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Published on Leave a comment on Are There Any Long Term Risks From Tonsil or Adenoid Removal in Childhood?

When I was growing up, it was quite fashionable for children to have their tonsils removed. A few sore throats, and BOOM - they were taken out. But what are the long term consequences of having the tonsils or adenoids removed in childhood? Are there any?

An interesting large study from Denmark, using Danish public health data, examined this issue and found a higher long-term risk of certain diseases. In those who had either tonsils or adenoids or both removed during childhood (up to the age of 9), years later there were higher rates of respiratory, infectious, and allergic diseases. Tonsil removal (for recurrent sore throats) is a tonsillectomy, adenoid removal (due to frequent middle ear infections) is an adenoidectomy, and removing both at once is a adenotonsillectomy. However, both adenoids and tonsils are parts of the immune system, have roles in pathogen detection and defense, and during childhood the immune system is still developing. From Science Daily:

Tonsil and adenoid removal associated with respiratory, allergic and infectious disease

Removing tonsils and adenoids in childhood increases the long-term risk of respiratory, allergic and infectious diseases, according to researchers who have examined -- for the first time -- the long-term effects of the operations. The researchers suggest renewed evaluation of alternatives to these common paediatric surgeries that include removal of tonsils (tonsillectomy) to treat chronic tonsillitis or adenoids (adenoidectomy) to treat recurrent middle ear infections.   ...continue reading "Are There Any Long Term Risks From Tonsil or Adenoid Removal in Childhood?"

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?"

Published on Leave a comment on Mediterranean Diet Linked to Lower Risk of Macular Degeneration

Once again, a study linked a person's diet with the chances of getting age-related macular degeneration (AMD). Macular degeneration is a leading cause of vision loss in Americans 60 years and older, and it has no cure. The study (conducted at the University of Bordeaux, France) found that people who eat a Mediterranean diet are less likely to develop advanced age-related macular degeneration. The study was presented at a conference (not a medical journal), but it builds on other research with similar findings.

What is the Mediterranean diet? It is a diet rich in fruits, vegetables, whole grains, legumes (beans), nuts, seeds, olive oil, and fish. The diet is a good source of fiber, omega-3 polyunsaturated fatty acids (especially fatty fish such as salmon, mackerel, and sardines), and of vitamin C, vitamin E, lutein, zeaxanthin, zinc, and copper. Lutein and zeaxanthin are carotenoids found in green, yellow and red vegetables.

From Medscape: Mediterranean Diet Linked With Lower Incidence of Advanced AMD

People who eat a Mediterranean diet are less likely to develop advanced age-related macular degeneration (AMD). That's according to research presented May 1 at ARVO 2018, the annual meeting of the Association for Research in Vision and Ophthalmology, in Honolulu, Hawaii.  "Higher adherence to the Mediterranean diet was associated with a 39% reduced risk of developing advanced AMD. These results highlight that eating a healthy diet, such as a Mediterranean-type diet, may help to limit progression to advanced AMD," Dr. Benedicte M. J. Merle of the University of Bordeaux, France, and her colleagues write in their abstract.  ...continue reading "Mediterranean Diet Linked to Lower Risk of Macular Degeneration"

Published on Leave a comment on Walking At a Brisk Pace Is Best For Health

Walk, walk, walk for health - and the faster, the better. The message from a  large study (in Britain and Scotland) is that walking is associated with healthier, longer lives - but if you walk at a fast pace (brisk walking), the effects are even better. Walking at an average or brisk pace reduced death (from any cause) by 20% to 24% - as compared to those walking slowly. Heart disease deaths were reduced by  21% to 24% at an average or brisk pace - when compared to those walking at a slow pace.

