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Are you aware that other countries do not recommend all the tests and screenings that medical specialty organizations in the U.S. recommend? Medical panels in different parts of the world may issue guidelines that vary from U.S. medical specialty guidelines, and sometimes even conflict with them. This is happening even though all groups in various countries are looking at the same medical evidence on which to base recommendations.

This is because in the United States (unlike European countries and Canada) there is a fee for service medical system - the more tests, screenings, and procedures, the more a doctor is paid. Conflict of interest? Bias? Of course. Does it make for better care for patients? Based on the evidence - no.

Interestingly, independent medical groups in the U.S. (such as the U.S. Preventive Services Task Force) that don't have financial interests in the medical services at stake recommend guidelines that are more in line with Canadian and European country guidelines. The U.S. Preventive Services Task Force is an "independent, volunteer panel of national experts in disease prevention and evidence-based medicine".

As many have pointed out, the approach recommended by medical specialty groups of more and more tests and screening leads to  overdiagnosis, overtreatment, and increasing health care costs. There also is specialty bias - which means whatever the physician is trained in, they are biased toward recommending those treatments and procedures. [Similarly, Dr. John Mandrola has written about the issue of employers evaluating physicians on the number of tests and procedures done (with the more, the better the evaluation), and on the harms that can result from screening, tests, and procedures.]

Dr. Ismail Jatoi (Univ. of Texas Health) and Dr. Sunita Sah (at Cornell) have written a thought provoking article in the Canadian Medical Association Journal about these issues with a call to reduce these conflicts when medical organizations give medical guidelines. The panels should be multidisciplinary in composition, independent of specialty societies, and avoid fee-for-service conflicts of interest.

From Science Daily: Medical guidelines may be biased, overly aggressive in US ...continue reading "Why Do Medical Guidelines Vary So Much?"

How frequently do you eat foods with nanoparticles in them? The use of nanoparticles in foods is increasing every year, with the result that people may eat foods with them daily (thus having chronic exposure). Nanoparticles in foods are ingredients so small that they are measured in nanometers or billionths of one meter. The most common nanoparticle is the food additive titanium dioxide, which in Europe is known as E171. Titanium dioxide is added to many processed foods, candy, and even supplements  and non-prescription medicines (e.g. antihistamines) as a "coloring" to make foods whiter or brighter. Currently there are no restrictions on using titanium dioxide nanoparticles in foods.

We still know very little about whether titanium dioxide nanoparticles have health risks to humans, but studies suggest they may cause intestinal inflammation, may disrupt gut microbes, and may migrate to other parts of the body. Now another study is raising more questions about the safety of titanium dioxide in food. It was done in mice, but the researchers feel it applies to humans. The researchers found that titanium dioxide resulted in a "pro-inflammatory environment and biofilm formation" in the intestines of the mice, and in this way could predispose humans to conditions such as inflammatory bowel disease and colorectal cancer. Bottom line: Read food ingredient lists!

From Science  Daily: Common food additive found to affect gut microbiota

...continue reading "Do You Eat Foods With Nanoparticles In Them?"

Did you know that over 90% of all Americans have pesticide residues in their bodies? How do we know this? From studies and from the Centers for Disease Control and Prevention (CDC) which does biomonitoring of large groups of Americans in order to measure pesticides (and other toxic environmental chemicals) in their bodies. Biomonitoring tells us the "body burden" of toxic chemicals, usually by measuring them in our blood and urine, but also in hair, breast milk and meconium (an infant's first feces gives a measure of prenatal exposure to pesticides). Biomonitoring studies have detected hundreds of different chemicals (including many pesticides) in people, and shown that every single person has a mixture of many contaminants in their body.

The bad news is that we don't really know what all these chronic low level mixtures of pesticides are doing to us. Studies are finding health problems (e.g. various cancers, endocrine disruption, neurological and reproductive problems, even semen quality) with pesticide exposures - especially during pregnancy (the developing fetus), and during childhood. We're talking about pesticide exposures of ordinary people, living ordinary lives, in cities, suburbs, and rural areas.

How do pesticides get into us? Pesticides get into us from inhalation, through the skin, and through ingestion (foods, water). Studies find that conventionally grown fruits and vegetables are good ways to ingest pesticides, and with more of these foods eaten, the higher the pesticide residue levels in the body. Unfortunately, as more and more pesticides such as fungicides, glyphosate and 2,4-D are used on crops, our exposures and levels of these pesticides in our bodies are increasing.

When our homes, our gardens, and lawns are treated with pesticides, we also get exposed to pesticides. We track them from the outside, and children (and pets) play in them on treated lawns. We are exposed to pesticide "drift" from neighboring properties. Pesticides used inside the house stay in the house dust (they don't break down easily in homes). Pesticides are even found in rain and fog. Scary, isn't it?

Can we lower the levels of pesticides in our bodies? Absolutely yes. Eat as many organic foods as possible - the levels of pesticide residues in the body (as measured in the blood and urine) will go down rapidly. Study after study shows this. A study even found an association with eating organic foods and a lower cancer rateDon't use pesticides on lawns. Think of weeds as "native grasses" and clover as beneficial. When dealing with indoor pest problems, use least-toxic Integrated Pest Management.

