John Wiens DC

Cochrane systematic review has demonstrated that antioxidant supplements may increase mortality

By John Wiens DC|January 13, 2013|Nutrition|

Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases

Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C

Previous research on animal and physiological models suggests that antioxidant supplements have beneficial effects that may prolong life. Some observational studies also suggest that antioxidant supplements may prolong life, whereas other observational studies demonstrate neutral or harmful effects. Our Cochrane review from 2008 demonstrated that antioxidant supplements seem to increase mortality. This review is now updated.

The present systematic review included 78 randomised clinical trials. In total, 296,707 participants were randomised to antioxidant supplements (beta-carotene, vitamin A, vitamin C, vitamin E, and selenium) versus placebo or no intervention. Twenty-six trials included 215,900 healthy participants. Fifty-two trials included 80,807 participants with various diseases in a stable phase (including gastrointestinal, cardiovascular, neurological, ocular, dermatological, rheumatoid, renal, endocrinological, or unspecified diseases). A total of 21,484 of 183,749 participants (11.7%) randomised to antioxidant supplements and 11,479 of 112,958 participants (10.2%) randomised to placebo or no intervention died. The trials appeared to have enough statistical similarity that they could be combined. When all of the trials were combined, antioxidants may or may not have increased mortality depending on which statistical combination method was employed; the analysis that is typically used when similarity is present demonstrated that antioxidant use did slightly increase mortality (that is, the patients consuming the antioxidants were 1.03 times as likely to die as were the controls). When analyses were done to identify factors that were associated with this finding, the two factors identified were better methodology to prevent bias from being a factor in the trial (trials with ‘low risk of bias’) and the use of vitamin A. In fact, when the trials with low risks of bias were considered separately, the increased mortality was even more pronounced (1.04 times as likely to die as were the controls). The potential damage from vitamin A disappeared when only the low risks of bias trials were considered. The increased risk of mortality was associated with beta-carotene and possibly vitamin E and vitamin A, but was not associated with the use of vitamin C or selenium. The current evidence does not support the use of antioxidant supplements in the general population or in patients with various diseases.

Authors’ conclusions:

We found no evidence to support antioxidant supplements for primary or secondary prevention. Beta-carotene and vitamin E seem to increase mortality, and so may higher doses of vitamin A. Antioxidant supplements need to be considered as medicinal products and should undergo sufficient evaluation before marketing.

Abstract included here.

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FluView

By John Wiens DC|January 11, 2013|General Health|

ILInet provides an interactive activity level indicator of Flu-Like Illness for the United States.

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How a drug went from $50 to $28,000 a vial

By John Wiens DC|December 30, 2012|Health Care|

Source NY Times

The doctor was dumbfounded: a drug that used to cost $50 was now selling for $28,000 for a 5-milliliter vial.

The physician, Dr. Ladislas Lazaro IV, remembered occasionally prescribing this anti-inflammatory, named H.P. Acthar Gel, for gout back in the early 1990s. Then the drug seemed to fade from view. Dr. Lazaro had all but forgotten about it, until a sales representative from a company called Questcor Pharmaceuticals appeared at his office and suggested that he try it for various rheumatologic conditions.

“I’ve never seen anything like this,” Dr. Lazaro, a rheumatologist in Lafayette, La., says of the price increase.

How the price of this drug rose so far, so fast is a story for these troubled times in American health care — a tale of aggressive marketing, questionable medicine and, not least, out-of-control costs. At the center of it is Questcor, which turned the once-obscure Acthar into a hugely profitable wonder drug and itself into one of Wall Street’s highest fliers. (more…)

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Could High Insulin Make You Fat? Mouse Study Says Yes

By John Wiens DC|December 30, 2012|Nutrition|

Source Science Daily

Animals with persistently lower insulin stay trim even as they indulge themselves on a high-fat, all-you-can-eat buffet.

