Health warning over popular sugar substitute
Friday January 11th, 2008
Chewing gum and other sugar-free products can trigger long-term diarrhoea and pain, a gastroenterologist warned today.
The effect is due to the sweetener sorbitol, say Dr Juergen Bauditz and colleagues at the University of Berlin, Germany.
Excess sorbitol intake has long been associated with gastrointestinal problems. In the British Medical Journal, the team describe two cases of chronic diarrhoea, abdominal pain and severe weight loss. Once the patients were questioned about their diet, doctors realised sorbitol could be to blame.
The patients were consuming 20g to 30g of sorbitol a day from sugar-free chewing gum and sugar-free sweets. They both recovered after removing sorbitol from their diets.
"Their diarrhoea subsided, normal bowel movements resumed and weight gain was achieved," write the authors.
They point out that up to 20 per cent of the population has functional bowel disorder symptoms. Sorbitol is a known laxative, they explain, and laxative misuse is thought to be the leading cause of chronic diarrhoea of unknown origin.
"Sugar-free or low sugar foods are increasingly eaten in Western countries," they write, adding that people with diabetes often eat diabetic foods containing sorbitol. "Consumers may be unaware of sorbitol's laxative effects and fail to recognise a link with their gastrointestinal problems."
Ingestion of relatively small amounts (5-20 g) causes gastrointestinal symptoms such as gas, bloating, and abdominal cramps in a dose-dependent manner, they warn, and higher doses (20-50 g) can trigger symptoms that fulfil the criteria of "severe nutritional risk".
"The investigation of unexplained weight loss should include detailed dietary history with regard to foods containing sorbitol," they conclude.
Bauditz, J. et al. Lesson of the Week: Severe weight loss caused by chewing gum. The British Medical Journal, Vol. 336, January 12, 2008, pp. 96-97.
Add statins to diabetes treatment - researchers
Friday January 11th, 2008
Patients with diabetes should be added to the list of those who take routine statin treatment, researchers reported today.
Taking statins helps reduce the risk of heart disease and stroke in people with diabetes, researchers found.
A major British and Australian study found that statins prevented illness even when patients had no heart disease that could be diagnosed.
The conclusions, published in The Lancet, come from an analysis of 14 trials involving more than 18,000 people with diabetes and another 71,000 without.
The study showed that over a five year period statin treatment reduced the number of heart-related events by about four per cent.
The study was conducted by groups in Oxford, UK, and the Medical Research Council Clinical Trial Centre in Sydney, Australia.
A spokesman for the Medical Research Council said: "Most people with diabetes should now be considered for statin therapy, unless their risk is low, eg, as in children, or statin therapy has been shown to be unsuitable for them, eg, as in pregnancy."
Writing in the journal, Professor Bernard Cheung says statins are among the "most notable triumphs" of modern medicine.
He writes: "Apart from drug treatment, one must not forget the importance of lifestyle changes, such as cessation of smoking, healthy diet, and regular exercise."
Honey fails ulcer test
Thursday January 10th, 2008
Some recent studies have found healing properties in honey - but a new study suggests it should not be used to treat leg ulcers.
Researchers from New Zealand found it did not improve the rate of healing and also led to an increase in complications.
The study compared conventional dressings with dressings impregnated with honey.
The findings, which involved some 386 patients, have been published in the British Journal of Surgery.
Researchers said there was no difference in the rate of healing between patients - but the honey treatment was more expensive.
Researcher Dr Andrew Jull, of the University of Auckland, said: "In our trial the honey dressing did not significantly improve healing, time to healing, change in ulcer area, incidence of infection or quality of life.
"The current focus of venous ulcer management should remain on compression and other treatments that have demonstrated that they improve compression’s ability to work or prevent ulcer recurrence."
British Journal of Surgery 2008; DOI: 10.1002/bjs.6059
A drink to good health
Thursday January 10th, 2008
A new study has linked moderate drinking and exercise to longer life.
Danish researchers found that people who did not drink or exercise had a 30-49 per cent higher risk of heart disease than those who drank, exercised, or both.
