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作者:佚名来源:本站原创发表时间:2009/6/5 21:52:14浏览:

Lesson One

Fossil oil/ fossilization

Those are factors that encourage fossilization.

His account is different from what I learned.

Recount v.

The procedures were described in Chapter one.

Tell a story

Relate v.

Legend n.

The account is legendary.

Famous a.

Migrate v.

migrating birds

immigrant n.

emigrant n.

move to/ migrate to


hydrophilic groups

hydrophobic groups


philosophy n.


freshmen / sophomore/ junior/ senior



ancestor/ offspring

ancient a.


The vegetable began to go bad.

The wine turns sour.


They found that the blood lipids in the subjects were higher.

plants found in the area

Please find a knife on the table.

You won’t find many people studying Latin.

Attached please find a copy of my resume.

A box keeps popping up.

I read of the accident in a newspaper.

It happened.

You said you would fix this but it did not happen.

I know it’s hard but I want to make it happen.

far east

You are learning!

The better part of us will go there.

Don’t blame kids. They don’t know better.

preservation liquid

The better part of the organ was conserved.

This is a bowl handed down from our ancestors.

generation gap

time gap / cultural gap

To bridge the gap, we have to arrange a nurse to cover this time.

We have to find a person to cover her when she is absent.

The train has covered a distance of 2000 miles.

top 10 news stories in 2009

His job is to cover the story.

They did this to attract more news coverage.

Nobody can tell what will happen.

Can you tell who is more important?

Your handwriting can tell people more about you.

You are telling me!

I can’t live with her/ the noise.

These are principles we live by.

I was wondering if you could help me with my study.

remote control

That explains it.

The probation time, if any, should not exceed 2 months.

I will put him on probation.

The symptom, if any, is usually mild.

find out/ find

I found out that she is his daughter.

frames made of steel

His childhood experiences greatly shaped his character.

a U-shaped stuff

His understanding of nursing care is skin-deep/ superficial.

rot away

Teeth decay.

Love hurts.

Time flies.

These days, Japanese governments come and go.

Money comes and goes.

He speaks English.

He fights.

Nothing remained.

The symptoms remained.

He fired three shots but the target remained.

Two pieces were fired.


He is literate.

Computer literacy is a must/ plus.

He is computer-illiterate.

way of doing something/ way to do something

I have to remove something in my way.

The lipid level was way above the normal.

She is way way better.

Way back in 1990, he was….

teaching/ instruction method

The tool can enable/ allow/ permit us to operate with one hand.

Please allow some time for the prepapration.

a 2 mm allowance

Please allow 2 mm for cutting.

pass knowledge

To my knowledge, …

Knowledge of the rule is important.

I have passed the note to Ms. Lin.

We are evaluating the likelihood of the accident.

The accident is unlikely if you follow all the rules.

an unlikely time/ couple

make it better

All the machines should be left inoperative.

Leave me alone.

You should leave the machine off.

preserved apple

I asked that question out of sheer curiosity.

Kids are curious about everything.

an non-inhabited area

Light travels/goes fast.

The ball goes/ travels along the wall.

The informed consent in written form was obtained from the subjects.

No big deal.

We are learning English by listening to radio.

Here entertainment and education go hand in hand.

He is doing this empty-handed.

He died young.

The vegetable can be eaten uncooked.

He started young.

The reason why he doesn’t like it is that ….

They conducted a causal analysis.

contextual analysis

effect / influence/ impact

The technique is cost-effective.

This domestic computer outperforms/ outdoes its imported counterpart in terms of value for money (cost-effectiveness).

She stood out in the competition/ the interview.

All the answers are not correct.

Who has the final say/ word?

What’s the make of your car?

medical record /

We have to pay for the know-how.

I will give you a definite answer after I compare notes with Mr. Wang.

He noted that money is not everything but you can’t afford to go without it.

I can assure you that everything will go as scheduled.

It goes like this.

original / a copy

the elderly

I can’t afford to buy that car.

I can’t afford that car.

We can’t afford to lose the war against the crisis.

I can’t afford to fail again.

an original idea



Lesson Two Spare that spider

I will spare no effort in helping others.

Beauty and Beasts

America, love it or leave it.

Fire: Fight or flight?


Demographic data came from local government.

statistics /

The difference is statistically significant.

acre n.

area n.

He is not content with what he has achieved so far.

happy, satisfied, patient, honest,

spare time/ spare parts


(infml ) manage without (sb) 无(某人)也可以

During the war, critics pressed Lincoln to replace Grant, but the president replied, "I can't spare this man. He fights!" (我们没他不行, 他能打仗!)

I'll spare the details.

And the first of these criteria is -don't laugh- whom can we spare.

Those who can be spared are generally the new recruits who have not yet earned themselves a spot in the "starting lineup."


I can't spare him today -- we need everybody here. 我今天需要他--我们需要人人都到齐.

I can't spare you for that job; you must finish this one first.  我不能放你去做那件事;你必须先把这件做完.

We can’t spare the nurse.


Spare her!

The bandits spared the old man and children.

I am wondering if you can help me.

The machine is very user-friendly.

fire-proof /  water-proof/ fool-proof

smart bank / missile

destroy something

car race/ human race

What makes a good hospital?

Clothes make a man.

live by / live with

He not only talks about the principles but also lives/ practises them.

possible/ likely

possibility/ likelihood

probable / probability


devour: eat up


If my mother knows this, she will kill me.

If my father knew this, he would turn in his grave.

If it were not for you, I wouldn’t have achieved so much.

disease-causing germs/ pathogenic bacteria

cancer-causing substances

You owe me ten yuan.

You owe me a report.

You owe him an apology.

IOU 10 yuan./ Where R U?

I am indebted to Mr. Wang for his assistance in the preparation of the manuscript.

China is bigger than Korea and Japan combined/put together.

All the three parts combined are smaller than this one.

All the money put together is only a fraction of his salary.

My days are numbered.

Please number each paragraph.

All the tubes are numbered.

In the past the female teachers outnumbered their male counterparts in elementary schools.

We are far outnumbered.

Smoking does more harm than good.

Disadvantages far outweigh advantages.

You don’t belong.

The table doesn’t belong here.

possessions/ personal belongings/effects

How to remove these unsightly spider veins?

What’s this for?

It’s for cosmetic purpose.

The two animals are intimately related.

tell the difference / distinguish between two things/ make distinction between the two insects

On behalf of all the nurses of Tongji Hospital, I would like extend my thanks to all the people who made this activity/ event happen.

We are engaged in a great program.

This must be his work.

It must have been the work of wind.

She is an authority in nursing science.

make a census/ conduct a study

estimation /football pitch

Let me give you an idea of how much 1 million is.

She is busy taking care of the patient.

make a guess

He is more than a doctor and he is a savior of us.

It’s more than a mobile phone. It’s a way of life.

He is no more than a doctor.

You are no better or no worse than others.

Can you make a guess at how much he makes each year?

According to an educated guess,

He is a greedy man, not content with what he is earning now.

He died young.

He is cooking/ preparing his three meals.

prepare an injection solution

a preparation

total/ subtotal

greater than/ less than

benefactor/ beneficiary

You have to pay premium on regular basis.

We offer different policies.

I sold two policies today.

You are hurting me./ It hurts.

Such events are mentally traumatic.

He flew me to Beijing.

He can fly helicopter.


The American company is very active in China.

The health care center will be activated next week.

We have been doing this all the time.

Just in time for Chinese New Year, a new nursing station was activated.

In time they became good friends.

It’s minimal.

minimum value/ maximum value

to minimize loss/ bleeding

to maximize efficiency/ profit

I made it!

Silver makes a good conductor.

She makes a good nurse.

You should stay calm in face of danger.

Take this away, and this one will stay.

To be or not to be?--- this is a question.

To work or not to work?

human being/ come into being/ existence

I think therefore I am.

She is not much a nurse.

He was involved in that scandal.

Get involved, today!


He did buy that because of money/distance involved.

Kind of/ Sort of.

It’s kind of showy, color-wise.

It’s sort of costly, money-wise.

Do you like it, color-wise?

I have to defend my paper.

dissertation defense

Drive defensively.

guard one’s reputation

Our house has been insured against fire.


Lesson 3

She pioneered the field.

She is a pioneer in the field.


She blazed a trail for us.

Her work paved the way to further development of the project.

apex of the heart

Top 10 Nurses of Tongji Hospital

Climbers held summit talk on Qumulangma

When we reached the mountain summit, we were greeted by a beautiful view.

When I entered the ward, I was greeted by a unpleasant smell.

It stinks./ It smells.

sense of achievement

achieve, attain, accomplish

achieved a great attainment

to achieve/strike a balance/ equilibrium

The balance has been upset.

This will further exacerbate the imbalance.

danger/ jeopardy/ peril

You are jeopardizing my job security.

perilous : dangerous

I shuddered at the thought.

My legs began to tremble at

even mention/sight of it.

At this, she cried.

The patient is shivering in cold.

I won’t court such trouble.

You are begging for trouble.

only, one, single, sole, solitary

Making more money is his solitary goal.

destitute, penurious, poor, impoverished

The government brought many people out of poverty.

poverty-hit area/ flood-stricken area

quake-hit regions

hungry: famish

dirty: filthy

a flea-ridden pillow

They are scratching their heads why the flea is so hard to remove.

This question made me scratch my head.

The question is head-scratchingly hard.

Take twice a day to avoid congestion.


fine / coarse

coarse voice/ coarse wine

water down the wine/ dilute

The hotel boasts the best chefs in the city.

Wuhan boasts the highest TV tower in Asia.

Epithelia form the lining of the vessels.

This will give you good sport.

climb social ladders

upward and downward mobility

rung n.

route / path


This kind of thing is held in low/ high regard in the society.
look up to/ look down on

It is highly regarded in the society.

It must be the case that you made a mistake somewhere.


It has nothing to do with the quality and amount of the dancing.