A nice discussion of this is in a recent article by journalist Liza Gross. Excerpts from The Nation: More Than 90 Percent of Americans Have Pesticides or Their Byproducts in Their Bodies

...continue reading "Almost All Americans Have Pesticide Residues In Their Bodies"

Another study finds beneficial health effects from eating real foods - this time eating Montmorency tart cherries reduces blood pressure and insulin levels up to 5 hours after ingestion. Of course. It was a small study done in the United Kingdom, with only 11 middle-aged participants, all with metabolic syndrome (increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels). It is estimated that about a third of U.S. adults have metabolic syndrome, which significantly increases the risk of cardiovascular disease and type 2 diabetes.

It was a nicely designed study, and the Montmorency tart cherries were taken in either juice form or capsules which contained freeze-dried Montmorency tart cherry powder. Drinking the juice had slightly better health effects than the freeze dried capsules. It would have been nice if they had also looked at a group of people eating fresh Montmorency tart cherries, rather than just juice or freeze dried cherries.

Keep in mind that this study found positive health effects from real food. However, in contrast, studies find that taking supplements and vitamins generally don't result in health benefits (e.g. calcium, omega-3, niacin, antioxidants), and can even cause harm - unless one has a nutritional deficiency. Studies also don't find that there are "superfoods" - instead, what is beneficial or not is the overall dietary pattern. Studies show that a diet rich in fruits, vegetables, whole grains, nuts, seeds, and legumes has many health benefits (something along the line of the Mediterranean dietary pattern). Try to eat a variety of fruits and vegetables - each has different micronutrients, and even different microbes (good!). Eating that way also results in a high fiber intake, which has many health benefits.

From EurekAlert!: Montmorency tart cherries may provide benefits for adults with metabolic syndrome

Montmorency tart cherries reduced systolic blood pressure, insulin levels and insulin concentrations in adults with metabolic syndrome participating in a small pilot study published in the Journal of Functional Foods.  ...continue reading "Add Cherries To Your Diet"

A recent study found that within hours of applying sunscreen, the chemicals in the sunscreen appear in the person's blood - and at levels high enough to be of concern. Of course the chemicals enter the body! Why is anyone surprised? Generally, assume that what you put or get on your skin enters your body - lotions, pesticides, etc.

The small study was conducted by the Center for Drug Evaluation and Research, which is a part of the US Food and Drug Administration (FDA). Commonly available sunscreens (2 different sprays, a lotion, and a cream) were applied on 24 volunteers according to directions. Within hours the four sunscreen ingredients being studied (avobenzone, oxybenzone, ecamsule and octocrylene) had entered the bloodstream at levels high enough to cause concern.  They also found that the blood concentration of three of the ingredients continued to rise as daily use continued and then remained in the body for at least 24 hours after sunscreen use ended.

The four chemicals studied are among a dozen chemicals that the FDA recently said needed to be researched by manufacturers before they could be considered "generally regarded as safe and effective." Especially worrisome is oxybenzone, which is in 85% of chemically based sunscreens - and has also been found in breast milk, amniotic fluid, urine, and blood. It is an endocrine disruptor, and linked to various health problems. With these chemicals, the more one uses, the more gets into the body - and people may apply sunscreen several times a day. They may also be found in personal care products and cosmetics. But unfortunately, as with so many chemicals that we are exposed to - long-term effects of frequent or chronic exposure are unknown.

The Environmental Working Group (EWG) rates sunscreen chemicals and is an excellent resource in finding safe sunscreens, as well as those that should be avoided. The EWG has a page discussing the problems with these chemicals, including that they are endocrine disruptors. They also have a page on nanoparticles (typically zinc and titanium dioxide), which are also used in sunscreens.ided. The EWG has a page discussing the problems with these chemicals, including that they are endocrine disruptors. They also have a page on nanoparticles (typically zinc and titanium dioxide), which are also used in sunscreens.

...continue reading "Sunscreen Chemicals Enter the Bloodstream"

Study after study is finding that having pets in early childhood or living on a farm with lots of exposure to animals is associated with a lower incidence of allergies. Pets with all their "germs" (bacteria and other microbes) appear to have beneficial effects on children's developing immune systems. One study from the Univ. of Gothenburg (in Sweden) actually found that the more pets a child lives with in the first year of life, the lower the incidence of later allergies in children. The results were dose-dependent - with each additional pet, the incidence of allergies is a little lower.

The numbers are amazing - allergies decreased from 49% in those with no pets to zero in those with five or more pets. The researchers suggest that there is  a “mini-farm” effect, with exposure to a number of cats and dogs protecting against all allergy development (animal, food, and pollen allergies). What an about face in medical views in a few decades! It used to be viewed that if you wanted to prevent allergies in children, then avoid pets such as dogs and cats. Hah!

