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May 31st, 2010
A ha-ha-ha study.
OK, I know it’s just me but I must say that I got a lot of pleasure out of this new study about the bacterial content of bottled water.
In this still-unpublished Canadian study (it was presented at a meeting, so the only data we get is that offered in press reports), the researchers claim they bought bottles of “several different popular brands of bottled water” and found that the content of heterotrophic bacteria was up to 100 times higher than the permitted limit (US standards) and here’s the irony, way higher than the level you’d find in tap water.
Now, it’s important to note that this bacterial load will not make most people sick (although I think anyone with significantly impaired immunity and pregnant women might worry just a tad about any extra bacterial load, no matter how benign it might be) but hey, why in the world would you ever want any extra non-probiotic bacteria to enter your delicate digestive tract?
Given that Canada generally (and BC particularly) has a terrific supply of ready and delicious tap water, why would anyone, I wonder, bother buying bottled water when all they have to do is run to the nearest tap and sip?
Better still, next time you’re thirsty and tempted to buy a bottle of
water, why not run to the nearest coffee bar and buy yourself a nice
anti-oxidant-rich double cappuccino instead?
I’m Dr Art Hister
May 28th, 2010
Another warning about proton pump inhibitors
Backing up what a Canadian study had discovered a couple of years ago, and which you can read about buried somewhere deep in these archives, the US FDA has issued a warning that the use of those drugs that lower stomach acid output known as proton pump inhibitors (Nexium, Prevacid, Losec, Pariet) leads to a higher rate of fractures, particularly in the elderly and those on higher doses of those drugs, in other words, especially in the people most apt to need and use PPIs.
The FDA warns that PPIs should be sued for the shortest duration possible and in the lowest dose, which is not only true, of course, but which is also a caution that should apply to the use of any drug at any time.
And the addendum to that warning is: before taking a drug, always inform yourself as much as possible about the risks (you will always be told about the benefits) and then to the extent you can, weigh those known risks (and assume that there will also be unknown longer-term risks) against the potential benefits.
Also keep in mind that those potential benefits don’t usually measure
up to the promises poferred in studies.
I’m Dr Art Hister
May 21st, 2010
Post-partum depression in men
An interesting report published in the Journal of the American Medical Association
detailed the researchers investigation of previous studies about the rarely-discussed
condition of post-partum depression in men, that is, depression in men following
the birth of a child.
And the researchers concluded that it’s a common phenomenon, with about
10 % of men suffering from post-partum depression, although interestingly,
there was a terrific cultural gradient so that the condition was reported
to be much more common in American men than in men elsewhere, which may
be due, perhaps, to American fathers coming forth more willingly to complain
of PPD, which I doubt, or perhaps to American doctors being quicker than
doctors elsewhere to diagnose this problem, which I also doubt, or perhaps
to the post-partum period being much harder on American men than men
elsewhere, which is also highly doubtful, so that the main explanation
for this discrepancy still eludes us, I think, but offers up a great
topic to research.
Also interestingly, PPD in men peaks at 6 months or so, which is quite
explicable, I think, since by that point in the newborn’s life, most
dads have gotten over the puzzle of “Hey, we did that 9 months ago and
we ended up with this? How did that happen?” and they’ve gotten over
the amazing awe of holding a newborn close, and they’re tired and they
need sleep and most of all, it has finally dawned on many new dads that,
“Hey, I just signed on to this job for 40 years, maybe more, and I’m
not really prepared for this. Yikes!”
That said, once a condition is recognized and acknowledged, it’s much
easier to deal with it, so that the good news is that as a consequence
of this recent report, it probably going to be easier for men who do
end up with PPD to admit it and to seek help, which doctors will likely
be more willing to give.
I’m Dr Art Hister
May 18th, 2010
Eating meat
Meat is a lot like coffee, by which I mean that just like those militant rabid anti-coffee folks are always trying to pin everything bad they can come up with – heart disease, diabetes, even 2nd hand-caffeine jitteriness – on drinking coffee (ed. comment: and happily, they’re always proven dead wrong about those links because coffee is in fact a health drink), similarly, many people are always trying to pin all sort of evil outcomes on meat.