One case in point is ….

variety n.

seek independence

my prize cat

In the end, we attained the summit.

We are facing both challenges and opportunities.

His authority has been challenged.

The question is kind of challenging, calculation-wise.

We have to face the reality.

face the music

We were faced / confronted with enormous tasks.

The symptoms are mild.

The symptoms are of mild nature.

symptoms of mild nature

It depends on the nature of the materials involved.

Do you realize the nature of your crime?

death penalty

a task of dangerous nature

The computer is equipped/ armed with a digital camera.

:You should equip/ armed yourself with more knowledge. 

Equipped with a recommendation letter from his professor, he began his job hunting.

table manner

He always goes out of his way to help others.

Do you know how to use/operate the machine?

Eureka! I figure it out!

He even has no sofa to grace his living room.

We all went there except him.

He was totally cut off from the outside world.

You should not cut yourself off from others.

Holiday Inn

along with

food and shelter

What’s the make of your car?

vary / variables/ constant


for peoples used to good life, ..

appetizer / main course/ deserts

A friend in need is a friend indeed.

Beauty is in the eyes of the beholder.


Beauty is also in the eyes of the beholdee.

trainer/ trainee

We eat what we can and can what we can’t in cans.

A differs from B in that A is bigger.

successor / predecessor

Wang, then the head of the department, is now a retired worker.

You can operate the machine by following the instruction manual.

Only 34 subjects completed the follow-up study.

To test the theory, he…

The real test of truth is reality.

If it does not work in reality, it’s not true.

get to/ reach/ arrive at

We really had a hard time during our pioneering days.

primitive way of taking care of patients

fell from a height / the victim was brought to a safety/ He is sitting in the comfort of a sofa.

We have a big fish to grace the table.

You are not more important.



equivalent in English

helping/ serving

You read my mind.

How do you read/ interpret the situation?

food and board

standard of living

Your standard of service has become much worse.

To improve the standard of nursing care, …

a likable person

The single most important issue is …

generalization n.

The situation is hard to generalize with one word.

under such conditions,..

cardiovascular events

What a pity!/ What a shame!

Shame on you!

The milk has turned sour.

Our relation has turned sour.

about/ approximately/ roughly

The certificate is no in my possession.

May I see a show of hands?

I made a poor show this time.

That little girl stole the show.

Let’s enjoy the show!

It doesn’t show.


Lesson 4

a T-shirt in solid color

liquid / gaseous / solid

His study laid solid foundation for the further investigation of the disease.

firm/ infirm

firm stand

safe n.

combination of the safe

password n.


transparent/ translucent

This plate is X-ray opaque.

play bridge/ chess

chess board/ chess master

lottery n.

winning number

He is blind-fold.

We should be color-blind when we judge the merits of different peoples.

disease-causing germs

a flying disc

cases of sars/ patients with sars/ sars patients

4 subjects reported headache after taking the medicine.

They reported life-time happiness.

In this paper, 3 rare cases were reported.

You read my mind.

How do you read the situation?

Can you tell Japanese from Korean?

detective n.

finger-point v.

We should stop finger-pointing.

see through/ the wooden pattern shows through

The story concerns you.

norm n.

normal distribution

five senses/ sight

acuity n.

He already perceived the trend.

I smelt a rat.

I smelt the danger.

He sensed the danger.

sensor n.

Did you notice that?

Please put these books away.

Please do up the books with a length of string.

He described the way he resolved the problem.

Can you show me they way you do up the books?

Do up the books and put they away.

I asked that question out of sheer curiosity.

I am just curious.


This was brought to my notice yesterday.

near the hospital/

I have to take a test next week.

They nursing department administered/gave two tests last month.

There were two administrations last month.

I was given an oral test last week.

a broad array of studies showed that …

No complications took place in our series.

We also have some complications here.


CEO/chief executive officers

cabinet  / prime minister

The final assessment was made by an expert panel.

federal: national

nation state/ city state

state government/ federal government

federal law

Treason is a federal offense.

This is only a minor offense.

A good many medical workers failed to follow the rule. Young nurses are the worst offenders.

Mangers are the worst offenders.


 a screenful of information

a spoonful of syrups

Please print!

I need a hard copy.

on another occasion

I can make out the meaning of these Japanese kanji.

kimono n.

sashimi /sumo

hemophilia / Theophile/ bibliophiles

philosopher/ hydrophilic groups/ hydrophobic groups/ anemia

The job is half / 70% done./

Stay healthy, it is desirable to be 70% full when you eat.

half-full/ half-empty

upside of the thing/ downside of the thing

It’s upside down.

It’s right-side up.

:You are wearing your T-shirt inside out.

I can only make out a man.

The truck has made for Hankou station.

He likes to experiment/try.

sensitive data

Empty-handed, he entered the lion cage.

He entered the lion cage when empty-handed.

When a topic is no longer controversial, it ceases to be interesting.

the moment

Now that you have finished your job, you can play with me.

We have to remove the obstacle before we can go further.

remove several things in my way

The visibility was very low due to heavy fog.

invisible man

vision n.

His job is to supervise compliance.

People who don’t comply with the rules will be penalized.

all parties concerned

Part A and Part B and a third part

You can’t have a talent show without talent.

He made the discovery by accident.

These are procedures you have to go through.

The theory has to be tested in reality.

This is a real test for her.

If you ask him for help, chances are he will turn you down.

He meant it.

He meant/ intended to go with me.

The book is not meant/ intended to be read by kids.

He is non-committal about this.

It’s consensual.

conduct a study/ investigation

While many people rush to look for a job, he prefer to stay at home.

He talks as if he were our teacher.

“This is good” he observed/ remarked/ commented/ said.

He is regarded/ deemed as a hero.

He is considered to be a hero.

We consider him a hero.

This is to acknowledge the receipt of you letter of March 10.

He had the accident due to inattention.

You should be attentive during the class.

Take care!

Sometimes he stopped, weighing his words.

The sentence is beautifully worded.

In response to the renewed interest in nursing, the school decided to offer courses of nursing sciences.

I went to the library to renew the books I borrowed.

The contract is good for only one year and it has to be renewed.

The contract has been terminated.

Ideas contained in the book is not new but renewed.


Lesson Youth

take leave to do something

All the machines should be left inoperative when you repair one of them.

The panel should be tagged out.

tag n.


glory and dream

The film tried to glorify the sexual relation out of wedlock.

a child out of wedlock

fantastic/ terrific

bright future

That’s not the point.

identify n.

He identified himself as an FBI agent.

Peace and progress, these are things we can identify with.

endorse v.

endorse a check

seek endorsement from the party

dull/ boring

intriguing/ fascinating

commit a mistake/ murder / suicide

perpetrate v.

perpetrator n. offender/ criminal

commit a lot of money to build the road

commit energy and time


We are committed to helping the poor.

Commitment to Excellence

I am seeking long-term commitment.

too much commitment

He is a guy without commitment.

Marriage involves a lot of commitment.

Commitment to Quality Nursing Care

It depends on what your commitment is.

American professor is not that mean.

social mobility/ upward and downward mobility

If a farmer doesn’t work hard, he won’t have good harvest. The mother nature can’t be fooled.

He is a very dedicated nurse.

We thank her for her dedication.

a devoted husband

He devoted all his time and energy to helping the handicapped.

Inability to speak English is a major handicap when you live abroad.

cosmos n. universe

sense of pride

It’s outrageous.

stupid / foolish

in her youth,

suspect vs doubt

He is deliberately creating difficulties for me.

the nursing care of the elderly  

Let’s get down to the business.

basics/ essentials of the nursing procedures


He is after all a kid.

To err is human and to forget divine.

Oh, he is human.

We put actions behind our words.

He has many intriguing experiences behind him.

I would like to thank her for her behind-the-scene work.

She is brand new./ He is a new comer.

We have been engaged in a huge project.

seek independence

She has an air of elegance.

It’s elegant.

Freedom is not free.

The room is free of dust.

The surface is free of bacteria.

Freedom from dust is critical.

I hope you will be free from diseases.

freedom from cares

He is doing this without expecting any material gains.

return on investment (Roi)

The black letters are in stark contrast with their white background.

You should have/ bear this in mind when you take care of him.

I am your attending nursing.

table manner

Every time he was in trouble, he turned to God for help.

You can’t find an equivalent in English.

He said/argued that he was hungry.

This is arguably the best treatment for the condition.

ill-mannered /ill-advised

The inside of the machine is poorly protected.

The ill-fated plan aborted.

It backfired.

It won’t backfire.

hard-won victory / hard-earned money

much-discussed topic/ much-traveled road

He gave me much-needed help.

consider him to be a hero

regard/deem him as a hero

sex difference

We forgive but won’t forget.

There are many uncertainties/ variables.

He is seeing the issue from a different perspective.

If you put things in perspective, you will feel better.

She is an ambitious nurse.


The bolt came loose.



following necessarily

There is no doubt that the new economy based on high-tech has provided many new opportunities, but the gains will not be automatic.

What you call choices are nothing more than automatic responses to outside conditions or stimuli.

A university degree doesn't automatically confer talent on you.

In that case, you will automatically lose/ forfeit your right to use the facility.

A fine for this offence is automatic.

That will not automatically makes him a candidate for the presidency.

ref. The margin between the two candidates was within 0.5% of total votes cast, which meant an automatic recount is needed.


(of actions) done without thinking, esp from habit or routine; unconscious

They automatically classify me as a pop singer.

For most of us breathing is automatic.

His response is automatic.

All men are created equal.

creatures/ the Creator

The method is problematic.

identification of cells

He seems to be right.

He gave me a seemingly correct answer.

be related/ lined/ tied to/ associated/ connected with

We failed to find any definite connection between the consumption/ intake of the food and the condition.


One China, that’s bottom-line.

You have to finish your work. That’s bottom-line.

You have get the job done, one way or anther.

Just in time for the Chinese New Year, …

For each 500-g vegetable food you consume, your risk of developing heart disease will be reduced by 20%.

