Monday, December 2, 2013

Health Research Recap (Week of Nov. 25, 2013)

Researchers have known that increased social activity lowers mortality risk in older adults, and a recent study shows that part of this effect is due to increased mobility.  Being social with friends almost always requires people to get up and move, and by doing so older adults maintain better mobility throughout older age than do less social adults.  Part of this may also be due to increased muscle mass as maintaining muscle mass throughout later adulthood also decreases mortality risk.  The researchers also found that adults who maintained cognitive function and had fewer depressive symptoms were more likely to engage in social activity.  People with poorer cognitive function and/or who experience depressive symptoms should be encouraged more to be more social and partake in social activities with friends.

A recent study looking at how meals of different composition affect the blood glucose and insulin response in Type 2 diabetics showed that a high fat diet produced better blood glucose responses than a low fat or Mediterranean diet.  This study is interesting because one aspect of the Mediterranean diet that people tend to ignore is that it only includes coffee for breakfast.  In this study, people eating the Mediterranean diet ate their breakfast calories with lunch and enjoyed a glass of wine also.  Despite a much larger meal, the blood glucose response between the low fat diet and the Mediterranean diet were identical for lunch.  This flies in the face of the recommendation that Type 2 diabetics should eat frequent, small meals.  One thing I would have liked to have seen in this study was the absence of bread.  Despite the low carbohydrate group consuming <20% of their calories from carbohydrate, they still ate bread for breakfast and lunch.  I would have liked to see them get their carbohydrates from an unprocessed source.  I also would have liked to see what happened in both the low carbohydrate and low fat group if they had skipped breakfast as well.  Here's a link to the actual study.

If you never had a reason to question the decisions of the FDA, now you do.  Researchers have been taking a peep at thalidomide, a drug infamously banned for causing birth defects in children in the 1950s,
as a potential cure for Crohn's disease.  While the drug did show impressive efficacy in treating Crohn's disease and keeping children in remission for much longer than placebo, one has to question the judgement to use such a drug in young children.  While the researchers state that children of reproductive age should use methods to prevent pregnancy, I'm guessing a study of sufficient duration to determine if there is any sort of permanent damage on future reproductive health has been carried out. 

Need another reason to question the decisions of the FDA?  Do you remember the diabetes drug Avandia?  Two years ago the FDA restricted it's use because of research that suggested it was linked to heart problems.  Dr. Steven Nissen, head of cardiology at the Cleveland Clinic sounded the alarm in 2007 when a review of 42 studies showed a 43% increased risk of heart attack in people taking the drug.  A review of 50 studies by the FDA also showed an increased risk of heart attack, so they asked the drug maker, Glaxsmith Kline, to go back and look at their data.  In what should come back as no shock to anyone, GSK's review of their own clinical trials showed no increased risk of heart problems.  As a result, the FDA has lifted their restrictions on the drug.  Normally, I put way more stock in clinical trials than in epidemiological research.  However, I don't do that with pharmaceutical research performed and funded by Big Pharma.  Research funded by non-profit organizations tend to show results in favor of a newer treatment 40% of the time while pharmaceutical industry funded research tends to show results in favor of the newer treatment 66% of the time.

In a study on magnesium and bone loss, researchers from the VA showed that supplementation with magnesium led to lower blood levels of chemicals that indicate bone breakdown. The study was carried out in healthy, young men and included a 350mg daily dose of magnesium for 30 days.

Finally, in gut bug news, researchers took a deeper look at how fecal microbiota transplant(FMT) works to help people with recurrent C. difficile infection(RCDI) become healthy.  Transplanting the healthy microbiota from healthy individuals caused a major shift in the microbiota composition of people suffering from recurrent C. difficile infection.  C. difficile infection occurs after standard antibiotic therapy at a rate of about 20% after one round of antibiotics and is more frequent as the number of courses of antibiotics increases.  The primary symptom is diarrhea.  The proportion of pathogenic(bad) bacteria increased and the number of butyrate producing bacteria(good) decreased in people with RCDI. FMT partially reversed this change, causing greater diversity of bacteria in the gut, but not totally restoring the microbiota to that of healthy people.  Over time, the microbiota of people who undergo FMT for RCDI continues to change, suggesting that recovery from RCDI is pretty long.  A healthy diet high in vegetable matter should, in theory, speed up this process.