June 6, 2002 Research Update

James Bogash, D.C. Mesa, AZ
info@lifecarechiro.com
www.lifecarechiro.com

Doctor sues company over unethical marketing

I'm just putting this in here so everyone out there can begin to realize that pharmaceutical interference with prescribing practices is a reality and patients' best interests are never served in this matter. Some of these doctors were paid $350 a day just to let sales reps observe and interact during patient encounters. And to think I get excited when one of the nutriceutical reps gives me the current copy of Clincal Pearls...

bmj.com Charatan 324 (7348): 1234b

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Early nutrition and leptin concentrations in later life

This article is incredibly important wake up call for parents of today. This study stresses the importance of nutrition in the infant. Formula feeding may lead to altered hormone patterns that lead to obesity later in life. I cannot stress the importance of good nutrition in the infant enough. When I see parents putting soda into their child's sippie cup I know society has a serious, serious problem. As parents we need to take 100% responsiblity for the nutrition of our children--you control the diet of your child and subsequently their long term health.

AJCN -- Abstracts: Singhal et al. 75 (6): 993

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Whey protein rich in -lactalbumin increases the ratio of plasma tryptophan to the sum of the other large neutral amino acids and improves cognitive performance in stress-vulnerable subjects

Okay...I know the title is a little difficult to swallow, but there are several important concepts here. First a lesson in biochemistry of neurotransmitters... Tryptophan is an amino acid that crosses the blood brain barrier to get converted to serotonin. Serotonin is a neurotransmitter that plays a major role in mood and satiety. The major class of antidepressants (selective serotonin reuptake inhibitors or SSRIs) increases serotonin's effects on the brain. However, when tryptophan is absorbed along with a bunch of other large neutral amino acids, passage of tryptophan across the blood brain barrier drops via competition. Hence some of the side effects with those wonderful and safe high protein diets--serotonin depletion from decreased brain tryptophan. Well...this article suggests an alternative method for getting enough tryptophan into the brain in patients under high levels of stress.

AJCN -- Abstracts: Markus et al. 75 (6): 1051

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Chromium Picolinate Improves Carbohydrate and Lipid Metabolism

Chromium is one of the mainstays for use in insulin disorders because it is believed to help insulin due its job. This article suggests that one of the mechanisms by which this is accomplished is via glut-4 translocation to the cell membrane. Glut-4 acts as the "mitt" that cells put out to catch glucose as it floats by, thereby lowering levels in the bloodstream and allowing for an energy source in the cell.

nutrition.org -- Abstracts: Cefalu et al. 132 (6): 1107

Pre-eclampsia and magnesium sulphate

Magnesium sulphate is incredibly cheap as far as medical interventions go. This study found that this intervention cut risk of pre-eclampsia (a dangerous condition of protein in urine and elevated blood pressure) in HALF. Half. And this was a large study. Not to mention the fact that the safety of this intervention is almost unparelleled (with the exception of water, which probably wouldn't be as effective..). So, with the rapid transition from research to clinical practice, I would anticipate this becoming the standard of care sometime after Halley's comet reappears...

The Journal : Current Issue

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Nutrition More Effective Than Steroids in Children With Crohn's Disease

Okay, so if this is more effective for children, why do most adults not get the same therapeutic thrust? Personally, I feel that yeast overgrowth is a major factor in many patients with Crohn's. This would necessitate avoiding sugars and alcohol and supportive probiotics.

DDW Annual Meeting: Abstracts 103976, 107178. May 19 and 21, 2002

Nutritional therapy achieves better long-term outcome than steroids in children with active Crohn's disease, according to 2 studies presented May 19 and 21 at the Digestive Disease Week annual meeting in San Francisco, California. "In children with Crohn's disease, clinical trials have demonstrated that polymeric or elemental diet therapy is as effective as steroids in inducing remission, whilst avoiding steroid side effects," write Bhupinder Sandhu and colleagues from Bristol, England.Of 44 children (median age at diagnosis of Crohn's disease, 12.8 years) elemental diet therapy induced clinical remission in 40 (90%). Median time to remission was 6 weeks (range, 2-12 weeks), and median duration of first remission was 54 weeks (range, 4-312 weeks). At follow-up, 17 children (38%) had not relapsed, and the remaining 27 children suffered a total of 52 relapses. Of 16 children whose relapses were treated with elemental diet therapy, 12 (75%) went into remission. "This data suggests that there are significant long-term benefits to using elemental diet therapy as first-line therapy for Crohn's disease," the authors write. "Steroids may be avoided in nearly half the cases, or their use postponed by 68 weeks."In a second study from Naples and Rome, Italy, 37 patients, aged 7 to 16 years, with active Crohn's disease received nutritional therapy, while 10 comparable patients received methylprednisolone, 2 mg/kg/day for 4 weeks, with subsequent tapering over at least 4 weeks. Nutritional therapy included polymeric diet given orally and semielemental or elemental diet formulae infused with a pump through a nasogastric tube. Within 8 weeks of treatment, 32 of the 37 children assigned to nutritional therapy and 9 of the 10 given steroids went into clinical remission. Mean time elapsed to achieve remission was 2.5 weeks for those on nutritional therapy and 3.7 weeks for those on steroids (P<.05). Seven patients on nutritional therapy and none on steroids showed complete mucosal healing (P<.005). "In children with active Crohn's disease, exclusive nutritional therapy shows a more rapid effect than steroids in inducing clinical remission and is markedly more effective than steroids in producing healing of mucosal inflammation," write Roberto B. Canani and colleagues. "Nutritional therapy alone is the preferred form of therapy for children with active Crohn's disease."