The event/incident is mentally traumatic.

It hurts./ I don’t want to hurt your feeling.

They are looking at the issue.


Lesson 6 The sporting spirit

We do this to show goodwill towards them.

Goodwill of a business is also valuable.

incline v.

I want to say that…

Let’s see what they have to say.

He has an inclination to gain weight.

People with depression have inclination to commit suicide.

Girls tend to cry at this.

slope n.

a road with some inclination

competition n. / game

contestant number 2

We have two entries here.

core competence

I want to know our competition.

The selection is on competitive basis.

Our salaries/ prices are very competitive.

We are competing with Class B for the title.

patriot n.

ambition/ guilty

That’s disgraceful.

grace v.n.

He has no sofa to grace its living room.

I felt I was disgraced.

He stole the show.

I made a poor show this time and I felt disgraced.

Savage Land

They are barbaric.

combat: fight

The government launched a campaign to combat/fight/ crack down on the crime.

look like/ mimic/ resemble

The symptoms of flu mimic those of common cold.

mimic war/ mock test

I took a mock test today.

You won a battle but lost the war.

Behave yourself!

the biological behaviors of benign tumors

The plastic material behaves like metal.

The boy behaves like a girl.



fair play

You are cheating.

She is amazingly beautiful.

You never cease amazing me.

nation-state / city-state

If only I could pass the exam!

He has an inclination to kill.

a war without bloodshed

concrete/ abstract

deduce v.

If a=b and b=c, we can deduce that a=c.

Those are principles I live by.

abide by law

due to a nurse’s failure to follow the standard operation procedures

His job is to supervise compliance.

The treatment didn’t work because of the poor compliance of the patient.

practice v.

It’s important for a business to practice honesty and democracy.

practice medicine/ law

In the past, women were not allowed to practice some professions.

practice crime/ sports

It’s a small gift but it means a lot.

The speed means nothing here.

I will do my best to help you.

You play to win.

He who laughs last laughs best.

He was the only one who picked up this mistake.

Head or tail?

No money is involved.

We are here for both business and pleasure.

You can exercise your right to keep silent.

His authority has been questioned/ challenged.

She is the nurse in question.

A question may arise:

rise a question/

She brought up several points at the meeting.

arouse the hatred

This aroused my sympathy.

Babies do this by instinct.

To be frank with you,…

That’s not the point. The significant point is that…

I am going to work this 100-word summary into a 10-page paper.

I am going to reduce the 10-page paper into a 100-word summary.

He had worked the room into a bar.

anger: fury

furious a.

The class is divided over the issue.

I don’t have control over that department.

This is a real test of his stamina.

Reality is the real test of a theory.

The method has some virtues.

Brevity is a virtue.

Honesty is a virtue.


assumption n./ assume

Don’t assume too much.

assumption/ news/ evidence/ fact that….

These are the three laws that govern the movement of objects.

Nobody can beat him.

This beats them all.

rival n.

Shame on you!

What a shame!

This country is at war with that country.

enter for a contest / competition

Did he sit for the test?

Such accident sometimes can bring out the best qualities of a person.

She cried the moment I left.

provided/ if

It’s desirable that we all can go there together.

turn to desired channel/ adjust to desired temperature

He is bent on getting rich.

He is bent on making an important discovery.

opportunity cost

I included him in the list and the inclusion turned out to be a right decision.

He went wild at the news.

sign n.

The long-term low prices signal (is the sign of) economic depression.


Lesson 7

Batman is back!

Strictly speaking, …

Broadly speaking, / in a broader sense

Breadth is very important.


He is very strict/honest/happy/patient with me.

utility n.

include utilities

The utility of the commodity should also be taken into account.

for some utilitarian purposes

This is only for cosmetic purpose.

The bowl will appreciate with time.

depreciate v.

Nobody appreciated the value of the stone.

He is a guy who can appreciate people’s talent.

appreciation of a piece of artistic work



The tube got clogged.

This stuff will obstruct the flow of the liquid.

I have to remove some obstacles in my way.

The temperature rises/drops with time.

change of temperature over time

With time passing/ elapsing,…

Time elapsed quickly.

body shop

time interval of 3 seconds

receive v.

This is to acknowledge the receipt of 200 yuan from Mr. Wang.

donor / and recipient

instrument / device/ apparatus

school of fishes

cod oil


All the answers are not correct.

This part serves as a handle.

56 healthy women served/acted as controls.

Serve right!

This will serve that purpose.

A piece/length of string will do the job.

serve the functions of liver

Nobody served me.

Every time he is in trouble, he turns to God.

I believe he is the right person you should turn to.

I haven’t found my Mr. Right.

Mr. Football


The doctor failed to locate the tumor.

location n.

situation n.

a case

play a role/part

to get a full appreciation of the importance of environmental protection, ..

Let me give you an idea of how much a million yuan is.

He meant to go.

This book is not meant to be read by kids.

I mean it.

surrounding /adjacent tissues

tissues in the vicinity of the tumor

The earlier the better.

pass/ take

It takes time./ Take your time.


Did you hear the taps?

He miscalculated.

compute v.

He is good at doing math.

The device came into being at the beginning of this century.

The reform is at the corner.

She is a born artist.

This new system will be put into use/ service/ operation.

Make sure his suggestions will be put into practice.

The medical center will be activated next week.

Personalities vary with persons.

Climate varies according to different regions.

The penalty depends on the nature of your mistake.

The force applied depends on the nature of the material.


There is only a very fine line between friendship and love./between strictness and cruelty.

You are only one step from crime.


With time passing, a pattern showed.

The change of temperature follows some pattern in this region.


calcium found in the food

emit: give off

The substance can give off X-ray.

radiate/ irradiate

The infected region has been irradiated by UV light.

The pain was at the stomach and it radiated to the other parts of the body.


We feed on both plants and animals.

Life is likened to a journey.

This is a measured step.


He worked out a wonderful plan.

I figured it out!

impulse and reflection

epiphany n.





spot v.

He pinpointed problem.

This is a case in point.

Should you meet him, tell him I want to see him.

Please check with Mr. Wang.

The system is still in infancy in China.

I am second to nobody.

We ranked no. 2 and were second only hospital A.

In the year-end performance appraisal, I was rated B.

The pain is rated on a 4-point scale.

Nobody beats him.

It all depends.

influence/ effect/ impact of A on B



Lesson Trading Standards


He was killed by electricity.

You are killing me.

All the animals were sacrificed by decapitation.

capital penalty

Heads will roll.

beer consumption per capita

He is having a fit/ episode.

He is not fit for the job.

It doesn’t fit.

They are not compatible.

It fits very well.

He has no sofa to grace his living room.

grace period

I put him on probation.

tax / tarrif


duty-free shop

income tax

All the patients meet the criteria.

living standard/ service standard

Even by American standards, this is good.

analysis / lysis

He was executed.


This possibility can not be eliminated/ rule out

They want to eliminated the people from this planet.

He wanted to make the earth Jew-free.

instrument / device/ apparatus

I figure it out!

He worked out a wonderful plane.

His job is to devise and advise.

treaty / WPO/ NATO

I don’t want to trade my reputation for money.

land-for-peace package deal

software package/ We offer a variety of packages.

He claimed to have seen ghosts.

You must have stayed up late yesterday.

He had a whole fish to grace the table.

You can serve dog meat to grace the table.

It is always better to be on the safe side.

To be on the safe side, we used a small dose.

Who has the final say/ the final word?

You are not busy, right?

You are fine.



regulation n.

The market has been deregulated.

The market has to be regulated.

The government introduced strict regulation to regulate the market.

I am not complaining.

He lodged a complaint against a nurse with the administration department.

You can file an application with the administration office.

No charge has been filed.

He was put into prison on three counts.

The alarm will go off  when all the three conditions are met/ satisfied.

The plan has been OKed by the Congress.


It will be intensively tested before being put into practical application.

approval n. okay

One kuai will do the job.

in principle

the strike/reach a deal

Give it a double-check.

Double check it.

in time for the Chinese new year

Principles are not negotiable.

garage sale

They are negotiating the fence.

negotiate a curb

complex, complicated, intricate

Don’t push me so hard.

He is pressing me for an interview.

How to construct an outline?

transaction n.

Do you want another transaction?

contract/ agreement

He is too ready/ happy to do that.

The rule doesn’t apply to you.

The rule is not applicable here.


What goes for you may not go for others.

He wantsw to extend the rules to students of higher grades.

It’s not right to extend the rule to others.

Are you telling me or are you asking me?

Is this a statement or question?

Is this statement true?

He likes to complain about weather.

problem with his heart

comply with

His job is to supervise compliance.

The nursing department will mete out the punishment.

The punishment has been meted out.

His authority has been questioned/challenged.

The situation is far from satisfactory.

We are going to abandon/give up/ drop the plan.

The plan is now under strict review.

year-end review

set up a test

the other/ the rest

If a=b and b=c, it follows that a=c.

The rotting will result.

All the animals are treated and sacrificed in accordance with the state regulations.

It must be a mistake./ It can’t be a mistake.

You are trying my patience.

My patience has run out.


We are also getting a lot of complications here.

Rules are made to be broken. At least mine by me.

Nobody can match/ beat her.

He is trying to get rid of Jack.

You should stay away from him. He is really mean.

The decision is really far-sighted./ short-sighted/ myopic

He answered my question in great/ certain certainty.

Hopefully, he will be there.

Thank you for unselfish and long-term enthusiasm and support.


















































































































Blood Sugar Control Helps Diabetics Preserve Sight


Close monitoring means type 1 patients can avoid retinopathy, study suggests


(HealthDay News) -- Maintaining good control over one's blood sugar levels can help people with type 1 diabetes better avoid retinopathy, a serious disorder that damages the eye's retina, researchers say.

The findings come from a 25-year study that confirms prior large studies. The findings were published in the November issue of Ophthalmology.