From Medical Xpress: Pet-keeping in early life reduces the risk of allergy in a dose-dependent fashion

A team of researchers at the University of Gothenburg has found that when infants live with pets, they grow up to have fewer allergies and other diseases. In their paper published on the open access site PLOS ONE, the group describes their study of datasets that held information on children's health and whether they had lived with pets as infants, and what they found.  ...continue reading "Exposure to Pets in Infancy Reduces the Risk of Allergies"

There has been a lot of excitement over intermittent fasting and eating only during restricted time periods each day in order to lose weight and improve health. But does it really improve health? A recent study adds support to health benefits from eating only during a 9 hour restricted time period, so as to extend the "fasting" time to 15 hours each day. The researchers found that 18 overweight men at high risk for type 2 diabetes had improved glycemic control and glucose responses to a meal after 1 week of time restricted feeding (TRF).

They also lost a little weight and had a reduction in triglycerides. Which are great results, especially because the men ate normally during the 9 hour eating time. Improve health while eating all meals!

From Medical Xpress: Time-restricted eating shows benefits for blood glucose

By restricting the time period during which they could eat, researchers have seen promising results for controlling blood glucose levels in men at risk of type 2 diabetes ...continue reading "Time Restricted Eating Improves Blood Glucose Levels"

Many, many people wind up taking numerous courses of antibiotics at some points in life. Think of recurrent sinus infections or urinary tract infections or other infections. Or some conditions (e.g. dental or skin conditions) are treated with really long courses of antibiotics  New research (from 36,429 women participating in the long-running Nurses' Health Study)  found that women who take antibiotics over a long period of time during middle-age (40 to 59 years old), but even more so in late adulthood (60 years and over), are at increased risk of heart attack or stroke within the next 8 years.

How increased a risk for cardiovascular diseas? 28% or higher risk (compared to those who didn't take antibiotics)! But looking at the actual numbers it means: Among women who take antibiotics for two months or more in late adulthood, six women per 1,000 would develop a cardiovascular disease, compared to three per 1,000 among women who had not taken antibiotics.

Eight years was the length of the study, so it is unknown if the increased risk persists longer. The authors give a number of possible reasons for these results, but think it might be because antibiotic use results in gut microbial alterations. And the longer the antibiotic use, the more persistent the gut microbiome (microbial community) alterations. Other research studies supports this link (antibiotic use - gut microbe disruptions - increased cardiovascular disease). Another reason to eat in as healthy a manner as possible to feed beneficial gut microbes: a diet rich in fruits, vegetables, whole grains, seeds, and nuts.

From Medical Xpress: Antibiotic use linked to greater risk of heart attack and stroke in women

Women who take antibiotics over a long period of time are at increased risk of heart attack or stroke, according to research carried out in nearly 36,500 women. The study, published in the European Heart Journal today, found that women aged 60 or older who took antibiotics for two months or more had the greatest risk of cardiovascular disease, but long duration of antibiotic use was also associated with an increased risk if taken during middle age (aged 40-59). The researchers could find no increased risk from antibiotic use by younger adults aged between 20-39.  ...continue reading "Link Between Antibiotics, Heart Attacks, and Stroke Risk In Older Women"

For a few years I've been noticing that studies of vitamin D have had mixed results for a number of medical conditions. A number of times initial studies found an association with low levels of vitamin D and a number of medical conditions, but follow up well-designed studies are just not finding the same results with vitamin D supplementation - or results have been mixed. Also, in some studies, what initially looked like vitamin D being protective for some cancers and multiple sclerosis, now looks like it's sunlight that is giving the protective results. In some cases, vitamin D levels are a proxy for sunlight exposure (the more sunlight exposure, the higher the vitamin D levels in the person). The following 6 studies recently published highlight this same trend of mixed results.

While vitamin D levels increased from high dose vitamin D, there was no change in bone bone mineral density (BMD) in older adults during the 12 months of the study. No adverse effects form the vitamin D supplementation was reported [the older adults received 12,000 international units (IU), 24,000 IU, or 48,000 IU once a month]. From Science Daily: Vitamin D supplements are of no benefit to the over 70s

There is little benefit for those over 70 taking higher dose vitamin D supplements to improve their bone strength and reduce the risk of falls, new research has revealed.

High doses of vitamin D (4000 international units) appeared more beneficial than low dose vitamin D (400 international units) supplements in advanced colorectal cancer patients. From Medical Xpess: High-dose vitamin D shows benefit in patients with advanced colorectal cancer

...continue reading "Recent Vitamin D Studies Have Mixed Results"

A recent study examined whether consuming sugary products (including sugary drinks) causes an improvement of mood and alertness - a "sugar rush" - and found that to be a total myth. After reviewing 31 studies (in which 1259 individuals participated), the researchers found that people do not get a "sugar rush" with an improvement in mood from consuming sugary products - instead it makes people feel less alert and more tired within an hour of ingestion

From Science Daily: No such thing as 'sugar rush'! Sugar worsens mood rather than improving it

Sugar does not improve mood and it can make people less alert and more tired after its consumption -- according to a new study by the University of Warwick, Humboldt University of Berlin, and Lancaster University.  ...continue reading "No Such Thing As A Sugar Rush"