Thursday, October 21, 2010

Osteoporosis screening in postmenopausal women

* Approximately 50% of white women will have a fracture attributable to osteoporosis at some point in their lives.
* Data show that more women with diabetes that without suffer osteoporotic fractures.
* Any test designed to check bone mineral content at only one site will not be as accurate as a composite evaluation.
* The advantages of densitometry are its low cost, portability, and ease of use.

Many can remember an older female family member who had the classic dowager's hump in her upper spine and seemed to literally shrink between gatherings. Unfortunately, osteoporosis that was considered a common consequence of aging in that generation often still goes undetected in spite of widespread availability of screening methods. Even with these tools, many women every year learn of their osteoporosis only after suffering an osteoporosis-related fracture.


The North American Menopause Society's 2010 position statement for the management of osteoporosis emphasizes some significant changes with regard to the way this condition is treated in primary-care practice.1 These changes illustrate the increasing focus now placed on prevention in health care in the United States. 


Prevalence and significance


In the United States, there are nearly eight million women with osteoporosis, and an estimated 34 million with osteopenia.2,3 While postural body changes are the most obvious consequence of osteoporosis, the immense increase in fracture risk is the most significant. Approximately 50% of white women with osteoporosis will have a fracture attributable to the disease at some point in their lives.2,3 Sadly, many of these will be hip fractures that have a resultant mortality of nearly 20% at one year and a 25% incidence of need for long-term skilled nursing facility care.2-4 


When injury and pain fail to convey real significance, dollars usually tell the rest of the story. According to the U.S. Department of Health & Human Services, the typical cost of a hip fracture in 2002 was between $34,000 and $43,000, with osteoporotic fractures costing our health systems nearly $18 billion in just one year.5,6 If statistics and money still do not depict the impact of this disease, consider the immeasurable but significant secondary decline in mental and psychosocial quality of life after a hip fracture.7


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Diabetics Can Control Cholesterol Levels With Dark Chocolate


It has been claimed that one of the ingredients of dark chocolate may in fact help diabetics control high cholesterol levels.

The Hull University study has suggested that chocolate with high levels of cocoa solids is rich in polyphenols and can reduce the risk of heart disease.

It found that cholesterol fell in a small number of diabetics given bars rich in this ingredient.

A total of 12 volunteers with the type II form of the condition were given identical chocolate bars, some enriched with polyphenols, over a 16 week period.

Those given the enriched bars experienced a small improvement in their overall cholesterol 'profile', with total cholesterol falling, and levels of so-called 'good' cholesterol rising.

Steve Atkin, lead author of the study, suggested that it could mean a reduction in heart risk.

"Chocolate with a high cocoa content should be included in the diet of individuals with type II diabetes as part of a sensible, balanced approach to diet and lifestyle," BBC News quoted him as saying.

However, researchers at Diabetes UK said that the message would be interpreted as a 'green light' to eat more chocolate.

They pointed out that even bars with the highest levels of cocoa solids would contain high levels of fat and sugar, and could end up doing more harm than good.

Via : medindia

Type 2 diabetes, insulin use linked to colorectal cancer in men

A new study has revealed that type 2 diabetes mellitus is associated with colorectal cancer (CRC) among men.

Hyperglycemia and hyperinsulinemia, which are especially pronounced during the early stages of type 2 diabetes, have been proposed as mediators for the association between CRC and type 2 diabetes.

Although it is known that type 2 diabetes is associated with an increased risk of CRC, it is not clear if this association varies by gender or other factors.

"While our study supports an association of type 2 diabetes with colorectal cancer incidence among men, our results also suggest that insulin use is associated with a slight, but not a substantially increased, risk of colorectal cancer among men with type 2 diabetes," said Peter T. Campbell, lead author of this study.

"Prevention strategies should emphasize adherence to guidelines intended for the general population such as smoking cessation, weight management, exercise and regular early detection exams," the author said.

Among men, type 2 diabetes was associated with increased risk of incident CRC compared to not having type 2 diabetes. CRC risk was higher for those participants with type 2 diabetes regardless of whether or not they used insulin.

Among women, type 2 diabetes and insulin use were not associated with CRC risk.

The study appears in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute. (ANI).

