Chronic fatigue syndrome is a biological illness: new ‘robust’ evidence

Researchers at the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health identified distinct immune changes in patients diagnosed with chronic fatigue syndrome, known medically as myalgic encephalomyelitis (ME/CFS) or systemic exertion intolerance disease. The findings could help improve diagnosis and identify treatment options for the disabling disorder, in which symptoms range from extreme fatigue and difficulty concentrating to headaches and muscle pain.

These immune signatures represent the first robust physical evidence that ME/CFS is a biological illness as opposed to a psychological disorder, and the first evidence that the disease has distinct stages. Results appear online in the new American Association for the Advancement of Science journal, Science Advances.

With funding to support studies of immune and infectious mechanisms of disease from the Chronic Fatigue Initiative of the Hutchins Family Foundation, the researchers used immunoassay testing methods to determine the levels of 51 immune biomarkers in blood plasma samples collected through two multicenter studies that represented a total of 298 ME/CFS patients and 348 healthy controls. They found specific patterns in patients who had the disease three years or less that were not present in controls or in patients who had the disease for more than three years. Short duration patients had increased amounts of many different types of immune molecules called cytokines. The association was unusually strong with a cytokine called interferon gamma that has been linked to the fatigue that follows many viral infections, including Epstein-Barr virus (the cause of infectious mononucleosis). Cytokine levels were not explained by symptom severity.

“We now have evidence confirming what millions of people with this disease already know, that ME/CFS isn’t psychological,” states lead author Mady Hornig, MD, director of translational research at the Center for Infection and Immunity and associate professor of Epidemiology at Columbia’s Mailman School. “Our results should accelerate the process of establishing the diagnosis after individuals first fall ill as well as discovery of new treatment strategies focusing on these early blood markers.”

There are already human monoclonal antibodies on the market that can dampen levels of a cytokine called interleukin-17A that is among those the study shows were elevated in early-stage patients. Before any drugs can be tested in a clinical trial, Dr. Hornig and colleagues hope to replicate the current, cross-sectional results in a longitudinal study that follows patients for a year to see how cytokine levels, including interleukin-17A, differ within individual patients over time, depending on how long they have had the disease.

Stuck in High Gear

The study supports the idea that ME/CFS may reflect an infectious “hit-and-run” event. Patients often report getting sick, sometimes from something as common as infectious mononucleosis (Epstein-Barr virus), and never fully recover. The new research suggests that these infections throw a wrench in the immune system’s ability to quiet itself after the acute infection, to return to a homeostatic balance; the immune response becomes like a car stuck in high gear. “It appears that ME/CFS patients are flush with cytokines until around the three-year mark, at which point the immune system shows evidence of exhaustion and cytokine levels drop,” says Dr. Hornig. “Early diagnosis may provide unique opportunities for treatment that likely differ from those that would be appropriate in later phases of the illness.”

The investigators went to great lengths to carefully screen participants to make sure they had the disease. The researchers also recruited greater numbers of patients whose diagnosis was of relatively recent onset. Patients’ stress levels were standardized; before each blood draw, patients were asked to complete standardized paperwork, in part to engender fatigue. The scientists also controlled for factors known to affect the immune system, including the time of day, season and geographic location where the samples were taken, as well as age, sex and ethnicity/race.

In 2012, W. Ian Lipkin, MD, director of the Center for Infection and Immunity, and colleagues reported the results of a multicenter study that definitively ruled out two viruses thought to be implicated in ME/CFS: XMRV (xenotropic murine leukemia virus [MLV]-related virus) and murine retrovirus-like sequences (designated pMLV: polytropic MLV). In the coming weeks, Drs. Hornig and Lipkin expect to report the results of a second study of cerebrospinal fluid from ME/CFS patients. In separate ongoing studies, they are looking for “molecular footprints” of the specific agents behind the disease–be they viral, bacterial, or fungal–as well as the longitudinal look at how plasma cytokine patterns change within ME/CFS patients and controls across a one-year period, as noted above.

