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HEALTHBEAT SHOW NOTES .... Episode #161 - Recorded August 8, 2008  

Hello and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s Health, News and Informational Podcast, and Proud to be the #1 Search Result for Chiropractic Podcasts in the iTunes Podcast Directory.

In this week’s news:  We’ll Look At –

• New Diagnostic Monitoring for Heart Disease

• California Bans Trans Fats

• Special warm-up prevents knee injury

• And Finally, a recent Study finds Soft Drinks and Fruit Drinks Linked to Diabetes Risk in African American Women

For HealthBeat, This is Dr. Todd Eglow!

Welcome to HealthBeat Podcast #161, recorded August 8, 2008.

HealthBeat is Chiropractic OnLine Today’s radio program, providing current news and commentary about Chiropractic and Health.

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New Diagnostic Monitoring for Heart Disease

Comparing blood pressure in the ankle and the arm could give doctors a quick way to know which patients are at higher risk of cardiovascular disease, according to researchers.

The measure, known as the ankle brachial index, could help address a serious public-health challenge — determining who is at risk of heart attack and stroke.

The problems often occur in patients with no known history of cardiovascular problems. And current approaches to figure out who is at risk, which look at things like smoking, blood pressure and cholesterol, give mixed results.

For the report, which appears in the July 9 issue of The Journal of the American Medical Association, researchers reviewed 16 studies that looked at the medical histories of more than 24,000 men and more than 23,000 women.

To establish an ankle brachial index, doctors look at the ratio between the systolic pressure at the ankle and at the arm. A lower index number, the study found, was a reliable indicator of cardiovascular risk.

The study suggested combining the index with other scales now used, like the Framingham risk score, to get a more accurate measure. When they did that for the study, the researchers found, about one man in five fell into a lower risk category, while a third of the women ended up in a higher one. This would suggest that some men may have been getting treatment they did not need, while some women were not getting treatment they should have.

Surf to our Show Notes for more information - http://jama.ama-assn.org/cgi/content/short/300/2/197

http://www.nytimes.com/2008/07/15/health/research/15prev.html?ref=health

California Bans Trans Fats

California, a national trendsetter in all matters edible, became the first state to ban trans fats in restaurants when Gov. Arnold Schwarzenegger signed a bill recently to phase out their use over the next few years.

Under the new law, the fats must be excised from restaurant products beginning in 2010, and from all retail baked goods by 2011. Packaged manufactured foods will be exempt.

New York City passed a regulation banning the fats in 2006, which became fully effective on July 1, and Philadelphia, Stamford, Conn., and Montgomery County, Md., have passed similar laws.

But placing a mandatory ban on the roughly 88,000 restaurants, bakeries and other food purveyors in the nation’s most populous state provides a major legislative boost for the movement against trans-fats. The effort has been led by scientists, doctors and consumer advocates who trace the largely-synthetic fat to a host of health woes, principally heart disease.

In recent years trans-fats have become almost the new cigarettes among public health policy makers, with consumer behavior as much in the crosshairs as the product itself in governments’ attempt to curb harmful effects.

Trans fats are created by pumping hydrogen into liquid oil at high temperature, a process called partial hydrogenation. The process results in an inexpensive fat that prolongs the shelf-life and 
appearance of packaged foods, but it has repeatedly been found in scientific studies to increase bad cholesterol, which can lead to diabetes and heart disease, California’s leading cause of death.

Under the new law, restaurants, bakeries, delicatessens, cafeterias and other businesses classified as “food facilities” will have to discontinue use of oils, margarine and shortening containing trans fats in preparing all foods.

These purveyors will have to keep the labels on their cooking products so that they can be inspected for trans fat, a process that will become part of the duties of local health inspectors. Violators will face fines beginning at $25, and increasing as high as $1,000 for multiple violations.

Surf to our Show Notes for more information - http://www.nytimes.com/2008/07/26/us/26fats.html?_r=1&hp=&oref=slogin&pagewanted=print=

Special warm-up prevents knee injury

A specially designed warm-up program can help female athletes prevent a common knee injury, U.S. researchers reported on Friday.

Women who completed the Prevent Injury and Enhance Performance, or PEP, program were 1.7 times less likely to have anterior cruciate ligament injuries, the researchers reported.  The program, a rigorous series of running, jumps and stretches, is neuromuscular and aimed at strengthening the muscles and ligaments in and around the knee.

Dr. Bert Mandelbaum and colleagues at the Santa Monica Orthopedic and Sports Medicine Research Foundation in California developed the program and tested it among 61 college and university teams of 1,435 women, 850 of whom completed the program.

Athletes on teams using the PEP Program suffered no ACL injuries during practice, compared to six injuries among women on the other teams.

Female athletes have a higher risk than men of getting ACL injuries, which usually occur in stopping, turning, or landing from a jump.

Surf to our Show Notes for more information - http://www.reuters.com/articlePrint?articleId=USN2542170220080725

Soft Drinks and Fruit Drinks Linked to Diabetes Risk in African American Women

Regular intake of sugar-sweetened soft drinks and fruit drinks is associated with an increased risk for type 2 diabetes in African American women, according to the results of a prospective follow-up study reported in the July 28, 2008 issue of the Archives of Internal Medicine.

Since 1995, this study has observed 59,000 African American women, who reported on food and beverage consumption in 1995 and 2001 and completed biennial follow-up questionnaires to determine new diagnoses of type 2 diabetes.

