To drink or not to drink: Keep your brain young with moderate alcohol consumption

By Tom Secrest

27 August 2011

We get a lot of conflicting information regarding alcohol consumption and our health. It seems like that for the past 20 years, the more or less official line has been alcohol is bad. However, every now and then we hear reports that say alcohol, in moderation, is okay. When we analysis the word ‘okay’ it turns out to not be a powerful endorsement. If you needed surgery, knowing that your surgeon was ‘okay’ at their job wouldn’t be particularly reassuring.

So where does the medical and scientific community stand on this issue now? In Aug. 2011, Dr. Edward J. Neafsey, published a paper in Neuropsychiatric Disease and Treatment that suggests that light to moderate drinking may reduce the risk cognitive decline and dementia. Up front it is important to define what light to moderate means and it probably doesn’t mean what you think. For men, moderate drinking means no more than 2 drinks per day and for women, it means no more than one drink per day. As you can see moderate drinking is a misnomer, it really means that alcohol should be treated like medicine and not a social enzyme.

With that in mind, this huge meta-analysis study found that those who consumed beer, wine or spirits, in moderation, reduced their risk of dementia, including Alzheimer’s disease, by 23%. The evidence appears to indicate that there is little or no distinction between beer, wine and spirits. It is the alcohol that is protective and the source of alcohol seems to be relatively unimportant.

Let’s pause here and define what constitutes a ‘drink’ with regard to beer, wine and spirits. What constitutes a single drink depends on the alcohol content of the drink. The alcohol content of a beer is about 5%; although, some can be higher, perhaps up to 7%. Therefore, 12 oz. (355 ml) of beer is considered 1 drink. Remember not all cans are the same, some cans are 12 oz. and some are 22 oz. and represent almost two drinks in one can. The alcohol content of wine is around 11%, but like beer, it can be higher, perhaps up to 13% or 14%. The % content is clearly shown on the label. Therefore, 4-5 oz. (118 ml – 148 ml) of wine is considered to be one drink. Spirits can be confusing because the alcohol content is given as ‘proof,’ which is twice the percentage (i.e. 40% alcohol is 80 proof) and the variation in alcohol content between brands is considerable. Mixed drinks are even harder to calculate, therefore, I have linked to an alcohol content calculator so you can easily find the alcohol content of your favorite mixed drink.

One possible explanation for the benefits is offered by Dr. Neafey and Dr. Collins. They suggest that small amounts of alcohol stress brain cells just a tiny bit. The brain cells respond by increasing their production of protective compounds. As a result, when a more significant or even lethal stressor comes along, the brains cells are unaffected, due to the higher levels of these protective compounds.

If you plan to consume alcohol in a medicinal way, i.e. as described above, you might want to consider red wine. Current research suggests that there is some health benefit associated with resveratrol. This compound is found in many plants including red grapes. As a result, wine production tends to concentrate this substance in red wine, which makes red wine a reasonable source of this biologically important compound. For now the health benefits seem to be cardiovascular in nature, but current research is looking into many other potential health benefits.

It probably doesn’t need to be mentioned, but, if you have had alcohol problems the benefits are unlikely to outweigh the risks and if you are pregnant, definitely discuss even light to moderate alcohol consumption with your doctor. For everyone else, the research is very conclusive; there are no health benefits and multiple health risks associated with over consumption.

Live long and well.

Something New for Halloween: Trick or Flu Sho

By Tom Secrest

October 17, 2010

Each autumn, along with the arrival of pumpkins, ghosts and goblins, we start hearing Public Health announcements reminding us that it’s time for our annual flu shot, or as the British would say, our annual flu jab. Most people shrug off the suggestion, feeling that they are constitutionally strong enough to handle four or five days of a running nose, a slight fever, muscle aches and joint pains. For the most part they are probably right. Part of their apathy stems from busy schedules; however, some comes from stories they have heard about people who got the flu shot and then got the flu and some comes from rising public apprehension regarding vaccines in general, especially after the swine flu fiasco of 2009.

There’s not much I can say about the Swine Flu–Chicken Little situation, or perhaps I have more to say than a have paper to say it. Either way it’s not the topic of this article. On the other hand I can quickly and easily cast aside the myth about getting the flu from a flu vaccine: It can’t happen, it doesn’t happen and it won’t happen to you. Some people may have very, very mild flu-like symptoms (usually in the form of muscle aches) for 24 hours, but that’s usually the extent of it. If you actually come down with the flu after the vaccine, it simply means you were already infected when you got the vaccine or you were infected very shortly after getting the flu vaccine. The vaccine takes 2-3 weeks to work, so if you’re already infected when you get your flu shot or you are infected shortly after, you will still get sick, but it’s not because of the vaccine.

