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Published on Leave a comment on Problems With Paleo Diet?

The Paleo diet has been around for years and yet it continues to be controversial. The debate is whether following the Paleo diet long-term has health benefits or not? Supporters of the Paleo (Paleolothic) diet say it promotes gut health and is good for gut microbes, but recent research findings are a strike against this claim. The Paleo diet is based on the hypothesis that humans have not adapted to eating products of agricultural farming such as grains, dairy products, or legumes (beans), as well as all processed foods, so they should be avoided. Instead it stresses eating meat, fish, eggs, nuts, (some) fruits, and vegetables.

So what were the new research findings?  Australian researchers found that people who had been on a Paleo diet for more than a year ate lower amounts of resistant starch, and so had a different bacteria profile in the gut - with lower levels of some beneficial species. They also had high levels of a biomarker in the blood (trimethylamine-n-oxide or TMAO) that is linked to heart disease.

The problem seems to be the lower intake of resistant starch - which is a carbohydrate that resists digestion in the small intestine and ferments in the large intestine. As the fibers ferment they act as a prebiotic and feed the beneficial bacteria in the gut. More than one type of resistant starch can be present in a single food. And what foods contain resistant starches? Precisely some foods avoided in the Paleo diet: grains, rice, beans, peas, lentils, plantains, and green bananas. A number of studies find health benefits (e.g. gut health) from eating foods with resistant starches.

From Medical Xpress: Heart disease biomarker linked to paleo diet

People who follow the paleo diet have twice the amount of a key blood biomarker linked closely to heart disease, the world's first major study examining the impact of the diet on gut bacteria has found.  ...continue reading "Problems With Paleo Diet?"

Published on Leave a comment on Americans Ingest More Than 74,000 Microplastic Particles Each Year

Did you know that you are eating teeny tiny bits of plastic in your food every day? And inhaling the pieces floating in the air? These tiny bits of plastic are called microplastics, and are from all the plastic breaking down (degrading) in the environment. They have entered the food chain (e.g. from fish and other animals ingesting bits of plastic, food preparation, or from plastic packaging), and in this way we are also ingesting microplastics. They vary in shape and size, but some pieces can be so small that they can only be seen with a microscope. The problem is that microplastics can enter our body several ways (through ingestion get into the gut and so get into human tissues, or through inhalation into the lungs). They could trigger an immune response, or the plastic could release chemicals, such as carcinogens or endocrine disruptors. Unfortunately, the health effects from microsplastic ingestion are unknown.

A study by Canadian researchers looked at all available evidence from 26 studies to try to get some idea of how many microparticles of plastic Americans ingest over one year. The researchers estimate that annual consumption of microplastics ranges from 39,000 to 52,000 particles (depending on age and sex). When they added in inhalation of microplastic particles, the numbers increased to 74,000 to 121,000. And those who only drink bottled water may be getting an additional 90,000 microplastics (versus about 4000 microplastics from tap water).

These numbers are for about microplastics found only in certain foods (fish, shellfish, sugars, salts, honey, alcohol) that add up to about 15% of the diet. But the number of microplastics in other foods (such as fruits, vegetables, meats, grains) have not been studied. The researchers point out that we ingest microplastics that are in the air and settle on our food during meal preparation and during meals. So the actual numbers of microplastics that are ingested each year are certain to be much higher! [Microplastics are even in our house dust.]

What can one do to lower the number of microplastics that we eat? Number one, drink tap water or bottled water in glass bottles, and less water from plastic bottles. Since no one knows about how many plastic particles are in other foods, one possibility may be to eat more foods and beverages that come in glass containers, rather than plastic containers. As the researchers point out, microplastic research is still in its infancy. They also felt that since this study only looked at certain foods, then they really underestimated how many microplastics Americans ingest each year.

From Science Daily: Americans consumer 70,000 particles of microplastics per year    ...continue reading "Americans Ingest More Than 74,000 Microplastic Particles Each Year"

Published on Leave a comment on Why Do Medical Guidelines Vary So Much?

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?"

Published on Leave a comment on Could Antibiotics treat Endometriosis??

