Dr. Harriott's Commentary:
I hear this all the time, "I take aspirin every day, just in case." It has very real adverse effects on the digestive tract, it has questionable cardiovascular benefits. Dietary changes incorporating reduced sugars, empty carbs, and saturated animal fats with increased vegetables, omega-3 fats and other anti-imflammatory lifestyle changes including regular exercise, of course) are what created SIGNIFICANT improvements in cardiovascular health.
There is no pill that delivers health. THERE IS NO SUCH PILL!!!
=======================
Use of Low-Dose Aspirin in Primary Prevention of Cardiovascular Events Not Recommended
August 30, 2009 (Barcelona, Spain) — The use of low-dose aspirin in the primary prevention of cardiovascular events in healthy individuals with asymptomatic atherosclerosis is currently not warranted, according to the lead researcher of a large "real-world" study presented today at the European Society of Cardiology (ESC) 2009 Congress.
In the randomized trial of 3350 subjects deemed at high risk for cardiovascular and cerebrovascular events because of a low ankle-brachial index (ABI) (<0.95), aspirin had absolutely no effect on reducing events compared with placebo, Dr Gerry Fowkes (University of Edinburgh, Scotland) reported on behalf of the Aspirin for Asymptomatic Atherosclerosis (AAA) trialists.
full story: http://www.medscape.com/viewarticle/708139?sssdmh=dm1.522428&src=nldne
Wednesday, September 2, 2009
Friday, July 31, 2009
Organic - It's the Pesticides, not the Nutrition
Dr. Harriott's Comment:
It has been said that organic produce has higher nutrient value because it is grown in better soil. That is the result of a logical train of thought that is not regulated or even proven. This study suggests that the only differences in the organic v. non-organic foods is related to the fertilizers used (nitrogen, phosphorus, etc) and does not affect the quality of the nutrition. OK, I can accept that. But that isn't the reason why I choose local organics over mass-farmed foods. It's the pesticides and herbicides that cause untold damage to our bodies through estrogen mimicry and liver toxicity and ground water contamination that I am concerned with. So... move along... nothing to see here.
==================================================
Organic No More Nutritional than Conventional Foods
By Kristina Fiore, Staff Writer, MedPage Today
Published: July 30, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
Earn CME/CE credit
for reading medical news
LITTLE FALLS, N.J., July 30 -- When it comes to nutrition, there's no difference whether patients consume organic or conventionally produced foods, researchers say.
A review of more than 50 studies found no difference in nutrient content -- including vitamin C, calcium, potassium, and zinc -- between the types of food, Alan Dangour, PhD, of the London School of Hygiene & Topical Medicine, and colleagues reported.
The study appears in the September 2009 issue of the American Journal of Clinical Nutrition.
Marion Nestle, PhD, MPH, an expert on nutrition and food studies at New York University, disputed the scope of the findings. Action Points
Explain that a large review found no overall difference in nutritional content between organic and conventionally produced foods.
Note that there were differences in nitrogen and phosphorous content, but that was likely due to the type of fertilizer used.
"Plenty of studies have shown organics to have higher levels of nutrients," she said. "Nutrient levels ought to be higher in plants grown on better soils."
The "organic" label is reserved for farms that limit pesticide and herbicide use in crops and drug use in livestock.
Organic foods are typically more expensive, but sales have been booming because of the perception that they're healthier than conventionally produced foods.
So, to determine whether there is a difference in nutritional benefits, the researchers conducted a review of 55 studies published between Jan. 1, 1958 and Feb. 29, 2008.
They evaluated foods' nutrient content, including vitamin C, phenolic compounds, magnesium, potassium, calcium, zinc, copper, and total soluble solids.
They found no evidence of a difference between organic and conventional crops in terms of eight of those nutrient categories.
Conventional crops contained more nitrogen, while organics had more phosphorus and greater acidity.
The researchers said the differences were likely due to differences in fertilizer use and ripeness of fruits and vegetables at harvest.
But they said it's "unlikely that consumption of these nutrients at the levels reported in organic foods in this study provide any health benefit."
Nor did the researchers find nutritional differences with regard to animal-source foods -- although they noted that there were far fewer studies on these foods compared with produce. That made analysis was more limited, they said.
