them round the head with a sledgehammer. You get the idea of just how much all this drunken debauchery costs.

The authors of the paper trawled medical databases and the internet looking for hangover cures (it doesn’t say whether they were suffering the after effects of one too many sherberts themselves). They also contacted experts and manufacturers to find any randomised controlled trials of medical interventions that could prevent or treat hangovers.

The results of their search pulled up eight trials testing eight different agents: propranolol (a beta-blocking drug), tropisetron (drug for nausea and vertigo), tolfenamic acid (a painkiller), fructose or glucose, and the dietary supplements borage, artichoke, prickly pear (Opuntia ficus indica), and a yeast-based preparation [not to be confused with a yeast based infection, Ed.]

Of those trials none reported any significant positive effects on post-alcoholic health, although there was some evidence that borage, the yeast-based preparation, and tolfenamic acid had some benefits. “We are confident that our search strategy located all published trials on the subject,” say the authors. “Our findings show no compelling evidence to suggest that any complementary or conventional intervention is effective for treating or preventing the alcohol hangover.”

An earlier paper in the journal suggested that the main active ingredient in beer, wine, spirits and other alcoholic drinks, “ethanol itself may play only a minor part in producing the thirst, headache, fatigue, nausea, sweating, tremor, remorse, and anxiety that hangover sufferers report.” Research shows that hangover symptoms reach their peak, or should that be trough, when almost all the ethanol and its metabolite acetaldehyde have actually been cleared from the blood. Moreover, peak blood ethanol or acetaldehyde levels do not correlate closely with the severity of the subsequent hangover. This is borne out by the fact that between a quarter and half of drinkers claim not to get hangovers even after a drunken binge.

Rather, it’s the congeners – other organic molecules such as polyphenols, methanol, other alcoholic compounds, and histamine – that seem to be to blame more than ethanol itself. Different drinks have different amounts of these nasties. This likely explains why a heavy session on cheap bourbon or brandy – thick with congeners and blinding methanol – is more likely to leave you with a mouth like the bottom of a parrot’s cage and a skull-crushing headache than a half dozen shots of clear, pure vodka. Not that I’d know anything about parrots and skulls, of course.

Consultant anaesthetist Ian Calder of the National Hospital for Neurology and Neurosurgery in London, in a BMJ editorial suggested that “the fear of hangover prompts most people to moderate their ethanol intake.” This may have been true a decade ago. However, given the advent of vodka-based alcoholic shots type drinks in the last few years and the apparent burgeoning of binge drinker numbers across the UK it either no longer holds true or else this kind of research has reached the boozing masses and their drinking habits have evolved to home in on beverages with lower congener concentrations.

It’s all almost enough to make you turn to drink. Or, perhaps turn to a pharmaceutical alternative to alcohol that might emerge from research labs in the near future, according to a report in newscientist.

Alcohol exerts its effects on the brain by latching on to GABA-A receptors in the brain, and these come in various sub-types. Alcohol binds indiscriminately to them all, interfering with many brain pathways including memory and leading to its pleasant and unpleasant initial effects. A designer molecule that binds strongly to the “good” subtypes, producing the pleasurable effects of alcohol without interfering with essential brain processes, could easily be made the magazine reports. But, do we need yet another substance of abuse, especially one with a whiff of a Huxley-type world of Soma addiction?

Still, in the absence of the hangover-free substance, we’ll continue to see throughout the coming party season websites touting cure-alls from jalapeno peppers and the full English breakfast to a good old hair of the dog as the cure to end the morning-after blues.

My personal tip? Alternate your alcoholic drinks with the equivalent volume of good old-fashioned tap water and make sure you boogie more than you booze.

UPDATE: While it is quite easy to discuss a hangover in a relatively light-hearted way, Sciencebase guest author Sheila Gibbs discusses the far more serious side of drink and how alcohol destroys lives

Ayurvedic analysis

I, like many with a chemistry training, have on occasion dismissed the more mystical-seeming strands of non-western medicine. The origins of homeopathy, for instance, relied on literal Bible bashing of glass phials to ensure the infinitely dilute remedies would work. Which of course western medicine says is ludicrous. Herbal medicine on the other hand needed the industrial age to extract its active ingredients and bring us the likes of aspirin from the sap of the cricket bat willow and asthma inhalers from ephedra plants.