Even though there are many people who opt out of the annual flu shot, many people, including myself, go out of their way to find the time needed to get the jab. People get the flu shot for many reasons; some are specific health related reasons, while others, this would include me, find it much easier to find an hour to get a flu shot than to find 4 or 5 days when we can stay home sick.

Perhaps you’ve been sitting on the fence just waiting for that little piece of information that prompts you to become a regular flu shot recipient. Well this might be the piece of news you’ve been waiting for.

A new study from the United Kingdom, published in the September 21, 2010 issue of the Canadian Medical Association Journal, found that the flu vaccine is associated with a 20% reduction in the risk of a first heart attack or myocardial infarction (MI). Any way you cut it, 20% is nothing to sneeze at. The authors noted that there was no reduction associated with the pneumococcal vaccine, which is also routinely recommended for those with pre-existing health complications.

The study also found two things that were a bit surprising; (1) earlier vaccinations (i.e. given before the middle of November) were associated with greater reductions in the risk of a first MI than vaccinations given after the middle of November and (2) the benefits extended to those aged from 40 to 65 in the same way as those 65 and older.

Historically, flu shots have been aggressively recommended only for those over 65. In an interview with Heartwire, the lead author, Dr. Siriwardena, was asked if he thought flu vaccine recommendations needed to be changed. Dr. Siriwardena responded that recommendations won’t likely be changed until the cause and effect of the MI risk reduction was established, but added that if it is established, recommendations might be extended to those between the age of 40 and 65 who are at increased risk of heart attacks (i.e. smokers, those with high cholesterol, high blood pressure, diabetes, etc.).

Now when you consider the inconvenience of going to get a flu shot you must also consider the inconvenience of having a heart attack. With a potential 20% reduction in your risk, finding the time seems like a pretty good value. Remember, don’t delay, the study showed you can reduce your risk even more if you get your flu shot before the middle of November.

Live long and well.

Smoke your way to breast cancer

What makes a woman a woman? If you said breasts you’re partially correct, but if you said a second X chromosome you would be spot on. Whether it is the second X that makes women more likely to get breast cancer is beyond this scope of this little article. What is not beyond the scope is a new study that has, hopefully, driven another nail into the cigarette coffin.

More than likely you are not actually the target audience for this article. However, the target audience is not likely to be reading this, so it falls to you to become the messenger. While tobacco companies don’t view Europe or the U.S. as their most profitable markets, they haven’t entirely abandoned them either. These companies view you, the reader, pretty much as a lost cause. Either you already smoke and are unlikely to switch brands, or you don’t smoke and are not likely to start. Either way, they’re not particularly interested in you. On the other hand, a teenager is a different story. A teenager represents a desirable target, which, if acquired, represents perhaps 50, or more, years of sales. Therefore, my hope is that when you read this you will carry the message to the people I can’t reach; to your daughter or niece, or to your friends and colleagues, who can then pass it on to their daughters and nieces. This article may not be THE message that makes the difference, but it might be part of an overall message that stops a young woman (girl) from becoming a smoker.

Women, especially western women are breast centric. This is in no small part because men are also breast centric and the fashion and advertising world has been well aware of this for a long, long time. Whether breasts should define a woman is irrelevant, the fact is, in part, they do. Few things scare a woman more than the idea of breast cancer. While treatments today are less disfiguring that those of the past, the psychological trauma is no less real. Breast cancer strikes at both a woman’s body and her mind. In many ways it would be similar to a man dealing with testicular cancer, although, in my opinion, society has made it more difficult for a woman. If you disagree I only ask that you watch a little TV tonight or flip through a magazine and count how many times you encounter suggestively exposed testicles. On the other hand, if you were counting suggestively exposed breasts, I think you would get tired of counting pretty fast.

Now to the point; in a recent study, presented by lead author Dr. Dejana Braithwaite, at the 9^th Annual American Association for Cancer Research international conference, she describes that current and former smokers had an alarming 39% higher rate of dying from breast cancer than those that had never smoked. The prospective study was large and involved 2265 women with a follow-up period of 9 years. In the past the link between smoking and dying of breast cancer was not well established and the studies that suggested a link where not technically strong. However, the size and scope of this study greatly increases its statistical predictive power. What that means is, you can’t ignore this study and hope it goes away.