The Wisconsin Epidemiologic Study of Diabetic Retinopathy also found that being male, having higher blood pressure, having protein in urine (a manifestation of diabetic kidney disease) and a greater body mass index also increased one's risk of developing diabetic retinopathy.

Maintaining glycemic control, based on blood levels of glycosylated hemoglobin A1 -- a measure of average blood sugar -- helped improve the condition in those that had it as well, regardless of how long the patient had type 1 diabetes or how far along the diabetic retinopathy was at the start of the study.

The almost 1,000 study participants had all been diagnosed with type 1 diabetes before age 30, and were on insulin to combat it. All were initially evaluated between 1980 and 1982, and were followed up on periodically over 25 years. About half completed the entire study.



Bottled or Tap? The additional work poses great burden on us.


 Common pollutants are riskier for some

(HealthDay News) -- Depending on where you live, the water that comes from your tap can be just as safe as bottled water.

But in some people, common pollutants found in tap water can pose a greater health hazard. The U.S. Department of Health and Human Services offers this list:

People with a weakened immune system.

People with HIV/AIDS.

People who take steroids.

People who are being treated for cancer.

Young children are at greater risk of harm from lead that's found in older pipes. To avoid this hazard, use only the cold tap for drinking water, and let it run for a minute if you haven't used the tap in more than six hours.

On the other hand, children will benefit from the cavity-fighting fluoride found in public tap water. Most bottled waters do not contain fluoride. (You should find a better way of venting your pent-up pressure.)


Suggestions to help you feel better


(HealthDay News) -- 'Tis the season for a runny nose, cough, sore throat and other symptoms of the common cold.


You shouldn't treat a cold -- always caused by a virus -- with antibiotics, since these medicines are meant/ intended to treat bacterial infections. But there are things you can do to feel better while the cold runs its course.


The University of Virginia Health System offers these suggestions:



Try over-the-counter medications, such as an antihistamine, decongestant or cough medicine.

(Take twice a day to avoid congestion.)

Get plenty of sleep.


Increase the amount of fluids you drink.


Take a pain reliever to control headache and fever.


Soothe a sore throat by gargling with warm salt water. (The pill has a soothing effect.)


Apply petroleum jelly to sore, dry skin around the nose and lips.


Use a warm steam to ease congestion.


Exercise to Beat Arthritis Pain


How activity can help you feel better


(HealthDay News) -- Arthritis is a rheumatic disease that affects the body's joints and connective tissues. Exercise is a relatively easy way to help control its symptoms.

The list is going longer and longer.

The University of Virginia Health System lists the benefits of exercise for people with rheumatic disease:


Keeps joints from feeling and acting stiff. My left knee joint is acting stiff./ Please act normal./ When in doubt, act stupid.


Strengthens muscles surrounding the joints.


Improves joint flexibility and alignment.


Reduces joint pain and swelling.


Strengthens bone and cartilage tissue.


Makes you more physically fit overall. (He is physically fit overall than you are.)



Peppermint Oil, Fiber Can Fight Irritable Bowel


These older treatments may sometimes work best, researchers say


(HealthDay News) -- For some patients, the best therapy for irritable bowel syndrome (IBS) may be older, cheaper drugs such as fiber, antispasmodics and peppermint oil, a new study finds.


According to researchers, these simple treatments have fallen out of favor because of the availability of newer (and more expensive) drugs, some of which have been taken off the market due to safety concerns. (The problematic diary products have been taken of the market./ The older patterns have fallen out of favor. / )


But more traditional therapies should become first-line treatments in guidelines for the treatment of IBS, the experts say. Exercise to Beat Arthritis Pain



How activity can help you feel better


(HealthDay News) -- Arthritis is a rheumatic disease that affects the body's joints and connective tissues. Exercise is a relatively easy way to help control its symptoms.


The University of Virginia Health System lists the benefits of exercise for people with rheumatic disease:



Keeps joints from feeling and acting stiff.


Strengthens muscles surrounding the joints.


Improves joint flexibility and alignment.


Reduces joint pain and swelling.


Strengthens bone and cartilage tissue.


Makes you more physically fit overall.



"IBS can be difficult for physicians to treat," noted lead researcher Dr. Alex Ford, from McMaster University, Health Sciences Centre in Ontario, Canada.

(The two companies are teaming up to develop a new drug.)

"New drugs are always being developed, but recent ones such as alosetron and tegaserod have been withdrawn, and are now only available on a restricted basis, and renzapride has not been shown to be effective," he said. On the other hand "older drugs, which are cheap, safe, and in some cases available over the counter, appear to be effective in IBS."


The report is published in the Nov. 14 online edition of the BMJ.


As many as 45 million Americans may have IBS, the International Foundation for Functional Gastrointestinal Disorders reports. Between 60 percent and 65 percent of IBS sufferers are women.

medicine taker/ test-taker/ test-administer/ patient/ victims/ The Nursing Department administers the test twice a year./ The test paper will be used in the first administration.

In addition to pain and discomfort, people with IBS experience chronic or recurrent constipation or diarrhea -- or bouts of both. While the exact cause of the condition isn't known, symptoms seem to result from a disturbance in the interaction of the gut, brain and nervous system, according to the foundation. (The patient had two episodes/ fits this morning. / )


For the study, Ford's team reviewed trials that compared IBS treatment with fiber antispasmodics and peppermint oil to a placebo or no treatment. The trials included more than 2,500 IBS patients.


The researchers found that fiber, antispasmodics and peppermint oil were effective treatments for IBS. Specifically, that meant that to prevent IBS symptoms in one patient, 11 needed to be treated with fiber, five with antispasmodics, and 2.5 with peppermint oil.


There were no serious side effects associated with any of these treatments, the researchers note.


Peppermint oil appeared to be the most effective therapy of those reviewed, the researchers found.


In trials comparing fiber with placebo, insoluble fiber such as bran was not effective. Instead, only soluble fiber, such as ispaghula husk, reduced symptoms. For antispasmodics, the most effective was hyoscine. This should be used first among antispasmodics, Ford's group advised.


Mounting evidence showed that…/ The nurse takes charge of the ICU.

"Physicians, particularly those in primary care, who are being asked to take increasing responsibility for the management of IBS, should consider the use of these agents as first-line therapies for IBS," Ford said. (cold-combating agent)


Dr. Roger Jones, from Kings College London and author of an accompanying journal editorial, welcomed the study.

(He drank more than what is good for him./It worth the trip/trouble.)

"These treatments might be slightly more effective than recently thought and they are worth trying," Jones said.

(He can’t help it./ Ultrasound examination may help.)

For some patients with pain and diarrhea the antispasmodics may be useful. Patients with constipation should try fiber and for other patients, peppermint oil may be helpful, Jones said.

Lipid profile/ psychological profile/ the profile of liver function

"If you have IBS which is not under reasonably good control or you are not happy with your symptom profile, you should see your primary-care doc or gastroenterologist for review and perhaps remind them that there is new evidence about the effectiveness of these traditional medicines and you would like to give it a go," Jones said. (lipid profiles/ psychological profile)


"Alternatively, if you feel sufficiently well-informed and confident, you can go do it yourself and get these treatments at the pharmacy," Jones added. (as another option)


How to keep them looking strong and healthy


(HealthDay News) -- Like the skin, your finger and toe nails can indicate health problems, including conditions that affect the kidneys, liver and thyroid gland.


On their own, it's important to keep your nails healthy and in good condition. The U.S. National Library of Medicine offers these suggestions:



Don't bite your nails, or pick or tear at them. If you have trouble stopping these behaviors, talk with your doctor.


Clip hangails regularly.


Cut your toenails in a straight line.


Wear comfortable shoes that don't squeeze the toes.


Keep fingernails short.


Take the vitamin biotin to help strengthen brittle nails, and apply a coat of clear nail polish that contains protein.



Lack of Potassium Linked to High Blood Pressure


(HealthDay News) -- Consuming too little potassium may be as big a risk factor for high blood pressure as eating too much sodium, especially for blacks, new research says. (too big a box/ one dollar too expensive/ one e too many/ cake/
The wall is 2 centimeters too high./ My lie)


The study also identified a gene that may influence potassium's effects on blood pressure. The scientists identified 8 talents people may possess. At the meeting, four tasks of 2009 have been identified. / They identified a gene responsible for the disease.


The findings, based on a Texas heart study done/conducted on the urine samples of 3,300 people, support previous studies that made similar conclusions about potassium and blood pressure.


The new study was to be presented Saturday at the American Society of Nephrology's annual meeting, in Philadelphia.


"The lower the potassium in the urine, hence the lower the potassium in the diet, the higher the blood pressure," lead study author Dr. Susan Hedayati, of the University of Texas Southwestern Medical Center at Dallas, said in a news release issued by the conference organizers. "This effect was even stronger than the effect of sodium on blood pressure."  (This is a new release.)


The link between high blood pressure and low potassium was strong even when age, race, and other cardiovascular risk factors, such as high cholesterol, diabetes and smoking, were factored in (figured in). About half the study participants were black, and they tended to consume the least amount of potassium in their diet, Hedayati said. (We factored sick days and vacations in when we prepared the work schedule. take into consideration/ account/ Did you factor bad weather in?/ His money is three times mine.).


Laboratory research for the study suggests that the WNK1 gene may be responsible for potassium's effects on blood pressure. More research is being done to test how fixed levels of potassium in a diet affect blood pressure and the gene's activity.


Meanwhile, the researchers urged people to consume more potassium and less sodium. "High-potassium foods include fruits such as bananas, and citrus fruits and vegetables," Hedayati said. "Consuming a larger amount of these foods in the diet may lower blood pressure."



Anxiety Linked to Heart Attack Can Raise Death Risk


The psychological toll appears to shorten lives, study finds


(HealthDay News) -- Post-traumatic stress disorder (PTSD) linked to a heart attack can raise the long term risk of death for people with implanted cardiac defibrillators, a new study suggests.


Surviving a heart attack or cardiac arrest can cause significant distress. As a result, many patients later develop PTSD, which includes intense anxiety, flashbacks and "hyperarousal," according to background information in the article.