One area of non-western science that many western medics and scientists say is nothing more than pseudoscientific claptrap is Ayurvedic medicine. This is a holistic healing system that emerged in ancient India. It talks of the mind-body balance and the kind of “energy” and humours that modern science claims not to exist, yet there may be a grain of truth in some aspects of this system for which modern science has not given due credit.

Consider the western approach to the common problem of anaemia in pregnancy. The treatment of choice, according to western medicine, is simply to ingest iron sulfate. In this form, iron can be readily absorbed by the body, assimilated into new red blood cells, and anaemia solved.

Unfortunately, many pregnant women cannot tolerate iron sulfate and regurgitate it so they don’t get to ingest the iron and the anaemia remains.

Now consider the Ayurvedic approach. The sage assesses the pregnant woman, finds she has an imbalance in her energies, humours, whatever, and prepares a herbal infusion aimed at shifting the balance towards a more healthy state. It works, there’s no vomiting, the morning sickness subsides, and that anaemic look is replaced by the flush of pregnancy once more.

So, what is going on? How can a bunch of herbs cure anaemia so readily?

AP de Silva of the Queen’s University Belfast, whom I recently interviewed for Reactive Reports, was once equally as sceptical of the possibilities of Ayurvedic medicin. He told me that, as a fledgling chemist, he challenged an Ayurvedic practitioner to answer the question of validity. The practitioner, however, was entirely confident of his position and turned the tables on AP suggesting that he take away the herbal infusion and analyse it in his lab, which he did.

The result? A standard elemental analysis revealed the infusion to contain a stabilised concentration of iron(II) ions. Natural chelating agents in one of the herbs provide a suitable chemical environment to maintain iron in the II state, as opposed to its more common (III) state. This allows it to be ingested, absorbed, and to cure the anaemia without the sickness of raw iron sulfate.

This is, of course, circumstantial evidence, and does not provide the support of full double-blind placebo-controlled clinical trials. However, the chemical analysis provides one possible rational explanation of the efficacy of this remedy beyond a placebo effect.

Perhaps it is time modern science took a closer look at the multitude of alternative remedies that sit under the Ayurvedic umbrella. Ancient herbal remedies evolved from folk knowledge and a huge proportion of modern drugs are based on such remedies, 40% of them, or thereabouts. Instead of instantly assuming isolation of an active ingredient is the optimal approach, perhaps science should consider the holistic approach to drug discovery with a view to coping with the side effects and improving efficacy overall.

Statistics and low GI foods

New, healthier alternatives to processed food starches with a lower GI, or glycaemic index, may soon be on the menu, thanks to scientists in China and the US. The researcher have begun to unlock the secrets of starches that make dehusked grains, potatoes, and processed foods such as biscuits and breakfast cereals less healthy compared with low GI foods. Their statistical analysis of starchy data could lead to new processed carbohydrates that do not cause the worrying blood sugar spikes associated with conventional processed starch.

Now, Hamaker and his colleagues have looked at the various physical properties of rapidly digested starches (RDS) and SDS (slowly) to try and determine the underlying differences. They have found that the degree of crystallinity of the starch content is key. Semicrystalline structure is critical to the beneficial slow digestion properties of low GI foods but cook, or otherwise process, an SDS, however, and this semicrystallinity can be lost and a once-slow starch becomes an RDS.

Read the full story in my latest news round-up on SpectroscopyNOW.com

Heart disease and the death zone

atheroma Arterial plaques represent a "death zone" within the artery in which white blood cells that would otherwise clear away such fatty deposits are killed before they can do their job.

The result is that these plaques eventually reduce the blood supply to the heart causing heart problems. These plaques can break apart at any stage in a person’s life, although most commonly in middle age, whether they are otherwise fit or not.

Chinese researchers have now used analytical chemistry to determine the toxic components of arterial plaques that are so deadly to white blood cells. Their finding not only improves our understanding of this form of heart disease, but might one day lead to new approaches to treating atherosclerosis.

Find out more in the latest news from SpectroscopyNOW.com