Vitamins, minerals & supplements Archive

New medications and side effects warrant an evaluation.

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A medication regimen isn't something you can set and forget. You and your doctor need to keep tabs on what you're taking and how it's affecting your health. "We are required to do a medication 'check-up' at every visit, regardless of the specialty, which means that every clinician who sees you is supposed to review your medications and check off a box," says geriatrician Dr. Suzanne Salamon, an assistant professor at Harvard Medical School.

Sometimes things change between visits, and adjustments need to be made. It's up to you to schedule an appointment. Here are seven reasons why that may need to happen.

News briefs

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Here's another reason to say goodbye to hot dogs, soda, and white bread: A Harvard study published online Jan. 18, 2018, by JAMA Oncology suggests that diets promoting chronic inflammation are associated with colorectal cancer. Researchers analyzed the self-reported eating habits of more than 120,000 men and women, who filled out surveys every four years over a period of 26 years. People in the study who ate the most foods that promoted inflammation — such as red and processed meats, sugary drinks, and refined grains — had a higher rate of colorectal cancer compared with people who ate the least of these foods. For men, the risk was 44% higher; for women, the risk was 22% higher. The people who ate pro-inflammatory diets also ate fewer vegetables and drank less tea, wine, and coffee. A growing number of studies have found that chronic inflammation is associated with cancer. And many other studies have shown links between pro-inflammatory diets and chronic diseases such as type 2 diabetes and heart disease. The bottom line: Anything you can do to reduce the risk of chronic inflammation is a good idea. That could mean cutting out foods that are associated with inflammation, reducing stress, or getting more exercise.

Eating more whole grains is linked to a lower risk of heart disease.

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The word "refined" often describes things that have been stripped of impurities or other unwanted elements. But when it comes to wheat, rice, and other grains, the refining process instead removes the most healthful parts of these nutritious foods.

For example, white flour and white rice have far less of the vitamins, minerals, healthy fats, fiber, and other plant-based chemicals called polyphenols found in whole-wheat flour and brown rice. The combination of those beneficial nutrients may explain why people who eat more whole grains have a lower risk of developing and dying from heart disease.

Asparagus is often available year-round. But spring is the peak season for this popular vegetable, with April being the prime month. In the market, look for bright green stalks with firm, tight tips (which may have a purplish cast).

If you notice that your urine smells a bit unpleasant after you eat asparagus, you're definitely not alone. The odor comes from sulfur-containing chemicals that form when your body metabolizes asparagusic acid, a compound found in the vegetable. Not everyone notices this phenomenon, however, either because they metabolize the chemical differently or because of an inherited inability to perceive the smell.

Research we're watching

Cholesterol-lowering statins may be underused in younger people at risk for heart attack, new research suggests.

The study, in the Jan. 23, 2018, Journal of the American College of Cardiology, included more than 1,600 people ages 50 and younger who had experienced a heart attack. Only one in eight was taking a statin before the heart attack.

On call

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Q. I am about the same age as President Trump, and I also had a recent physical. My LDL (bad) cholesterol reading was 136, which my doctor thought was too high. But Mr. Trump's doctor said his LDL cholesterol of 143 was "excellent." Which is it?

A. The report of President Trump's health status brought out many armchair cardiologists — and real cardiologists — to comment on his cholesterol levels and risk for heart disease. The White House doctor's report stated that the president's "heart health" (not his cholesterol) was deemed excellent based on a normal exercise test and heart ultrasound. However, his LDL level of 143 was felt to be too high, and his doctor recommended doubling the president's statin medication. While the president doesn't show evidence of current heart disease, what is his future risk? A 71-year-old man with his cholesterol value would have a 10-year risk of heart attack, stroke, or cardiac death of 16% (about a one-in-six chance).

In the journals

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Migraine sufferers may be able to prevent future attacks with a new medication called galcanezumab, suggests a study published online Dec. 18, 2017, by JAMA Neurology. Currently, there are five FDA-approved drugs for migraines, but none were designed specifically for treating attacks or addressing the mechanisms at work.

In comparison, galcanezumab works to suppress the activity of calcitonin gene–related peptide (CGRP) in people. That molecule is believed to play an integral role in migraines and cluster headaches.

In the journals

A prescription cream called 5-fluorouracil (5-FU, sold as Adrucil and other brands) may help people reduce their risk for squamous cell carcinoma (SCC), according to a study published in the Jan. 3, 2017, JAMA Dermatology. SCC, the second most common cancer in the United States, strikes twice as many men as women.

Researchers recruited 932 people, 98% of whom were men, with an average age of 71. Each had experienced at least two skin cancers — SCC, basal cell carcinoma (BCC, the most common skin cancer), or both — on their face or ears within the past five years. They were randomly assigned to receive either the 5-FU cream or a placebo cream. Everyone applied a thin layer twice a day to their face and ears for up to four weeks. Over the course of a year, the 5-FU group had a 75% lower incidence of SCC compared with the placebo group. They also had a 11% lower incidence of BCC, but this difference was not statistically significant. It's not known why 5-FU helped prevent SCC but not BCC, according to the researchers.

You can head off problems from nonprescription drugs by following instructions carefully and communicating with your doctor.

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Relief for your symptoms can be as close as the nearest drugstore. Over-the-counter medicines and supplements can offer quick results, whether you've got heartburn, a headache, or a stuffy nose. And many people assume these products are safe, simply because they don't need to visit the doctor to get them. Unfortunately, that's not always the case.

Any medication that works cannot be completely safe, says Dr. Gordon Schiff, associate professor of medicine at Harvard Medical School and associate director of Brigham and Women's Center for Patient Safety Research and Practice. The decision to make a drug available over the counter is often more a matter of marketing than safety, he says.

Research we're watching

A study published October 2017 in the Journal of the American College of Cardiology found that people who regularly skip breakfast may have more arterial plaque than those who don't. Researchers used ultrasound to scan the arteries of more than 4,000 adults in Spain who were categorized into three groups: those who ate a heavy breakfast, those who ate a light breakfast, and those who ate no breakfast at all. They found that nearly 75% of those who regularly skipped breakfast had signs of plaque buildup in their arteries, compared with only 57% of people who reported eating a big breakfast every day and 64% who ate a small meal in the morning.

It's not clear why this was the case, although the authors noted that the people in the study who skipped breakfast were more likely to be obese and to have high cholesterol, high blood pressure, or diabetes. However, even when the researchers adjusted for those factors, the differences in arterial plaque levels between the groups persist.