The German study, published in the November issue of Archives of General Psychiatry, found that almost 70 percent of the 211 recipients of the heart-shocking devices experienced some PTSD symptoms. About 31 percent of the recipients died within five years of the attack, and those with PTSD were about 2.4 times more likely to be among the deceased. (Father, if deceased, )


"Our findings provide direct evidence for an independent influence of PTSD symptoms on fatal outcome in these patients," wrote the authors of the study, led by Dr. Karl-Heinz Ladwig of Technische Universitaet Muenchen, Munich.


While patients with PTSD in the study reported more cardiac symptoms (such as chest pain) than those without the disorder, the clinical experiences in such patients -- for example, the frequency at which their defibrillator administers shocks -- were similar between the two groups. (The subjects reported headache after having taken the medicine./ They reported life-long happiness/ that they are happy ./ Mr. Wang reports to Mr. Li.)


"Therefore, the perceived severity rather than the objective severity of a cardiac condition as determined by cardiac criteria may be associated with PTSD," the authors wrote.


They called for further studies to determine whether behavioral and biological factors affect the death rates in these patients, but in the meantime, they called for screening for PTSD in patients with implantable cardiac defibrillators, as it is "likely to be clinically beneficial, and treatment in selected patients should be attempted."


administer sth (to sb)

(fml ) hand out or give sth formally; provide


The test was given fairly.

Every effort is made to ensure that IELTS is administered securely and fairly and that IELTS results can be trusted as valid indicators of candidates' English language ability.

We administered a severe blow to the enemy.

If necessary it can administer an electrical impulses to return the heartbeat to normal.

The drug was administered orally to the patient.

A promptly administered kick in the ass would serve the memory well.

mete sth out (to sb) : give or administer (punishment, rewards, etc)

administer punishment, justice, comfort 予以惩罚、主持正义、给予安慰

administer the last rites to a dying man 为临死的人主持临终仪式

administer an oath to sb, ie hear him swear it officially使某人宣誓.

Cf. administration

Many larger centers co-ordinate the use of material to ensure that a particular set of test versions is delivered at each administration and not subsequently re-used. From September 2003, IELTS will only be available on 48 fixed dates throughout the year. The test material for each of the 48 administrations will be used once only.

The test is administered four times a year. This test paper will be used at the first administration.

The pace-maker administers impulses to the heart at 60 times a minutes.


toll n.

The amount or extent of loss or destruction, as of life, health, or property, caused by a disaster.


flashback n.

An unexpected recurrence of the effects of a hallucinogenic drug long after its original use.


distress n.

Anxiety or mental suffering.


Severe strain resulting from exhaustion or an accident.


Acute physical discomfort.




Vitamin Holds Promise for Alzheimer's Disease (A newly developed drug holds promise for lung cancer.)


Treatment cured memory problems in mice, researchers found


 (HealthDay News) -- Researchers report that huge doses of an ordinary vitamin appeared to eliminate memory problems in mice with the rodent equivalent of Alzheimer's disease. (You can find an equivalent of the Chinese word in English./ counterpart)


At the moment, there's no way to know if the treatment will have the same effect in humans. Researchers are beginning to enroll Alzheimer's patients in a new study, and scientists aren't ready to recommend that people try the vitamin on their own outside of normal doses.


Still, "it's definitely promising, and if we combine this with other things already out there, we'd probably see a large effect," said study author Kim Green, a researcher at the University of California at Irvine.


Alzheimer's disease affects an estimated 5.2 million Americans, causing senility and often leading to death. The Alzheimer's Association estimates that the disease will strike one in eight Baby Boomers.


There's no cure for the neurodegenerative condition, and medications have only limited effects.


In the new study, Green and colleagues looked at nicotinamide, a form of Vitamin B3 that is found in foods such as pork, peanuts, turkey, chicken, veal, fish, salmon, swordfish, tuna and sunflower seeds.


Previous research has suggested that vitamins such as Vitamin E, Vitamin C and Vitamin B12 may help people lower their risk of developing Alzheimer's disease, said Dr. Ralph Nixon, vice chair of the Alzheimer's Association Medical & Scientific Advisory Council.


In the new study, researchers genetically engineered mice to develop the equivalent of human Alzheimer's disease. They tested their memory by putting them in a shallow pool of water and seeing if they could remember the location of a platform that would allow them to emerge from the water.


The researchers then gave Vitamin B3 to some of the mice; the amount was equal to about 2 grams to 3 grams of the vitamin for humans, Green said. The mice were again tested in the pool.


The findings were published online Nov. 5 in The Journal of Neuroscience.


The forgetful mice who took the vitamin did well. "Cognitively, they were cured," Green said. "They performed as if they'd never developed the disease."


The vitamin appears to work by clearing "tangles" of a protein known as tau in brain cells. In Alzheimer's disease, the protein becomes poisonous and contributes to dangerous clogging inside brain cells.


Nixon said the new study is "intriguing," but people should be cautious and not assume that "more is better" when it comes to possible treatments, even ones that appear to be safe.



Nutrients Shown Vital to Children's Development


I would like to spend this week's newsletter focusing on children's nutrition. An interesting article has just been published in the November 2008 edition of the British Journal of Nutrition on a randomized double-blinded, placebo controlled trial involving 81 healthy children in Australia, between the ages of 8 to 14 years old. The study was conducted to assess the effects of cognitive performance and mood pre-dose, one and three hours post-dose on the first and last days of twelve weeks of vitamin supplementation. The children were randomly assigned to receive either a daily multi-vitamin and mineral supplement or placebo for twelve weeks.


It was found that those children who were given the vitamin supplementation performed more accurately on two tests of attention. Interestingly, researchers noted that there were first signs of improvement only after three hours following the first dose on the first day. The improvement in attention continued throughout the entire twelve-week study. There was no appreciable change in mood. The authors concluded that the results would seem to suggest that vitamin/mineral supplementation has the potential to improve brain function in healthy children.


Recently a related study was published in the September 2008 edition of the British Journal of Nutrition on the effect of micro-nutrients on cognitive function in children. Conducted in Kenya, the study analyzed the intake of certain nutrients including iron, zinc, B12, and riboflavin. After controlling for other factors, such as socio-economic status, etc., it was found that these micro-nutrients were associated with significantly higher gains in cognitive functioning. The authors of the study indicated that this analysis demonstrates the influence of improved dietary micro-nutrients in school children's cognitive functioning. (The patients and controls were controlled for age, sex and severity of disease.)


The journal Brain Research published two articles published in its October 2008 edition regarding the omega-3 essential fatty acid, docosahexaenoic acid (DHA). These articles noted that DHA is important for nervous tissue growth and function. Inadequate intake of omega-3 fatty acids decreases DHA and increases omega-6 fatty acids in the brain. They further explained that decreased DHA in the developing brain leads to deficits in the generation of certain neuro-transmitters which aid in learning and visual function. Unfortunately, western diets are generally low in omega-3 fatty acids. The articles also indicated that epidemiologic studies have linked low maternal DHA levels to increased risk of poor child neuro development. (A recent study linked high blood lipids to the development of heart disease.)


They also noted that there is sufficient evidence in the medical literature to conclude that it is important for pregnant women to have adequate intake of DHA which can be transferred to the infant before and after birth. This has both long and short term implications for brain and nervous system function. Research done at the University of British Colombia found that higher intakes of omega-6 (such as soybean, corn and other oils common in most people's diets) actually compromise DHA levels which can have negative impacts on nerve development and function. (It has long-term implications for mentally retarded children./ When you do this, you should not compromise the interest of the company. Care should be taken in increasing dosage not to compromise the liver functions. / The 1 mm thickness is a compromise between sensitivity and strength./)


I cannot stress enough the importance of children getting adequate micro-nutrient supplementation, especially essential fatty acids in the omega-3 class, EPA and DHA. I am very fortunate to have five healthy grandchildren, all with excellent cognitive functioning. I attribute this in part to the fact that during their pregnancies, my daughters were diligent in taking supplemental DHA and other nutrients, along with providing the children these supplemental nutrients after breast feeding stopped. (I read many books written in English, along with listening to many MP3 player.)


Whole Grains Lower Risk of Heart Failure


Eating these foods and reducing intake of high-fat dairy, eggs improve odds against disease


(HealthDay News) -- Keep eating whole grains and reduce your consumption of eggs and high-fat dairy food to improve your odds against suffering heart failure, a new long-term study shows. (increase your odds against losing money)


The study, which looked at more than 14,000 people over 13 years, found that participants had a 7 percent lower risk of heart failure (HF) per one-serving increase in whole grain consumption. The risk increased by 8 percent per one-serving increase in high-fat dairy intake and by 23 percent per one-serving increase in egg consumption. Other food groups did not appear to directly affect risk of heart failure.


The findings were published in the November issue of the Journal of the American Dietetic Association.


"The totality of literature in this area suggests it would be prudent to recommend that those at high risk of HF increase their intake of whole grains and reduce intake of high-fat dairy and eggs, along with following other healthful dietary practices consistent with those recommended by the American Heart Association," article co-author Jennifer A. Nettleton, an assistant professor in the Division of Epidemiology and Disease Control at the University of Texas Health Sciences Center at Houston, said in an association news release. You should take non-fat food, along with following the doctor’s instructions.


Fish Twice a Week Cuts Diabetics' Kidney Risks


Dietary change enhances blood glucose control, study finds


(HealthDay News) -- Eating fish twice a week may help reduce the risk of kidney disease in people with diabetes, according to a British study of more than 22,000 adults, including 517 with diabetes.


The participants' fish consumption was determined using dietary and lifestyle questionnaires. People with diabetes who ate less than one serving of fish per week were about four times more likely (18 percent) to have protein in their urine than those who ate at least two servings of fish per week (4 percent). (I had two servings of fish this week./ He went to get another helping.)