Bottom line: average walking pace is good, but getting your heart rate up (and getting a little sweaty) while walking briskly is better. By the wayr, the researchers did not find any effect of walking speed on cancer deaths.  ...continue reading "Walking At a Brisk Pace Is Best For Health"

Published on Leave a comment on Study Finds No Benefit From Most Supplements

Another study has found that the most common vitamin and mineral supplements (multivitamins, vitamin D, calcium, and vitamin C), don't offer hoped for health benefits, and may actually carry some risks. This latest study was a review of other studies, and examined whether specific vitamins or minerals would  lower the risk of cardiovascular disease (including heart attacks and strokes) and death from any cause (referred to as all cause mortality"). [Posts discussing other research finding problems with supplements.]

In general, the review of studies of popular supplements (multivitamins, vitamin D, calcium, and vitamin C) show no consistent benefit (no significant effect) for the prevention of cardiovascular disease, heart attacks, or stroke, nor any lowering of death (all cause mortality). On the other hand, folic acid and B-vitamins with folic acid, B6, and B12 reduced stroke (folic acid showed a 20% reduction in stroke), but niacin and antioxidants were associated with an increased risk of death from any cause (10% increase). But overall the effects in the studies were small. Vitamin D did not show any benefits in reducing death, but the researchers pointed out that many vitamin D studies are now under way, and the results of vitamin D studies so far are mixed (e.g. 16 showing positive effects from vitamin D, 17 showing a more favorable effect in the control group, and 10 neither).

On the other hand, the researchers stressed that eating a well balanced diet has lots of health benefits and is recommended by the U.S. Dietary Guidelines Advisory Committee. Three dietary patterns are frequently discussed as beneficial: 1) a healthy American diet (sometimes called a "prudent diet") low in saturated fat, trans fat, and red meat, but high in fruit and vegetables, 2) a Mediterranean diet, and 3) a vegetarian diet. All 3 of these diets are rich in fruits and vegetables (which means increased fiber), are relatively rich in vitamins and minerals, and meet Dietary Reference Intake guidelines.  ...continue reading "Study Finds No Benefit From Most Supplements"

Published on Leave a comment on Is A New Organic Label Needed For Farmers Following Traditional Organic Practices?

Something a little different today. For years I've posted studies showing that eating organic foods lowers pesticide levels in the body quickly, eating organic foods is the only way to avoid the presence of the controversial pesticide glyphosate (Roundup) in food, the nutritional profile (especially fatty acids) of meat and milk from grass-fed, pasture raised animals is different and healthier than conventionally raised animals (and even organic animals not raised on pasture), and on and on. In other words, eating organic foods has health benefits. All good.

But meanwhile, the National Organic Program and National Organic Standards Board (which controls the national organic foods certification program) is being influenced by big agriculture lobbying - to the dismay of real organic farmers. Yes - real organic farmers, who farm the way we expect our organic meat and crops to be raised. You know - cows grazing outside, chickens pecking away for insects outside, crops being raised in real soil (and not hydroponics).

But ... Big Agriculture with the mega-farms and lots of chemicals, and animals confined by the thousands indoors, have decided they want a piece of the organic action, and have now influenced the National Organic Program and National Organic Standards Board with the result of weakening of organic standards. But there are other problems too with the organic program as it currently exists.

The Washington Post did a series of articles last year about a huge issue of fraud -  about how so-called organic food from other countries may really not be organic (esp. corn and soybeans), and this mega-influx of fake organic food with lower prices is something real organic farmers in the US can't compete with. Also, how "larger agricultural companies have sought to loosen organic rules in the name of efficiency and affordability". The organic market is a big one, and growing bigger every year (billions of $$). It benefits large corporations and huge mono-crop farms financially to have watered down standards.

Another example: the organic milk that one buys may not really be organic (and the same issue with organic chickens). Organic dairies are supposed to have their dairy cows out grazing in the pasture for a minumum of 120 days per year - it is a requirement. But big dairies that are only organic in name ignore that requirement - such as the huge Aurora Dairy. Yup, they lie.

