Study May Dispel Worries About High Levels of Folic Acid

FRIDAY, June 10 (HealthDay News) -- Consuming high amounts of folate -- through supplements and foods fortified with folic acid -- does not disrupt a healthy body's use of vitamin B12, according to new research.

Folic acid -- the synthetic form of the vitamin folate -- is added to grain products in the United States to reduce women's risk of conceiving a child with a neural tube birth defect. But some worry that folic acid levels in these foods may be too high for other people. Their concerns stem from studies that found that people with low B12 levels and high folate levels were more likely to have anemia than those with low B12 levels and normal folate levels.

B12 is needed to make red blood cells, and people with low levels of B12 can develop anemia, as well as numbness and tingling in the hands and feet.

The new study found, however, that anemia and other problems related to low levels of vitamin B12 were not likely to get worse with higher intake of folic acid.

It included more than 2,500 university students who reported the amount and type of folic acid-fortified foods and folic acid supplements they consumed in the previous week and in an average month. Blood samples collected from the participants showed that about 5 percent were B12 deficient. Of the students with low B12 levels, there was no significant difference in rates of anemia between those with high and those with low folate levels.

The study, conducted by researchers at the U.S. National Institute of Child Health and Human Development and five other institutions in the United States, Ireland and Norway, was published online June 8 in the American Journal of Clinical Nutrition.

"Our findings are reassuring for people who have low vitamin B12 levels," Dr. James L. Mills, the study's first author, said in a U.S. National Institutes of Health news release. "We found no evidence that folate could worsen their health problems."

Natural sources of folate include leafy green vegetables, citrus fruits and beans.

More information

The U.S. Centers for Disease Control and Prevention has more about folic acid.

SOURCE: U.S. National Institute of Child Health and Human Development, news release, June 8, 2011Copyright

Weight-Loss Surgery May Not Lower Death Risk: Study

SUNDAY, June 12 (HealthDay News) -- Weight-loss surgery doesn't decrease the risk of death among severely obese middle-aged adults, a new study says.

U.S. researchers looked at 850 male patients at Veterans Affairs medical centers who had weight-loss (bariatric) surgery between January 2000 and December 2006. Their average age was 49.5 and their average body mass index was 47.4 (a body mass index, or BMI, over 40 is considered severely obese).

The death rate in this group of patients was compared to that of a control group of about 41,000 VA patients (average age 54.7, average BMI 42) who didn't have surgery.

Eleven of the 850 bariatric surgery patients (1.29 percent) died within one month after surgery. Unadjusted analysis of the death rates over a six-year period showed that the bariatric surgery patients had lower death rates than those in the control group, but further analysis showed that bariatric surgery was not significantly associated with reduced risk of death, said Matthew L. Maciejewski, of the Durham VA Medical Center in Durham, N.C., and colleagues.

The study, published online and in the June 15 print issue of the Journal of the American Medical Association, was to be presented Sunday at an AcademyHealth research meeting in Seattle.

Even though bariatric surgery doesn't reduce the risk of death among middle-aged male patients, many of them still decide to undergo the procedure because there's strong evidence that it reduces body weight and obesity-related health problems, and improves quality of life, the researchers said.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about bariatric surgery.

SOURCE: Journal of the American Medical Association, news release, June 12, 2011Copyright

Fit Doctors More Likely to Prescribe Exercise: Study

FRIDAY, June 3 (HealthDay News) -- Medical students who are physically fit are more likely to encourage their future patients to exercise, according to a new study.

Researchers found that medical students who had normal cholesterol levels and who met the current U.S. physical activity guidelines often felt strongly that being active themselves would set a better example for the people they were treating.

In analyzing certain markers of physical health -- such as cardiorespiratory fitness -- and attitudes on physical-activity counseling in 577 medical students over the course of five years, the investigators found that 80 percent of students believed physical-activity counseling would be highly relevant in their future clinical practice.

The study authors, led by Dr. Felipe Lobelo, health scientist with the U.S. Centers for Disease Control and Prevention, pointed out that the students who said exercise counseling was important were in good shape themselves. In fact, they were 1.7 times more likely to exhibit healthy levels of cardiorespiratory fitness and 3.2 times more likely to have normal triglyceride (blood fat) levels than students who didn't believe exercise was as important.

"I'm a strong believer in doctors practicing what they preach, and I think this study illustrates the concept perfectly because it's based on doctors' objective markers of health," Lobelo said in a news release from the American College of Sports Medicine.