What is important to note is NEVER SMOKING is key. The study included both current and former smokers. What was found was that former smokers were still at risk.

As important as what the study says, is what it leaves unanswered. The relationship between smoking and an increased risk of breast cancer is controversial. What is known is that many of the chemicals found in tobacco smoke can be found in breast milk; this means that known carcinogens are, at the very least, interacting with a woman’s breast tissue, a tissue which, by its very nature, tends to be more susceptible to cancer than many other body tissues. Additionally, there have been studies in animal models (rodents) that have suggested a strong link between chemicals in tobacco smoke and breast cancer.

I’m not one given to lecturing, but before you give in to peer pressure, social pressure, or any of the myriad of other factors that persuasively encourage you to take that first puff – stop take a deep, smoke-free breath and think long and hard about your future. Then look down at those delicate symbols of femininity and imagine a cancer growing inside one of them. Now ask yourself – do you really, really want to become a smoker?

Live long and well.

Beam My Brain Mr. Scott

By Tom Secrest

06 FEB 2010

With the exception of implantable cardiac devices, there are few pieces of technology with which we have such intimate contact. Depending on how much time you spend on the phone the amount of contact can range from less than a minute per day to perhaps hours per day. What makes mobile phone use special is that we press these devices against our heads as part of normal use.

People have been worried about potential health effects of mobile phones for many years. The concern may date back to April 3, 1973 when Martin Cooper of Motorola, made the first modern mobile phone call to, his engineering rival, Joel Engel of Bell Labs. With almost forty years of use, you would think we would have a respectable amount of data regarding potential health effects.

As it turns out there have been numerous studies that have examined the link between various forms of tumors and cancers and mobile phone use. However, at best, the results of these studies are inconclusive. Some studies found links to both benign and malignant tumors, while other studies actually found that mobile phone use was protective and reported odds ratios less than 1.

The question becomes what to do with multiple studies that present conflicting results. The well-established answer is to do a meta-analysis. In the November 20, 2009 issue of Journal of Clinical Oncology, Seung-Kwon MD presented the results of his meta-analysis on this subject. His conclusion was that the use of mobile phones was not significantly associated with the risk of tumors compared to people who infrequently or never used mobile phones.

However, the beauty of a meta-analysis is that you can create subsets of studies and then draw additional conclusions. In a subset of 13 studies, the research group found that those with more than a 10 year history of mobile phone use did have a significantly higher risk of tumors.

In another subset, they found that research that had, at least in part, been funded by groups associated with the mobile phone industry, generally showed protective effects from phone use, while a subset without any association with the mobile phone industry, generally, reported higher risks of both benign and malignant tumors, or no effects at all.

While we scientists like to believe that we are beyond corruption, this inconclusive meta-analysis may offer a valuable lesson – sometimes you get exactly what you pay for.

Additionally, the meta-analysis may provide us with a good reason to go buy one of those ear-piece microphone headsets. But be prepared, we will, no doubt, have to wait another 30 years before there is a meta-analysis of studies regarding the effects of sticking a short length radio wave transmitter, i.e. Bluetooth, in your ear.

Rare, Medium, or Melanoma

By Tom Secrest

It’s hard to know why it took so long to reach the conclusion announced on 29 July 2009 by the World Health Organization’s International Agency for Research on Cancer (IARC).

If you stop and think about it, a sun bed, or tanning bed, looks a lot like some sort of futuristic device for grilling a very large klobása. Why humans would want to get inside and be bar-b-qued to a golden brown is an interesting social and cultural, question. Perhaps it’s because we believe that once sautéed to perfection, we will look like the models that are used to advertise the tanning beds.

However, the days of being ultravioletly grilled like a kabab may soon be over now that UVA light has made it onto the list of Class (Group) 1 carcinogens. You may recall that sun beds were supposed to be safe since the light bulbs used in sun beds generated more UVA and less UVB light. Vincent Cogliano, PhD, said studies have shown that UVA, UVB, and UVC all cause cancer in animal models and that evidence linking indoor tanning to melanomas was “sufficient and compelling.”

In 2006 the IARC published a report indicating that regular use of sun beds before the age of 30 increased the risk of melanoma by 75%. The group also noted that there has been a change in the character of the melanomas being seen today. The IARC reported that beginning in the early 1990s there has been a significant increase in the number of thicker, more deadly, lesions. Researchers believe that sun beds may have played a major role in both the increase in numbers as well as the change in the character of melanomas. Eleni Linos, MD, DrPh, Stanford University, one of the study co-authors, also noted that there are several studies indicating that tanning is on the increase again, particularly in younger women. The National Institute of Health reported that the number of cases of melanoma among young women tripled between 1973 and 2004. A personal observation, as I looked through Google images for pictures of tanning beds, of the 90 images I viewed, only one featured a male model.