It is the major second study this week to quantify the benefits of a moderately healthy lifestyle, including light consumption of alcohol. Another study, conducted in Norfolk, UK, found that four simple lifestyle changes, involving exercise, diet, drink and not smoking, can add 14 years to life.
The Danish study, published yesterday in the European Heart Journal, included 11,914 people. Non-drinkers consumed less than one alcoholic drink a week, moderate drinkers between one and 14 drinks and heavy drinkers more than 15 a week.
Researchers said the study showed that being physically active and drinking moderately was important for lowering the risk of fatal heart disease and death from all causes.
"A weekly moderate alcohol intake reduced that risk of all-cause mortality among both men and women, whereas the risk among heavy drinkers was similar to non-drinkers," the authors said.
But study lead author Jane Ostergaard Pedersen from the National Institute of Public Health added that people who had reasons for alcohol abstention - such as religious beliefs - could use physical activity to reverse some of the adverse health effects of abstention.
She said non-drinkers who exercised moderately or frequently had a lower risk of heart disease than inactive non-drinkers.
European Heart Journal, doi:10.1093/eurheartj/ehm574
Overweight women more likely to have a hysterectomy
Wednesday January 9th, 2008
Being overweight or obese may increase the risk that a women will need to under hysterectomy, researchers have revealed.
New research from the UK's Medical Research Council suggests there is an increased risk for women who are overweight from their 30s onwards.
Data comes from 1,790 women taking part in the "1946 British birth cohort". The women were followed from their births in the first week of March 1946 until the age of 57.
In BJOG: An International Journal of Obstetrics and Gynaecology, the researchers explain that women who were underweight from age 20 had lower hysterectomy rates.
They also found that women who were overweight from the age of 36 onwards had a raised risk of hysterectomy. Greater weight increases between ages 36 and 53 years were associated with higher rates of hysterectomy in later adulthood.
These links were not due to number of children, age at first period, or social factors, the authors add.
They conclude that hysterectomy risk may be partially explained by body weight, so "with the recent changes in levels of overweight and obesity in populations, there may be increasing demand for gynaecological treatments in the future".
However, researcher Dr Cooper said: "The relationship between weight and hysterectomy may not be the same among women born more recently. Overweight and obesity are now more common and hysterectomy has become less popular with the introduction of alternative treatments for the gynaecological problems that many women experience."
Editor of the journal, Professor Philip Steer, added: "With a growing prevalence of obesity in the community, the study findings are a cause of concern."
Cooper. R., Hardy, R. and Kuh, D. Is adiposity across life associated with subsequent hysterectomy risk? Findings from the 1946 British birth cohort study. BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 115, January 2008, pp. 184-92.
Healthy living worth 14 years
Tuesday January 8th, 2008
Living a healthy lifestyle adds fourteen years to life, British researchers reported today.
Fruit and vegetables, light alcohol intake, some regular exercise and not smoking all combined to add years to the life of people from the county of Norfolk in the UK.
The conclusions, by a Cambridge University team, come from a study of some 20,000 middle-aged and elderly people in Norfolk.
The study was conducted over a ten year period after the participants in the study had filled in questionnaires identifying how healthy their lifestyles were.
During the decade the unhealthiest people - who scored zero on the four measures of healthy living - were four times as likely to die as those whose lives were "healthy".
The findings are published in the journal PLoS Medicine today.
Researcher Kay-Tee Khaw said the team used an "easy to understand" measure of health behaviour.
The findings were independent of whether the participants were overweight and the researchers also eliminated age and social class as factors.
A healthy diet of fruit and vegetables was judged to be five portions a day.
A spokesman for the journal said: "The results of the study strongly suggest that these four achievable lifestyle changes could have a marked improvement on the health of middle-aged and older people, which is particularly important given the ageing population in the UK and other European countries."
PLoS Med 5(1): e12.
Not enough sun in Britain
Tuesday January 8th, 2008
Advice to avoid the sun may dop more harm than good in northern countries such as Britain, experts warned last night.
