August

People with moderate-to-severe vitamin D deficiencies are significantly more likely to develop Alzheimer’s disease or other forms of dementia than those who have an adequate supply of the vitamin in their body, a new study has found.

Researchers, led by David J. Llewellyn at the University of Exeter Medical School, found that adults who suffered from a moderate deficiency of vitamin D had a 53 percent higher risk of some form of dementia, while the risk increased 125 percent in those with severe deficiencies. People moderately deficient in vitamin D were 69 percent more likely to develop Alzheimer’s-caused dementia, while those severely deficient raised the risk to 122 percent.

The team discovered what appear to be clear threshold levels for brain health using standard medical measurements of concentration in the blood. The risk of dementia appears to rise for people with vitamin D blood levels below 25 nanomoles per liter, while vitamin D levels above 50 nanomoles appear to be good levels for brain health.

Llewellyn said that although the international team of researchers expected to find a link between vitamin D deficiency and dementia, the strong correlation between the two was surprising. He said further study was necessary to determine whether consuming oily fish or vitamin D supplements might prevent Alzheimer’s disease.

Alzheimer’s disease is the leading form of dementia, affecting more than 5 million people in the United States. That number is expected to reach 16 million by 2050 as the population ages.

Vitamin D, which helps the body use calcium, is created when skin is exposed to sunshine. Milk is often fortified with the vitamin, and it is also found in fatty fish and other foods.

Researchers in the Exeter study noted that laboratory experiments have shown that vitamin D may play a role in ridding cells of beta-amyloid plaques, an abnormality that distinguishes Alzheimer’s.

“It seems to be that vitamin D was actually helping to break down and take away those protein abnormalities,” Llewellyn said Wednesday in an interview.

The study, funded in part by the Alzheimer’s Association, appeared Wednesday in Neurology, the medical journal of the American Academy of Neurology.

Source: Washington Post

PHC’s Dr. Elting appeared on News Channel 8 Monday with Bruce Depuyt to discuss Ebola virus. Depuyt asked Dr. Elting, an infectious disease specialist, for insight into the virus and the pair of American patients who just arrived in the United States for treatment.

From the broadcast:

We begin this time with the latest on the Ebola crisis in Africa. A new report just out overnight finds 826 people have died from the virus. There’s been a surge of cases in Liberia and Sierra Leone. The American doctor suffering from Ebola is now being treated in a Georgia hospital and a colleague is on her way home.

Joining us now is Dr. Jeffrey Elting. Dr. Elting is the Medical Director of the Presidential Healthcare Center in the district. Before taking his current position, he coordinated bioterrorism responses for the DC Hospital Association.

“It’s a hemorrhagic fever virus,” Dr. Elting said. “There have been over 40 outbreaks over the last 40 years, mostly in Africa, and with that comes a high death rate.”

“You have to take into account that, in some of those areas, they don’t have the assets to provide the correct isolation and the correct care.”

Dr. Elting spoke on the treatment the two American patients– Dr. Kent Brantly and Nancy Writebol– will receive at Emory Hospital in Atlanta. He also answered questions from viewers calling into the show.

“It’s transmitted by bodily fluids. It’s not transmitted by respiratory droplets like the flu or a cold,” Dr. Elting said. “Once a person gets infected, there’s an incubation period between the time they get exposed to the time they actually have symptoms. That can range anywhere from two to 21 days.”

“The initial symptoms are somewhat flu-like. They get muscle aches, headaches, fever, don’t feel well, they have vomiting. But it is a hemorrhagic virus. It causes hemorrhaging, in which case you’ll get things like bleeding into your eyes, bleeding into your lungs, bleeding into your internal organs. Generally, that’s what your cause of death is.”

View the whole interview here.

Running for only a few minutes a day or at slow speeds may significantly reduce a person’s risk of death from cardiovascular disease compared to someone who does not run, according to a study published today in the Journal of the American College of Cardiology.

Exercise is well-established as way to prevent heart disease and it is component of an overall healthy life, but it is unclear whether there are health benefits below the level of 75 minutes per week of vigorous-intensity activity, such as running, recommended by the U.S. government and World Health Organization.

Researchers studied 55,137 adults between the ages of 18 and 100 over a 15-year period to determine whether there is a relationship between running and longevity. Data was drawn from the Aerobics Center Longitudinal Study, where participants were asked to complete a questionnaire about their running habits. In the study period, 3,413 participants died, including 1,217 whose deaths were related to cardiovascular disease. In this population, 24 percent of the participants reported running as part of their leisure-time exercise.

Compared with non-runners, the runners had a 30 percent lower risk of death from all causes and a 45 percent lower risk of death from heart disease or stroke. Runners on average lived three years longer compared to non-runners. Also, to reduce mortality risk at a population level from a public health perspective, the authors concluded that promoting running is as important as preventing smoking, obesity or hypertension. The benefits were the same no matter how long, far, frequently or fast participants reported running. Benefits were also the same regardless of sex, age, body mass index, health conditions, smoking status or alcohol use.