"Protein in the urine is one of the earliest signs of kidney disease," noted study co-author Dr. Amanda Adler, of the Medical Research Council epidemiology unit at Addenbrooke's Hospital, Cambridge.


The study was published in the November issue of the American Journal of Kidney Diseases.


Adler and her colleagues suggested the "unique nutrient composition of fish" may benefit kidney function by enhancing blood glucose control and improving plasma lipid profiles. (You should take the lipid-lowering medicines according to the plasma lipid profiles.)


People who consume fish may have other lifestyle factors that reduce their risk of having protein in the urine (albuminuria), but the study design attempted to account for that possibility, Adler said. Eating healthy food may reduce the risk of developing heart diseases.


"Diet is a relatively simple lifestyle change to make, and the benefits could be significant," Dr. Kerry Willis, senior vice president for scientific activities at the U.S. National Kidney Foundation, said in a foundation news release. (This time I asked a red one for a change./ Can’t you tell truth for a change?)


In addition to eating fish, other measures that help lower the risk of albuminuria include tight control of glucose, keeping blood pressure under control, quitting smoking, and following a diabetic diet as prescribed by a doctor, according to the kidney foundation.



FDA Faulted for Stance on Chemical in Plastics


BPA widely used in baby bottles, food containers; has been linked to diabetes, heart disease


(HealthDay News) -- A U.S. Food and Drug Administration advisory panel agreed Friday that the agency had erred in August when it said that a chemical widely used in baby bottles and other plastic packaging for foods and beverages posed no health risks.


On Wednesday, a panel of toxicology experts said the FDA hadn't properly assessed the potential health risks posed by the chemical bisphenol A (BPA), which some studies have linked to cancer, diabetes, heart disease and developmental delays in children. The toxicologists said the FDA had relied too heavily on studies funded by the chemical industry to make its decision, and had failed to consider other studies that questioned the safety of BPA.


The panel of toxicologists had been convened by the FDA after the agency ruled that BPA was safe at current exposure levels -- a stance that prompted criticism from some lawmakers and consumer groups.


On Friday, the FDA's Science Board, which consists of scientists from academia, government and industry and advises the FDA commissioner, seconded the toxicologists' concerns about the FDA's August ruling. The issue will now go to FDA Commissioner Dr. Andrew von Eschenbach. It's unclear how the FDA might respond, the Washington Post reported. (The court of law ruled that he is guilty of theft.)


"Let me be clear: There's no shame for having" your hypothesis disproved, von Eschenbach said during Friday's session, referring to BPA without mentioning it by name, the Dow Jones news service reported.


The FDA's position/stance on BPA has been controversial because it contradicted more than 100 studies, as well as a finding by the U.S. National Toxicology Program, that there was "some concern" that BPA may affect the brain and behavioral development in fetuses, infants and small children, the Post said.


Norris Alderson, associate commissioner for science at the FDA, told Dow Jones that the agency will probably start research early in 2009 to determine the toxic effects of BPA on babies less than 1 month old. Babies are considered the most susceptible group to BPA's effects. It's unclear when those studies would be done, the news service said.


In September, a study published in the Journal of the American Medical Association said that people with high levels of BPA were more likely to have heart disease, including heart attack, or diabetes. High BPA levels increased the risk for these diseases by 39 percent, the researchers reported.


Speaking at Friday's hearing, Steven G. Hentges, of the American Chemistry Council's Polycarbonate/BPA Global Group, said: "The Science Board is receiving many diverse viewpoints on bisphenol A. But the common ground we all share is a commitment to do what's right to protect the health and safety of American consumers -- adults and children alike."


Hentges called the FDA's August draft assessment "consistent with the conclusions of other scientific and government bodies worldwide, such as the European Food Safety Authority, Health Canada, the European Union, and NSF International, all of which completed or updated their assessments this year. We rely on their conclusions, which are that polycarbonate plastic and epoxy resins are safe for use in food contact applications."


Earlier this month, Canada moved to ban plastic baby bottles containing BPA. Several U.S. states are considering restricting BPA use.


Commenting on Friday's developments, Dr. Hugh S. Taylor, director of the Division of Reproductive Endocrinology and Infertility at Yale University School of Medicine, said: "While the dangers of BPA exposure are far from definitively proven, the clear and mounting evidence that BPA is very likely to be harmful should not lead to a statement from the FDA that there is no concern. The panel's recommendation was misleading and gave people false reassurance. Decisions that may affect the health of the next several generations (due to the effects on the fetus as well) should be made cautiously and with input from all interested parties. The FDA is to be commended for this re-evaluation." (The project is commended / commissioned / entrusted by the school authorities.)



End of Daylight Saving Time Could Be Heart-Wrenching


Swedish researchers say heart attacks go up when clocks are adjusted


(HealthDay News) -- The end of daylight saving time is just about here, and it may pose health problems much more serious than just a lack of rest and increased grumpiness.


Swedish researchers have found a jump in the number of heart attacks following the semi-annual one-hour time changes.


"This was the very first study on this topic and further studies are needed," said Dr. Imre Janszky, of the Karolinska Institute in Stockholm, and co-author of a letter published in the Oct. 30 issue of the New England Journal of Medicine.


"However, we can certainly say that our study adds some further evidence that vulnerable individuals might benefit from avoiding sudden changes in their biological rhythms," Janszky said.


Those vulnerable individuals would include people already sleep deprived, other experts said. sleep-deprived people


"When somebody has sleep deprivation, obviously that deprivation does affect their health, including the possibility of having heart attack and stroke," said Susan Zafarlotfi, clinical director of the Institute for Sleep-Wake Disorders at Hackensack University Medical Center in New Jersey. "Those patients who do have a higher risk -- such as high cholesterol and, specifically, if they snore -- should be very, very careful with their time to bed and time to rise, not only for the fall back but also across the board."


The end of daylight saving time occurs Sunday, Nov. 2, when clocks are turned back one hour.


"Our circadian rhythm, which is the biological clock within the human body, gets its cues from time and light," Zafarlotfi explained. "This coming Sunday when we go backwards, our bodies are not going to be clocking so quickly, so the clinical consequences would be fatigue, tiredness and a little bit of lack of attention and lack of concentration."


For the new research, the study authors used a registry with information on all heart attacks occurring in Sweden since 1987. Then they compared how many heart attacks happened during each of the first seven days after "spring forward" and "fall back," and the average of how many occurred on the corresponding weekdays two weeks before and two weeks after the day of transition.


There was a spike in heart attacks for the first three weekdays after the change to daylight saving time in the spring, an effect that was more pronounced in women. But, in the fall change, a significant increase was seen only on the first weekday after the transition; this effect was more pronounced in men, the researchers found.


Regardless of the time of year, the effects tended to be stronger for people younger than 65 than for those over 65.


The study authors hypothesized that the increase in risk was likely due to the negative effects of sleep deprivation on heart health.


The next step in the research would be to see if prolonged sleep might reverse the problem, especially given that people in western societies tend to lack sleep. Their average night's rest has decreased from 9 hours to 7.5 hours during the last century.


There's a chance that more sleep might help, given the surprising finding that the highest risk of heart attack in the autumn occurs on Monday, the first workday of the week.


Family Halloween Safety Can Be Fiendishly Simple


Limit trick-or-treating to familiar places, don't take candy from strangers, expert says


(HealthDay News) -- With Halloween right around the corner, many parents are wondering how they can help keep their kids safe.


According to Meridith Sonnett, director of pediatric emergency services at Morgan Stanley Children's Hospital of New York-Presbyterian, taking a few precautions can help make Halloween a happy and safe occasion for everyone.


She particularly recommends limiting trick-or-treating to familiar neighborhoods and neighbors.


Here are more tips parents should keep in mind for Halloween:



Accompany your children when they go trick-or-treating.


Examine all candy before letting your children eat it.


Have your children discard any unwrapped foods.


Make sure your children's costumes are non-flammable and short enough so that they don't trip.


Make sure the eye holes in masks are the right size and in the right place for clear vision.


If your children are old enough to trick-or-treat without a parent, have them go in groups.


At night, make sure your children wear costumes that are bright in color, or have them wear reflectors.


If the streets are dark, have your children take a flashlight.


Accompany your children in apartment buildings.


Have your children use proper street-crossing safety.


Do not allow your children to enter a stranger's home; have them ask for treats and wait outside the door.


Exercise Improves Stroke Outcome



Attacks are also less severe among people who are active, researchers say


(HealthDay News) -- Recovering from a stroke is easier if you were physically active before the attack, a new Danish study finds.


Researchers found that such patients had less severe strokes and a better chance of long-term recovery.


"Keeping fit will increase your chance of a life without stroke," said lead researcher Dr. Lars-Henrik Krarup, from the Bispebjerg University Hospital in Copenhagen. "However, should you suffer a stroke, the chance is that it will be of milder severity, and you will make a better recovery." (The condition is of milder severity./ The patient made a quick recovery after the surgery./ a picture taken of a small boy. /Economic growth has been a top priority in government’s agenda.)


"The findings may have implications for future prevention campaigns, as people can be told of the beneficial effects of physical activity even if they get a stroke," Krarup said.


For the study, Krarup's team looked at the medical records of 265 people who had suffered a stroke. These people were all able to walk without help, according to the report in the Oct. 21 issue of Neurology. (If you play too much, your study will suffer./ The liver sustained extensive damage.)


The researchers interviewed each person about their weekly exercise habits before their stroke. Krarup's group found the top 25 percent of people who exercised most were two-and-a-half-times more likely to have a less severe stroke compared with people who did the least amount of exercise. In addition, people who exercised the most had a better chance of long-term recovery.


Dr. Norman M. Kaplan, a clinical professor in the Division of Hypertension at the University of Texas Southwestern Medical Center at Dallas, thinks exercise is an important component to reducing the number and severity of strokes.


"Regular physical activity has repeatedly been proven to have multiple cardiovascular benefits that could reduce both the frequency and severity of strokes," Kaplan said. "These include a lowering of blood pressure, improvement of vascular endothelial function, and prevention of obesity."