"Previous evidence indicates that nearly two-thirds of patients would be more willing to become physically active if their doctors advise it, and these patients find an active, healthy doctor's advice more credible and motivating. It is critical for current and future doctors to understand the public health importance of providing physical activity counseling to every patient," Lobelo concluded.

The findings were scheduled for presentation this week at the annual meeting of the American College of Sports Medicine, held in conjunction with the World Congress on Exercise Is Medicine, in Denver. Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Library of Medicine has more on the link between exercise and health.

SOURCE: American College of Sports Medicine, news release, June 2, 2011Copyright

Bone Drug Reduces Odds for Breast Cancer's Return: Study

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Transplant Surgery No Riskier at Night: Study

TUESDAY, May 31 (HealthDay News) -- Surgeon fatigue has been blamed for adverse outcomes among patients operated on at night, but new research finds that time of day has no effect on the survival rates of patients undergoing heart and lung transplants.

"We aren't suggesting that fatigue is good," said the study's lead author, Dr. Ashish S. Shah, an assistant professor of surgery at the Johns Hopkins University School of Medicine, in a university news release. "But what is important is that, at least in this specialty, it seems we're able to deal with it without subjecting the patient to risk."

The study, published June 1 in the Journal of the American Medical Association, compiled data on a decade of transplants across the United States involving a total of 27,118 patients. Researchers found survival rates up to one year after surgery were similar regardless of when the organ transplants were performed -- day or night.

Although researchers noted there was a slightly higher rate of airway dehiscence (a surgical complication) associated with nighttime lung transplants, total hospital length of stay was similar no matter what time of day surgeons operated.

The study's authors concluded that experienced transplant teams have probably found effective ways to cope with and overcome fatigue and emotional stress in order to do their jobs well. "It is likely that because urgent nighttime operations are common in all types of transplant surgery, health care personnel involved in the transplant have developed various systems to prevent errors and directly cope with the limitations associated with nighttime medical care," they wrote in the news release.

The researchers also argued that surgeons from other specialties could reduce adverse patient outcomes by copying the strategies and coping techniques used by heart and lung transplant teams.

"The authors provide us with firm evidence that even highly complex procedures can be performed safely and with good results at any time during the day," said Dr. Ernesto P. Molmenti, vice chairman of surgery and director of the transplant program at the North Shore-LIJ Health System in Manhasset, N.Y., who was not involved in the study.

"We should consider the performance quality guidelines of cardiothoracic transplant centers as a way to improve other medical and surgical outcomes," Molmenti concluded.

More information

The U.S. National Institutes of Health provides more information on heart transplant survival rates.

SOURCE: Ernesto P. Molmenti, M.D.,vice chairman of surgery and director, transplant program, North Shore-LIJ Health System in Manhasset, N.Y.; Johns Hopkins Medicine, news release, May 31, 2011.Copyright

Study Finds Almost 1 in 5 Young Adults Has High Blood Pressure

WEDNESDAY, May 25 (HealthDay News) -- About 19 percent of U.S. adults aged 24 to 32 have high blood pressure, but many of them are unaware that they have the potentially life-threatening condition, new research reveals.

High blood pressure, or hypertension, is associated with a slew of health problems, including coronary heart disease, heart failure, stroke and kidney failure. The study, funded by the U.S. National Institutes of Health (NIH), found the risk for this condition among young adults is actually greater than previously thought.

Researchers analyzed the blood pressure readings of more than 14,000 young adults who took part in the National Longitudinal Study of Adolescent Health (Add Health).

The findings, published in the current online edition of the journal Epidemiology, are a departure from previous study findings. In the recent U.S. National Health and Nutrition Examination Survey (NHANES), only 4 percent of young adults were found to be hypertensive.

"This fivefold increase in the incidence of high blood pressure in a younger, healthier population is the start of a trend of 'un-health' that we are about to see in our youth," said Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City. She was not involved in the study.

"As 30 percent of people are overweight or obese, there is a rise in other issues associated with that, such as diabetes and, now high blood pressure," Steinbaum added. "With high blood pressure happening at this younger age, the chances that we will see heart developing earlier is likely."

The reasons for the difference between the new study findings and those from NHANES is unclear.

"We explored several possible explanations for the difference between this study and NHANES, including participant characteristics, where they were examined and the types of devices for measuring their blood pressure," Kathleen Mullan Harris, principal investigator of the new study, said in an NIH news release. "None of these factors could account for the differences in estimates between the two surveys."