Could this be true for humans - that antibiotics can treat endometriosis? A nicely done series of studies found that treatment with the antibiotic metronidazole reduced both early growth and progression of endometrial lesions. Also, the researchers found microbiome (community of microbes) differences in endometriosis vs healthy  subjects. The researchers felt that the research results suggest that gut bacteria promote endometriosis progression, and that the antibiotics worked to stop the progression of endometriosis because it reduced specific gut bacteria.

Endometriosis is a chronic condition causing abdominal pain and infertility and afflicts up to 10% of women between the ages of 25 and 40. Unfortunately, current treatments , including hormone therapy and surgery, have serious side effects and do not prevent recurrences. So a study finding another treatment approach is exciting. But...before everyone gets too excited, keep in mind that the series of studies were done in mice, but... the researchers of the study are optimistic that this could be true for women also. And yes, the Washington University School of Medicine (in St. Louis, Missouri) researchers are going to  conduct a large clinical trial to test the antibiotic metronidazole in women with endometriosis.

From Medical Xpress: Antibiotics may treat endometriosis

Researchers at Washington University School of Medicine in St. Louis have found, in mice, that treatment with an antibiotic reduces the size of lesions caused by endometriosis. The researchers are planning a large, multicenter clinical trial to test the drug metronidazole in women who have the painful condition.  ...continue reading "Could Antibiotics treat Endometriosis??"

Published on Leave a comment on Be On the Lookout For This Tick

Recent research is finding scary amounts of a new tick in Staten Island (a borough of New York City). The Asian longhorned tick (or Haemaphysalis longicornis) was only discovered in NJ in 2017, and now it appears that it is spreading rapidly (Virginia, West Virginia, Arkansas, North Carolina, NY, Conn, Maryland, Pennsylvania). This tick is a native of east Asia (Japan, New Zealand, Australia, etc.), and transmits a number of diseases and infests livestock in eastern Asia.

It is especially worrisome because females can clone themselves. This is because the tick is a parthenogenetic species, meaning that the females can lay and hatch eggs without needing to mate with a male. Each offspring is essentially a clone of the mother tick.  This means that they can be found on animals in really large numbers in varying stages - thousands of ticks on one animal. (The photos are horrifying.) The ticks feed on a wide range of mammals and birds, so it is expected to spread rapidly.

The authors of the study say that the ticks can tolerate a wide range of environmental temperatures ( 28°F to 104°F or −2°C to 40°C ), although they are most successful in moist, warm-temperate conditions. But note that the NYC metro area (which includes Staten Island) always, always has temperatures lower than that every winter! So... it can handle lower temperatures just fine. Unlike deer ticks, this tick can be found in the grass.

According to the CDC, as of March 25, 2019, no harmful germs have been found in the ticks collected in the United States. But researchers are worried about the possibility that soon they will carry the diseases commonly carried by ticks (Lyme, etc.) in the United States. If you find this tick on a person or pet - remove the tick as quickly as possible (the usual tick advice).

Excerpts from Science Daily: New Yorkers brace for self-cloning Asian longhorned tick

Staten Island residents have another reason to apply insect repellent and obsessively check for ticks this spring and summer: the population of a new, potentially dangerous invasive pest known as the Asian longhorned tick has grown dramatically across the borough, according to Columbia University researchers. And the tick -- which unlike other local species can clone itself in large numbers -- is likely to continue its conquest in the months ahead.  ...continue reading "Be On the Lookout For This Tick"

Published on Leave a comment on Bug Bombs Don’t Reduce Cockroach Numbers

Bug bombs don't work in reducing cockroach infestations. At all. A study comparing bug bombs vs gel baits found that while big bombs didn't reduce German cockroach numbers, the baits did. And on top of that, even when used correctly (according to directions) the bug bombs resulted in a lot of pesticide residue throughout the residences - at 6 hours after being used, and one month later. The technical name for bug bombs is total release foggers. Different brands of bug bombs, with different pesticides,  were used in the study - two different kinds of Hot-Shot No-Mess Foggers and two different kinds of Raid foggers. The gel baits used were Combat Insect Control Systems and Maxforce Gel Bait.

The North Carolina State Univ. researchers pointed out that one major problem with bug bombs is that cockroaches have built up resistance to the pesticides used. Another problem is that their use in residences results in pesticide residues, even one month later. That means that people living there will breathe in or ingest the pesticide residues. Which can lead to health problems.