And in September 2017, the USDA (US Department of Agriculture) didn't punish the 15,000 cow Aurora Dairy - instead they "exonerated the enormous Aurora Dairy CAFO (Confinement Animal Feeding Operation) of any wrongdoing at their Colorado “farm.” This dairy operation was described in detail in one Washington Post article, along with compelling test results to prove the cattle weren’t on pasture." So of course now they and other mega-dairies will just ignore the organic regulations, because they can without any penalty.  ...continue reading "Is A New Organic Label Needed For Farmers Following Traditional Organic Practices?"

Published on Leave a comment on Blood Type Affects Severity of Illness From E. Coli Strain

Does it matter what blood type (A, O, B, AB) we have when dealing with microbes that can make us sick? Apparently it does for certain illnesses.

New research suggests that people with blood type O  and B can handle a strain of Escherichia coli referred to as "enterotoxigenic E. coli" better than those with blood type A. This bacteria is associated with traveler's diarrhea and diarrhea in developing countries, with especially severe effects among young children. It turns out that those with blood type A get sicker (more severe diarrhea) and sooner, than those with blood type O and B. Antibiotics successfully treats the diarrhea.

By the way, other research also finds a link with certain diseases and blood types (e.g. diabetes, malaria, and cholera). From Medical Xpress:

Blood type affects severity of diarrhea caused by E. coli

A new study shows that a kind of E. coli most associated with "travelers' diarrhea" and children in underdeveloped areas of the world causes more severe disease in people with blood type A.

The bacteria release a protein that latches onto intestinal cells in people with blood type A, but not blood type O or B, according to a study led by researchers at Washington University School of Medicine in St. Louis. A vaccine targeting that protein could potentially protect people with type A blood against the deadliest effects of enterotoxigenic E. coli (Escherichia coli) infection.  ...continue reading "Blood Type Affects Severity of Illness From E. Coli Strain"

Published on Leave a comment on Walnuts Feed Beneficial Gut Bacteria and Other Health Benefits

Once again, a study finds that consumption of nuts is beneficial to health - this time by impacting the gut microbiome (community of microbes) in a beneficial way. This was a nicely done study -18 healthy adults randomly assigned first to either eating about a handful of walnuts daily (42 g) or zero nuts daily for 3 weeks, and then assigned to the other group for 3 weeks, with a "washout period" of 1 week in-between. Walnut consumption resulted in higher amounts of beneficial gut bacteria (Faecalibacterium, Clostridium, Dialister, and Roseburia) which are butyrate producing (beneficial!), and lowering of proinflammatory secondary bile acids and LDL cholesterol (both beneficial).

As seen in this walnut study from the University of Illinois, adding walnuts to the diet has quick effects on the gut microbiome. Other studies find that diets rich in nuts (which are a source of dietary fiber and unsaturated fatty acids) are associated with a reduced risk of death from cancer and heart disease. Bottom line: eating some nuts daily feeds beneficial bacteria in the gut, and so has beneficial health effects. This walnut study had everyone eating about a handful of walnut halves a day (42 g, which is a little less than 1/2 cup walnut halves).

From Science Daily: Walnuts impact gut microbiome and improve health

Diets rich in nuts, such as walnuts, have been shown to play a role in heart health and in reducing colorectal cancer. According to a new study from the University of Illinois, the way walnuts impact the gut microbiome -- the collection of trillions of microbes or bacteria in the gastrointestinal tract -- may be behind some of those health benefits.  ...continue reading "Walnuts Feed Beneficial Gut Bacteria and Other Health Benefits"

Published on Leave a comment on Antibiotics Better Than Ibuprofen For UTI Treatment

The majority of women experience at least one urinary tract infection (UTI) at some point in their life. The normal treatment is antibiotics, but some researchers have questioned whether this is necessary - because some studies found most cases will simply resolve on their own without antibiotic treatment. Another issue is growing antibiotic resistance in treating UTIs - some women try one antibiotic after another in their UTI treatment due to antibiotic resistance.