Even before the announcement, Texas lawmakers were considering strengthening legislation that would require anyone under 18 to have a doctor’s permission and be accompanied by a parent in order to use commercial tanning beds. Current Texas law requires children under 18 to have a note of permission from their parent’s, children younger than 16 must be accompanied by a parent, and children under 13 require permission from a doctor.

Naturally there is a tanning bed lobby, who, not surprisingly consider the warnings to be overly alarmist and suggest that like most things, tanning beds, if used properly and in moderation, are safe. As I recall, these comments are strikingly similar to the comments made by the tobacco lobby and the plutonium lobby.

The next time you want something golden brown, consider throwing a steak on the grill and not yourself; there’s nothing wrong with being a whiter shade of pale.

The Lancet Oncology, Aug 2009, A review of human carcinogens – Part D: radiation.

Vocabulary

* medium rare – stredne propecený

* long reach – velký dosah

* tanning – opalující

* recall – pripomenout

* sufficient – dostatecný

* compelling – presvedcivý

* thicker – tlustší, silnejší

* lawmaker – zákonodárce

* considering – vzhledem k, se zretelem na

* strengthening – zesílení, posílení

* require – požadovat (se 4.pádem)

* permission –povolení, svolení

* accompanied – doprovázený

* surprisingly – prekvapive, kupodivu

* strikingly – prekvapive, nápadne

* throwing –házení, vrhání

* shade – odstín, nádech

* pale – bledý

H1N1: Are you at special risk?

Step on a scale and find out.

By Tom Secrest

Question: How do you know if you’re too fat?
Answer: You know you’re too fat if whenever you go to the beach, people rush up and start pouring water over you, while others try to drag you back into the ocean.

As if obesity didn’t present enough health issues by itself, there is now another one to worry about.

The first case of H1N1 in the United States was confirmed on April 15, 2009. By July 10^th the number of confirmed and probable cases had increased to 37,246. Globally the virus has killed almost 500 people, with 211 of those in the U.S. Also on July 10^th directors from all the relevant U.S. health agencies met to strategize for what they expect will be a resurgence of the virus this fall. Current estimates suggest that the resurgence and the availability of the first vaccine will have an uncomfortably close proximity in time, and no one knows for sure which will arrive first, but several things point to the flu. The fall flu season in the U.S. coincides with the beginning of the new school year. Depending on the state, that date can range from August 24 to mid September. The vaccine isn’t scheduled to arrive until the middle of October. If cases begin to appear as predicted, the virus may have at least one month’s head start.

The H1N1 virus is a bit different in that it seems to target younger people, which make schools perfect spreading grounds. However there is another factor that’s going to put both children and their parents at risk. America has been getting fatter and fatter, or to be more politically correct, more and more obese. We often think of young people, even young fat people as being healthy, perhaps not fit, but healthy. The dangers of obesity are generally viewed to come much later in life. However on 11 July, 2009, an advanced report from the CDC hinted that obesity may be emerging as a risk factor for flu complications and death.

The CDC report followed ten H1N1 cases admitted to the University of Michigan Health System hospital intensive care unit between May 26 and June 18, 2009. All 10 cases were severe enough to require the patients to be put on ventilators and six required treatment for acute renal failure. Of the 10 cases, 9 were obese (BMI > 30) and 7 of the 9 were extremely obese (BMI > 40). Of the 10 cases there were 3 deaths. All three deaths involved obese patients and 2 of the 3 were extremely obese. The least obese of the 3 had asthma as an underlying condition and was age 28. The other 2 patients had no underlying medical conditions and were aged 43 and 44. Of the 7 that lived, the report goes to say, none have fully recovered.

The CDC report fell well short of a blanket statement suggesting that obesity is an independent risk factor associated with more severe complications; noting that in previous flu outbreaks, obesity had not be identified as a risk factor. However, in the editorial note the accompanied the report, the CDC observed “the high prevalence of obesity in this case series is striking.”

The same report also suggests that doctors can double the normally prescribed does of Tamiflu (Roche AG) without any additional risks, but stopped short of saying that higher doses should be used in obese patients. Dr. Tim Uyeki, a CDC influenza expert, also noted that, as with H5N1, patients seem to do better when given Tamiflu for periods longer than the recommended five-days.

