Vitamins, minerals & supplements Archive

Ask the doctor

Q. I've read news reports that the heartburn drug I take may cause heart attacks. Should I worry about this?

A. Several studies have reported an association between proton-pump inhibitors (PPIs) and heart attacks. PPIs are medications for heartburn, such as omeprazole (Prilosec) and pantoprazole (Protonix). Overall, however, the evidence suggests these medications are not risky for your heart.

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Calcium is required for good health, and you can obtain most of what you need from common foods.

Calcium builds strong bones—right? In general that's true, because calcium forms the bricks and mortar of bones. That's why you need to take in sufficient calcium from your diet to replace worn-out bone as you age. Being deficient in calcium can weaken bones, leaving them more prone to breaking. Vitamin D is the helpmate to calcium, allowing the body to absorb more of the mineral during digestion.

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In the journals

The influential U.S. Preventive Services Task Force (USPSTF) has endorsed low-dose daily aspirin to prevent cardiovascular disease in people ages 50 to 59 who have a 10% or greater chance of heart attack or stroke in the next 10 years. Unless a person already has cardiovascular disease, the actual number of heart attacks and strokes prevented with daily aspirin is relatively small. This draft recommendation did not recommend aspirin for those younger than 50 or 60 or older, citing insufficient evidence to make a recommendation.

The USPSTF statement is at odds with a statement in 2014 by the FDA that evidence does not support general use of aspirin to prevent a first heart attack or stroke in otherwise healthy adults. However, daily aspirin is often recommended for those with a history of cardiovascular disease, since the potential benefit (preventing heart attacks and strokes) outweighs the risk of bleeding that comes with regular aspirin use.

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In the journals

Eating a heart-healthy diet is associated with better dental health, according to a study in the Journal of the American Geriatrics Society. The Dietary Approaches to Stop Hypertension (DASH) diet was originally developed to lower blood pressure, but research has uncovered a variety of other possible health benefits.

In the new study, researchers with the Veterans Affairs Dental Longitudinal Study followed 533 men ages 47 to 90. The men had dental exams every three years over a 20-year period. A trained examiner checked the men for signs of root cavities, which can occur if the gums recede and expose the root surface. Root cavities lead to tooth loss, an outcome that most men understandably want to avoid.

Ask the doctor

Q. I've had some severe bouts of depression before my periods. I have done my own research and I am willing to try an antidepressant. What dosage of Sarafem or Prozac is usually given to treat this?

A. Selective serotonin reuptake inhibitors (SSRIs) are an excellent option for treating premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). In fact, most physicians now consider them first-line therapy. Many different SSRIs have been studied, including the one you asked about—fluoxetine (Prozac or Sarafem)—and they all appear to be equally effective.

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Research we're watching

A preliminary study published Sept. 14, 2015, in JAMA Internal Medicine reported that older women in Spain who ate a traditional Mediterranean diet enhanced with extra-virgin olive oil were less likely to be diagnosed with breast cancer. The study was part of a large Spanish clinical trial, Prevención con Dieta Mediterránea (PREDIMED).

PREDIMED looked at three different groups of women. One followed the Mediterranean diet plus extra servings of olive oil. A second followed the diet plus extra servings of nuts. Those in the third group were ad-vised to reduce their fat intake. The study followed about 4,300 women ages 60 to 80 for five years.

Almost everyone suffers from trouble sleeping at one time or another. Insomnia — defined as trouble falling asleep or staying asleep — isn't a single disorder itself, but rather a general symptom, like fever or pain.

Because insomnia is so common, you can walk into any drugstore and find a bewildering variety of over-the-counter sleep products. And people are buying them. One small survey of people ages 60 and over found that more than a quarter had taken nonprescription sleeping aids in the preceding year — and that one in 12 did so daily.

Q. I've been drinking Fresca since I was in college. Lately I've been reading that diet drinks may cause weight gain and have other bad effects. Is that true?

A. There is some controversy about whether drinking diet soda helps or hurts in maintaining or achieving a healthy weight. Some studies show that people who consume artificially sweetened drinks take in fewer calories and are better able to control their weight. However, other studies show the opposite—that consuming diet drinks may result in weight gain as well as type 2 diabetes.

Many of my patients, colleagues, friends, and even neighbors have asked me about the new drug flibanserin (Addyi), which the FDA recently approved for treatment of low sexual desire in women. Flibanserin has generated more questions, comments, and media inquiries for me than I've ever experienced in my 20-year career as an obstetrician/gynecologist. While there are several medications that improve sexual function in men (including Viagra, the most famous one), flibanserin is the first to be approved for that purpose in women. Here are what I consider the relevant facts about flibanserin, and what I say to my patients.

Beer, wine, and spirits are foods as well as intoxicants that have different effects in women than in men.

In the first episode of the sitcom "Grace and Frankie," the title characters, played by Jane Fonda and Lily Tomlin, are ordering drinks before dinner. When carb-conscious Fonda sends the breadbasket away and asks for a very dry vodka martini, Tomlin reminds her that vodka is made from potatoes. Fonda responds, "Alcohol has its own rules."