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April 2012


White rice increases diabetes risk

Berries slow brain decline
Testosterone helps heart failure
Exercise helps menopause
Sun damages teens’ skin
High salt diet increases stroke risk

White rice increases diabetes risk

White rice is the most commonly consumed rice in the world, and it is common in cultures where traditional diets have generally led to good health. However, it is now well established that whole grains, rather than refined grains, are far more healthful. White rice is also called “polished” rice because the bran and germ have been rubbed off by industrial machinery from the naturally occurring brown rice. The loss of the bran and germ removes important minerals and B vitamins as well as the fiber.

New research confirms that, in spite of otherwise healthy diets, consuming white rice is detrimental to health, and is associated with an increased risk of type 2 diabetes. Researchers analyzed four published studies involving 352,384 participants, with follow-up periods ranging from 4 to 22 years. They involved both Asian and Western populations. During the follow up, 13,284 cases of type 2 diabetes were diagnosed.

The Asian populations included were Chinese and Japanese. These groups had a much higher intake of white rice than the Western populations. The Asian average intake levels were three to four servings per day, while the Western populations consumed one to two servings per week.

The relative risk of type 2 diabetes was 55 percent higher in the Asian populations with the highest white rice intake compared to those with the lowest intake. Western populations had a 12 percent increased risk in the highest versus the lowest intake groups. Overall, the data indicated that for each serving per day increase in white rice consumption there was an 11 percent increased relative risk of type 2 diabetes. (Hu EA, et al., White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ. 2012 Mar 15;344:e1454. doi: 10.1136/bmj.e1454.)

Brown rice and other whole grains are associated with a decreased risk of diabetes, possibly due to the high amounts of fiber, B vitamins, magnesium, and other minerals that they contain. It was not until the latter part of the 19th century that steel rolling mills made possible the large-scale production of refined grains. Diets everywhere have been degraded as a result.

Berries slow brain decline

Strawberries and blueberries are the most commonly consumed berries in the United States. They are rich in antioxidants, including a number of flavonoids and anthocyanidins, plant pigments that provide a number of health benefits (such as reduction of cancer and heart disease). A recent study shows that consumption of berries is also associated with better maintenance of cognitive function. (Devore EE, et al., Dietary intakes of berries and flavonoids in relation to cognitive decline. Ann Neurol 25 Apr 2012 DOI: 10.1002/ana.23594 (Epub ahead of print)

Starting in 1980, the Nurses’ Health Study administered a food frequency questionnaire every four years. Cognitive function measurements began from 1995 to 2001 in 16,010 participants older than 70 years and were repeated every two years. The researchers then related the long-term intake of berries and flavonoids to the rate of cognitive decline.

They found that those participants with the highest berry intake delayed cognitive decline by up to 2.5 years compared to those with the lowest berry intake. They also found that greater total intakes of flavonoids and anthocyanidins were associated with slower rates of cognitive decline. These numbers add up to a great health benefit to individuals and families, better lives, and a greatly reduced cost of health care over time.

Testosterone helps heart failure

In patients with congestive heart failure (CHF), low testosterone is an independent predictor of lowered exercise capacity and poor clinical outcomes. The question is whether increasing testosterone levels with supplements (oral, topical, or injectable) or through other medication might improve exercise capacity. CHF is the reduced ability of the heart muscle to pump out the normal amount of blood from the ventricle with each beat. Typically the left ventricle pumps out 55 to 70 percent of the blood that it contains, but with CHF that can drop to less than 10 percent in the most severe cases. (This heart weakness is usually due to coronary disease but can have other causes.)

In a review of four trials with a total of 198 patients, two walking tests and a measure of oxygen utilization were used to evaluate heart function. Compared to placebo, testosterone treatment led to an increased walking distance of 54 meters and 47 meters and an increase of oxygen utilization of 2.7 ml/kg/min. The walking tests showed a 50 percent improvement compared to placebo. (Toma M, et al., Testosterone Supplementation in Heart Failure: A Meta-Analysis. Circ Heart Fail. 2012 Apr 17. [Epub ahead of print])

The New York Heart Association classification of heart failure ranges from class 1 to class 4, each related to functional capacity. In these testosterone studies, the NYHA class improved 1 to 2 classes in 35 percent of treated patients but only 9.8 percent of patients on placebo.