On the other hand, there was no pesticide residue from the baits in the residences. And they reduced numbers of cockroaches. Using baits for cockroach control is a wonderful example of Integrated Pest Management - a least-toxic way of dealing with pests using various methods (e.g. baits, traps, fixing holes, vacuuming pests). Even though they were not used in the study, one should also consider bait gels containing boric acid.

From Beyond Pesticides: Bug Bombs Don't  Work - At All, According to Study

Bug bombs are completely ineffective at reducing German cockroach infestations, according to new research published in the journal BMC Public Health.  Not only are they ineffective, research indicates that these products are putting people at unnecessary risk.  “In a cost-benefit analysis, you’re getting all costs and no benefits,” said Zachary DeVries, PhD, co-author of the study. “Bug bombs are not killing cockroaches; they’re putting pesticides in places where the cockroaches aren’t; they’re not putting pesticides in places where cockroaches are and they’re increasing pesticide levels in the home.” ...continue reading "Bug Bombs Don’t Reduce Cockroach Numbers"

Published on Leave a comment on Perhaps No Treatment Is Best For Tennis Elbow?

Suffering from "tennis elbow" ? A new study suggests that it may be best to just wait for the elbow to heal on its own.

Tennis elbow is the painful condition that develops after "overuse" - it's a repetitive stress injury, which typically occurs in the person's dominant arm. The medical name for tennis elbow is enthesopathy of the extensor carpi radialis brevis (eECRB), or lateral epicondylitis. There are many non-surgical alternatives available, such as ultrasound, laser therapy, botulinum toxin injection, corticosteroid injection, etc., but there has been controversy over what works best in reducing pain and improving grip strength (grip strength is diminished in tennis elbow).

Researchers at Beth Israel Deaconess Medical Center compared 11 non-surgical methods of treating tennis elbow, including a placebo group (which received a "sham treatment", such as a saline injection to mimic a treatment, but really was a no treatment group. They reviewed 36 high quality studies, and found that for persons receiving only a placebo - within four weeks most reported little or no pain, and by 26 weeks 99 percent reported little or no pain. Those who received no treatment (placebo) also had the fewest side-effects (e.g. worsened pain, reduced elbow movement, skin rash, nausea, allergic reaction). The odds of an adverse effect was significantly greater in all treatment groups than in the no treatment (placebo) group.

The researchers did mention that of all the treatments, only laser therapy improved both pain and grip strength more than placebo at one month. Some treatments, such as corticosteroid injections, while relieving pain short-term (in the first month), resulted in more pain at 26 weeks than individuals who received no treatment. The researchers wrote: " At best, all treatments provided only small pain relief while increasing the odds of adverse events." They also said that perhaps some people, such as manual laborers, may benefit by short term pain relief treatments. But long-term - doing nothing is best.

From Science Daily: Tennis elbow treatments provide little to no benefit, study finds        ...continue reading "Perhaps No Treatment Is Best For Tennis Elbow?"

Published on Leave a comment on We Are Eating and Breathing In Tiny Plastic Particles?

Most people have heard about the three huge "garbage patches" in the ocean - where tiny pieces of plastic are floating and unfortunately also being eaten by fish and birds. But the story doesn't end there - we, all humans, are also ingesting tiny pieces of plastic, for example when we breathe and eat food (e.g tiny pieces are now in fish and shellfish, so we're also eating tiny pieces of plastic). How much are we inadvertently ingesting?  What is it doing to us? 

These tiny pieces of plastic less than 5 mm in size are called microplastics. As we know, plastic doesn't break down like food and wood (into compost, soil), but it does break apart into tiny particles (from friction, heat, and light). Right now research suggests that we are exposed to more microplastic particles in indoor air then outdoor air - for example, it's in the dust from breakdown of textiles used in our furniture and synthetic fabrics in the clothing we wear and wash. (Fleece especially sheds a lot into the air when worn and into our water when washed.) There are plastic microparticles in the air, in the wind, in our street dust. Examples of microplastics in outdoor air are from the use of vehicles, such as tire abrasion, construction activities, from artificial turf, and plastic litter. It's in our water - in rivers and lakes (and our drinking water), oceans, and in our soil.

Right now no one knows what the effects of ingesting these plastic microparticles are to humans (as pointed out in a 2017 study of urban dust by  Sharareh Dehghani et al) and whether we get rid of them or whether they persist in the body. Or even how much we're ingesting and breathing in. Another concern is whether there is an effect on developing children. Some research finds that microparticles can persist in the lungs.