Also, the researchers did not include an analysis of contaminants or chemical residues used in the food products.
Chemical fertilizer, herbicides, and pesticides may also affect the chemical content of foods, they said, and the organic foods may have an advantage because of their controlled use of chemicals and medicines. That warrants further study, the researchers said.
Niyati Parekh, PhD, professor of nutrition at New York University who was not involved in the study, said the findings regarding nutritional content are not surprising. The larger concern with organic versus nonorganic foods is chemical content.
"The person who spends the extra $5 to buy organic is not doing it for the nutrients," Dr. Parekh said. "They're concerned with the chemicals."
She said there is not a large body of literature on the chemical content of organic versus nonorganic food because organic labeling is still a "gray area."
"No one has defined what organic is," Dr. Parekh said. "Until we do that, it's hard to study."
Maria Romano, MS, RD, clinical nutritionist for adult oncology at Montefiore Medical Center in New York, said that even though they're difficult to design and execute, studies comparing organic and nonorganic products are important.
"We know pesticides pose a risk to human health even in small doses, or those considered safe by industry," she said. "They can have toxic effects and in the long term can contribute to cancer."
Meanwhile, Dr. Nestle emphasized that "organics aren't about nutrients. They are about cleaner and more sustainable production methods," including "lower levels of pesticides and herbicides, which seems like a good idea."
The authors noted the possibility of reporting bias, which is a potential limitation of systematic reviews.
It has been said that organic produce has higher nutrient value because it is grown in better soil. That is the result of a logical train of thought that is not regulated or even proven. This study suggests that the only differences in the organic v. non-organic foods is related to the fertilizers used (nitrogen, phosphorus, etc) and does not affect the quality of the nutrition. OK, I can accept that. But that isn't the reason why I choose local organics over mass-farmed foods. It's the pesticides and herbicides that cause untold damage to our bodies through estrogen mimicry and liver toxicity and ground water contamination that I am concerned with. So... move along... nothing to see here.
==================================================
Organic No More Nutritional than Conventional Foods
By Kristina Fiore, Staff Writer, MedPage Today
Published: July 30, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
Earn CME/CE credit
for reading medical news
LITTLE FALLS, N.J., July 30 -- When it comes to nutrition, there's no difference whether patients consume organic or conventionally produced foods, researchers say.
A review of more than 50 studies found no difference in nutrient content -- including vitamin C, calcium, potassium, and zinc -- between the types of food, Alan Dangour, PhD, of the London School of Hygiene & Topical Medicine, and colleagues reported.
The study appears in the September 2009 issue of the American Journal of Clinical Nutrition.
Marion Nestle, PhD, MPH, an expert on nutrition and food studies at New York University, disputed the scope of the findings. Action Points
Explain that a large review found no overall difference in nutritional content between organic and conventionally produced foods.
Note that there were differences in nitrogen and phosphorous content, but that was likely due to the type of fertilizer used.
"Plenty of studies have shown organics to have higher levels of nutrients," she said. "Nutrient levels ought to be higher in plants grown on better soils."
The "organic" label is reserved for farms that limit pesticide and herbicide use in crops and drug use in livestock.
Organic foods are typically more expensive, but sales have been booming because of the perception that they're healthier than conventionally produced foods.
So, to determine whether there is a difference in nutritional benefits, the researchers conducted a review of 55 studies published between Jan. 1, 1958 and Feb. 29, 2008.
They evaluated foods' nutrient content, including vitamin C, phenolic compounds, magnesium, potassium, calcium, zinc, copper, and total soluble solids.
They found no evidence of a difference between organic and conventional crops in terms of eight of those nutrient categories.
Conventional crops contained more nitrogen, while organics had more phosphorus and greater acidity.
The researchers said the differences were likely due to differences in fertilizer use and ripeness of fruits and vegetables at harvest.
But they said it's "unlikely that consumption of these nutrients at the levels reported in organic foods in this study provide any health benefit."
Nor did the researchers find nutritional differences with regard to animal-source foods -- although they noted that there were far fewer studies on these foods compared with produce. That made analysis was more limited, they said.