“This study delivers what has eluded us for so long: unequivocal evidence of immunological dysfunction in ME/CFS and diagnostic biomarkers for disease,” says senior author W. Ian Lipkin, MD, also the John Snow Professor of Epidemiology at Columbia’s Mailman School. “The question we are trying to address in a parallel microbiome project is what triggers this dysfunction.”


Co-authors include Andrew F. Schultz, Xiaoyu Che, and Meredith L. Eddy at the Center for Infection and Immunity; Jose G. Montoya at Stanford University; Anthony L. Komaroff at Harvard Medical School; Nancy G. Klimas at Nova Southeastern University; Susan Levine at Levine Clinic; Donna Felsenstein at Massachusetts General Hospital; Lucinda Bateman at Fatigue Consultation Clinic; and Daniel L. Peterson and Gunnar Gottschalk at Sierra Internal Medicine. The authors report no competing interests.

Support for the study was provided by the Chronic Fatigue Initiative of the Hutchins Family Foundation and the National Institutes of Health (AI057158; Northeast Biodefense Center-Lipkin).


Posted in Chronic Fatigue Syndrome | Leave a comment

Level of pollutants accumulated in the body linked with obesity levels

A team of Spanish scientists, which includes several researchers from the University of Granada, has confirmed that there is a relation between the levels of certain environmental pollutants that a person accumulates in his or her body and their level of obesity. Subjects with more pollutants in their organisms present besides higher levels of cholesterol and triglycerides, which are important risk factors for cardiovascular disease.

This is a study published in the prestigious journal Environmental Pollution, which has counted with the participation of researchers from the University of Granada, the San Cecilio and Virgen de las Nieves university hospitals, and the Andalusian School of Public Health, all of them members of the Granada Biohealth Research Institute.

This research has analysed the levels of pollutants accumulated in adipose tissue (fat) in nearly 300 men and women, who were attended in the surgery services of two hospitals in the province of Granada (Spain).

The substances analysed, known as persistent organic pollutants (POPs), can remain in the environment for years, even decades, without degrading.

“Humans are exposed to POPs mainly through diet. Besides, POPs accumulate gradually in body fat, and this is the reason why the median levels in our study give us an idea of an individual’s accumulated exposition over a number of years”, says Juan Pedro Arrebola, the main author of the article.

Using complex statistical methods, these scientists confirmed that the accumulated levels of several POPs were related to obesity and to serum levels of cholesterol and triglycerides in individuals, irrespective of the gender, age, place of residence or smoking habits of participants in the survey.

“In general we found that people with higher levels of POPs were quantitatively more obese, and also showed higher levels of cholesterol and triglycerides, all of them regarded as important risk factors for cardiovascular disease, although these relations were complex and they did not always show linear patters”, Arrebola claims.

POPs subject to analysis

Those POPs subject to analysis include DDE, the main metabolite of pesticide DDT, widely used all over the world in the 1980s, and currently employed by some countries to combat malaria. They also included the insecticide lindane, frequently used in the past in agriculture and also in certain medicaments for lice and scabies

The survey also included a group of polychlorinated biphenyls or PCBs, used in numerous industrial equipment, and which are still present in old electric transformers. All these pollutants were somehow associated with obesity indexes, as well as cholesterol and / or triglycerides levels.

In spite of the fact that their use is currently very restricted, POPs are a very serious public health problem. Actually, 100% of participants in this survey presented detectable levels of one or more of these compounds.

“This universal exposition turns their impact on human health into a most important issue. Besides, our results suggest that there are no safe exposure levels for these pollutants, which can also interact among them to affect health”, Arrebola added.

Previous studies have demonstrated that the general population is exposed to POPs mainly through food with a high fat content. This includes fish and meat from large animals with a high level of fat. This is the reason why a growing number of researchers recommend to consume them in moderation.

Doctor Arrebola’s research group is currently monitoring the subjects of their study over the course of several years, to confirm whether those subjects exposed have shown a higher risk of developing certain pathologies, such as high blood pressure, obesity, or cardiovascular disease.

