So, ladies, this is something to try if you suffer from hot flashes or if you have stomach discomfort after eating wheat. If it doesn’t work for you, it will certainly do no harm and you might enjoy sampling the alternatives to wheat. There are many glucose free products that taste good to the whole family. We eat brown rice/pecan bread, and rice pasta. There are mac and cheese and other convenience mixes. Amy has a great pizza with a rice crust. IKEA does a delicious glucose free almond cake. Going wheat-free will cost more unless, perhaps, you make everything from scratch, but it may be worth it if it saves on physical discomfort.

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“More and more studies indicate a prevalence of CD of more than 1% in both adults and children. This should be compared with lower prevalence figures [from] 20 to 30 years ago,” Jonas Ludvigsson, MD, from the Department of Medicine, Epidemiology Unit, at the Karolinska Institute and Orebro University Hospital, Sweden, and an expert in CD, noted in an email to Medscape Medical News.

“The reason for this increase is mutlifactorial, but there is probably a true underlying increase. This has been shown when old sera have been analyzed with modern techniques, (eg, in Finland),” Dr. Ludvigsson pointed out.

Mayo Clinic Research Confirms Rise in CD

Researchers at the Mayo Clinic also report an increase in CD, according to an article in the summer issue of the Mayo Clinic’s research magazine Discovery’s Edge. Joseph Murray, MD, and colleagues analyzed stored blood samples, taken from Air Force recruits in the early 1950s, for gluten antibodies. They assumed that 1% would be positive, mirroring today’s rate. That assumption was wrong — the number of positive results was far smaller, indicating that CD was “rare,” Dr. Murray noted in the article.

This led him and his colleagues to compare those results with 2 more recently collected sets from Olmsted County, Minnesota. Their findings suggest that CD is roughly 4 times more common now than in the 1950s.

“This tells us that whatever has happened with CD has happened since 1950,” Dr. Murray said. “This increase has affected young and old people. It suggests something has happened in a pervasive fashion from the environmental perspective,” he added.

Excess Mortality Seen With CD and Latent CD

Recent research by Dr. Ludvigsson’s team (JAMA. 2009;302:1171-1178) and others supports the concept of “latent CD” or “gluten sensitivity.” Latent CD, defined in the Journal of the American Medical Association study by Dr. Ludvigsson’s team as having normal small intestinal mucosa but positive CD serology, is something that is estimated to occur in at least 1 in 1000 individuals.

Dr. Ludvigsson’s team has also reported evidence that in 1 year, 10 of 1000 individuals with CD will die compared with an expected 7 in 1000 without the disease.

“Not only is the mortality raised in patients with [CD] but also in those individuals with latent [CD],” Dr. Ludvigsson noted in a statement from the United European Gastroenterology Federation.

However, in comments to Medscape Medical News, he emphasized that “although patients with CD are at increased risk of a number of disorders, and at increased risk of death, the absolute risk increase is very small.”

A Tricky Disease

CD remains a “tricky disease,” Dr. Ludvigsson said. “It can be asymptomatic; have so-called traditional symptoms such as diarrhea, weight loss, failure to grow (in children), fatigue, and malnutrition; and have nontraditional symptoms such as osteoporosis, depression, adverse pregnancy outcome; and increased risks of both malignancy and death.”

The onset of certain autoimmune disorders including autoimmune liver disease, thyroid disease, type 1 diabetes, and Addison’s disease can actually signal CD, he noted. “This means that clinicians should consider CD in a number of symptoms and disorders.”

CD Often Undetected; Cause Unknown

CD often goes undetected, although the percentage of undetected cases varies between countries, Dr. Ludvigsson noted. “In most countries, at least two thirds of individuals with CD have not received a diagnosis by a doctor.” The reason for the high percentage of undetected disease is that the disease can be difficult to diagnose, and “it is sometimes almost asymptomatic,” he added.

Detection Methods Are Improving

Over the years, Dr. Ludvigsson told Medscape Medical News, “we have improved existing means to diagnose CD. Antibody tests are becoming better and better, although a positive antibody test should be confirmed with a small intestinal biopsy before the diagnosis is certain. Transient increases in CD antibody levels occur. In the future, I expect microscopy in the very small intestine to become a tool for diagnosis.”

Alternatives to the Gluten-Free Diet?

At this time, Dr. Ludvigsson said, the gluten-free diet remains the cornerstone of treatment for CD. However, “in the future, alternative treatment strategies may be available. The recent discovery of the structure of transglutaminase 2 may help in designing inhibitors of transglutaminase 2 to treat CD,” he said. “Another potential treatment strategy is to ingest enzymes that digest gluten, thereby increasing the safe threshold for gluten intake.

“There is also ongoing research on the topic of decreasing the bowel’s permeability to gluten, Dr. Ludvigsson told Medscape Medical News. He added, however, that the safety of this approach is unclear, as “a decreased permeability here might mean that the body cannot absorb other needed substances.

“Finally, agricultural research may mean that we can modify the gluten structure in wheat produce a kind of wheat that will not illicit an immune response in patients with CD,” the researcher noted.