"This article provides good evidence for these benefits and should further encourage all people to exercise to reduce the likelihood of strokes," Kaplan added.


Dr. Larry B. Goldstein, director of the Duke University Stroke Center, said that living a healthy lifestyle can significantly cut the risk of stroke.


"The importance of getting regular exercise is part of primary stroke prevention," Goldstein said. The other factors include eating a healthful diet, maintaining a lean body, not smoking, and restricting alcohol, he said.


"People who follow all of these healthy lifestyle habits have about an 80 percent reduction in the risk of stroke," Goldstein said. "There is nothing we do that is associated with an 80 percent reduction in the risk of stroke medically."


A recent study found that among people with high blood pressure, exercise can be the most important lifestyle change they can make.


Although exercise is important, two-thirds of doctors don't take the time to tell their patients with high blood pressure about the importance of exercise and physical activity, the University of Wisconsin researchers found.




Cases have increased since the mid-1990s, study shows


(HealthDay News) -- The number of American women with rheumatoid arthritis (RA) is growing again after four decades of decline, according to a Mayo Clinic study.


The researchers tracked 350 adult patients, averaging 56.5 years of age, from Olmsted County, Minn. Of those patients, 69 percent were women.


In the United States, the incidence of RA had steadily declined from 1955 to 1994. But that changed in the mid-1990s, the study found. The Mayo researchers' analysis of data from early 1995 to the start of 2005 revealed that both the incidence and prevalence of RA were rising.


During those 10 years, the incidence of RA among women increased to 54 per 100,000, compared to 36 per 100,000 in the previous 10 years. The incidence of RA among men remained at about 29 per 100,000.


The rate of RA in the overall population increased from 0.85 percent to 0.95 percent.


The reason for the increase isn't clear, but environmental factors may play a role in the rise of the joint disease among women, the researchers suggested.


The study was to be presented at the annual meeting of the American College of Rheumatology/Association of Rheumatology Health Professionals, in San Francisco.



(HealthDay News) -- Call it the "tart heart-smart diet."


New research ties eating tart cherries to lowering cholesterol, reducing inflammation and cutting one's body weight and fat -- all major risk factors for heart disease. (I can assure you that everything will go as scheduled.)


This latest study, scheduled to be presented by University of Michigan researchers at the American Dietetic Association annual meeting, in Chicago, reached these conclusions after feeding whole tart cherry powder to obese rats. (We fed fat-rich chow to the animals.)


After 12 weeks, the rats had 14 percent less body fat while maintaining lean muscle mass, compared to other rats who ate the same foods minus the cherry powder. The rats eating cherries also lost significant amounts of body weight -- notably a loss of "belly" fat, a known risk for heart disease, according to the American Heart Association. (The rats were fed food minus fat.)


The rats eating a cherry-enriched diet also dropped their total cholesterol levels by about 11 percent. Levels of two known markers of inflammation linked to increased risk for heart disease also dropped by 31 percent to 40 percent. (The animal also dropped their blood lipid level by approximately 30 percent.)


"Heart disease is the number one killer of Americans today, so it's important we continue researching ways people can improve their diet to help reduce key risk factors," study co-author Dr. Steven F. Bolling, a cardiac surgeon at the University of Michigan Cardiovascular Center, said in a news release from the study's sponsor, the Cherry Marketing Institute. "We know excess body fat increases the risk for heart disease. This research gives us one more support point suggesting that diet changes, such as including cherries, could potentially lower heart disease risk." (He is one of the study co-authors.)


Researchers said the animal study is encouraging and will lead to further clinical studies in humans to explore the link between diet, weight, inflammation and lowering heart disease risk.


Tart cherries, often sold as dried, frozen or juice, contain powerful antioxidants known as anthocyanins. In addition to providing the fruit with its rich red color, studies suggest these plant compounds may be responsible for the fruit's health benefits.




Work smarter and slower


(HealthDay News) -- If you often feel out of breath or seem to tire easily, you probably should better pace yourself. To minimize stress, you should better pace yourself and balance your life. You time should be re-structured to allow more time for relaxing.


Here are suggestions to help boost your energy, courtesy of National Jewish Health: (Give credit to the original writers/ authors)


Work slower, and take short, frequent breaks. Don't rush yourself.


Find the most efficient way to perform everyday tasks. Don't make yourself work harder than you have to. (than usual, than me)


Break out strenuous tasks into smaller projects, with breaks in between (break the general items down/ to manageable size).


Breathe slowly and deeply, and avoid short, jerky breaths.


Plan your activities, schedule time for them, and relax.


Fish Oil Boosts Cardio Function & More


There was a significant study on the health benefits of fish oil just published in the prestigious British journal The Lancet. In this study, researchers from Italy examined the effects of fish oil in patients with poor heart function. Almost 7,000 patients with known poor heart function participated in the randomized double-blinded, placebo-controlled trial. Half of the patients were given 1 gram a day of omega-3 fatty acids while the other half was given placebo. The patients were then followed for almost four years on average.


It was found that those patients given omega-3 had a relative reduction in mortality by 9% and an 8% relative reduction in hospital admissions for cardiovascular reasons compared to those individuals who were given placebo. The study was so important that it caught the attention of The Wall Street Journal. A spokesperson for the European Society of Cardiology, who was not involved in this research, commented this reinforces the idea that patients with poor heart health should consider additional ideas beyond drugs alone.


The journal Cancer Letters also published a very positive article2 in its October 2008 edition noting that both omega-3 and omega-6 highly unsaturated fatty acids are necessary for human health. Presently, our western diet contains a disproportionate amount of omega-6 and a relatively low amount of omega-3, resulting in a high omega-6/omega-3 ratio that is thought to contribute to poor cardiovascular health, inflammation and abnormal cellular growth. The article explained that studies in human populations have linked high consumption of fish or fish oil to reduced risk of abnormal cellular growth in the prostate, colon and breast.


There was a nice review article3 published in the October–November 2008 edition of the journal Advanced Drug Delivery Review concerning lipoic acid in regard to cognitive health. The authors of the paper state that despite extensive research into the pathogenesis of poor cognitive health, neuroprotective treatment, particularly for the early stages, remains unavailable for clinical use. They further note that lipoic acid may actually fulfill the goal of promoting good cognitive health.


Lipoic acid has been shown to have a variety of properties that can interfere with or inhibit the progression of poor cognitive health. The authors explain that lipoic acid increases acetylcholine production through certain enzyme systems. Lipoic acid helps chelate transition metals, thus inhibiting the formation of free radicals. It also helps scavenge reactive oxygen species.


The authors also said that data from cell cultures and animal models suggest lipoic acid could be combined with nutraceuticals, such as curcumin, EGCG from green tea and DHA (from fish oil) to synergistically decrease oxidative stress and inflammation which appears to play a significant role in the development of poor cognitive health. I could not agree more with them based on my review of hundreds of studies on these powerful nutrients.


In a completely unrelated topic, I came across an interesting article that just published in the Mayo Clinic Women's HealthSource. As you know, there are millions of people in this country who are overweight and/or obese. However, the article indicates that there are people with normal body mass indexes (BMI) who may have issues with obesity. Authors Dr. Francisco Lopez-Jimenez and his colleagues reported that people with normal BMIs, but with excessive body fat, were more likely to have high cholesterol, excess belly fat and other characteristics of the metabolic syndrome. These symptoms put people at greater risk of developing poor heart function and elevated blood sugar.


Amazingly, Dr. Lopez-Jimenez found that in a sample of 2,127 men and women with normal BMIs, 61% had what he described as "normal weight obesity." He noted that sedentary living is usually the factor responsible for causing muscle mass to dwindle as fat accumulates. Dr. Lope-Jimenez and his colleagues are now investigating what people with "normal weight obesity" can do to replace their excess body fat with lean mass. Clearly exercise of at least 30 minutes every other day is extremely important along with a healthy diet. Also, Atkins proved reducing sugar and simple carbs has amazing benefits for promoting healthy BMI/weight.


You learn new knowledge along the way./


Help prevent problems


(HealthDay News) -- Skin problems are common in people with diabetes.


The American Diabetes Association offers these suggestions to help diabetics keep their skin in good health:


Always keep your skin clean and dry, and apply talcum powder in areas in contact with other skin.


Don't take baths or showers with very hot water, and don't take bubble baths if you have dry skin.


Use mild shampoos, and moisturizing soaps and body lotions. Don't apply lotions between the toes, as this may encourage fungus to grow.


Treat any cuts or abrasions promptly to prevent infection. Talk to your doctor about the best antiseptic solutions to use.


During the cold winter months, keep your home more humid, keep your skin well-moisturized, and try to bathe less frequently.


Check your feet regularly for problems.


Guidelines for use


(HealthDay News) -- Women should be cautious about exposure to any chemicals during pregnancy, even to hair dyes and treatments.


Here are guidelines for pregnant women about the use of these products, courtesy of the American Pregnancy Association:


Try to avoid treatments that straighten, bleach, perm or color hair until the second trimester.


Make sure that any treatment is applied in a well-ventilated area.


Don't leave hair chemicals in longer than necessary.


Make sure your hair and scalp are thoroughly rinsed with water after the treatment.


Always wear gloves when applying these chemicals yourself, and always follow manufacturer directions carefully.


Try testing on a small patch of hair first, to monitor for any allergic reaction.


Pain More a Cause of Arthritis Than a Symptom


Nerve cells may help spur inflammation, study shows


(HealthDay News) -- The pain caused by osteoarthritis may be as damaging as the disease itself, according to a new study.


According to a University of Rochester study published Monday in the journal Arthritis & Rheumatism, the nerve pathways carrying pain signals between the arthritic joints and the spinal cord transfer inflammation to the spine and surrounding cells and back again.