Also, the researchers did not include an analysis of contaminants or chemical residues used in the food products.
Chemical fertilizer, herbicides, and pesticides may also affect the chemical content of foods, they said, and the organic foods may have an advantage because of their controlled use of chemicals and medicines. That warrants further study, the researchers said.
Niyati Parekh, PhD, professor of nutrition at New York University who was not involved in the study, said the findings regarding nutritional content are not surprising. The larger concern with organic versus nonorganic foods is chemical content.
"The person who spends the extra $5 to buy organic is not doing it for the nutrients," Dr. Parekh said. "They're concerned with the chemicals."
She said there is not a large body of literature on the chemical content of organic versus nonorganic food because organic labeling is still a "gray area."
"No one has defined what organic is," Dr. Parekh said. "Until we do that, it's hard to study."
Maria Romano, MS, RD, clinical nutritionist for adult oncology at Montefiore Medical Center in New York, said that even though they're difficult to design and execute, studies comparing organic and nonorganic products are important.
"We know pesticides pose a risk to human health even in small doses, or those considered safe by industry," she said. "They can have toxic effects and in the long term can contribute to cancer."
Meanwhile, Dr. Nestle emphasized that "organics aren't about nutrients. They are about cleaner and more sustainable production methods," including "lower levels of pesticides and herbicides, which seems like a good idea."
The authors noted the possibility of reporting bias, which is a potential limitation of systematic reviews.
Flax Reduces Blood Cholesterol
Dr. Harriott's Comment:
In reviewing this article referenced below the interesting take away points are: 1) Flax oil did not render the benefit that whole flax seed did. 2) It appears that the benefit is only towards lowering cholesterol and LDL, not towards increasing HDL, and 3) the effects on women appear to be on the order of 3 times higher than the the effects on men. Interesting stuff...
=====================================
Flaxseed Reduces Blood Lipids
http://www.medscape.com/viewarticle/706641?sssdmh=dm1.506978&src=nldne
July 29, 2009 — Whole flaxseed and flaxseed lignans significantly reduce circulating total cholesterol and low-density lipoprotein (LDL) cholesterol levels, showing their greatest effect in postmenopausal women and individuals with high initial cholesterol concentrations, according to the results of a meta-analysis published in the August 2009 issue of the American Journal of Clinical Nutrition.
Interpret Findings With Caution
The authors point out that the limitations of their study include the heterogeneity of the studies in the meta-analysis, and a lack of information on the quality, quantity, and bioavailability of the flaxseed that was used. Therefore, they write, their findings must be interpreted with caution.
The results of this meta-analysis indicate that flaxseed consumption may be a useful dietary approach for the prevention of hypercholesterolemia, especially in some patient subgroups, the authors conclude. They add that further studies should be done to investigate the effectiveness of flaxseed supplementation on cardiometabolic risk factors other than blood lipids and, ultimately, on cardiovascular disease–related morbidity and mortality.
In reviewing this article referenced below the interesting take away points are: 1) Flax oil did not render the benefit that whole flax seed did. 2) It appears that the benefit is only towards lowering cholesterol and LDL, not towards increasing HDL, and 3) the effects on women appear to be on the order of 3 times higher than the the effects on men. Interesting stuff...
=====================================
Flaxseed Reduces Blood Lipids
http://www.medscape.com/viewarticle/706641?sssdmh=dm1.506978&src=nldne
July 29, 2009 — Whole flaxseed and flaxseed lignans significantly reduce circulating total cholesterol and low-density lipoprotein (LDL) cholesterol levels, showing their greatest effect in postmenopausal women and individuals with high initial cholesterol concentrations, according to the results of a meta-analysis published in the August 2009 issue of the American Journal of Clinical Nutrition.
...
There were no significant changes in HDL cholesterol or triglyceride levels.
Interpret Findings With Caution
The authors point out that the limitations of their study include the heterogeneity of the studies in the meta-analysis, and a lack of information on the quality, quantity, and bioavailability of the flaxseed that was used. Therefore, they write, their findings must be interpreted with caution.
