People May Eat Less When Food Is Cut Into Smaller Pieces.

People May Eat Less When Food Is Cut Into Smaller Pieces.

ABC World News (7/10, story 6, 0:35, Sawyer) reported on a new study suggesting that people may eat less when their food is cut into smaller pieces.

        On its website, ABC News  (7/11, Tackett) reports that for the study, presented at the international conference for the Society for the Study of Ingestive Behavior, investigators "gave 301 hungry college students either a whole bagel or the same bagel cut into four separate pieces."

        WebMD  (7/11, DeNoon) reports, "The group that got the whole bagel ate a little more of it than those who got the cut-up bagel. But the real difference came 20 minutes later, when all of the students were offered a free meal." The researchers found that "those who'd eaten the cut-up bagel -- even though they'd eaten a little less -- ate less of the free meal."

Sitting For Three Hours Per Day Or Longer May Reduce A Person's Life Expectancy.

The Wall Street Journal  (7/10, D4, Seidman, Subscription Publication) reports that, according to a study published in the online in BMJ Open, sitting for three hours per day or longer may reduce an individual's life expectancy.

        USA Today  (7/10, Hellmich) reports that investigators "looked at several studies that evaluated sitting and all causes of death."

        Bloomberg News  (7/10, Ostrow) reports, "They combined the data with figures from the National Health and Nutrition Examination Survey, which was used to determine how much time US adults spent sitting and watching TV."

        On its website, ABC News  (7/10) reports, "Based on all this data, the researchers calculated that limiting the time Americans spend sitting to three hours or fewer each day would increase the life expectancy of the US population by two years. Cutting down TV watching to fewer than two hours each day would bump life expectancy up by another 1.4 years."

        MSNBC  /MyHealthNewsDaily (7/10) reports, "About 27 percent of deaths in the studies could be attributed to sitting, and 19 percent to television viewing, the researchers said."

        HealthDay  (7/10) points out that "A number of previous studies have linked a lot of time sitting or watching TV with poor health, such as diabetes and death from heart disease and stroke."

        AFP  (7/10) reports that in an email, study co-author Peter Katzmarzyk said, "We now have some physiological studies showing that when you are sitting, your leg muscles (the largest in the body) are completely inactive, which causes problems with how you handle your blood sugar and how you handle cholesterol." The CNN  (7/10) "The Chart" blog and BBC News  (7/10, Roberts) also cover the story.

FDA releases safety measures for prescription pain relievers.

The New York Times (7/10, B2, Meier, Subscription Publication) reports, "The Food and Drug Administration, overriding the advice of an expert panel, said Monday that it would not require doctors to have special training before they could prescribe long-acting narcotic painkillers that can lead to addiction." The FDA, however, "said companies that make the drugs...would be required to underwrite the cost of voluntary programs aimed at teaching doctors how to best use them." The Times adds, "In introducing the plan on Monday, both Dr. Margaret A. Hamburg, the F.D.A. commissioner, and R. Gil Kerlikowske, President Obama's top drug policy adviser, said they were hopeful that Congress would eventually enact mandatory physician training," although the Obama administration has not yet drafted legislation.

        The Wall Street Journal (7/10, Martin, Dooren, Subscription Publication) reports that during a teleconference with reporters, Kerlikowske said, "The most cost-effective and efficient way to stem our nation's prescription-drug-abuse epidemic is by stopping abuse before it ever starts."

        The Columbus (OH) Dispatch (7/10, Torry) reports, "Hamburg said that more than 20 companies which produce these painkillers will offer educational programs to the nearly 320,000 prescribers on the safe use and disposal of these drugs. Hamburg estimates than within three years, 60 percent of the prescribers will have taken the program," although she added that "we would like to see the number even higher."

        According to the Philadelphia Inquirer (7/10, Sell), "Endo, Pfizer and Janssen said Monday they support the FDA's move."

        The AP (7/10, Perrone) reports, "The FDA has issued a number of warnings on prescription pain relievers in recent years but with little effect." Government statistics indicate that "inappropriate use of the drugs caused nearly 425,000 emergency department visits in 2009." The medications "were blamed for 15,600 deaths that year, up from 14,800 in 2008."

        MedPage Today (7/10, Fiore) reports, however, that "critics cite a number of problems with the guidance, including its reliance on industry sponsorship of education, even with middle-man medical education companies. Also, extended-release and long-acting opioid analgesics training will not be mandatory for prescribers." Meanwhile, "the program will not cover powerful short-acting opioids such as hydrocodone (Vicodin) that have an equally high potential for abuse." Also covering the story are Reuters (7/10, Yukhananov), Medscape (7/10, Jeffrey), and the Pittsburgh Tribune-Review (7/10, Harding).