Counseling CD Patients Is Important

Although evidence is scarce, said Dr. Ludvigsson, “most researchers believe that a gluten-free diet will reduce the risk of complications/comorbidity in CD, and it is important for the doctor to underline this for the patients. In patients with CD who do not become better on a gluten-free diet, the most common reason is probably that the patients do not eat a strictly gluten-free diet,” he said.

Dr. Murray advocates greater vigilance in CD patients. “It’s not enough to say, ‘You’ve got CD, be gluten-free, goodbye,’ ” he said. “CD requires medical follow-up.”

This October, at the United European Gastroenterology Week in Barcelona, Spain, Dr. Ludvigsson will be 1 of 8 researchers to receive the Association of National European and Mediterranean Societies of Gastroenterology and United European Gastroenterology Federation Rising Stars award.

Source: MedScape

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Multiple potentially carcinogenic meat-related compounds related to cooking and processing, including nitrate, nitrite, heterocyclic amines (HCAs), and polycyclic aromatic hydrocarbons (PAHs) could all be contributors to the increased rate of bladder cancer.

“Our findings highlight the importance of studying meat-related compounds to better understand the association between meat and cancer risk,” senior author Amanda J. Cross, PhD, also from the National Cancer Institute, said in a news release. “Comprehensive epidemiologic data on meat-related exposures and bladder cancer are lacking; our findings should be followed up in other prospective studies.”

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Beginning in January of 2010, the cleaning products industry is voluntarily sharing their ingredients with us. This information will show up on their labels, on their websites, by telephone request, or by written request.

This has been a long time coming and welcomed by many of us who believe we have the right to know what we are using in our homes and whether it is safe. Remember, this is voluntary, so not all companies are on board. But it is a good start!

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High total intakes of vitamins B6 and B12 are associated with a lower risk for depressive symptoms over time in community-residing older adults, according to the results of a cohort study reported online June 2 in the American Journal of Clinical Nutrition.

“B-vitamin deficiencies have been associated with depression,” write Kimberly A. Skarupski, from Rush University Medical Center in Chicago, Illinois, and colleagues. “We examined whether dietary intakes of vitamins B-6, folate, or vitamin B-12 were predictive of depressive symptoms over an average of 7.2 y in a community-based population of older adults.”

The Chicago Health and Aging project is an ongoing, population-based study in adults at least 65 years old. A sample of 3503 adults from this cohort, of whom 59% were African American, completed a food frequency questionnaire for dietary assessment. The 10-item version of the Center for Epidemiologic Studies Depression scale was used to determine incident depression, defined as 4 or more depressive symptoms. The association between vitamin intake and depression was examined with logistic regression models using generalized estimating equations.

After adjustment for age, sex, race, education, income, and use of antidepressant medications, higher total vitamin intakes including supplements were associated with a lower risk for incident depression during follow-up for up to 12 years. Odds of depressive symptoms were 2% lower per year for each additional 10 mg of vitamin B6 and an additional 10 μg of vitamin B12. Further adjustment for smoking, alcohol intake, widowhood, caregiver status, cognitive function, physical disability, and medical conditions did not abolish these associations. Food intakes of these vitamins or folate were not associated with depressive symptoms.

“Our results support the hypotheses that high total intakes of vitamins B-6 and B-12 are protective of depressive symptoms over time in community-residing older adults,” the study authors write.

“In the assessment and treatment of depressive symptoms in older adults, clinicians and other healthcare professionals should be mindful of the patient’s nutritional status in general, and whether there are vitamin insufficiencies in these nutrients before treatment,” the study authors conclude.

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High fructose intake in the form of added sugar is independently associated with higher blood pressure (BP), according to the results of a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES 2003 to 2006), reported online ahead of print July 1 in the Journal of the American Society of Nephrology.

“The recent increase in fructose consumption in industrialized nations mirrors the rise in the prevalence of hypertension, but epidemiologic studies have inconsistently linked these observations,” write Diana I. Jalal, from University of Colorado Denver Health Sciences Center in Aurora, and colleagues. “We investigated whether increased fructose intake from added sugars associates with an increased risk for higher BP levels in US adults without a history of hypertension.”

In the study sample of 4528 adults without a history of hypertension, median fructose intake was 74 g/day, which is approximately equivalent to 2.5 sugary soft drinks each day. Increased fructose intake of at least 74 g/day was independently and significantly associated with higher odds of elevated BP levels.

“These results suggest that high fructose intake, in the form of added sugar, independently associates with higher BP levels among US adults without a history of hypertension,” the study authors write.

“These findings support the hypothesis that increased intake of fructose may result in hypertension through a variety of mechanisms,” the study authors conclude. “Limiting fructose intake is readily feasible, and, in light of our results, prospective studies are needed to assess whether decreased intake of fructose from added sugars will reduce the incidence of hypertension and the burden of cardiovascular disease in the US adult population.”

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Patients with headache and migraine may need to have their vitamin D levels assessed, report researchers. Preliminary findings released here at the American Headache Society (AHS) 52nd Annual Scientific Meeting reveal low vitamin D levels in these patients, with levels similar to those found in patients with chronic pain.