Sunlight is the main way of generating vitamin D and the new study suggests people in northern Europe may not get enough of it.
Official advice warns Britons against exposure to the sun in the summer and the fashion for holidays in hot climates has been linked to growing rates of the skin cancer melanoma.
American and Norwegian scientists say that Britons get a mere quarter of the vitamin D from sunlight enjoyed by Australians. Scandinavians get even less.
The study, published in the Proceedings of the National Academy of Sciences, links low levels of vitamin D to high rates of a range of cancers in northern countries, in particular those of the colon, lung, breast and prostate.
The researchers said their earlier studies suggest that patients enjoy improved survival from these cancers when they are diagnosed mid-summer.
Researcher Richard Setlow, of the Brookhaven Institute, New York, USA, said: "There is a clear north-south gradient in vitamin D production with people in the northern latitudes producing significantly less than people nearer the equator."
He called for sunscreens to be redesigned so they do not block out UVB radiation, which generates vitamin D in the body. Melanoma is caused by exposure to UVA radiation from the sun.
Proceedings of the National Academy of Sciences January 7, 2008.
Fathers face cancer risk
Monday January 7th, 2008
A major new study links fatherhood to the development of prostate cancer.
Researchers in Denmark found that men without children enjoy a slightly reduced risk of developing the disease.
Although the difference in risk is small it is significant. The study to be published on-line by the journal Cancer today involved all men born in Denmark over a period of more than 50 years.
During this period some 3,400 of the men developed prostate cancer.
The researchers found that childless men enjoyed a 16 per cent less risk than fathers.
However the risk faced by men with children reduced, the more children they had.
The findings have perplexed researcher as until know prostate cancer has only been linked with age and genetic factors.
The researchers led by Kristian Jørgensen of the Statens Serum Institut, in Copenhagen, Denmark, conclude there is evidence that childless men are "somehow" at reduced risk of developing the cancer.
They write: "Additional studies are required to identify the underlying biologic, environmental, social and/or behavioural factors that explain the observed differences in prostate cancer risk between fathers and childless men and between men fathering few and those fathering many children."
Cancer, January 7, 2008 (DOI: 10.1002/cncr.23230); Print Issue Date: February 15, 2008.
Hormone-resistant breast cancer treatment works
Monday January 7th, 2008
The outlook for hormone-resistant breast cancer has improved over the past three decades, despite challenges faced in its treatment, British researchers have reported.
Hormone-resistant, or oestrogen-receptor (ER) negative, breast cancer is less common than ER-positive breast cancer, and does not respond to the usual treatments. Furthermore, about two-thirds of cases do not respond to newer treatments such as herceptin, so patients are given different types of anti-cancer drugs.
Researchers writing in the Lancet say that even the older chemotherapy regimens of the 1970s and 1980s have improved long-term survival. Newer treatments should be even more effective, believe Professor Sir Richard Peto of Oxford University, UK, and colleagues.
The team analysed data on 6,000 women, collected by the Early Breast Cancer Trialists' Collaborative Group. These women took part in randomised trials of chemotherapy for ER-negative breast cancer.
Chemotherapy safely reduced the rate of relapse and death from all causes in women below 50 years and those aged 50-69 years.
For those below the age of 50, the ten-year risk of relapse was 33 versus 45 per cent, death from breast cancer 24 versus 32 per cent, and death from any cause 25 versus 33 per cent, in favour of chemotherapy. Rates were higher, but also significantly improved, for women aged 50-69 years when given chemotherapy.
Tamoxifen had little effect, the authors report. They write: "These older adjuvant polychemotherapy regimens were safe (i.e., had little effect on mortality from causes other than breast cancer) and produced substantial and definite reductions in the ten-year risks of recurrence and death.
"Current and future chemotherapy regimens could well yield larger proportional reductions in breast cancer mortality."
Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Adjuvant chemotherapy in oestrogen-receptor-poor breast cancer: patient-level meta-analysis of randomised trials. The Lancet, Vol. 371, January 5, 2008, pp. 29-40.
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