The results of this meta-analysis indicate that flaxseed consumption may be a useful dietary approach for the prevention of hypercholesterolemia, especially in some patient subgroups, the authors conclude. They add that further studies should be done to investigate the effectiveness of flaxseed supplementation on cardiometabolic risk factors other than blood lipids and, ultimately, on cardiovascular disease–related morbidity and mortality.
Wednesday, July 22, 2009
Lower Your Risk of the Leading Cause of Death 50%
Dr. Harriott's commentary:
Cardiac disease is the leading cause of death in the United States. In the general population that risk at the age of 40 years old is about 20%. The study below reports that the risk drops to about 10.1% for men who adopt 4 out of 6 of the following lifestyle modifications:
1. Recommended body weight,
2. Non-smoking,
3. Regular exercise,
4. Moderate alcohol intake,
5. consumption of breakfast cereals, and
6. consumption of fruits and vegetables.
So, question for you to ponder if you are not doing this already... What other benefits do you suppose you would enjoy if you were to be in a low cardiac risk category? We always seem to focus on the end, but I want you to think about what happens between now and then. A healthy lifestyle means, more activity, better sleep, better sex, fewer medications, more vacations. Get on the wagon everyone :) !!!!
======================================================================
Relation Between Modifiable Lifestyle Factors and Lifetime Risk of Heart Failure
http://jama.ama-assn.org/cgi/content/abstract/302/4/394?etoc
Luc Djoussé, MD, ScD, MPH; Jane A. Driver, MD, MPH; J. Michael Gaziano, MD, MPH
JAMA. 2009;302(4):394-400.
Context The lifetime risk of heart failure at age 40 years is approximately 1 in 5 in the general population; however, little is known about the association between modifiable lifestyle factors and the remaining lifetime risk of heart failure.
Objective To examine the association between modifiable lifestyle factors and the lifetime risk of heart failure in a large cohort of men.
Design, Setting, and Participants Prospective cohort study using data from 20 900 men (mean age at baseline, 53.6 years) from the Physicians' Health Study I (1982-2008) who were apparently healthy at baseline. Six modifiable lifestyle factors were assessed: body weight, smoking, exercise, alcohol intake, consumption of breakfast cereals, and consumption of fruits and vegetables.
Main Outcome Measure Lifetime risk of heart failure.
Results During a mean follow-up of 22.4 years, 1200 men developed heart failure. Overall, the lifetime risk of heart failure was 13.8% (95% confidence interval [CI], 12.9%-14.7%) at age 40 years. Lifetime risk remained constant in men who survived free of heart failure through age 70 years and reached 10.6% (95% CI, 9.4%-11.7%) at age 80 years. Lifetime risk of heart failure was higher in men with hypertension than in those without hypertension. Healthy lifestyle habits (normal body weight, not smoking, regular exercise, moderate alcohol intake, consumption of breakfast cereals, and consumption of fruits and vegetables) were individually and jointly associated with a lower lifetime risk of heart failure, with the highest risk in men adhering to none of the 6 lifestyle factors (21.2%; 95% CI, 16.8%-25.6%) and the lowest risk in men adhering to 4 or more desirable factors (10.1%; 95% CI, 7.9%-12.3%).
Conclusion In this cohort of apparently healthy men, adherence to healthy lifestyle factors is associated with a lower lifetime risk of heart failure.
Cardiac disease is the leading cause of death in the United States. In the general population that risk at the age of 40 years old is about 20%. The study below reports that the risk drops to about 10.1% for men who adopt 4 out of 6 of the following lifestyle modifications:
1. Recommended body weight,
2. Non-smoking,
3. Regular exercise,
4. Moderate alcohol intake,
5. consumption of breakfast cereals, and
6. consumption of fruits and vegetables.
So, question for you to ponder if you are not doing this already... What other benefits do you suppose you would enjoy if you were to be in a low cardiac risk category? We always seem to focus on the end, but I want you to think about what happens between now and then. A healthy lifestyle means, more activity, better sleep, better sex, fewer medications, more vacations. Get on the wagon everyone :) !!!!