Cranberry for UTI More Than Folk Remedy?

 MedPageToday Direct Link

 

By Cole Petrochko, Associate Staff Writer, MedPage Today

Published: July 09, 2012

Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Action Points

• Cranberry-containing products have long been used as a remedy to prevent UTIs possibly by inhibiting adherence of uropathogens to uroepithelial cells.
• Point out that this study found evidence that cranberry containing products are associated with protective effects against UTIs.

Drinking cranberry juice or taking cranberry capsules or tablets was associated with a protective effect against urinary tract infection, a systematic review found.
The pooled data from 10 studies comparing cranberry-product consumers against nonusers showed cranberry consumption had a risk ratio protective against UTI at 0.62 (95% CI 0.49 to 0.80), according to Chien-Chang Lee, MD, of the National Taiwan University Hospital, and colleagues.
A subgroup analysis found the cranberry products were more effective in women with recurrent UTI, female populations, children, regular cranberry juice drinkers, and those who used cranberry products more than twice daily, Lee and co-authors wrote in the July 9 issue of Archives of Internal Medicine.
"Cranberry-containing products have long been used as a folk remedy to prevent UTIs," the authors explained. Cranberry is thought to interfere with the attachment of bacteria to uroepithelial cells, potentially preventing infection.
The meta-analysis evaluated randomized controlled trials that compared the effectiveness of cranberry containing products, such as juices and pills, with placebo and non-placebo control groups at preventing UTIs. The review included data from 10 trials of 1,494 patients, with 794 in the cranberry group versus 700 in the control group.
In pooled trials, there was an association with protective effects for the cranberry group and significant heterogeneity between the trials (RR 0.68, 95% CI 0.47 to 1.00), but the results were nonsignificant, Lee and colleagues wrote.
They added that sensitivity analyses "showed that the protective effect of cranberry containing products was stronger in nonplacebo-controlled trials" and suggested that expectations of efficacy had an effect on outcomes.
When broken down by subgroup, there was a nonsignificant trend for protection in certain groups consuming cranberries, including:

• Women with recurrent UTI (RR 0.53, 95% CI 0.33 to 0.83)
• Female patients (RR 0.49, 95% CI 0.34 to 0.73)
• Children (RR 0.33, 95% CI 0.16 to 0.69)
• Cranberry juice drinkers (RR 0.47, 95% CI 0.30 to 0.72)
• Patients consuming cranberry products more than twice daily (RR 0.58, 95% CI 0.40 to 0.84)

The authors noted that patients who drank cranberry juice versus other forms of cranberry may have been better hydrated, and additives in juice may have offered additional protective benefits not seen in cranberry tablets or capsules.
However, the high sugar content in most cranberry drink products may cause gastrointestinal problems or raise concerns about sugar control in diabetic patients, the authors warned.
They concluded that although their meta-analysis showed an association between cranberry product consumption and protection against UTI, "this conclusion should be interpreted with great caution" due to the "substantial heterogeneity across trials."
The authors said that their review was limited by absent searches for conferences, proceedings, and clinical trial registries; inability to reach some study authors to acquire missing data; and missing proanthocyanidin content for cranberry products in several trials. Proanthocyanidins are compounds that may potentially inhibit the adherence of Escherichia coli to urological mucosa, they wrote.

The authors declared no conflicts of interest.

Primary source: Archives of Internal Medicine
Source reference:
Lee CC, et al "Cranberry-containing products for prevention of urinary tract infections in susceptible populations" Arch Intern Med 2012; 172: 988-996.

Add Your Knowledge ™

---

Cole Petrochko
Associate Staff Writer
Cole Petrochko started his journalism career at MedPage Today in 2009, after graduating from New York University with B.A.s in Journalism and Psychology. When not writing for MedPage Today, he blogs about nerd culture, designs websites, and buys and sells collectible card game cards. He is based out of MedPage Today’s Little Falls, N.J. Headquarters.

Related Article(s):

• Cranberries Get New Vote of Confidence in UTI Prevention
• Antibiotics Trump Cranberries for Bladder Infections

Heart Disease Still Leading Cause Of US Deaths.

USA Today  (7/9, Hellmich) reports, "Although the rate of death from cardiovascular disease declined by 31% from 1998 to 2008, the disease is still the leading cause of death in the USA." About "one in every three deaths are from heart disease and stroke, according to the heart association and the Centers for Disease Control and Prevention." In particular, "the article...discusses heart disease in men, who 'suffer from the disease at a younger age because they 'tend to have higher blood pressure, higher cholesterol, and they are more likely to be smokers than women,' says [Russell] Luepker, program director of the Minnesota Heart Survey, a population-based study that tracks trends in heart disease."