Via : topnews

Fair Trade Chocolate and Halloween


Xander Wells, age five, is spreading the word about Fair Trade chocolate. It’s October 31st, 2009, in Oak Park Illinois, and he is part of a group of thousands of people across the United States and Canada participating in Reverse Trick or Treating. With his mother’s help, he is handing out glossy information cards with a Fair Trade chocolate attached. The people on the receiving end are bemused by the gesture. They laugh. They make it a point to read more about the topic later. Later, they read the cards, and they understand the seriousness behind Xander’s effort.

Through Halloween post cards and downloadable flyers, San Francisco based human rights organization Global Exchange coordinated direct Fair Trade public education to a staggering 72,000 households in a single night in 2009. This message was further amplified by dozens of print, internet, blog, radio, and television media reports on Reverse Trick-or-Treating. The effort was a collaboration of seven major national/regional nonprofit organizations, and countless local Fair Trade Coalitions, schools, congregations, and individual families.

Why the massive effort? Two words: child slavery.

Child slavery is rampant in the cocoa industry. There are an estimated 150,000 child slaves in Cote d’Ivoire alone, part of an estimated 285,000 children working on cocoa plantations throughout Africa. Every day, slave traders sell human beings into servitude for as little as two or three dollars each. Giant multinational cocoa purchasers, well aware of the rampant abuses on cocoa plantations, push the price down so low that many farmers resort to child labor. In 2001, Pascal Affi N’ Guessan, Prime Minister of Cote d’Ivoire, the world’s number one producer of cocoa, named a price ten times higher than the (then) current price to ensure quality of life for Cote d’Ivoire’s farmers.

Free-market ideology has failed the cocoa producers of the region, leaving them left to fend for themselves in the chaotic environment of a worldwide commodities market, where fluctuating prices oftentimes dip below the cost of production. For substantial portions of the last decade, for instance, the worldwide commodity price for cocoa has been below the cost of production, almost guaranteeing the perpetuation of abusive labor practices in the region.

Also, as the governments of cocoa producing nations rely heavily on the income generated from cocoa production, when prices dive, social services in health and education are cut. In cocoa producing nations, failure to set a minimum fair price hurts not only the cocoa producers themselves, but all of society.

Children, unlike heads of multinational corporations, seem to have a fundamental understanding of the concept of fairness. Xander Wells points out that people should buy Fair Trade chocolate “cause it had farmers who got paid enough money.” Xander also stressed repeatedly the importance of correcting a worrisome social injustice that he found very troubling…cocoa producing families have typically never tasted chocolate. “Some people have no chocolate and they would like to try it.”

Unless there are big changes in the way chocolate business gets done, those families might have to wait a some time to try. Chocolate manufacturers have a way of insuring that prices stay low, despite the devastating impact upon the farmers of West Africa.

Hershey’s and M&M’s Mars, two of the world’s largest chocolate companies, have refused to take substantial steps to insure that child slavery and other abuses are eliminated from cocoa plantations. Multi-million dollar lobbying efforts protect their bottom lines and guarantee that the plantations’ horrendous conditions remain under wraps.

They know the drill. They’ve been stalling for decades. In 2001, threatened with the passage of a measure in the United States House of Representatives that would have called for manufacturers to label their products ‘slave free’ or not, the United States chocolate industry fought back with a fierce lobbying effort, arguing that the ‘slave free’ label requirement would actually end up hurting the cocoa producers of West Africa. Hiring Bob Dole and George Mitchell (Senate Majority Leader from 1989 to 1994) to lobby on their behalf, the Chocolate Manufacturer’s Association successfully defeated passage of the bill.

Later that year, bowing to intense international pressure, chocolate manufacturers agreed to the ‘Harkin-Engel’ protocol, named for Senator Tom Harkin and Eliot Engel, who facilitated its creation. Major signatories included the Chocolate Manufacturer’s Association, Hershey’s, M&M’s Mars, the government of Cote d’Ivoire, and the child labor office of the International Labor Organization.

Critics of the Harkin-Engel protocol note that the measure, the only major effort to date by manufacturers to reduce suffering in the region, does nothing to prevent the root cause of the problems in the cocoa industry: unfair pricing.

That’s the core concept behind Fair Trade: people deserve to be paid a fair wage for their products. Fair Trade certification guarantees minimum pricing and a better life for cocoa farmers. And that’s why thousands of children and their parents are knocking on doors, engaging their neighbors, their friends. “Imagine this is your child,” they might say.