When we eat too much, obesity may develop as a result of chronically high insulin levels, not the other way around. That’s according to new evidence in mice reported in the December 4th Cell Metabolism, a Cell Press publication, which challenges the widespread view that rising insulin is a secondary consequence of obesity and insulin resistance.

The new study helps to solve this chicken-or-the-egg dilemma by showing that animals with persistently lower insulin stay trim even as they indulge themselves on a high-fat, all-you-can-eat buffet. The findings come as some of the first direct evidence in mammals that circulating insulin itself drives obesity, the researchers say.

The results are also consistent with clinical studies showing that long-term insulin use by people with diabetes tends to come with weight gain, says James Johnson of the University of British Columbia.

“We are very inclined to think of insulin as either good or bad, but it’s neither,” Johnson said. “This doesn’t mean anyone should stop taking insulin; there are nuances and ranges at which insulin levels are optimal.” (more…)

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Best and worst jobs for people in pain

By John Wiens DC|December 23, 2012|General Health|

Source Health.com

Going to work when you have a chronic pain-causing condition can be difficult or even downright impossible, depending on the job. Studies have shown that people with rheumatoid arthritis are more likely to change jobs, reduce their hours, be fired, and retire early than people without the condition.

If you have chronic pain and are in the workforce, you should try to find an occupation that isn’t too physically demanding and allows you to work at your own pace.

Best: Administrative assistant
Sitting at a desk all day is not ideal for someone with painful joints. Working as an administrative assistant, however, could have its benefits. You may not have to perform a lot of repetitive movements, unless it’s typing. Also, this position probably comes with some flexibility—it’s important to be able to move around when you need to and take breaks as necessary.

A 2012 study out of the University of Georgia found that administrative assistants and office staff in general had the fewest reported injuries of the occupations studied.

Worst: Landscaping
If you have a green thumb, it’s wise to limit your talents to your own yard. Landscaping tasks like pruning that involve frequent use of hand tools can cause pain in the small joints.

Landscaping also requires a lot of bending, stooping over, and kneeling, which can cause pain in joints, particularly the knees. Finally, it also involves lifting and hauling, sometimes in wheelbarrows, which can cause back pain. (more…)

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Vertebral artery strains during high-speed, low amplitude cervical spinal manipulation.

By John Wiens DC|November 23, 2012|Research|

J Electromyogr Kinesiol . 2012 Oct;22(5):740-6. doi: 10.1016/j.jelekin.2012.03.005. Epub 2012 Apr 5.

Herzog W, Leonard TR, Symons B, Tang C, Wuest S.

Abstract

Spinal manipulative therapy (SMT) has been recognized as an effective treatment modality for many back, neck and musculoskeletal problems. One of the major issues of the use of SMT is its safety, especially with regards to neck manipulation and the risk of stroke. The vast majority of these accidents involve the vertebro-basilar system, specifically the vertebral artery (VA) between C2/C1. However, the mechanics of this region of the VA during SMT are unexplored. Here, we present first ever data on the mechanics of this region during cervical SMT performed by clinicians. VA strains obtained during SMT are significantly smaller than those obtained during diagnostic and range of motion testing, and are much smaller than failure strains. We conclude from this work that cervical SMT performed by trained clinicians does not appear to place undue strain on VA, and thus does not seem to be a factor in vertebro-basilar injuries.

The October 2012 issue is devoted to the study of spinal manipulation.

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About John Wiens DC

Cochrane systematic review has demonstrated that antioxidant supplements may increase mortality

Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases

FluView

ILInet provides an interactive activity level indicator of Flu-Like Illness for the United States.

How a drug went from $50 to $28,000 a vial

The doctor was dumbfounded: a drug that used to cost $50 was now selling for $28,000 for a 5-milliliter vial.

Could High Insulin Make You Fat? Mouse Study Says Yes

Animals with persistently lower insulin stay trim even as they indulge themselves on a high-fat, all-you-can-eat buffet.

Best and worst jobs for people in pain

Vertebral artery strains during high-speed, low amplitude cervical spinal manipulation.

Abstract