“Obesity-genic” Pollutants

Obesity has become a universal epidemic whose impact in Europe has tripled during the last few decades. The most important problem is that obese people have a high risk of suffering from numerous health problems such as cardiovascular disease, which the World Health Organisation considers the main cause of death worldwide.

It has been traditionally thought that obesity results from a high caloric intake in comparison with energy expenditure. “We believe that the results are not just the consequence of a higher intake of food by obese people. There is evidence that human exposure to certain chemical substances called “obesogenic” could favour the growth and proliferation of adipocytes (fat cells), and provoke therefore an increase in body fat. We suspect besides that certain environmental pollutants could also provoke alterations in cholesterol and triglycerides levels and therefore contribute to the development of cardiovascular disease”, Arrebola concludes.

Posted in Environmental Health: Persistent Organic Pollutants (POPs), Exercise: Benefits, Obesity | Leave a comment

Secondhand smoke risk for infants rises with mom’s stress levels

LAWRENCE — New mothers who experience higher levels of social stressors are the least likely to have rules that ban smoking in the home, which could expose their infants to secondhand smoke and increase health risks, according to a study that includes a University of Kansas researcher.

Jarron Saint Onge, assistant professor of sociology and the study’s lead author, said mothers with a high level of prenatal social stressors — including possibly less control over their own housing situation or economic distress — had 2.5 times higher odds to have only partial or no restriction on smoking in their home than those with no stressors.

He said while the study, published in January in the American Journal of Public Health, identified statistically significant sociodemographic and socioeconomic trends on home smoking rules where an infant lives, the underlying commonality was the amount of stressors the mother faced.

“Even if you take out all of those other factors, if you’re dealing with all of these notions of disadvantage that is tied up in low education and low income, you will see that if you can address the stressors, you are going to increase the amount of people who restrict smoking at home,” said Saint Onge, who also serves in the KU Medical Center’s Department of Health Policy within the School of Medicine. “You can still say that stress is has an independent risk on home smoking rules.”

The researchers examined data for 118,062 women who had recently given birth in the United States and participated in the Pregnancy Risk Assessment Monitoring System from 2004 to 2010. As anti-smoking sentiment in recent years has led to many restrictions on public smoking, the study found that it had also greatly influenced the prevalence of home smoking rules. Tami Gurley-Calvez, an assistant professor at KUMC’s Department of Health Policy, served as a co-author on the study.

Overall, a relatively small amount — 6 percent — of mothers in the survey reported to having only a partial rule or no smoking rule at all, meaning 94 percent of mothers did not allow smoking in the home.

However, Saint Onge said the study could help identify causes of stressors that would increase the risk of exposing infants in certain groups to secondhand smoke. For example, controlling for other factors, mothers under the age of 20 had increased the odds of having no or only a partial home smoking rule by 34 percent, compared with those ages 20-34.  Similarly, black mothers have 23 percent higher odds compared to white mothers of not fully banning smoke from the home.

Saint Onge said because members of those groups reported facing significant stressors that might compromise social control, self-efficacy or power within a household context, that could possibly leave them powerless to change established and immutable smoking habits. Also, smoking, which is a health-compromising behavior, might also be a coping mechanism for people with resource-limited social or environmental settings. The study shows how stress appears to have particularly strong effects for current smokers.

The health risks of smoking and exposure to secondhand smoke are widely known, which makes it important to attempt to identify factors that could cause situations in which a mother’s house would not fully prohibit smoking.

“Nobody wants to smoke around their child. So it’s these broader social forces that are at play. It’s about recognizing at what point are you compromised to forgo smoking rules in your household?” Saint Onge said.  “When it comes to smoking, everyone knows that smoking is bad. It’s just having the ability to do anything about it.”

Because the higher amount of stressors was the common factor for reducing the level of a full home-smoking rule, Saint Onge said public health departments and health professionals could use results of the study to begin planning prenatal risk assessments to identify potentially dangerous stress levels of the mother.

“Clinicians could begin thinking about stress when they’re going through pre-pregnancy visits to identify stress early on or to identify risk groups early on and to identify home-smoking environments early on as well,” Saint Onge said.