This civic engagement aspect drew the attention of Equal Exchange’s Rodney North to the project. Equal Exchange designed and printed informational cards, donated chocolate, and shipped the Reverse Trick-or-Treating kits free of charge to schools, congregations and schools across the country. “Equal Exchange was very happy and proud to participate. I loved the idea of regular folks having a straightforward opportunity to bring up this issue with their neighbors and at the same time introduce a positive step forward in the form of a tasty piece of Fair Trade chocolate. For us, the thing that demonstrated the significance of this project was the many letters from the participants thanking us for helping provide this opportunity to engage in this important work.”

The industry has shown signs that they are listening to the demands of consumers. Major industry players, like Green and Black’s, and Cadbury (UK) have agreed to source Fair Trade cocoa. And Ben and Jerry’s ice cream has made a commitment to going completely Fair Trade by 2013.

But still the chocolate giants don’t make any legitimate moves to eliminate child slavery. Hershey’s, despite saving money by moving most production facilities to Mexico, still can’t find a few extra cents per pound to ensure that nine year olds aren’t the ones harvesting the cocoa pods.

They probably won’t be able to resist the pressure to go Fair Trade for much longer. The next generation of chocolate lovers will bring a much greater knowledge of product origins than those who came before. People want to know more about where things come from, and the story of cocoa right now isn’t so sweet.

The kids get it.

Like many other participants, Oliver and his mother prepared for Reverse Trick-or-Treating by reading Global Exchange’s Fair Trade chocolate curriculum for children. “The day before Halloween, I sat down with my son and went over that wonderful activity book together and by the end he was so jazzed that he was going to be giving out Fair Trade chocolates that he was jumping up and down, waving his hands in the air,” recounted Oliver’s mom Joan. “And I said ‘Do you support Fair Trade?” and he shouted ‘yes!’ and I said ‘why?’ and he said ‘because it doesn’t make kids work in the farms!”

Via : conducivemag

Mediterranean Diet Preferable to Low-Fat Diet in Lowering Diabetes Risk

A study published on the Diabetes Care website (October 7, 2010) has announced that a Mediterranean diet is preferable to a low fat diet in preventing type 2 diabetes mellitus. The study was led by Universitari de Sant Joan’s Jordi Salas-Salvadó, M. D., Ph. D.

The study followed 418 non-diabetic subjects between the ages of 55 and 80 who were at high cardiovascular risk. Over a period of 4 years three groups of participants were assigned to different dietary regimens: the Mediterraneandiet supplemented with 1 litre of olive oil per week; the Mediterranean diet supplemented with 30g of nuts per week; and a low fat diet, which served as the control group.

During the follow-up researchers found the highest incidence of diabetes in the control group, with 17.9% of individuals having developed the disease. There was a 10.1% incidence in the group consuming the Mediterraneandiet supplemented with olive oil, and 11.0% in the group consuming the Mediterranean diet supplemented with nuts.

Researchers concluded that an increased adherence to the Mediterranean diet was inversely related to diabetes incidence in subjects at high cardiovascular risk. Heavy consumption of olive oil and vegetables, supplemented by nuts, is estimated to reduce the risk of diabetes by 52%.

Via : topnews

Avandia might cause heart patients: FDA

The U.S. Food and Drug Administration asserted that the type 2 diabetes mellitus drug Avandia, made by GlaxoSmithKline, is associated with increased heart risk like a condition similar to myocardial infarction (heart attack) and stroke.

The FDA will be discontinuing the use of Avandia, or rosiglitazone, to patients with type 2 diabetes mellitus.

Dr. David Graham, veteran drug safety examiner at the FDA, previously said, “There was no reason for the agency to keep the risky diabetes drug on the market, now that another drug Actos, which is in the same class, but much safer, compared to the Avandia.”

A study done by Dr. Steven Nissen, famous cardiologist at the Cleveland Clinic, did an examination and published the finding in 2007 at the New England Journal of Medicine, which associates usage of Avandia to 43 percent increased risk of heart attack and hospitalization for blocked coronary arteries.

The FDA on the other hand asks Glaxo to commission an independent re-adjudication of the controversial trial. This fact indicates the lameness of the report as stated by Dr. Nissen.

Dr. Nissen further added that the FDA restriction in association with the European ban of Avandia might prohibit the usage of drug by 99 percent.

Via : topnews