Legislation to Fight Obesity May Hit Congress Soon

I just love when government gets decides to through money at a problem. Here we see they are suggesting throwing some $80 million to increase physical education and educate on nutrition. Hello??? How about these awful school lunches? And how about the fact that schools are given large sums of money to place pop machines in the schools? Don't count on any intervention here; that would actually make sense and end up with positive results. Don't choke on the quote from one of the lobbyist stating that we should not steer kids towards healthier food choices--these people actually said this!!

May 22 - The US Senate will soon see legislation aimed at reducing skyrocketing levels of obesity in American children and adolescents, lawmakers said Tuesday. Draft legislation in circulation on Capitol Hill could authorize billions in government spending to encourage increased physical activity and improved nutrition at schools. The proposal is an attempt to help quell the number of obese and overweight children in the US, which has doubled over the last 20 years, they said. American obesity and overweight rates have become an increasing source of concern for US health officials. A recent report from former US Surgeon General Dr. David Satcher said that obesity had reached "epidemic proportion," leading to 300,000 premature deaths and costing the economy $120 billion annually. Over 8 million US children currently meet the clinical definitions of being overweight or obese, according to federal health figures. "The data are likely to get worse, not better," said Sen. Bill Frist (R-TN), the ranking member of the Senate Health, Education, Labor and Pensions Committee subpanel on public health. The committee is preparing to introduce legislation that would authorize $40 million in federal spending next year to expand a federal program designed to help schools implement physical education and nutrition classes. Another $40 million would be authorized for states and communities to build parks, bike paths, and recreation centers and to promote physical activities among residents. Some money in the bill would also be funneled through a nutrition and physical activity program at the Centers for Disease Control and Prevention (CDC). Some health groups have called for restrictions on "pouring rights" at schools in which soft drink makers or food manufacturers send cash to financially needy schools in exchange for exclusive marketing rights to students attending classes. Senate aides said that the bill, still in draft form, is unlikely to directly restrict soft drink and food manufacturers from pursuing the deals. Lobbying groups for the beverage and food industries said they support nutrition programs in schools but urged lawmakers to avoid funding any programs that seek to steer children to healthier foods. "Restricting, taxing, or prohibiting certain foods will almost certainly not work," said Lisa Katic, a health policy advisor with the Grocery Manufacturers of America.

Abbott Should Be Prosecuted for 'Withholding' Meridia Info

This really isn't "bash pharmaceuticals" week...it just works out that way in the medical literature... Besides, they can be such an easy target it is hard not to take aim.

May 22 - Claiming that Abbott Laboratories withheld from the US Food and Drug Administration (FDA) crucial information about adverse events and deaths that may be related to its obesity drug Meridia (sibutramine), the advocacy group Public Citizen on Tuesday called on the government to criminally prosecute the company. The group's allegations are based on an FDA inspection of an Abbott manufacturing plant conducted in late March and early April. The agency was searching Abbott paperwork and databases for clues to help determine if Meridia played any role in the 34 deaths reported so far in patients taking the drug. In a query of an Abbott database using the keywords "Meridia" and "death," the FDA found a death that had never been reported. "Abbott had not performed this type of query prior to the inspection," wrote the agency's staffer in a report. "They completely withheld information on one death," claimed Sidney Wolfe, director of Public Citizen's Health Research Group. That alone is enough to press charges, Wolfe told Reuters Health. The FDA inspector also said that Abbott files on several deaths were missing important data that could be used to prove the drug had caused the patient to die. Public Citizen also alleged that Abbott should be criminally charged for failing to notify the FDA about three adverse events, including one death, within the 15 days required by law. Abbott reported one death 41 days later, and the other two adverse events 232 days and 79 days later, respectively, said Wolfe. His organization petitioned the FDA in March to ban Meridia, claiming that its risks - including elevated blood pressure and heart rate, and abnormal electrocardiograms - outweighed its benefits. Abbott said there has been no definitive causal link between Meridia and the deaths reported to the agency, and pointed out that obese people have a higher risk of cardiovascular death, thus explaining deaths attributed to Meridia. The company also denied that it kept any information from the FDA. "The charges alleged by Public Citizen and Sidney Wolfe are without merit, are not factual, and have been intentionally written to alarm and mislead physicians and patients," said Eugene Sun, Abbott vice president, in a statement. Abbott has responded to the FDA inspector's concerns, the statement said, adding that the company "is confident that all confirmed deaths reported to the company coincident with Meridia use have been reported to the authorities as appropriate." As far as the death that supposedly was unreported, Abbott said its own investigation found the initial report was a "rumor," that the company was "unable to substantiate."