The investigators also pointed out that the proportion of young people who had been previously diagnosed with high blood pressure was similar in both studies: 9 percent for NHANES respondents and 11 percent for Add Health respondents.

Whatever the reason for the disparity, the new data "are a call to action," Steinbaum said. "We need to remind our younger population the critical nature of the role of diet and exercise in staying healthy, and that it must begin as early in their lives as possible or it will have negative effects on their health."

More information

The American Heart Association has more on the prevention and treatment of high blood pressure.

SOURCE: Suzanne Steinbaum, M.D., preventive cardiologist, Lenox Hill Hospital, New York City; U.S. National Institutes of Health, news release, May 25, 2011Copyright

Daily Four-Drug Combo Pill Halves Heart Disease Risk: Study

WEDNESDAY, May 25 (HealthDay News) -- A cheap, once-daily, four-drugs-in-one medication, dubbed a "polypill," appears to cut users' odds for heart disease and stroke by 50 percent, a new international study finds.

The pill combines two blood pressure-lowering medications with aspirin and a cholesterol-lowering statin and is designed to make all these heart-protecting drugs easy to take, researchers say. That, along with its expected cheap cost, might improve compliance with medication regimens, experts suggest.

"We think the role for the polypill is among those at risk of heart disease, in preventing heart attacks and strokes," said lead researcher Dr. Anthony Rodgers, a professor of global health at The George Institute in Sydney, Australia.

The study was funded by public health agencies in Australia, Brazil, New Zealand and the United Kingdom. India-based drug maker Dr. Reddy's Laboratories supplied the pill but did not play a role in funding.

Rodgers stressed that there are still unanswered questions about the pros and cons of using this type of combination pill versus prescribing several pills, where doses and medications are tailored to individual patients. A trial is ongoing to look at that question, he said.

However, tailoring medications in this area is not as important as it once seemed, Rodgers believes. "We realize now the importance of treating the overall risk. And this

Study Suggests Supplement May Protect Against Preeclampsia

FRIDAY, May 20 (HealthDay News) -- Though a new study suggests that a dietary supplement could lower the likelihood that high-risk pregnant women will develop preeclampsia, the jury is still out over whether it actually works and a specialist recommends that women not try it yet.

Preeclampsia is a pregnancy complication that can boost blood pressure to abnormally high levels, causing hypertension. It affects about 5 percent of first pregnancies.

"Women die of uncontrolled hypertension through stroke or multi-organ failure," said Dr. David Williams, an obstetrician and consultant in maternal medicine at University College London Hospitals, who co-wrote a commentary accompanying the study, which was published online May 19 in BMJ.

"Comprehensive prenatal care and modern medical practice in developed countries makes maternal mortality from preeclampsia a rare event, but it accounts for 20 percent of maternal mortality in many developing countries," Williams explained.

Scientists suspect that low levels of an amino acid called L-arginine could play a role in the development of the disease, and some have wondered whether antioxidant vitamins could lower the risk of the condition.

For the study, researchers in Mexico assigned high-risk pregnant women to one of three groups: 228 ate food bars containing L-arginine and antioxidant vitamins; 222 ate bars with vitamins only; and 222 ate bars that didn't contain the amino acid or the vitamins, considered the placebo group.

After eating the food bars daily from 20 weeks into their pregnancy through delivery, only 13 percent of the women who ate bars with L-arginine plus antioxidants developed preeclampsia; they also were less likely to give birth prematurely. In the vitamins-only group, 23 percent developed preeclampsia, as did 30 percent of women in the placebo group.

"This relatively simple and low-cost intervention may have value in reducing the risk of preeclampsia and associated preterm birth," the study concluded.

But the authors of the accompanying commentary raise questions about possible harmful effects and suggest there needs to be more research to understand "the numerous inconsistent strands of evidence relating to L-arginine and its possible effects on preeclampsia."

Williams said: "We still do not understand the complex, interacting ways in which preeclampsia develops, and it is likely to be different in different women. More work needs to be done to understand the potential of L-arginine with antioxidant vitamins, and at this stage, we do not recommend that this supplementation should be given to women at risk of preeclampsia."

More information

For more about preeclampsia, visit the U.S. National Library of Medicine.

SOURCES: David Williams, M.D., consultant in maternal medicine, University College London Hospitals, London; BMJ, news release, May 19, 2011Copyright