Additional co-authors of the study are Teresa Orth and Felix Okah, both of the University of Missouri-Kansas City School of Medicine.

– See more at:

Posted in Environmental Health: Indoor Pollution, Human Behavior: Stress, Second-hand Smoke, Smoking, Third-hand Smoke | Leave a comment

Aggressive boys tend to develop into physically stronger teens

Boys who show aggressive tendencies develop greater physical strength as teenagers than boys who are not aggressive, according to new research published in Psychological Science, a journal of the Association for Psychological Science.

“This work was motivated by a long-standing controversy over the relationship between physical development and personality,” says psychological scientist Joshua Isen of the University of Minnesota, Minneapolis. “The physiques of boys and girls increasingly diverge during adolescence, leading to a profound sex difference in physical strength, and there’s also an observable sex difference in personality traits like physical aggression and risk taking.”

Research has suggested a link between male upper-body strength and aggressive tendencies, but the mechanisms that account for the link are not well understood.

“Very little is known about how this association unfolds developmentally,” explains Isen. “Our study is unique because we used a prospective longitudinal design to examine whether male-typical behavioral tendencies are related to pubertal change in physical strength.”

The researchers examined data from two large samples of twins collected as part of the Minnesota Twin Family Study. The twins began participating in the study at age 11 and researchers followed up with them every 3 years.

Isen and colleagues were specifically interested in looking at the children’s levels of aggression and their physical strength at ages 11, 14, and 17. Aggressive-antisocial tendencies were measured using a combination of teacher and self-report ratings, while strength was measured using hand-grip strength, which is highly correlated with other measures of muscular strength. To gauge hand-grip strength, the children were instructed to squeeze a dynamometer as hard as they could in both their left and right hands.

The data revealed an interesting trend: Boys who showed high levels of aggression and those who showed low levels of aggression were equally strong at age 11, but their strength seemed to diverge over time. Specifically, more aggressive boys showed greater gains in physical strength during adolescence in comparison to their less aggressive peers.

And this trend could not be attributed to participants’ weight or height, which the researchers had accounted for in their analyses.

As expected, the data showed no relationship between aggressive-antisocial tendencies and development of physical strength among girls.

The researchers note that there are a couple possible mechanisms that could explain the findings. For example, it’s possible that muscular strength and aggressive-antisocial traits are both mediated by changing hormone levels from childhood through adolescence. Or it could be that more aggressive boys engage in activities that facilitate greater development of strength.

Either way, the researchers believe that the developmental relationship between aggressive traits and physical strength is likely to have an evolutionary basis:

“The pubertal changes responsible for males’ superior strength were likely shaped by inter-male competition for mates,” says Isen, which would explain why competitive personality traits correlate with physical strength among males only. “Our findings indicate that other aggression-related characteristics — including deceit, risk taking, and lack of empathy — predict future development of strength in males.”


Co-authors on the study include Matthew K. McGue and William G. Iacono of the University of Minnesota, Minneapolis.

This research was supported by grants from the National Institutes of Health (DA 013240, DA 05147, AA 09367).

The article abstract is available online:


Posted in Human Behavior: Aggression, Human Behavior: Risk, Parenting, Pediatric Health: Teenagers | Leave a comment

Autism sociability may be improved with inhaled drug: article in the journal Translational Psychiatry

(Reuters Health) – In an early study, inhaling the hormone oxytocin appeared to encourage men with autism to make more eye contact. But this was a small experiment with several limitations and does not mean oxytocin should immediately become a therapy for autism, experts cautioned.

Oxytocin has been touted as the “love hormone” and the “moral molecule” in the past. Naturally released during intercourse and breastfeeding, it seems to at least make people more social, if not actually more loving.

For the new study, researchers from the Autism Research Centre at the University of Cambridge in the UK and other European institutions compared 32 men with Autism Spectrum Disorder (ASD) or Asperger Syndrome and another 34 men without those disorders but of similar age and IQ.

Individually, the men video-chatted with a female researcher twice. Before one interview, participants inhaled oxytocin. Before the other, they inhaled a placebo spray.

The video-chat software included eye tracking, which recorded how often the subject focused on the eyes, mouth or other face areas during the interviews.

