Health Notes

Folic acid scores another point

The naysayers on the importance of nutrients for health don’t sneer as they used to. They have been silenced by the overwhelming evidence in favor of nutritional therapy for both prevention and treatment of a number of conditions.

We have known for years that folic acid is essential to prevent certain birth defects and in the prevention of cardiovascular disease. I have written extensively on the importance of folate in the neutralization of homocysteine and xanthine oxidase. The latest discovery on the benefits of folic acid may be as momentous as these earlier findings.
A continuing study of 678 nuns has revealed that those who showed little evidence of Alzheimer’s disease at the time of their deaths-all elderly-also had high levels of folic acid when they died. There was not a single case of Alzheimer’s disease, which was confirmed by post-mortem examination of their brains.

The researcher, Dr. David A. Snowdon, from the University of Kentucky, found that his findings compared well with those from a 1998 study that examined Alzheimer’s disease from a different perspective: the levels of folic acid in patients with Alzheimer’s at the time of their deaths. The blood levels of folic acid proved to be low in these patients.

Of course, there are a lot of confounding factors in a study like this one: Were the nuns all from the same village or area where people are known to enjoy long lives? Did they drink red wine consistently all of their lives? Did they eat a lot of high-quality animal protein and animal fat? Did they restrict their amounts of refined carbohydrates?

Whether this study is valid or not, folic acid (folate) has proven itself to be a “broad-spectrum” nutrient. Just imagine protection from high blood pressure, depression, stroke, blood-clot formation, cardiovascular disease, cancer protection, and now possibly Alzheimer’s disease. That’s quite an arsenal for a single nutrient!

While vegetables and fruit contain folic acid, cooking washes most of it out from the vegetables. Your most reliable sources are egg yolks, liver, and fish. The U.S. recommended daily allowance of folic acid for adults is 400 micrograms a day, but since larger amounts are quite safe, I recommend a supplement of 1,000 micrograms daily.

References:
MARIAN BURROS, The New York Times 5/16/01

Taking the “hype” out of hypertension

Researchers from the State University of New York, Stony Brook, reported in the journal Psychosomatic Medicine that stressed and aggressive personalities may not be as prone to high blood pressure as many doctors have been led to believe.

The doctors compared the presence of high blood pressure to anger, anxiety, restrained aggression, submissiveness, and “inner tension.” (Before you ask, I have no idea what that is supposed to mean.)

“The relationship between psychological variables and hypertension, if one exists at all, is probably quite complex,” concluded researcher Dr. Joseph Schwartz (emphasis added).

I have always thought this Freudian piffle would eventually go into the historical trash can of pseudoscientific babble-and good riddance.

Reference:
Psychosomatic Medicine, February 2001

NSAIDs increase the risk of congestive heart failure

According to an Australian study, elderly users of NSAIDs who have a history of heart disease have a greater risk of developing congestive heart failure (CHF) than nonusers.

There is the usual spooky delay between suspecting danger from a drug and the actual studies performed to confirm or deny the threat to patients. These products have been on the market for 30 years!

The researchers estimate that approximately 19 percent of new CHF cases are due to consumption of NSAIDs. The authors conclude that use of NSAIDs (other than low-dose aspirin) doubles the odds of death due to an episode of CHF for the elderly. The risk increases substantially for those with a history of heart disease.

It should be noted that aspirin is indeed part of the NSAID family, and is implicated in CHF as well, though less so.

Reference:
Archives of Internal Medicine 2000; 160: 777-784

Verdict: Super aspirin is deadly

Drug companies are always looking for more powerful drugs to cover symptoms rather than finding causes for actual underlying diseases. This time they’ve put their feet into a snake pit with a new class of blood thinners known as IIb/IIIa antagonists, sometimes called “super aspirin.”

The idea behind these drugs is that they would be taken by millions of people with bad hearts to ward off heart attacks, strokes, and death. Aspirin, according to the experts, reduces the risk of death from heart disease by 20 percent (though I have always thought that to be a gross exaggeration). So these new drugs would be just like aspirin, the thinking went, except more effective-and, of course, a lot more expensive.

“Super aspirin” may be more aptly named “super killer.”

Dr. Eric Topol, cardiology chief at the Cleveland Clinic, has estimated that in the five studies done, between 150 and 200 volunteers may have died from the treatment itself.

The Data and Safety Monitoring Board (DSMB) conducted its own investigation, independent of the sponsoring drug company, Smith Kline Beecham. The DSMB is a watchdog group that monitors clinical trials to ensure patients are not being put at risk of death or injury from the particular drug being tested.

Its investigation revealed that the death rate among volunteers receiving the actual drug was significantly higher than that among patients receiving a placebo.

The committee sent a letter, headed “URGENT: PLEASE READ,” to the 700 hospitals in 30 countries with patients participating in the study, instructing officials to take these patients off the drugs pronto.

Dr. Topol has summarized the results. Combining the five studies, he found that taking “super aspirin” increases people’s risk of death by 36 percent.

Nevertheless, the testing continues. As consolation, the researchers said they would be more careful. That’s very reassuring.

Reference:
Lancet, 4/01

Keeping a lid on side effects

According to a recent study published in The Journal of the American Medical Association, researchers reporting on the effectiveness of new drugs give short shrift to information on their safety and side effects.

Out of 192 articles giving the results of randomized drug trials that compared drugs against each other and against placebo, only about a third of the studies gave specific information about toxicity levels or the severity of side effects.

Only about half spelled out details about the reactions that led patients to drop out of the trial. This is called “selective filtering.”

On average, less than a third of a page was devoted to side effects and safety. The same amount of space was taken up by the listings of contributor names and institutional affiliations. Coincidence?

Reference:
Journal of the American Medical Association, 1/24/01

Persimmons for your heart

A recent collaborative study posits that persimmons may be better than apples for promoting cardiovascular health. Persimmons contain significantly more of the polyphenol antioxidants, which prevent hardening of the arteries, than apples do.

The combination of relatively high fiber content, polyphenols, minerals, and other trace elements “makes persimmons preferable [to apples] for an antiatherosclerotic diet,” one of the researchers from Israel concluded.

Persimmons are available in most grocery stores.

Reference:

Journal of Agriculture and Food Chemistry, 2/1/01