======================================================================
Relation Between Modifiable Lifestyle Factors and Lifetime Risk of Heart Failure
http://jama.ama-assn.org/cgi/content/abstract/302/4/394?etoc
Luc Djoussé, MD, ScD, MPH; Jane A. Driver, MD, MPH; J. Michael Gaziano, MD, MPH
JAMA. 2009;302(4):394-400.
Context The lifetime risk of heart failure at age 40 years is approximately 1 in 5 in the general population; however, little is known about the association between modifiable lifestyle factors and the remaining lifetime risk of heart failure.
Objective To examine the association between modifiable lifestyle factors and the lifetime risk of heart failure in a large cohort of men.
Design, Setting, and Participants Prospective cohort study using data from 20 900 men (mean age at baseline, 53.6 years) from the Physicians' Health Study I (1982-2008) who were apparently healthy at baseline. Six modifiable lifestyle factors were assessed: body weight, smoking, exercise, alcohol intake, consumption of breakfast cereals, and consumption of fruits and vegetables.
Main Outcome Measure Lifetime risk of heart failure.
Results During a mean follow-up of 22.4 years, 1200 men developed heart failure. Overall, the lifetime risk of heart failure was 13.8% (95% confidence interval [CI], 12.9%-14.7%) at age 40 years. Lifetime risk remained constant in men who survived free of heart failure through age 70 years and reached 10.6% (95% CI, 9.4%-11.7%) at age 80 years. Lifetime risk of heart failure was higher in men with hypertension than in those without hypertension. Healthy lifestyle habits (normal body weight, not smoking, regular exercise, moderate alcohol intake, consumption of breakfast cereals, and consumption of fruits and vegetables) were individually and jointly associated with a lower lifetime risk of heart failure, with the highest risk in men adhering to none of the 6 lifestyle factors (21.2%; 95% CI, 16.8%-25.6%) and the lowest risk in men adhering to 4 or more desirable factors (10.1%; 95% CI, 7.9%-12.3%).
Conclusion In this cohort of apparently healthy men, adherence to healthy lifestyle factors is associated with a lower lifetime risk of heart failure.
Sunday, July 5, 2009
You'll Never Guess What Else Causes Heartburn and Acid Reflux!!
Dr. Harriott's Commentary: this is why you are stonger and healthier when you heal and recover naturally, without dependence on medical procedures or lotions and potions. The body does what it does for a reason. You can often jumper past or bypass a system to force a response, but there will be ramifications that the MD cannot often predict. It's often like a toss of the dice...
Rebound Acid Reflux with PPIs May Induce Dependence
SAN FRANCISCO, July 2 -- Proton-pump inhibitors (Nexium) may cause or aggravate the very acid-reflux symptoms they're used to treat, according to a randomized trial.
Nexium Causes Gerd?
Apparently, a double-blind, placebo controlled trial showed that 44% of people with no heartburn to begin with, developed heartburn after taking Nexium for two months. Wow, who'd have thunk it?
Rebound Acid Reflux with PPIs May Induce Dependence
SAN FRANCISCO, July 2 -- Proton-pump inhibitors (Nexium) may cause or aggravate the very acid-reflux symptoms they're used to treat, according to a randomized trial.
Nexium Causes Gerd?
Apparently, a double-blind, placebo controlled trial showed that 44% of people with no heartburn to begin with, developed heartburn after taking Nexium for two months. Wow, who'd have thunk it?
Thursday, June 25, 2009
The Miracle of Baking Soda and Your Overall Health
The write-up below was provided to me by the office of Dr. Thomas MacKinnon, DDS MAGD
My only objection to this is the use of fluoride toothpaste. I am not a dentist and I would not want to go head-to-head in a dental debate with Dr. MacKinnon, but I have not seen any information to suggest that fluoride does anything for adult teeth. On the other hand, I have heard of health problems associated with fluoride ingestion, including interference with normal iodine metabolism/absorption/excretion which is critical to our health. That being said...
Here is the write-up from Dr. MacKinnon:
"I now brush my teeth with baking soda and peroxide. New research on how to clean your mouth and teeth has shown that baking soda does a great job of breaking up the hard to remove oral biofilm. This same research points out the importance of regular visits to the dentist to get your teeth cleaned professionally. The heart of keeping your teeth for life is the mechanical removal of these stubborn deposits that will collect even in the face of the best flossing and brushing...