The female interviewer asked the men how they were doing, how the nasal spray made them feel, how they liked or didn’t like being in the study and similar questions for about five minutes.



Posted in Autism | Leave a comment

Middle-aged men increasingly see themselves as lost souls

I am sitting by the swimming pool at the Canyon Ranch resort in Tucson, Arizona, only it is not really a resort, it is a fitness/wellness/life-enhancing centre where people who are very stressed come to detox and, as I am discovering, “find” themselves.

But this resort is not brimming with stressed-out women, worn thin and ragged by juggling motherhood, wifedom and being the heads of companies. No. The classes here are full of men – men with great big identity issues.

There is 45-year-old Lee, who has just “gotten divorced” and has, in the course of a month, slept with 15 women. “I don’t see myself as that type of man,” he says, “but I feel so lonely and I don’t know what to do with my life.”

There is Ryan, aged 53, who has never married and is in crisis about why he hasn’t.

Then there is Steve, 49, a travel agent, long-time married, who has hit a midlife crisis. He says he really does want to buy a Harley-Davidson and head off down Route 66.

“Is that wrong?” he asks.

“I just don’t know what I want in my life anymore.”


Posted in Human Behavior: Sadness, Human Behavior: Self Esteem, Human Behavior: Self-Consciousness | Leave a comment

Employees become angry when receiving after-hours email, texts: study

People who receive electronic correspondence from work after hours become angry more often than not and that can interfere with their personal lives, a new study from a management researcher at The University of Texas at Arlington shows.

Marcus Butts, UT Arlington associate professor in the College of Business’ Department of Management, is lead author on a study recently published in the Academy of Management Journal. William Becker, TCU assistant professor of management, and Wendy Boswell, management professor at Texas A&M University, joined Butts in the study titled, “Hot Buttons and Time Sinks: The Effects of Electronic Communication during Nonwork Time on Emotions and Work-Nonwork Conflict.

The researchers surveyed 341 working adults over a seven-day period to track their feelings when they opened a work email away from the office. The three authors used Facebook, Linked In and Twitter contacts to build their sample pool.

“People who were part of the study reported they became angry when they received a work email or text after they had gone home and that communication was negatively worded or required a lot of the person’s time,” Butts said. “Also, the people who tried to separate work from their personal life experienced more work-life interference. The after-hours emails really affected those workers’ personal lives.”

Overall, Butts said two major categories of workers were identified: the segmentors and the integrators.

He said the segmentors wanted to keep their personal and work lives separate. Not surprisingly, that was the category of participant who was most negatively impacted when facing after business hours communications.

Butts said the integrators were the participants who wanted to know what was going on at work when they received an email or text. They got angry as well when receiving communications but it didn’t interfere with their personal lives.

Rachel Croson, dean of the College of Business, said Butts’ study is important because electronic communications have become a fabric of everyone’s life.

“Smartphones and the accompanying culture of ‘always on’ has made after-hours communication ubiquitous,” Croson said. “But, like everything else in business, it can be done well or badly, and implementation is critical for success. This study informs leaders not just whether and when, but also how to communicate with employees.”

Some of the recommendations the study makes include training for what to say and what not to say in an email or text, setting boundaries for when to send electronic correspondence, guidelines for proper communication style and topics best discussed face-to-face rather than electronically.

“This is the new world of work communication, and these recommendations might work in one department of a company but not in another area of the business,” Butts said. “The key is to develop your own appropriate communications rhythm within your department.”

Butts said one of the most surprising findings of the study was that people who received positive electronic communications after hours were happy. However, those “good vibes” weren’t long lasting, Butts said.

Butts said his wife, Erin, initially got him interested in the subject of electronic communications from work after hours. She works for a company that at times uses after-hours emails and texts.

“I just saw how her after hours communications often impacted our personal life for better or worse, and thought maybe other people have similar experiences,” Butts said.