“This potential biomarker should be studied in double-blind trials both for epidemiological and clinical reasons and for potential treatment effects,” said presenter John Claude Krusz, MD, from Anodyne Headache and Pain Care in Dallas, Texas. “Vitamin D may play some yet unknown role in multiple painful and possibly headache and migraine disorders.”

Researchers measured serum vitamin D levels in 900 patients and included 100 of these in the current analysis. About half of the patients had new migraine and headache (n = 55). The remaining patients had chronic pain disorders, including fibromyalgia, rheumatic, and neuropathic pain disorders (n = 45).
Investigators report low levels similar to those found in patients with chronic pain.

The average vitamin D level in patients with predominantly headache and migraine was 26.3 ng/mL. This compared to a mean vitamin D level of 25.2 ng/mL in chronic pain patients with no headache (P < .80).

These findings mirror those of another AHS poster presentation from 2008. In that study, Steven Wheeler, MD, from the Ryan Wheeler Headache Treatment Center in Miami, Florida, found low vitamin D levels in patients with migraine.

“Unfortunately, that study included a significant percentage of patients with coexistent pain disorders as well,” Dr. Krusz told Medscape Medical News. “We tried to separate, as much as possible, headache and migraine patients from those with chronic pain syndromes in order to measure and document vitamin D in both groups individually.”

In the current study, 15% of those in the headache and migraine group had other transient pain disorders in their medical history. “But not at the time their vitamin D levels were measured,” Dr. Krusz said.

He acknowledges this is a small study and neither group was compared to people without these clinical conditions.

“I screen everyone,” Dr. Krusz said, “and treat when the levels fall below the blue line”. “I think there are probably about 5 Nobel prizes to be won in this area. There’s still so much we don’t know.”
Dr. John Claude Krusz

Treat Vitamin D Deficiency

John Cannell, MD, executive director of the Vitamin D Council in San Luis Obispo, California, echoes this view. “We propose vitamin D deficiency syndrome exists when 25-hydroxyvitamin D levels of less than 50 ng/mL are found in patients with 2 or more of the following conditions: osteoporosis, heart disease, hypertension, autoimmune diseases, certain cancers, depression, chronic fatigue, or chronic pain.”

The Vitamin D Council is a nonprofit organization set up to educate the public and professionals about vitamin D deficiency. The Vitamin D Council’s recommendation of 50 ng/mL is a little lower than the current investigators cutoff of 60 ng/mL.

Dr. Cannell says that deficiency is more common among people with dark skin, elderly individuals, and those who avoid the sun. He suggests that vitamin D is safe when used in physiologic doses of at least 5000 IU/day from all sources, including sunlight, diet, and supplements.

Dr. Cannell points out that vitamin D hypersensitivity can occur in patients with primary hyperparathyroidism, occult cancers — especially lymphoma — or granulomatous disease such as sarcoidosis. “In such cases,” he notes, “treatment of vitamin D deficiency should be done under the care of a knowledgeable physician.”

The researchers have disclosed no relevant financial relationships.

American Headache Society (AHS) 52nd Annual Scientific Meeting: Poster 51. Presented June 26, 2010.

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With increasing restrictions of lead in products, cadmium is being increasingly used in jewelry products manufactured in China. Where is it found?

• cadmium batteries
• corrosion plating
• plastics
• pigments
• inexpensive jewelry
• blue ultraviolet laser light
• increasing use of this metal with products from China

HEALTH CONCERNS
Is this chemical a carcinogen?	Yes
How can it affect me?	Prolonged exposure to cadmium has been shown to cause kidney disease, severe bone loss and lung cancer. The danger is jewelry containing cadmium that is marketed to children. Children tend to put things in thier mouths where ingestion of cadmium is increased. Cadmium is less immediately toxic than lead since lead breaks down more easily when exposed to stomach acid. Ingesting larger amounts of cadmium would result in serious illness involving diarrhea and vomiting.  It’s not likely to be deadly as quickly as lead poisoning. There are currently studies underway by the Comsumer Product Safety Commission (CPSC) to determine a standard for acceptable levels, hopefully by the end of summer 2010.
Are there controversial issues?	There is increasing concern about products manufactured in China containing dangerous levels of cadmium. Many products consist of 84 % – 90% cadmium.  Most products are cheap metal pendants and bracelets, but have also been discovered in Shrek-themed drinking glasses marketed by McDonald’s. There is fear that with the strict regulations of lead in products that there will be more and more cadmium being substituted for lead.

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University researchers from Harvard and San Francisco reviewed the number of deaths and incidence of pneumonia of the deadly flu 90 years ago.

They determined that the fewest deaths and cases of pneumonia occurred in two southern American cities. These cities’ citizens had high exposure to sunlight and Vitamin D production, as compared to northern cities where the greatest deaths and pneumonia was seen.

Vitamin D is needed for the body’s production of cathelicidin, and antibacterial peptide that has been shown to fight tuberculosis and septicemia. Vitamin D also protects against endotoxins, which are release by bacteria when they are destroyed.

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