        Higher Levels Of Omega-6 Fatty Acid May Be Linked To Reduced CHD Risk. MedPage Today  (7/9, Petrochko) reports, "Higher levels of omega-6 fatty acid in the blood were associated with a lower risk of coronary heart disease (CHD), results of a nested case-control study found." Investigators found that "patients with the highest plasma concentration of omega-6 polyunsaturated fatty acids had a significantly lower risk of CHD compared with those who had the lowest concentrations (adjusted OR 0.84 95% CI 0.76 to 0.92, P<0.0001)." The researchers "also saw a weak but significant relationship between higher blood levels of saturated fatty acids and greater risk of CHD." The study was published in PLoS Medicine.

FDA Approves Roche Test For Tracking Cytomegalovirus.

The Wall Street Journal  (7/6, Dooren, Subscription Publication) reports that the Food and Drug Administration yesterday approved Roche Holding's COBAS AmpliPrep/COBAS TaqMan CMV Test, to aid physicians in tracking cytomegalovirus (CMV). A result showing a decline in the virus would indicate a successful treatment, while an increase would indicate that a different treat should be tried. The virus is common and is frequently found in patients with transplanted organs.

        Reuters  (7/6, Siddiqui) reports the test is for use on organ transplant patients being treated for CMV. The FDA said that the test cannot be used to diagnose CMV infection.

Scientists Use Natural Clot-Producing Mechanisms To Deliver Targeted Medicine.

Bloomberg News  (7/6, Tirrell) reports, "Scientists found a way to use the body's natural clot-producing mechanisms to deliver targeted medicine in a study that may have implications for treatments of heart attacks and stroke." This "delivery system, called shear-activated nanotherapeutics, is a bundle of tiny drug-coated particles that travel together until they reach the obstruction, when...shear stress causes them to break apart and attack clots." The research, "done in mice, used an approved clot-targeting therapy called tissue plasminogen activator, or tPA, and found that the system allowed for use of less than one-fiftieth the normal dose to dissolve clots...said" Donald Ingber, an author of the study, which was published in Science.

Cystatin C May Help Better Assess Kidney Impairment.

MedPage Today  (7/6, Gever) reports, "Using cystatin C levels along with serum creatinine to estimate the glomerular filtration rate (GFR) did a better job of assessing kidney impairment than the standard GFR formula," according to a study  (pdf) published in the New England Journal of Medicine. Investigators found that "substantially more patients were correctly classified as having GFR values above or below the critical threshold of 60 ml/min/1.73 m2 when it was estimated with the combined method versus the conventional GFR calculation that relies only on serum creatinine."

Shingles vaccine may be safe for patients on biologics.

CNN (7/5, Curley) "The Chart" blog reports that although shingles is a "painful but common condition, affecting half of Americans by age 85," not everyone is eligible to receive a vaccine against the condition recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices for all adults aged 60 and older. According to the blog post, "the vaccine is not recommended for people being treated with immune-suppressing drugs called 'biologics,' which control how the body reacts to inflammation in a variety of conditions such as rheumatoid arthritis and psoriasis." However, a new study published in the Journal of the American Medical Association "found no increased risk for shingles among people with rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, or inflammatory bowel disease who have been treated with biologic medicines and receive the shingles vaccine."

        Medscape (7/5, Laidman) notes that in the past, health concerns have led "the US Food & Drug Administration, the Advisory Committee on Immunization Practices, and the American College of Rheumatology" to "contraindicate the vaccine for patients receiving the immunosuppressives."

        MedPage Today (7/5) adds that "in a retrospective analysis of more than 460,000 Medicare beneficiaries, the herpes zoster vaccine was not associated with an increased rate of herpes zoster disease in the weeks after immunization, according to Jeffrey Curtis, MD, of the University of Alabama Birmingham, and colleagues." In addition, "in a multivariable analysis, the vaccine was associated with a 39% lower risk of herpes zoster disease after the 42 days immediately following vaccination."

        HealthDay (7/5, Reinberg) quotes the study authors as writing, "Despite the recognition that patients with immune-mediated conditions are at increased risk of [shingles], this and previous studies have shown that only a small fraction of these patients received the vaccine, likely in part due to safety concerns. Our data call into question the current recommendations that [shingles] vaccine is contraindicated in patients receiving biologics and suggest a need for a randomized controlled trial to specifically address the safety and effectiveness of [shingles] vaccination among patients receiving biologics."

Methadone overdose deaths fall a little after huge increase since 1999.