Posted in Human Behavior: Work Ethic, Workplace Issues | Leave a comment

Risk factors for heartburn: excess weight, smoking

(Reuters Health) – Excess pounds and smoking might each raise the likelihood of frequent heartburn or gastroesophageal reflux disease (GERD), according to a large study from Norway. Other factors linked to higher odds of new GERD symptoms included getting older, being a woman, having less education, and even quitting smoking – if it led to weight gain.

“Heartburn and acid regurgitation are very frequent, up to 30 percent of people in Western populations have these complaints at least weekly, so we wanted to know more about the reasons why these symptoms appear,” said Dr. Eivind Ness-Jensen, the study’s senior author.

GERD is defined as having “troublesome” symptoms of acid reflux – where stomach acid flows back into the esophagus – or complications of reflux at least once a week, the study team writes in the American Journal of Gastroenterology.

Other symptoms include hoarseness, laryngitis, dry cough and increased saliva. GERD can also eventually lead to precancerous changes in the esophagus.

To see what characteristics predict development of GERD, the researchers analyzed data on nearly 30,000 people in Nord-Trondelag County, Norway.

Subjects were interviewed in 1995-1997 and again in 2006-2009.


Posted in Gastroenterology: GERD, Obesity, Smoking | Leave a comment

The sun has as an impact on how the climate varies over time: Aarhus University study in the scientific journal Geology

The activity of the Sun is an important factor in the complex interaction that controls our climate. New research now shows that the impact of the Sun is not constant over time, but has greater significance when the Earth is cooler.

There has been much discussion as to whether variations in the strength of the Sun have played a role in triggering climate change in the past, but more and more research results clearly indicate that solar activity – i.e. the amount of radiation coming from the Sun – has an impact on how the climate varies over time.

In a new study published in the scientific journal Geology, researchers from institutions including Aarhus University in Denmark show that, during the last 4,000 years, there appears to have been a close correlation between solar activity and the sea surface temperature in summer in the North Atlantic. This correlation is not seen in the preceding period.

Since the end of the Last Ice Age about 12,000 years ago, the Earth has generally experienced a warm climate. However, the climate has not been stable during this period, when temperatures have varied for long periods. We have generally had a slightly cooler climate during the last 4,000 years, and the ocean currents in the North Atlantic have been weaker.

“We know that the Sun is very important for our climate, but the impact is not clear. Climate change appears to be either strengthened or weakened by solar activity. The extent of the Sun’s influence over time is thus not constant, but we can now conclude that the climate system is more receptive to the impact of the Sun during cold periods – at least in the North Atlantic region,” says Professor Marit-Solveig Seidenkrantz, Aarhus University, who is one of the Danish researchers in the international team behind the study.

A piece of the climate puzzle

In their study, the researchers looked at the sea surface temperatures in summer in the northern part of the North Atlantic during the last 9,300 years. Direct measurements of the temperature are only found for the last 140 years, when they were taken from ships.

However, by examining studies of marine algae – diatoms – found in sediments deposited on the North Atlantic sea bed, it is possible to use the species distribution of these organisms to reconstruct fluctuations in sea surface temperatures much further back in time.

The detailed study makes it possible to draw comparisons with records of fluctuations of solar energy bursts in the same period, and the results show a clear correlation between climate change in the North Atlantic and variations in solar activity during the last 4,000 years, both on a large time scale over periods of hundreds of years and right down to fluctuations over periods of 10-20 years.

The new knowledge is a small but important piece of the overall picture as regards our understanding of how the entire climate system works, according to Professor Seidenkrantz.

“Our climate is enormously complex. By gathering knowledge piece by piece about the way the individual elements work together and influence each other to either strengthen an effect or mitigate or compensate for an impact, we can gradually get an overall picture of the mechanisms. This is also important for understanding how human-induced climate change can affect and be affected in this interaction,” she says.


Link to Geology: Solar forcing of Holocene summer sea-surface temperatures in the northern North Atlantic


The Sun: A User’s Manual, by Claudio Vita-Finzi, Natural History Museum, London

Posted in Environmental Health: Climate, Environmental Health: Sunlight | Leave a comment

Why ‘Network More’ Is Bad Advice for Women

When well-meaning people give advice to young women about how to get ahead, networking is almost always at the top of the list. Make connections; get outside your comfort zone; don’t just build relationships, focus on your business. Find a mentorno, a sponsor! — and if your company doesn’t already have a women’s network, start one.