The study showed that participants who ran less than 51 minutes, fewer than 6 miles, slower than 6 miles per hour, or only one to two times per week had a lower risk of dying compared to those who did not run. DC (Duck-chul) Lee, Ph.D., lead author of the study and an assistant professor in the Iowa State University Kinesiology Department in Ames, Iowa, said they found that runners who ran less than an hour per week have the same mortality benefits compared to runners who ran more than three hours per week. Thus, it is possible that the more may not be the better in relation to running and longevity.

Researchers also looked at running behavior patterns and found that those who persistently ran over a period of six years on average had the most significant benefits, with a 29 percent lower risk of death for any reason and 50 percent lower risk of death from heart disease or stroke.

“Since time is one of the strongest barriers to participate in physical activity, the study may motivate more people to start running and continue to run as an attainable health goal for mortality benefits,” Lee said. “Running may be a better exercise option than more moderate intensity exercises for healthy but sedentary people since it produces similar, if not greater, mortality benefits in five to 10 minutes compared to the 15 to 20 minutes per day of moderate intensity activity that many find too time consuming.”

The outbreak of the extraordinarily lethal Ebola virus has worsened in West Africa, with the contagion showing no sign of coming under control, prompting the Centers for Disease Control and Prevention on Thursday to warn Americans to avoid nonessential travel to Guinea, Liberia and Sierra Leone.

In addition to raising the health threat level to 3, the agency’s highest level, the CDC said it is sending 50 infectious-disease experts to the affected region and will assist airports in Africa in screening outbound passengers. The CDC had already alerted U.S. hospitals and doctors to be on the lookout for signs of Ebola fever and to question patients about their recent travel history and contacts.

“This is a tragic, painful, dreadful, merciless virus. It’s the largest, most complex outbreak that we know of in history,” said CDC director Tom Frieden in a news briefing Thursday.

A patient who was infected with the virus in Africa is expected to be treated at Emory University Hospital in Atlanta within several days, the university said in a statement Thursday. The patient, his or her identity undisclosed, will be treated at a special containment unit set up in collaboration with the CDC to treat people exposed to serious infectious diseases. A spokeswoman said she did not know when the patient will arrive or who the patient is. CNN, citing an unnamed source, reported that a plane left Cartersville, Ga., Thursday evening to evacuate two U.S. charity workers in Liberia infected with Ebola.

It would be the first time a patient infected with Ebola has been treated in the United States, according to a CDC spokeswoman.

“Every precaution is being taken to move those infected safely and securely, to provide critical care en route and to maintain strict isolation upon arrival in the United States,” said the CDC spokeswoman, Barbara Reynolds. “The safety and security of U.S. citizens is our highest priority. These are U.S. citizens who are returning to the United States for medical care. They are being returned under strict medical protocols for infectious diseases.”

Frieden warned that this outbreak will take at least three to six months to suppress, under the best of circumstances. There is no cure or treatment for the disease, in which the virus replicates rapidly throughout the body, causing multiple organ failure and, typically, death in a matter of days. In the latest outbreak, about 6 of 10 people infected have died.

Vaccine research is progressing, and human trials of a possible vaccine could begin as soon as September, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Thursday. The CDC’s Frieden said a vaccine is at least a year away.

That leaves officials with low-tech tools for battling the virus as it rages across West Africa and threatens to spread to other continents. Doctors and disease detectives need to find victims and quarantine them. They have to track down people with whom they’ve been in contact. Caregivers have to be meticulous in wearing formidable protective gear. Family members must be instructed on how to handle the bodies of the deceased.

That’s been the formula for stopping all previous outbreaks in Africa, with the hot virus essentially burning itself out.

“Most of those little outbreaks of varying sizes would be contained because they were in rural areas, where health workers could isolate the people and ultimately get the villages to stop doing the things that propagated it,” Fauci said.

But this outbreak is trickier, he said, because it covers a larger region and several countries with porous borders and weak health-care systems. At the same time, Fauci and other health officials say that Americans should not fear that the epidemic will take hold in the United States. That’s because Ebola, deadly as it is, is contagious only when a patient is sick with symptoms of the disease. The virus is spread by direct contact with bodily fluids after the symptoms appear.

A person who becomes infected will not show symptoms for five to 10 days, sometimes as long as three weeks. In that incubation period, the person isn’t contagious. The symptoms, when they come on, are severe, and U.S. officials are confident that they can isolate any patients should Ebola manage to spread here.

“Ebola poses little risk to the U.S. general population,” Frieden said.

“There is certainly a possibility that someone might get on a plane who is infected in Sierra Leone or Liberia and come to the United States. But the chance of it being spread here the way you are seeing there is extraordinarily low, to the point that the CDC and me and other officials feel confident that there’s not going to be an outbreak here,” Fauci said.

The World Health Organization is not recommending any travel restrictions or closure of borders at this time. The International Air Transport Association said it will follow WHO’s lead on travel restrictions.