... The use of baking soda will whiten up your teeth since it can remove stains and it leaves your mouth feeling really clean. There are a lot of way s you can use baking soda. It is well researched as Dr. Keyes has studied it for 40 years. Visit his website for additional ideas about how to use this inexpensive and effective dental cleaning material.
Additional material on this subject can be obtained at the links below:
I use his "powerful antibacterial combination"
http://www.drpaulhkeyes.com/writings/dentifrice-01.html
If you know a young lady that may become pregnant, this is a good site for oral hygiene information. I still see gum disease in some of my pregnant patients and it can lead to real problems like early tooth loss or pregnancy problems:
http://www.baby-place.com/oralhealth.html
This site shows how to use baking soda and is written in a humorous style:
http://www.frugallawstudent.com/2007/06/11/frugall-esperiment
After the author used the baking soda a few times he had bad breath (I didn't experience this) my guess is that he should have used it for a week. He would then have removed the bulk of oral biofilm that caused the bad breath. Using regular toothpaste will also help this during the transition. I still use a fluoride toothpaste once a day."
My only objection to this is the use of fluoride toothpaste. I am not a dentist and I would not want to go head-to-head in a dental debate with Dr. MacKinnon, but I have not seen any information to suggest that fluoride does anything for adult teeth. On the other hand, I have heard of health problems associated with fluoride ingestion, including interference with normal iodine metabolism/absorption/excretion which is critical to our health. That being said...
Here is the write-up from Dr. MacKinnon:
"I now brush my teeth with baking soda and peroxide. New research on how to clean your mouth and teeth has shown that baking soda does a great job of breaking up the hard to remove oral biofilm. This same research points out the importance of regular visits to the dentist to get your teeth cleaned professionally. The heart of keeping your teeth for life is the mechanical removal of these stubborn deposits that will collect even in the face of the best flossing and brushing...
... The use of baking soda will whiten up your teeth since it can remove stains and it leaves your mouth feeling really clean. There are a lot of way s you can use baking soda. It is well researched as Dr. Keyes has studied it for 40 years. Visit his website for additional ideas about how to use this inexpensive and effective dental cleaning material.
Additional material on this subject can be obtained at the links below:
I use his "powerful antibacterial combination"
http://www.drpaulhkeyes.com/writings/dentifrice-01.html
If you know a young lady that may become pregnant, this is a good site for oral hygiene information. I still see gum disease in some of my pregnant patients and it can lead to real problems like early tooth loss or pregnancy problems:
http://www.baby-place.com/oralhealth.html
This site shows how to use baking soda and is written in a humorous style:
http://www.frugallawstudent.com/2007/06/11/frugall-esperiment
After the author used the baking soda a few times he had bad breath (I didn't experience this) my guess is that he should have used it for a week. He would then have removed the bulk of oral biofilm that caused the bad breath. Using regular toothpaste will also help this during the transition. I still use a fluoride toothpaste once a day."
Monday, June 22, 2009
Supplements and Dietary Change Make a Difference in Age-Related Macular Degeneration
Dr. Harriott's Comments:
This study acknowledges that modest levels of omega 3 fatty acid intake and a low glycemic diet are beneficial for AMD. It then shows, however that,concurrent supplementation with anti-oxidants like C, E, etc may necessitate higher levels of consumption of omega 3 fatty acids to maintain the benefit in earlier stages of the disease.
Take home message would be that omega 3 fatty acid supplements (these fatty acids are found in flax oil, walnut oil, fish oil, among other sources) are a good thing. Also, a low glycemic load diet is once again shown to be a clear path to healthy living. And lastly, if you have early stage AMD, additional anti-oxidant supplementation may interfere with the benefits of omega 3 fatty acids for that disease. Further study will be necessary to come up with specific dietary recommendations for AMD.
===================================
Other Factors May Affect Link Between Omega 3s and AMD
http://www.medpagetoday.com/Ophthalmology/GeneralOphthalmology/14789?
userid=69947&impressionId=1245645053617&utm_source=mSpoke&utm_medium=
email&utm_campaign=DailyHeadlines&utm_content=Group1
LITTLE FALLS, N.J., June 19 -- The association between omega-3 fatty acids and lower risk of age-related macular degeneration (AMD) appears to be modified by other dietary supplements and disease stage, researchers found.