A new study suggests that perhaps this network-your-way-to-the-top advice is, for women, a tad overblown. A working paper by Lily Fang, an associate professor of finance at INSEAD, and Sterling Huang, a Ph.D. candidate at the school, focuses on 1,815 Wall Street analysts, their school ties, and their forecasts and recommendations between 1993 and 2009.

Fang and Huang found that male and female analysts have an equal number of school-based connections — and in fact, in some cases the women were even slightly more connected to the firms they were covering – but that the men seem to get a lot more help from their contacts.

When it came to projecting the performance of the firms they were connected to, the male analysts’ forecasts were slightly more accurate, and their buy/sell recommendations were more likely to be followed.


Posted in Business, Human Behavior: Bias, Human Behavior: Gender Differences | Leave a comment

Poor response to cholesterol drugs may indicate blocked arteries

If your “bad” cholesterol level stays the same or increases after you take statin drugs, you may have more blocked arteries than people whose levels drop, according to research in the American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology.

Low density lipoprotein (LDL) cholesterol is considered the “bad” cholesterol because it contributes to plaque buildup, thick, hard deposit that can clog arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, heart attack or stroke can result.

“To lower their cardiovascular risk, it is essential to monitor LDL levels in patients with established heart disease who are receiving ongoing statin treatment,” said Stephen Nicholls, M.B.B.S., Ph.D., the study’s principal investigator and deputy director of the South Australian Health & Medical Research Institute and professor of cardiology at the University of Adelaide in Australia.

Researchers analyzed data from seven clinical studies on 647 patients with diagnosed coronary artery disease (CAD) who were prescribed statin drugs to help lower cholesterol. In each of the studies that compared diseased arteries before and after statin treatment, researchers used ultrasound to view inside arteries. Patients were followed 18-24 months.

LDL cholesterol levels either decreased to a small degree, stayed the same or increased in 20 percent of patients (“statin hyporesponders”). They had more plaque buildup in their arteries than patients who responded to statin therapy.

When cholesterol and other fatty substances collect inside an artery, they can partially or completely block blood flow — possibly leading to heart disease, kidney disease or stroke.

For some people, following a heart-healthy diet, being physically active, avoiding smoking and maintaining a healthy weight may control LDL levels. Others may also have to take medication.

The standard medication is a class of cholesterol-lowering drugs called statins. The American Heart Association and American College of Cardiology (AHA/ACC) recommend that certain patients, including those with high LDL levels, receive moderate to intense statin therapy.

The guideline recommends statin therapy for the following groups:

  • People without cardiovascular disease who are 40 to 75 years old and have a 7.5 percent or higher risk for having a heart attack or stroke within 10 years.
  • People with a history of a cardiovascular event (heart attack, stroke, stable or unstable angina, peripheral artery disease, transient ischemic attack, or coronary or other arterial revascularization).
  • People 21 and older who have a very high level of bad cholesterol (190 mg/dL or higher).
  • People with Type 1 or Type 2 diabetes who are 40 to 75 years old.

Some patients who do not fall into the four categories may also benefit from statins, a decision that should be made on a case-by-case basis.

For patients taking statins, the guidelines say they no longer need to get LDL cholesterol levels down to a specific target number – a significant departure from how doctors have treated cholesterol for years. While research clearly shows that lowering LDL lowers the risk for heart attack and stroke, there is no evidence to prove that one target number is best.

Among patients who didn’t respond to treatment, 79 percent were men, average age 56. Among statin responders, 66 percent were men average age 58. Most of the study participants were white.


Co-authors are Yu Kataoka, M.D.; Julie St. John, M.S.; Kathy Wolski, M.P.H.; Kiyoko Uno, M.D., Ph.D.; Rishi Puri, M.B.B.S.; E. Murat Tuzcu, M.D.; and Steven E. Nissen, M.D. Author disclosures are on the manuscript.