It is also possible to raise serum testosterone levels with the drug clomiphene. This is normally used as a fertility drug in women, but it also stimulates men’s production of testosterone. This effect depends on the continued ability of the testes to produce testosterone, which might be a problem if there is significant atrophy of the gonads. Treatment with testosterone itself can lead to a reduction in the usual gonadal production of the hormone, so there may be some good reasons to try this alternative.

Exercise helps menopause

No one disputes that regular exercise is a healthful activity, even those who do not exercise. It is helpful for the heart and the brain, and it helps emotional health. Now research from Finland suggests that aerobic training is also beneficial for menopausal symptoms, such as night sweats, mood swings, hot flashes, and irritability. (Moilanen JM, et al., Effect of aerobic training on menopausal symptoms-a randomized controlled trial. Menopause. 2012 Feb 13. [Epub ahead of print])

The study evaluated 154 women who completed the six-month protocol. They ranged in age from 45 to 63 years. About half of them were on a program of 50 minutes of aerobic training four times per week. The control group attended health lectures twice per month. Symptoms were reported twice a day by mobile phone.

The intensity of symptoms of depression, headache, vaginal dryness, and those listed above were rated on a scale of 1 (low) to 5 (high). The prevalence of all symptoms except vaginal dryness decreased among the intervention group, but when statistically analyzed, the benefits were significant primarily for mood swings, irritability, and night sweats. Mood swings and irritability dropped by 50 percent. (Earlier research by the authors showed benefit for hot flashes as well.) Many women can get relief without having to resort to hormone replacement therapy.

Sun damages teens’ skin

It is well known that overexposure to sun is damaging to the skin over the long term. New research shows that even in 12-year old children, damage has already occurred that, when combined with genetic risk factors, can lead to increased melanoma risk later in life. The testing was done on 585 children using ultraviolet, standard, and cross-polarizing photographs and computer analysis to help quantify sun damage.

The sun damage was greatest for non-Hispanic white children with fair hair and skin coloring, blue eyes, and facial freckling. (Gamble RG, et al., Sun damage in ultraviolet photographs correlates with phenotypic melanoma risk factors in 12-year-old children. J Am Acad Dermatol. 2012 Mar 9. [Epub ahead of print]) Excessive sun exposure is a problem for fair-skinned people. Even without sunburns, skin is damaged by any amount of tanning. Topical and oral supplements can mitigate the damage.

The researchers suggested that the dramatic photos could be used to motivate teens to learn about sun safety and avoid tanning parlors. Vitamin D production resulting from sun exposure is valuable, but you do not need much exposure to meet your basic vitamin D needs. Higher levels of vitamin D are more safely achieved through dietary supplements of vitamin D3. (It is always best to have blood levels tested to determine your needs. The proper test is the serum 25-OH vitamin D3.)

High salt diet increases stroke risk

Salt is known to be associated with an increased risk of hypertension, although some data have been interpreted to suggest that the problem is only true for susceptible individuals. However, it may be the case that everyone is affected by salt intake if the blood pressure is risky at lower levels than previously thought. Research suggests that even diastolic levels from 80 to 85 show increased risks at the higher end within this range. It is also possible that the recommended sodium intake is too high, which would obscure the effects of sodium at low levels. (The American Heart Association recommends limiting sodium to 1500 mg per day.)

This wing of the Northern Manhattan Study included 2657 participants to assess dietary sodium and the risk of stroke. The subjects mean age was 69 years, with 64 percent women. Of all participants, 21 percent were white, 53 percent Hispanic, and 24 percent black. The mean sodium intake was 3021 mg daily (double the AHA maximum recommendation). (Gardener H, et al., Dietary sodium and risk of stroke in the northern Manhattan study. Stroke. 2012 May;43(5):1200-5.)

Those subjects who consumed over 4000 mg of sodium daily had a stroke risk 2.59 times higher than those who consumed less than 1500 mg daily. The authors calculated that each 500 mg increase in sodium intake led to a 17 percent increased risk of stroke. They made adjustments for a number of confounding risk factors, including vascular disease. Native diets of unprocessed foods are naturally low in sodium and rich in potassium. Processed-food diets have a reversed ratio of sodium to potassium, leading to many health problems.

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Information herein is not medical advice or direction. All material in this newsletter is provided for information only. Its contents should not be used to provide medical advice on individual problems. Consult a health care professional for medical or health advice.