Although the association of diabetes with soft drink intake was almost entirely mediated by body mass index, the association with fruit drink consumption was independent of body mass index.

"Regular consumption of sugar-sweetened soft drinks and fruit drinks is associated with an increased risk of type 2 diabetes mellitus in African American women," the study authors write. "While there has been increasing public awareness of the adverse health effects of soft drinks, little attention has been given to fruit drinks, which are often marketed as a healthier alternative to soft drinks."

Limitations of this study include beverage consumption data collected at baseline, creating possible misclassification of exposure, and incident cases of type 2 diabetes based on self-report.

In an accompanying editorial, from Duke University Medical Center in Durham, North Carolina, it was noted that the greatest increase in weight was seen in those women who drank the most soft drinks.

"The critical issue in the development of diabetes is total caloric intake and subsequent weight gain rather than individual macronutrient composition, [but] modification of specific macronutrients might make it easier to decrease total calories".

The editorial continues that "Until we have more information, we have to assume that calories trump everything else, and that our number 1 goal for the reduction of new cases of type 2 DM [diabetes mellitus] should be to reduce the intake of high-energy, low-benefit foods, particularly in young members of the most vulnerable populations."

Surf to our Show Notes for more information including the Clinical Context of this study, along with a link to the study’s PDF file - http://www.medscape.com/viewarticle/578315

http://archinte.ama-assn.org/cgi/reprint/168/14/1487.pdf

Clinical Context

• High-fructose corn syrup is the main sweetener in sweetened soft drinks in the United States, and manufacturers may prefer this sweetener in a variety of foods because it is cheaper than sucrose while also offering a longer shelf life.

• An editorial by Feinglos and Totten reviews the effect of consumption of high-fructose corn syrup on health. Currently, high-fructose corn syrup accounts for 10% of the average total daily energy intake in the United States.

• Most consumption of high-fructose corn syrup is from soft drinks, and it appears that imbibing more soft drinks does not help to reduce appetite for more energy intake. However, there is conflicting evidence whether consumption of refined carbohydrates can contribute to an increased risk for type 2 diabetes when the total caloric intake remains stable.

• The current study examines how consumption of both soft drinks and fruit drinks affects the risk for incident type 2 diabetes in African American women, a high-risk group for this disease.

Study Highlights

• Study data were drawn from an ongoing study of African American women, which began in 1995.

• 59,000 women between the ages of 21 and 69 years were included in the study cohort.

• A baseline questionnaire examined medical history and health habits. Only women who were at least 30 years old at the end of follow-up and did not report a history of diabetes, gestational diabetes, or cardiovascular disease were included in the current analysis.

• Incident type 2 diabetes was assessed via a participant self-report every 2 years during 5 cycles of follow-up. In a separate analysis, self-report of diabetes was found to be accurate in 94% of cases.

• The 68-item short-form Block-National Cancer Institute food frequency questionnaire was used to measure subjects' dietary habits.

• The main outcome of the study was the effect of soft drink (excluding diet soda) and juice drink (excluding orange juice and grapefruit juice) consumption on the risk for incident type 2 diabetes. This outcome was adjusted for potential confounders, including age, family history, physical activity, anthropometric factors, and other dietary habits.

• 43,960 women had data for analysis.

• 17% of participants reported drinking at least 1 sugar-sweetened soft drink per day, and 32% consumed at least 1 sweetened fruit drink per day.

• Intake of sugar-sweetened soft drinks was inversely related to age, physical activity, and years of education, and cereal fiber intake. Soft-drink consumption was positively related to body mass index, cigarette smoking, total energy intake, and consumption of processed meats. Consumption of fruit drinks was positively associated with physical activity and a low-glycemic index diet.

• 2713 cases of type 2 diabetes were diagnosed during 10 years of follow-up.

• Increased consumption of soft drinks was associated with higher weight gain during follow-up, whereas reduced consumption of soft drinks was associated with weight loss. The relationship between juice drink consumption and weight change was less robust.

• Consumption of 2 or more soft drinks per day was associated with an increased risk for incident diabetes (incidence rate ratio, 1.24).

• Consumption of 2 or more fruit drinks per day was also associated with an increased risk for incident diabetes (incidence rate ratio, 1.31).

• Consumption of orange or grapefruit juice was not associated with an increased risk for incident diabetes.

• The effect of soft drinks on the risk for diabetes appeared to be mediated by body mass index, but the effects of fruit juice in increasing the risk for diabetes were unrelated to body mass index.

• Soft drinks were associated with an increased risk for diabetes regardless of baseline age or body mass index.

• Pearls for Practice

• High-fructose corn syrup is cheaper and has a longer shelf life vs sucrose. It accounts for 10% of the average daily energy intake in the United States , but it is unclear if consumption of refined carbohydrates independently increases the risk for type 2 diabetes.

• In the current study, both soft drink and fruit drink consumption were associated with a higher risk for incident type 2 diabetes in a cohort of African American women.

As always, please surf to our Podcast Show Notes at ChiropractiRadio.com for a full listing of web references mentioned in today’s show.

And remember - COT’s Healthbeat always recommends discussing any nutritional or exercise lifestyle modifications with a qualified healthcare professional.

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Finally, I leave you with the following quote:

"Everybody sooner or later, sits down to a banquet of consequences."
– Robert Louis Stevenson

For Chiropractic OnLine Today’s HealthBeat, This is Dr. Todd Eglow.

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