So the news is that at least one health problem, namely heart disease, is not co-related with meat consumption, at least not according to a systematic review of nearly 1600 studies that was recently published in the journal, Circulation.
In this review, the researchers detected absolutely no link between regular meat intake – your steaks, your pork loin, your lamb chops - and a higher risk of heart disease.
Woo hoo, vindaloo.
The researchers did, however, find that eating processed meats (cold cuts, sausages, hot dogs, etc) more than once a week co-related with a small increased risk of heart disease (42 %) and diabetes (19%), which the authors attribute to the salt and chemicals present in processed meats.
Anyway, bottom line: meat will not kill your arteries, but if you like to eat processed meats regularly, you should compensate by doing all those other things you know you should do to reduce your risks for heart disease.
I’m Dr Art Hister
May 11th, 2010
If you’re taking one of those drugs called a proton pump inhibitor or PPI...
If you’re taking one of those drugs called a proton pump inhibitor or PPI
(very commonly used drugs such as Pariet, Losec, Prevacid, and Nexium) which
lower the output of stomach acid, you might be put off by headlines in some
papers that claim that according to some new research, the risk of taking these
drugs is “high”.
That’s based on 5 studies just published in the Archives of Internal Medicine
that linked the use of PPIs to mildly higher risks of certain fractures (of the
spine and wrist in post-menopausal women) and severe diarrheal infections (in
hospitalized and post-hospitalized patients) from an organism known as Chlostridium
difficile.
These links – between the use of PPis and infection or fracture - are not new
(for example, a Canadian study had linked the use of PPIs to a higher risk of
hip fractures, and other studies have found a higher risk of pneumonia in hospitalized
patients using PPIs), but they do add to the risk profile of these drugs.
It’s also easy to understand why these drugs are linked to higher risks of more
infection and fractures.
It’s because stomach acid is needed both for 1) the absorption and utilization
of some nutrients, such as calcium, for example, and 2) fighting off some infections
(especially perhaps, for those organisms that enter our bodies via the gastro-intestinal
tract).
But before you jump to the conclusion that hey, that means we should never suppress
stomach acid production and no one should ever take these drugs, it’s important
to keep in mind a few key considerations.
First, these drugs are very effective and they make life tolerable for lots of
people – me, as a shining example - who suffer from severe reflux symptoms and
who, when they try to discontinue the use of these drugs (which I am again trying
to do yet again for perhaps the 8th or 9th time over the last decade), find that
the symptoms are just too intolerable (it’s really hard to convince someone who’s
never suffered constant reflux indigestion as to just how uncomfortable that
can be and how it colours the enjoyment of all else in life).
And yes, I have tried every single (and welcome) home remedy sent me over the
years by my very concerned (and I thank you all for that) listeners and viewers
and yes, I also do nearly all the other things that I’m supposed to do to reduce
my reflux symptoms, but nothing seems to work (no, I have never eliminated my
coffee intake, although I have reduced it significantly from time-to-time with
no change, and besides, coffee’s effects on reflux symptoms are debatable, and
anyway, even if coffee makes my reflux worse, I so believe in the benefits of
coffee that I am willing to risk the potential downsides of taking those meds).
Second, chronic reflux has been linked to higher risks of several life-limiting
complications including stricture of the esophagus (narrowing from inflammatory
scarring of the opening between the stomach and esophagus, which in turn makes
swallowing increasingly difficult) and cancer of the esophagus (which is a terrifically
hard cancer to treat), so anyone at higher risk of such complications likely
has a lot more to gain than to lose from reducing acid output through the use
of PPIs.
Third, we still don’t know just how much stomach acid is needed – most of it,
some of it, a bit of it, or perhaps just a tiny fraction of it – for the typical,
average person to absorb their daily nutrients, nor do we have any special insight
into which people might be most at risk from some diminution in stomach acid
output (all post-menopausal women, for example, or perhaps only those who don’t
eat a good diet?)