“What is key about this disease is that if people aren’t showing symptoms, they’re not contagious,” said Jason Sinclair, a spokesman for IATA.

What sets Ebola apart from other viruses is its lethality. Even the deadliest strain of influenza, for example, kills no more than 1 percent of patients. But some areas of Africa with poor health care have been known to have a 90 percent mortality rate from Ebola during previous outbreaks.

Since the first report of the deadly virus surfaced in March, there have been 1,323 cases reported and 729 deaths, according to the WHO.

One death attributed to Ebola has been reported in Nigeria. Patrick Sawyer, 40, a Liberia-born American citizen who worked for the Liberian Finance Ministry, fell ill while traveling from Liberia to Lagos, Nigeria, with stops in Ghana and Togo, according to the Associated Press. He died in Lagos on July 25. He reportedly had been caring for his sister, who had died of Ebola several weeks earlier.

Governments across the globe, from Washington to Europe to Hong Kong, are gauging the appropriate response. White House deputy press secretary Eric Schultz said President Obama had been briefed about the Ebola outbreak. He said the Ebola crisis won’t affect next week’s summit of African leaders being held in Washington.

“I would tell you that we’re working closely with regional governments to stem the spread of the virus. We have no plans to change any elements of the U.S.-Africa Leaders Summit, as we believe all air travel continues to be safe here,” Schultz said.

About 10,000 people arrive in the United States from the affected region of Africa every three to four months, Frieden said. The CDC has protocols in place to protect against further spread of the disease. These include notification to CDC of ill passengers on a plane before arrival, investigation of ill travelers and, if necessary, quarantine. CDC also provides guidance to airlines for managing ill passengers and crew and for disinfecting aircraft.

The CDC already has a dozen staffers working in West Africa. They are operating in regions that have been torn by civil war. Frieden said one CDC group was driven away after a hostile reception and retreated to a neighboring country, though he did not give details. There have been a couple of dozen outbreaks of Ebola previous to this one, with the first in 1976. This outbreak began in Guinea in March.

Two American aid workers in Monrovia, Liberia, have contracted the virus and are in grave condition, according to a statement released by the Christian aid group Samaritan’s Purse. The group said that Kent Brantly, a physician, was offered an experimental serum sent to the country Wednesday, but that there was only enough for one person, so he asked that it be given to Nancy Writebol, a missionary worker with the Charlotte-based missionary organization SIM. However, a SIM spokesperson said both aid workers were given the serum.

“There are efforts to bring her back,” said Palmer Holt, a spokesman for SIM. “We’re feeling optimistic about the process of relocating non-essential personnel and the two patients.”

The group is evacuating some workers from Liberia, but medical staff members have been left behind to treat patients. The outbreak has prompted the Peace Corps to temporarily remove its 102 volunteers in Guinea, 108 in Liberia and 130 in Sierra Leone.

Sierra Leone has declared a state of emergency and is mobilizing police and the military to quarantine the epicenters of the disease. Sierra Leone’s top Ebola doctor fell victim to the virus and died.

“It is very worrying to hear any reports of international agencies pulling out at the time when there is an absolute need for additional medical experts and health workers to get control of this outbreak,” said Jason Cone, communications director at Doctors Without Borders. The organization said it has 552 staffers on the ground in the three affected countries and it desperately needs more resources to battle the contagion.

Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, noted that Africa is a different place than it was 25 years ago. Africans travel much more often now, and this mobility boosts the chances for Ebola to spread.

The CDC’s Frieden expressed confidence that officials will get the situation under control eventually.

“Though it will not be quick, and it will not be easy, we do know how to stop Ebola,” Frieden said. “This is a marathon, not a sprint.”

Source: Washington Post

The U.S. government recommends that American adults eat 5 to 13 servings of fruits and vegetables depending on your age, gender, and activity level, but a new Harvard School of Public Health study suggests we don’t get additional health benefits if we eat more than five servings a day.

After analyzing 16 studies involving 833,000 participants who filled out dietary surveys, the researchers from Harvard and China discovered that each daily serving of produce was associated with a five percent lower risk of dying from heart disease or cancer during the studies, which lasted up to 25 years. Eating five servings a day, for example, lowered the risk of dying by 25 percent — but so did eating six or seven servings, according to the results published Tuesday in the British Medical Journal.

“The reduction in mortality plateaued at five [servings] a day, and five a day is a good target to achieve maximum health benefits in reducing mortality,” said study coauthor Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health, via email from China.

Is there any harm to over-indulging on the kale, celery, and sliced strawberries?

Likely not, since the research didn’t find any negative health effects in those who ate six or more servings a day, according to Hu. What’s more, it couldn’t prove that eating five servings of produce a day actually prevented deaths, but rather found it was statistically associated with a lower mortality risk.

Still, it’s a smart move to “diversify plant-based foods,” Hu said, adding nuts, legumes, and whole grains to those salads. That will ensure that you get a wider range of nutrients, which often interact in the body to have a synergistic effect on disease prevention.

Source: Boston Globe