Posted in Cholesterol, Statins | Leave a comment

Suicide rates rising for older US adults

Ann Arbor, MI, February 27, 2015 — Suicide rates for adults between 40 and 64 years of age in the U.S. have risen about 40% since 1999, with a sharp rise since 2007. One possible explanation could be the detrimental effects of the economic downturn of 2007-2009, leading to disproportionate effects on house values, household finances, and retirement savings for that age group. In a study published in the American Journal of Preventive Medicine, researchers found that external economic factors were present in 37.5% of all completed suicides in 2010, rising from 32.9% in 2005.

In addition, suffocation, a method more likely to be used in suicides related to job, economic, or legal factors, increased disproportionately among the middle-aged. The number of suicides using suffocation increased 59.5% among those aged 40-64 years between 2005 and 2010, compared with 18.0% for those aged 15-39 years and 27.2% for aged >65 years.

“Relative to other age groups, a larger and increasing proportion of middle-aged suicides have circumstances associated with job, financial, or legal distress and are completed using suffocation,” noted study authors Katherine A. Hempstead, PhD, Director of the Robert Wood Johnson Foundation, Princeton, NJ, and the Center for State Health Policy at Rutgers University, and Julie A. Phillips, PhD, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ. “The sharpest increase in external circumstances appears to be temporally related to the worst years of the Great Recession, consistent with other work showing a link between deteriorating economic conditions and suicide. External circumstances also have increased in importance among those aged ?65 years. Financial difficulties related to the loss of retirement savings in the stock market crash may explain some of this trend.”

Using data from the National Violent Death Reporting System (NVDRS), which links information on violent deaths from multiple sources including medical examiner and coroner reports, toxicology reports, law enforcement records, supplemental homicide reports, and death certificates, researchers were able to analyze 17 distinct suicide circumstances and four indicators related to planning and intent.

The suicide circumstances were grouped into three major categories: personal, interpersonal, and external. Examples of personal circumstances are depressed mood, current treatment for a mental health problem, or alcohol dependence. Interpersonal circumstances include an intimate partner problem, the death of a friend, or being a victim of intimate partner violence. Examples of external circumstances are a job or financial problem, legal problem, or difficulty in school.

The four planning and intent factors are crisis in the past two weeks, leaving a suicide note, disclosing an intent to commit suicide, or a history of prior attempts.

The authors caution that “increased awareness is needed that job loss, bankruptcy, foreclosure, and other financial setbacks can be risk factors for suicide. Human resource departments, employee assistance programs, state and local employment agencies, credit counselors, and others who interact with those in financial distress should improve their ability to recognize people at risk and make referrals. Increasing access to crisis counseling and other mental health services on an emergency basis, as is often provided at times of natural disaster, should also be considered in the context of economic crises.”


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13 Ways to Stop Drinking Soda for Good

You know soda’s not exactly good for you—but at the same time, it can be hard to resist. Its sweet taste, pleasant fizz, and energizing jolt often seems like just what you need to wash down your dinner, get you through an afternoon slump, or quench your thirst at the movies.

But the more soda you consume (regular or diet), the more hazardous your habit can become. And whether you’re a six-pack-a-day drinker or an occasional soft-drink sipper, cutting back can likely have benefits for your weight and your overall health. Here’s why you should be drinking less, plus tips on how to make the transition easier.

Why you should quit

The biggest risk for regular soda drinkers is the excess calories, says Lona Sandon, RD, assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center. “The calories in regular soda are coming entirely from added sugar, and you’re not getting any value in terms of vitamins or minerals, or even good quality carbohydrates,” she says.

But soda may also be causing other types of harm. Studies have shown that its consumption is linked with tooth decay and diabetes, and it also seems to be bad for your bones. “It may have something to do with the phosphorus in soda, or it could be that people are drinking soda instead of other beverages—like milk—that have nutrients necessary for healthy bones,” Sandon says.


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Posted in Nutrition: Food: Artificial Sweeteners, Nutrition: Food: Soft Drinks, Nutrition: Food: Sugar, Nutrition: Habits | Leave a comment