As expected, high intake of the omega-3s docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) was associated with a lower risk of progression to advanced AMD in a secondary analysis of a randomized trial, Chung-Jung Chiu, DDS, PhD, of Tufts University in Boston, and colleagues reported online in the British Journal of Ophthalmology.
For early AMD progression, however, the apparent protective effect of DHA was eliminated in patients taking supplements containing high doses of antioxidants, zinc, or both as part of the Age-Related Eye Disease Study.
"The present study adds additional support to the idea that diet and, if necessary, supplementation can be optimized for the prevention of AMD," the researchers said.
The original research showed that high doses of antioxidants protected against the progression of advanced age-related macular degeneration. (See High Antioxidant Diet May Delay Age-Related Macular Degeneration)
A number of other studies have also identified a link between high consumption of omega-3 fatty acids and a reduced risk of AMD, and some evidence points to a protective effect of a low glycemic index diet.
However, it had remained unclear how all of these dietary factors interacted, the researchers said.
So they performed an analysis of data from 2,924 patients participating in the Age-Related Eye Disease Study, an eight-year supplementation trial. Dietary intake was assessed using food-frequency questionnaires.
There were four arms in the trial: placebo, antioxidant supplementation with vitamins C and E and beta-carotene, supplementation with zinc, or combined supplementation.
The highest intakes of DHA (HR 0.73, 95% CI 0.57 to 0.94) and EPA (HR 0.74, 95% CI 0.59 to 0.94) and the diets lowest in glycemic index (HR 0.76, 95% CI 0.60 to 0.96) were linked to lower risk for progression to advanced AMD, independent of the type of supplementation.
There were significant interactions between dietary glycemic index and both DHA (P=0.0003) and EPA (P=0.0001) intake, such that patients who had low glycemic index diets and high consumption of the omega-3 fatty acids had lower risks of progression to advanced AMD than patients with high intakes alone.
Patients in the early stages of AMD, however, only derived a benefit from consuming large amounts of DHA if they were not taking additional supplementation as part of the study (HR 0.58, 95% CI 0.37 to 0.92).
"It appears that the high-dose supplements of the antioxidants and/or the minerals somehow interfered with the benefits of DHA against early AMD progression," said study co-author Allen Taylor, PhD, also of Tufts.
The levels of DHA and EPA consumed in the study were much lower than the recommended intake, according to the researchers.
To hit the target, individuals could consume two to three servings of cold-water fatty fish, such as salmon, tuna, mackerel, sardines, and herring, as well as shellfish.
However, it would be premature to make specific dietary recommendations for patients with AMD, the researchers said.
"Taken together, these data indicate that consuming a diet with higher levels of omega-3 fatty acids, antioxidants, and low-glycemic index foods may delay compromised vision due to AMD," Dr. Taylor said.
"The present study adds the possibility that the timing of a dietary intervention as well as the combination of nutrients recommended may be important," he said.
The study was funded by the U.S. Department of Agriculture, the NIH, the Johnson & Johnson Focused Giving Program, the American Health Assistance Foundation, and the Ross Aging Initiative.
The authors reported that they had no conflicts of interest.
Primary source: British Journal of Ophthalmology
Source reference: Chiu C-J, et al "Does eating particular diets alter risk of age-related macular degeneration in users of the age-related eye disease study supplements?" Br J Ophthalmol 2009; DOI: 10.1136/bjo.2008.143412.
This study acknowledges that modest levels of omega 3 fatty acid intake and a low glycemic diet are beneficial for AMD. It then shows, however that,concurrent supplementation with anti-oxidants like C, E, etc may necessitate higher levels of consumption of omega 3 fatty acids to maintain the benefit in earlier stages of the disease.
