May 2002

• Healthy Diet Eradicates Need for Trendy Supplements in Elderly
• In-vitro fertilization may cause birth defects, low birth weight
• Fish for Good Health
• Asthma Education Leads to Improvement in Children

Healthy Diet Eradicates Need for Trendy Supplements in Elderly

Magazine ads and television commercials tout dietary supplements that claim to be a veritable fountain of youth for seniors. Images of grandparents able to keep up with their grandkids convince older adults that shakes, energy bars, and special vitamins will help boost energy and decrease signs of aging.

Health experts, however, stress that a well-balanced diet rich in fruit and vegetables is just as effective and probably safer. But many older adults skip meals and eat small amounts of fruits and vegetables, citing reasons ranging from rotten teeth to unhappiness with eating alone.

While doctors acknowledge that nutritional shakes and energy bars are helpful for seniors who need to gain weight or have trouble chewing or swallowing, those who eat a balanced diet or stay active do not need them.

In spite of what the experts have said, the savvy advertisements are convincing millions of seniors that they need these expensive supplements, some of which have not even been proven safe.

Herbs are also a source of concern. Saw palmetto, an extracts made from the fruit of the saw palmetto plant, is promoted as a treatment for an enlarged prostate. Many people believe that herbs are natural and therefore safe but this is not the case. In fact, as with most nonprescription herbal products, the composition of the extract and the dosage have not been standardized and the supplement is not regulated by the FDA. If you decide to use saw palmetto, tell your doctor in order to alert him or her to possible interactions between it and other medications you may be taking.

People who are on strict diets — like those prescribed for kidney disease, heart disease, or diabetes — must be especially wary of adding any special supplements to their diet. Regardless of whether health problems are present, you should always consult a physician before starting any dietary regimen.

May 2002 Update

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In-vitro fertilization may cause birth defects, low birth weight

It's been 24 years since the first baby was conceived with the help of in-vitro fertilization (IVF), bringing hope to thousands of childless couples. In 1999 alone, over 30,000 babies were born in America with the help of artificial reproductive technologies (ART), including IVF. Since then, an estimated 300,000 IVF babies have been born worldwide. But this revolutionary way to overcome infertility is not risk-free. Two new studies published in the March 7, 2002, issue of the New England Journal of Medicine suggest that ART babies are more likely to be born with birth defects and low birth weights than newborns conceived naturally.

In IVF the man's sperm and the women's egg are combined in a laboratory dish. After fertilization, the resulting embryo is then transferred to the women's uterus to develop naturally. A special IVF procedure called intracytoplasmic sperm injection (ICSI), where the sperm is injected directly into the egg, can also be used for severe male infertility.

ARTs, including IVF, increase the risk of multiple births because several embryos are usually transferred to the uterus at one time to increase the probability of a successful pregnancy. But this practice is controversial because multiple births are associated with low birth weight, which puts the newborn at an increased risk for short- and long-term disabilities and even death. However, in one of the new studies, researchers with the U.S. Centers for Disease Control found that even ART babies born alone were 2.6 times as likely to have a low birth weight than a naturally conceived single infant.

In the other study, Australian researchers found that about 9% of the 301 IVF babies studied had birth defects, such as heart trouble, stunted limbs, Down syndrome, and cleft palate, compared to only 4.2% of the 4,000 naturally conceived babies studied. The risk was still more than doubled when multiple births were not considered.

Neither these nor previous studies have been able to identify whether the reason for the excess risk of low birth weight and birth defects is related to the underlying infertility itself or to the procedures and drugs used to overcome it.

To many advocates of assisted reproduction, the results of these studies aren't necessarily frightening, but reassuring. They look at them and celebrate that more than 90% of IVF babies are born healthy. But regardless of the interpretation of the numbers, couples looking for help with fertility should consider these risks.

May 2002 Update

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Fish for Good Health

In April, three studies delivered powerful evidence that fish is good for you — and could even save your life. The key is omega-3 (or n-3) fatty acids, beneficial polyunsaturated fats provided by many kinds of fish and certain plant foods.

Researchers in the Nurses' Health Study examined 16 years of data involving almost 85,000 women and found an association between fish intake and a lower risk for heart disease and death. Women who ate fish just once a week had a heart attack risk 29% lower than those who ate it less than once a month. Women who ate fish five times a week had nearly half the risk of death from a heart attack.

The Harvard's Physicians' Health Study, which involves more than 22,000 male doctors who initially had no heart disease, analyzed blood levels of omega-3 fatty acids and risk for sudden cardiac death. Researchers found that such deaths were 81% less likely in men with the highest levels of omega-3s. Over half of such deaths occur in people without prior symptoms of heart disease — a compelling reason for adding more fish to your diet.

Finally, Italian researchers reported that heart attack survivors who took fish-oil supplements had a lower risk of sudden death. This trial studied omega-3 fatty acids and vitamin E in 11,000 men and women who had recently suffered heart attacks. Researchers found that 1 gram of omega-3 fatty acids daily reduced the risk for sudden coronary death by up to 42%. This benefit apparently reflects their calming effect on arrhythmias, potentially fatal heartbeat irregularities. Omega-3 fatty acids may also inhibit clotting and improve blood vessel function. The American Heart Association recommends four servings of fish per week but doesn't endorse supplements because of too few data on the subject.

May 2002 Update

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Asthma Education Leads to Improvement in Children

Managing your child's asthma should include meeting with an asthma educator a few times, according to a follow-up study. Presented at the meeting of the American Academy of Allergy, Asthma, and Immunology, the study reports that after attending an interactive training program three times patients felt less worried about their asthma and had fewer asthma-induced awakenings during the night. Both patients and their caregivers, who also took part in the program, made better decisions about asthma care.

The 30 subjects, asthmatic children ages 6–12, underwent ACE IT! (Asthma Care Education: Intensive Training), an interactive, small-group education program. The sessions included a motivational talk by a teenage athlete with asthma and a pharmacist's discussion of medications. A nurse and asthma specialist also taught the participants about the clinical nature of asthma, environmental controls, relaxation techniques, and asthma action plans.

Researchers evaluated the children at the beginning and end of the training, after six months, and again a year later. After the courses, the number of patients reporting two or more nocturnal awakenings per month dropped from 9 to 5, and the number of symptom-free days also improved, from an average of 20 days per month to over 25 days per month.
The patients were more willing to use the tools available to them, such as medications and peak flow meters, devises that asthmatics breath into to help detect airway changes. They also worked harder to avoid things that triggered their asthma, such as pets or dust.

The researchers plan to continue tracking these 30 children to study the long-term effects on quality of life, morbidity, and cost of treatment. A previous study published in the Journal of Allergy and Clinical Immunology in 2000, found that the training program was much more effective than simply handing out educational materials.

May 2002 Update

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