Yes, of course, if you can eliminate the use of strong meds either by making
lifestyle changes (losing weight, adjusting your diet) or by using weaker drugs
(antacids or even weaker acid suppressors such as ranitidine, although you should
note that the latter has also been linked to some of the same higher risks noted
earlier but not by as much as PPIs have) or by (as a viewer just wrote me a moment
ago) using herbs and acupuncture, then, that’s clearly the way to go.
Prevention always trumps treatment, and weak effective treatment always trumps
strong treatment.
But if you can’t get rid of your symptoms, don’t be alarmed by provocative headlines:
the vast majority of people who use these drugs will not suffer undue consequences.
So, as always, the story in using these drugs is to balance the risks against
the benefits, and each of us must decide for ourselves what that ratio is and
how to use it in our lives.
I’m Dr Art Hister
May 5th, 2010
Capsules Are Not Food: Part 313
Yet another study has underlined what anyone with even 10 functioning brain
cells already knows: the benefits of eating certain foods can not be easily
mimicked by taking supplements.
Thus, although a diet high in fish oils has been linked to a reduced risk of
dementia and cognitive decline in several studies, no good study has ever found
that taking fish oil capsules has a significant positive effect on brain function,
and the latest one to fail was a study published in the American Journal of Clinical
Nutrition in which study subjects (all of whom were seniors and none of whom
had been diagnosed with any signs of cognitive failure) were randomized into
a placebo group and one that got 200 mg of fish oil capsules supplementation
every 2nd day for two years, and hey, what a surprise, at the end of the 2 years
there was no noticeable difference between the two groups.
Now, fish oil capsule supporters will immediately yell that the dose wasn’t high enough and the study didn’t go on long enough and the study wasn’t large enough (748 people), which any critic can say about nearly every study, but the bottom line is that if there was much positive effect from fish oil capsules, that should have become at least a bit evident in this study.
And it wasn’t.
Eat lotsa fish: that’s good for you.
But it’s very unlikely you can ever the same effect from capsules. Period.
I’m Dr Art Hister
May 3rd, 2010
Colon Cancer is the 2nd leading...
Colon cancer is the 2nd leading cause of cancer death in North Americans but
frustratingly, it's also the most avoidable one because colon cancer is so
easily detectable at an early and still easily-treatable stage (you could argue
that death from lung cancer is more avoidable if people didn't smoke, but they
do, so I'll stick with colon cancer as the number one avoidable cause of cancer
death).
And also frustratingly, screening for colon cancer is easy, although, and this
is really the most frustrating bit, not enough people get screened.
They back out of colon cancer screening tests, you might say, although I would
never put it like that.
So the great news is that an 11-year-long study (published in the Lancet) that
used a one-time easy-to-do colon cancer screen using a tube that's inserted
part-way up the colon (sigmoidoscopy) led to a 33 % reduction in colon cancer
deaths in the screened group compared to the non-screened control group.
So, hey, if you're over 50, and most of my readers and viewers are, then screw
up your courage, which is not that hard to do (and hey, trust me, I've had
3 of them and they're far worse in theory than they are in reality) and get
a screening test for colon cancer because even a one-time screening test saves
lives.
I’m Dr Art Hister
May 2nd, 2010
Chocolate
A much-hyped study of over 900 people has found that people who are depressed
eat more chocolate.
In fact, the more depressed a person is, the more chocolate they consume, which
is about as earth-shaking a conclusion as the one that found that Lindsay Lohan
likes to party.
But here's the question: in this study, which is the cart and which is the
horse?
In other words, does eating chocolate lead to more depression?
Or does feeling depressed lead you to eat more chocolate, either because the
chocolate improves your mood (oh yes, it does) or just because you want to
eat something that tastes so good (oh yes, it does).
Only thing to keep in mind is that chocolate has calories and fats, so a bit
is good for you, but a lot is not "gooder".
As always, moderation, moderation, moderation.
I’m Dr Art Hister
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