Current CDC guidance (http://www.cdc.gov/h1n1flu/recommendations.htm#table1) is that adults receive 75 mg, twice a day for 5 days, for treatment or 75 mg, once a day, for prophylaxis. Dosing for children less than 40 kg is weight specific. All ten patients in the above mentioned report received both larger doses of Tamiflu and extended dosing as part of their treatment.

It looks like we now have one more reason to start that diet we have been putting off; and with flu season rapidly approaching, now is as good a time as any to start shedding kilos.

Happy dieting.

The full CDC, July 10, 2009 MMWR Dispatch can be found at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0710a1.htm

Vocabulary

• to pour water (over) – polévat vodou
• to confirm – potvrdit
• to kill – zabíjet
• to expect – očekávat, předpokládat, domnívat se
• resurgence – obnova, oživení
• estimates – odhady
• availability – dostupnost
• uncomfortably – nepohodlně
• proximity – blízkost
• to coincide – shodovat se (časově)
• depending on – v závislosti na
• to spread – rozšiřovat (se)
• to emerge – objevovat se, vynořovat se
• to hint – naznačovat (co)
• underlying – zásadní, výchozí
• recovered – obnovený, zotavený
• to suggest – navrhovat; doporučovat
• outbreak – propuknutí
• accompanied – doprovázený
• striking – pozoruhodný, markantní, překvapivý
• additional – dodatečný, navíc
• dosing – dávkování
• to mention – zmínit, uvést
• reason – důvod, příčina
• approaching – blížící, přibližující
• to shed – shazovat

Music to Soothe the Savage Beast

Music to Soothe the Savage Beast

By Tom Secrest

Everyone has their own particular taste in music. Some like opera, some rock, some jazz, and others like what appears to be random noise played a very high volume, although I think the technical name is hip hop. I only mention the latter because the person who lives in the flat above mine appears to fall into this category.

While my personal physiological reaction to the wall shaking racket coming from above is not what the researchers were talking about in their recent publication in the 30 June, 2009 issue of Circulation, I feel strongly that it should definitely be included in their future research. Working Title: Hip Hop Induced CVA.

Putting my personal issues aside, what the researchers did find was a very positive correlation between music, especially music with distinct dynamics (i.e. crescendos, decrescendos, etc) and heart rate, blood pressure, dermal blood flow, ECGs, and respiration. It might be expected that musicians would be naturally responsive, but the research was carried out on both those with established musical inclinations and those, like me, with no more musical talent than a monkey with a stick. The results, while more pronounced in the musically inclined, were still very much evident in the less musically disposed.

It is generally accepted that music can produce emotional responses, sometimes even strong emotional responses. Music is used by many to relax and reduce stress, while others find certain types of music to be motivational while they exercise at a fitness center. However, Dr. Bernardi and his research group form Pavia University in Italy, took specific steps to minimize the affect of the emotional response variable. Once accounted for, it became clear that, regardless of the perceived emotional response, or lack thereof, there was still a measurable and correlated physiological response to the dynamics of the music.

The current research used subjects between 24 and 26 years old. According to Dr. Bernardi, he next wants to examine the response in older patients, those more than 70. Dr. Bernardi also noted that in the new study, he will include a wider variety of music including rock. Future studies may also include coronary patients with sever functional limitations. In such patients, even modest gains in BP, HR and blood flow could be very significant, noted Dr. Franklin, director of the cardiac rehabilitation laboratories at William Beaumont Hospital, Royal Oak, MI.

Now when you enjoy your favorite piece of music you can relax even more knowing that it is not only good for you psychologically, but good for you physiologically as well. Conversely the next time you are subjected to ear splitting hip hop, consider that you may drop dead from a stroke or your heart may explode in you chest. It's all part of the musical score of life.

Vocabulary

* to soothe – mírnít, uklidnit, utišit

* savage – divoký, neurvalý, krutý

* appears to be – zdá se být

* random – náhodný, libovolný

* shaking – otrásání

* racket – hluk, randál, rámus

* putting aside – zde: nechme stranou

* heart rate (HR) – srdecní frekvence

* distinct – zretelný, presný

* blood pressure (BP) – krevní tlak

* blood flow – tok krve

* established – zavedený, vžitý, tradicní

* pronounced – vyhranený, výrazný

* disposed – mající sklon, disponovaný

* regardless – bez ohledu na, navzdory všemu

* wider – širší

* even modest gains – i malé zvýšení

* conversely – obrácene, naopak

* to split – štepit, pukat, trhat

* to consider – zvažovat, brát v úvahu

* chest – hrud