The good news is that there are things one can do to lower the microplastic amounts in indoor air. To lower the amount of microplastics: open up your windows to vent the air (outdoor air is less polluted generally than indoor air), vacuum frequently, use a good filter on forced air heating systems and central air conditioning systems. Perhaps use a good air purifier. But also reduce the amount of plastics in your indoor environment by buying fewer items made from plastics (from furniture to ordinary household goods to toys to synthetic clothing, especially fleece). Try to buy "natural" as much as possible - especially natural fibers such as cotton, wool, linen, hemp.

Recently there have been a number of articles written about this issue for the general public. Well worth reading is: C. Joyce's article for NPR: Beer, Drinking Water And Fish: Tiny Plastic Is Everywhere  ...continue reading "We Are Eating and Breathing In Tiny Plastic Particles?"

Published on Leave a comment on Eye Problems Can Develop After LASIK Surgery

LASIK is an incredibly popular eye surgery to correct vision problems such as nearsightedness and farsightedness. But it turns out that LASIK surgery has more short and long-term complications than we realize. Studies show that the persistant "minor problems" (depends on who you ask if they're minor) are more frequent than we realize - up to 55% report symptoms such as dry eyes or visual distortions. But the really serious ones, such as corneal ectasia, and which occur rarely (less than 1%), typically occur a year or two after the LASIK surgery. And unfortunately ectasia can result in total loss of vision.

Sooo... Buyer beware. And before you consider LASIK surgery, please go to the site LASIK Complications to see exactly what can happen in a worse case scenario, read the following NY Times article in full, and this Washington Post article from 2016. This way if you do decide to do the voluntary procedure, at least you will be fully informed. Excerpts from an article by Roni Caryn Rabin in the  NY Times:

Lasik’s Risks Are Coming Into Sharper Focus

Ever since he had Lasik surgery two years ago, Geobanni Ramirez sees everything in triplicate. The surgery he hoped would improve his vision left the 33-year-old graphic artist struggling with extreme light sensitivity, double vision and visual distortions that create halos around bright objects and turn headlights into blinding starbursts. His eyes are so dry and sore that he puts drops in every half-hour; sometimes they burn “like when you’re chopping onions.” His night vision is so poor that going out after dark is treacherous.

But Mr. Ramirez says that as far as his surgeon is concerned, he is a success story. “My vision is considered 20/20, because I see the A’s, B’s and C’s all the way down the chart,” said Mr. Ramirez. “But I see three A’s, three B’s, three C’s.” None of the surgeons he consulted ever warned him he could sustain permanent damage following Lasik, he added.  ...continue reading "Eye Problems Can Develop After LASIK Surgery"

Published on Leave a comment on Is Melanoma Overdiagnosed?

Is melanoma overdiagnosed? I recently wrote about an article on cancer screening where melanoma was discussed as a cancer that was "overdiagnosed". And now an article, with supporting research, from Health News Review  (an excellent site that does "critical thinking about health care") about the issue of overdiagnosis of melanoma during skin screening tests. What? This is definitely news to many.

The following article was written because of a new skin cancer screening test developed using artificial intelligence (AI) that could distinguish between melanomas and benign moles. It turns out that a lot of people have concerns over melanoma being overdiagnosed (and therefore overtreated), including the U.S. Preventive Services Task Force.

But how do we know melanoma is being overdiagnosed? Because even though more and more melanomas are being found (through screening tests) and treated, the death rate from melanoma has stayed the same over the past 40 years (see the graph below).  Just note that what is described here are moles diagnosed as melanoma during screening tests, meaning that small moles just sitting there on the body are examined. It is not talking about moles that are changing in some worrisome way - those should absolutely be checked out. Excerpts from Kevin Lomangino's post at  Health News Review:

Yes, melanoma can be overdiagnosed, but news stories like these don’t discuss it

Many stories, like this U.S. News & World Report piece, suggested that AI “may serve physicians involved in skin cancer screening as an aid in their decision whether to biopsy a lesion or not.” But none of the stories I looked at paused to ask, Is finding more melanoma definitely a good thing?  ...continue reading "Is Melanoma Overdiagnosed?"