Take home message would be that omega 3 fatty acid supplements (these fatty acids are found in flax oil, walnut oil, fish oil, among other sources) are a good thing. Also, a low glycemic load diet is once again shown to be a clear path to healthy living. And lastly, if you have early stage AMD, additional anti-oxidant supplementation may interfere with the benefits of omega 3 fatty acids for that disease. Further study will be necessary to come up with specific dietary recommendations for AMD.
===================================
Other Factors May Affect Link Between Omega 3s and AMD
http://www.medpagetoday.com/Ophthalmology/GeneralOphthalmology/14789?
userid=69947&impressionId=1245645053617&utm_source=mSpoke&utm_medium=
email&utm_campaign=DailyHeadlines&utm_content=Group1
LITTLE FALLS, N.J., June 19 -- The association between omega-3 fatty acids and lower risk of age-related macular degeneration (AMD) appears to be modified by other dietary supplements and disease stage, researchers found.
As expected, high intake of the omega-3s docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) was associated with a lower risk of progression to advanced AMD in a secondary analysis of a randomized trial, Chung-Jung Chiu, DDS, PhD, of Tufts University in Boston, and colleagues reported online in the British Journal of Ophthalmology.
For early AMD progression, however, the apparent protective effect of DHA was eliminated in patients taking supplements containing high doses of antioxidants, zinc, or both as part of the Age-Related Eye Disease Study.
"The present study adds additional support to the idea that diet and, if necessary, supplementation can be optimized for the prevention of AMD," the researchers said.
The original research showed that high doses of antioxidants protected against the progression of advanced age-related macular degeneration. (See High Antioxidant Diet May Delay Age-Related Macular Degeneration)
A number of other studies have also identified a link between high consumption of omega-3 fatty acids and a reduced risk of AMD, and some evidence points to a protective effect of a low glycemic index diet.
However, it had remained unclear how all of these dietary factors interacted, the researchers said.
So they performed an analysis of data from 2,924 patients participating in the Age-Related Eye Disease Study, an eight-year supplementation trial. Dietary intake was assessed using food-frequency questionnaires.
There were four arms in the trial: placebo, antioxidant supplementation with vitamins C and E and beta-carotene, supplementation with zinc, or combined supplementation.
The highest intakes of DHA (HR 0.73, 95% CI 0.57 to 0.94) and EPA (HR 0.74, 95% CI 0.59 to 0.94) and the diets lowest in glycemic index (HR 0.76, 95% CI 0.60 to 0.96) were linked to lower risk for progression to advanced AMD, independent of the type of supplementation.
There were significant interactions between dietary glycemic index and both DHA (P=0.0003) and EPA (P=0.0001) intake, such that patients who had low glycemic index diets and high consumption of the omega-3 fatty acids had lower risks of progression to advanced AMD than patients with high intakes alone.
Patients in the early stages of AMD, however, only derived a benefit from consuming large amounts of DHA if they were not taking additional supplementation as part of the study (HR 0.58, 95% CI 0.37 to 0.92).
"It appears that the high-dose supplements of the antioxidants and/or the minerals somehow interfered with the benefits of DHA against early AMD progression," said study co-author Allen Taylor, PhD, also of Tufts.
The levels of DHA and EPA consumed in the study were much lower than the recommended intake, according to the researchers.
To hit the target, individuals could consume two to three servings of cold-water fatty fish, such as salmon, tuna, mackerel, sardines, and herring, as well as shellfish.
However, it would be premature to make specific dietary recommendations for patients with AMD, the researchers said.
"Taken together, these data indicate that consuming a diet with higher levels of omega-3 fatty acids, antioxidants, and low-glycemic index foods may delay compromised vision due to AMD," Dr. Taylor said.
"The present study adds the possibility that the timing of a dietary intervention as well as the combination of nutrients recommended may be important," he said.
The study was funded by the U.S. Department of Agriculture, the NIH, the Johnson & Johnson Focused Giving Program, the American Health Assistance Foundation, and the Ross Aging Initiative.
The authors reported that they had no conflicts of interest.
Primary source: British Journal of Ophthalmology
Source reference: Chiu C-J, et al "Does eating particular diets alter risk of age-related macular degeneration in users of the age-related eye disease study supplements?" Br J Ophthalmol 2009; DOI: 10.1136/bjo.2008.143412.
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