Recently a study was conducted in 3 Scandinavian countries that looked specifically at this issue: Can uncomplicated UTIs be simply treated with non-prescription ibuprofen (e.g. Advil) or are antibiotics better? Women with UTIs were randomly assigned to a 3 day course of antibiotics (178 women) or a 3 day course of the pain reliever ibuprofen (181 women). They found that 53% of the ibuprofen group recovered without antibiotics (even though it took about 3 days longer than women who received antibiotics). However, seven cases (3.9%) of pyelonephritis occurred in the ibuprofen group, and none in the antibiotic group. Five of these patients were even hospitalized - but all recovered with antibiotics. Pyelonephritis is a kidney infection (the bacteria of the UTI has traveled to the kidneys).

There were no cases of pyelonephritis in the antibiotic group (they took  pivmecillinam). But even with an initial 3 day course of antibiotics - 11.2% of the antibiotic group needed a second course of antibiotics within 1 month to recover. The researchers main conclusions: since we can't tell who will respond well without antibiotics - therefore everyone should take them for a UTI.

My only question is: why not do this same study testing a course of D-mannose vs antibiotics for UTIs? One study found that non-prescription D-mannose to be as effective as antibiotics in treating recurring UTIs. Anecdotal evidence (from women) is that it works especially well for those caused by E. coli (up to 90% of UTIs). And antibiotic resistance will never happen taking it, because it's not an antibiotic. (Post on a mannose product for UTIs in development).  ...continue reading "Antibiotics Better Than Ibuprofen For UTI Treatment"

Published on Leave a comment on Researcher Sees Potential for Sinusitis Nasal Probiotics

People ask me: what's going on with research in the treatment of sinusitis with probiotics? Well, the answer is that things are moving along slowly - very slowly, but there are good signs.

Earlier this year an interesting article by researcher Anders U. Cervin at the University of Queensland (Australia) was published that specifically talked about "topical probiotics" as a potential treatment for chronic sinusitis. By this he means that probiotics (beneficial bacteria) could be directly applied to the nasal passages in the nose, such as a nasal spray. And he discussed how the prevailing view nowadays, based on scientific evidence, is that in sinusitis there is an "imbalance of the sinus microbiome" - the community of microbes living in the sinuses. Yes!!!

Cervin mentioned all sorts of research showing beneficial effects of using different strains of probiotics for various illnesses, mentioned the Abreu et al study (which is the reason I focused on Lactobacillus sakei as a sinusitis treatment, and which works successfully for many people), but.... nowhere did he mention Lactobacillus sakei by name. What??? There are already excellent L. sakei probiotics out there for chronic sinusitis treatment such as Lanto Sinus.

Cervin discusses how studies are needed to test nasal sprays for the treatment of sinusitis, and made a lot of good points. He looked at studies already done, wondered what bacterial strains might be beneficial, but obviously didn't read the Abreu et al study carefully to see that L. sakei might be a good candidate to test.

And Cervin didn't do an internet search to see what probiotics people are using already as a successful treatment for sinusitis (see Sinusitis Treatment Summary page). He did mention that the only good trial using nasal spray probiotics in humans with sinusitis found no effect - because they tested the wrong Lactobacillus strains - they were honeybee strains, and not ones found in humans.

Eh... So once again I'm heartened by the focus on the microbial community in sinusitis, and heartened that he said there it was time to get out of the laboratory and start testing probiotics as treatments on people. But I'm dismayed that the focus is so narrow that he's missing what is in front of him - what is already out there. He also missed that a "snot transplant" study is now going on in Europe, which is sure to have interesting results.

By the way, some of the questions the article raises are ones which, based on the experiences of myself and others over the past 5 years, we can already answer: living bacteria as a treatment are better than dead bacteria (using dead bacteria doesn't work), nasal treatments work but just swallowing a probiotic pill doesn't, Lactobacillus sakei works as a treatment for many, the L. sakei bacteria reduces inflammation in the nasal passages, the probiotic can be used in place of an antibiotic, and only treat when needed and not continuously (continuously treating can also result in an imbalance in the sinus microbiome). [See post The Best Probiotic For Sinus Infections where these issues are discussed and the best L. sakei products.] ...continue reading "Researcher Sees Potential for Sinusitis Nasal Probiotics"