The AP (7/5, Stobbe) reports that a Vital Signs report from the Centers for Disease Control finds that "after a sharp rise, the number and rate of methadone-related overdose deaths have fallen since 2007," having risen "from fewer than 800 in 1999 to more than 5,500 in 2007, before slipping the next two years to 4,900 and 4,700." CDC director Dr. Thomas Frieden commented, "There aren't a lot of problems that have gotten so much worse so quickly as prescription drug overdose has." And "besides methadone, painkiller deaths primarily involve Vicodin (hydrocodone), OxyContin (oxycodone) and Opana (oxymorphone)." Methadone "accounted for just 2 percent of painkiller prescriptions in 2009, but more than 30 percent of overdose deaths." Methadone has been prescribed as "a safer alternative," to OxyContin, and "because it's cheaper than some other painkillers," but it "can disrupt breathing," and "can cause a fatal irregular heartbeat."

        CBS News (7/5) explains, "methadone carries more risks than other painkillers because levels build up in the body and may interfere with a person's normal heart rhythm or breathing." Frieden said, "Deaths from opioid overdose have increased four-fold in the past decade, and methadone now accounts for nearly a third of opioid-associated deaths," adding, "There are many safer alternatives to methadone for chronic non-cancer pain." The story notes that "the rise in deaths even prompted a 2006 warning from the Food and Drug Administration regarding careful prescribing of the drug."

        Reuters (7/3, Ebrahim) also quotes Dr. Frieden advising physicians that "there are many safer alternatives to methadone." He also said, "Although it may cost a couple of dollars less per pill, the result is many more emergency room visits, and a much higher societal cost in deaths, and addiction and other problems that can be avoided."

        The Boston Globe (7/3, Kotz) reports in its "Daily Dose" blog, "Many of these deaths could be prevented if doctors curtailed their prescribing of this drug, said the federal Centers for Disease Control and Prevention." It also quotes Dr. Frieden saying that prescribing methadone for chronic non-cancer pain is "penny wise and pound foolish."

        The CNN (7/5) "The Chart" blog reports, "If you are not grappling with cancer-related pain, you probably should not be taking prescription methadone." Dr. Frieden said, "It should only be used for pain when other drugs haven't been effective."

        The Salt Lake (UT) Tribune (7/5, May) reports, "In Utah, the number of methadone-related deaths has dropped as efforts to educate physicians and the public have increased." Those efforts include a 2006 warning by the FDA, as well as a 2008 move by manufacturers to limit "distribution of the largest formulation to authorized opioid addiction treatment programs and hospitals only." And "in 2009, the Utah Department of Health issued guidelines telling doctors to rarely if ever prescribe methadone for acute pain."

        Time (7/5, Szalavitz) reports in its "Healthland" blog, "Methadone kills pain for about six hours on average, but with accumulating doses, it can slow a person's breathing and disrupt heart rhythm," and "this means that taking methadone three times a day - exactly as prescribed - can lead to a potentially fatal overdose."

        MedPage Today (7/5, Fiore) reports that Frieden "emphasized that most of these accidental deaths are tied to the drug's use in chronic pain -- a condition for which there is little evidence of its benefit, he noted -- and are not associated with its indication for the treatment of substance abuse." HealthDay (7/5, Reinberg) also covers the story.

Pioglitazone May Increase Risk Of Bladder Cancer In Patients With Type 2 Diabetes.

HealthDay  (7/4, Gordon) reported, "Taking pioglitazone (brand name Actos) raised the risk of bladder cancer by about one-fifth, according to a new analysis  " of ten studies published online July 3 in the Canadian Medical Association Journal.

        "Any use of a thiazolidinedione was associated with a nonsignificant 45% higher risk in the pooled randomized trials and a significant 15% elevated risk across the observational studies," MedPage Today  (6/4, Phend) reported. "Pioglitazone users had pooled risk ratios ranging from 1.22 to 4.30," researchers reported. The article also pointed out that in 2011, the Food and Drug Administration "warned...of a further increase in bladder cancer risk with pioglitazone, now reflected in the drug's product label."

Western-Style Fast Food May Raise Risk Of Diabetes, Heart Disease.

MedPage Today  (7/5, Bankhead) reports that a study  published online July 2 in Circulation found that "eating Western-style fast food on a regular basis significantly increased the risk of diabetes and coronary heart disease in a large Asian cohort, investigators reported. The diabetes odds increased by 27% and CHD risk by 56% among Singapore residents who ate fast food at least twice a week." The study covered participants "from the Singapore Chinese Health Study, which enrolled 63,257 individuals from 1993 to 1998. For the fast-food study, investigators conducted follow-up telephone interviews during 1999 to 2004 for 52,584 members of the original cohort." HeartWire  (7/5, O'Riordan) also covers the story.