"Until relatively recently, osteoarthritis was believed to be due solely to wear and tear, and inevitable part of aging," Stephanos Kyrkanides, associate professor of dentistry at the school's Medical Center, said in a university news release. "Recent studies have revealed, however, that specific biochemical changes contribute to the disease, changes that might be reversed by precision-designed drugs. Our study provides the first solid proof that some of those changes are related to pain processing and suggests the mechanisms behind the effect."


The study gives strong evidence that this two-way "crosstalk" may first enable joint arthritis to transmit inflammation into the spinal cord and brain, eventually leading to it spreading through the central nervous system.


The researchers genetically engineered mice to study levels of a pro-inflammatory signaling chemical called interleukin 1-beta. Their experiments showed that higher levels of the chemical in a peripheral joint caused higher levels to be produced in the dorsal horns of the spinal cord and in spinal cord cells called astrocytes, which cause more osteoarthritic symptoms in joints.


In the mouse experiments, shutting down the signaling reversed the crosstalk effects. Some existing arthritis drugs, such as Kineret (anakinra), block the ability of interleukin 1-beta to send a pain signal through its specific nerve cell receptor, and Kyrkanides' group is experimenting with them as in osteoarthritis treatment.




Omega-3s Shown to Enhance Health


Omega-3 fatty acids are a group of fats that are very important for human health. They are called essential fatty acids (EFAs) because they cannot be manufactured by our bodies. Because of this fact, they must be consumed in our diets. Omega-3 is the chemical composition name that refers to a specific group of essential fatty acid molecules. Omega-3 EFAs include Alpha Linolenic Acid (ALA), Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA). Omega-3 EFAs contribute to the healthy functioning of cell membranes. They increase the fluidity of cell membranes and also improve their gate-keeping abilities. Omega-3 EFAs help keep toxins out while bringing nutrients to cells.


Many years ago, the majority of people were able to get enough EFAs in their diet. However, with the dietary changes that have occurred over the last half century, most people get some omega-3 EFAs through diet, but usually not enough to meet recommended daily amounts. Daily supplementation is the best way to ensure that you get all the health-protecting benefits of omega-3 EFAs.


Fish oil and flaxseed oil are two readily available sources of omega-3 EFAs and both can be obtained in supplement form. Recently, some interesting information on ALA has become available, which I wanted to share with you. ALA is commonly found in flax seed, whether it be the seed itself or the oil that is derived from the seed. While flax seed itself has wonderful health benefits, such as fiber to help cleanse the colon, you would have to consume a large amount of flax seed to get enough ALA to be clinically relevant. Some of the health benefits that have been attributed to ALA include a decrease in chronic inflammation and that it promotes healthy nervous and cardiovascular health.


A recent study in the American Journal of Clinical Nutrition examined the effects of different doses of flax oil on the levels of ALA, EPA, DHA and DPA (another omega-3 fatty acid). ALA is converted to EPA and DPA, and to a much lesser extent DHA. Study subjects were firefighters who were given different doses of flax oil, and another group of firefighters who were given fish oil supplements. A 2.4 gram daily dose of flax oil increased EPA 1.4-fold, while the 3.6 gram daily dose increased EPA 1.3-fold after six weeks. No significant level of DHA was seen in the flax oil group. This was expected, as the conversion of ALA to DHA is generally considered between 0.5 and 9%.


For the fire-fighters receiving the fish oil supplements, EPA levels increased 1.6 fold for the 0.6 grams per day group after two weeks and remained high for the rest of the study. Supplementation with 1.2 grams per day of fish oil also increased EPA levels 1.6-fold after two weeks, but levels had increased 2.1-fold after 12 weeks.


The conclusion of the study was that both the flax oil and the fish oil supplements caused a significant increase in EPA levels, and because the effect of the flax oil was similar to the fish oil, that consumption of plant derived omega 3 fatty acids (as found in flax oil) is sufficient to meet human needs. For those people who are vegetarian, or do not tolerate fish oil, flax seed oil represents a great alternative.


Another exciting recently published study indicates that supplementing with omega-3 fatty acids may protect the heart against exposure to air pollution. Exposure to high levels of particulate matter (PM) from vehicle exhaust and industrial pollution is known to damage the heart, due to increased inflammation and oxidative stress. Small particulate matter may also reduce the protective actions of antioxidant enzymes in the body, such as copper/zinc (Cu/Zn) superoxide dismutase (SOD), manganese SOD, and glutathione peroxidase (GSH-Px). Increased intake of omega-3 polyunsaturated fatty acids appears to support normal inflammatory response.


Researchers recruited residents from a nursing home in Mexico City who were chronically exposed to small particulate matter and randomly assigned the subjects in the double-blind study to receive either fish oil (n-3 PUFA) or soy oil. The researchers then followed them for nearly seven months. The study authors measured PM levels indoors at the nursing home and measured levels of antioxidant enzymes at different times during pre-supplementation and supplementation phases. Supplementation with either fish or soy oil was related to an increase in activity of the antioxidant enzyme Cu/Zn SOD and an increase in plasma levels of the antioxidant glutathione.


The omega-3s exerted a much greater protective effect compared to the soy oil. The researchers thought this difference was likely due to the fact fish oil contains EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). The researchers concluded, "Supplementation with n-3 PUFA appeared to modulate the adverse effects of PM (2.5) on these [antioxidant enzyme] biomarkers, particularly in the fish oil group. Supplementation with n-3 PUFA could modulate oxidative response to PM (2.5) exposure."




Help strained joints and muscles


(HealthDay News) -- Medication can help ease arthritis pain, but a gentle massage can also provide relief.


The Arthritis Foundation has this advice:


If you start to feel pain or discomfort while massaging the arthritic area, stop right away.


Avoid massaging any joints that are swollen or very painful.


Use lotion or massage oil on your skin.


If you massage using a menthol gel, make sure to wash it all off before you apply any heat to the area. This will help prevent burns. (I want to walk/swim off the calories.)


If you go to a professional masseuse, make sure he or she has experience in working with people who have arthritis. (I am still working on it.)


Vitamin C Protects Some Elderly Men From Bone Loss


New study doesn't show same result for women, however The study did not show the same result for children, however.


(HealthDay News) -- Eating fruits and vegetables can help elderly men guard against the bone loss that can lead to hip fractures, Tufts University researchers report.


What's important to realize is "that bone mineral density, bone status and fracture risk are related to many more nutrients than just calcium," said study author Katherine Tucker, a professor of nutritional epidemiology at Tufts.


She said vitamin C protects against inflammation, which contributes to bone absorption and bone loss, as well as being essential for the creation of collagen, which helps strengthen bones.


The study was expected to be published in the October issue of The Journal of Nutrition.


"Earlier studies reached similar conclusions about fruits and vegetables," Tucker explained, but weren't able to separate out vitamin C as one of the protective factors. Vitamin C supplements also benefited some of the men in the study, but it is too soon to recommend the use of such supplements, she added.


Ironically, the study did not show similar benefits for Vitamin C in women who suffer from bone loss associated with osteoporosis earlier and more frequently than men, Tucker said. "We don't really have a clear explanation for that. We did expect it to be helpful in both men and women." Possible factors leading to different results in men and women could include the small sample size and a variation in susceptibility, she added. (The discrepancy might be caused  by small sample size and a variation in susceptibility. / We can cut off the tumor because of its size./ It is of small size.)


Vitamin C was less protective in men who were smokers, which was also an unexpected finding, Tucker said. There are limitations to this finding because of other confounding factors such as male smokers may have been taking more vitamin C in the first place, she explained.


Dr. Mone Zaidi, director of the bone health program at Mt. Sinai Medical Center, said the study is one of many over the last decade that have shown an important association between vitamin C and protection against bone loss. He said the Tufts' research might have shown an even stronger association. The men and women in this study had a mean age of 75 years and consumed a total amount of vitamin C ranging from none to 482 milligrams for women and none to 520 milligrams for men. (Everybody should comply with the rule and his job is to supervise compliance./ This is just one of many.)


Zaidi added that laboratory experiments have shown that vitamin C inhibits bone reabsorption. To clearly establish that vitamin C protects men and women against bone loss as they age, Zaidi said that a randomized, double-blind, large clinical trial is needed. The problem is that because vitamin C can't be patented, drug companies, which usually finance this type of clinical trial, aren't interested, he said. (draw a parallel to modern political world/ Your health will get progressively poor when you age./ The diameters were progressively greater.)



CoQ10: Super Nutrient for Healthy Aging


 There have been a lot of interesting articles in the medical literature on nutrition of late. In the October 2008 edition of the British Journal of Nutrition, researchers from Japan studied1 the effects of coenzyme Q10 (CoQ10) regarding intensive physical exercise and muscular injury. Eighteen male students, who were all kendo athletes, were randomized to receive 300 mg of CoQ10 daily or placebo for twenty days. The subjects were randomized to received the drug therapy and placebo treatment.


All of the individuals participating in the study practiced kendo 5½ hours a day for six days during the experimental period. Blood levels of muscle enzymes and lipid oxidation were measured. Within three days, those athletes taking the CoQ10 had a reduction in certain muscle enzymes and evidence of oxidation. The researchers reported these results indicate that CoQ10 supplementation reduced exercise-induced muscular injury in athletes. (practice openness and democracy)


Oxidation is the result of excess free radical production and indicates cells may have been damaged or killed. In fact, one of the main theories for declining health with aging is the "free radical theory of aging". In 1956, Dr. Denham Harman published an article entitled "Aging: a theory based on free radical and radiation chemistry" in the Journal of Gerontology.


The free-radical theory of aging states that organisms age because cells accumulate free radical damage over time. A "free radical" is typically any atom or molecule that has a single unpaired electron in an outer shell. For most biological structures, free radical damage is closely associated with oxidative damage. Oxidative damage is similar to the process of rust formation of iron exposed to oxygen. Antioxidants such as vitamin C, vitamin E, CoQ10, green tea, grape seed and many others neutralize these free radicals and reduce oxidative damage to cells. (The books began to collect/ accumulate dust./ The water began to collect/ accumulate in the pool. with passage of time/ with time / change of blood sugar over time)


Specifically, the free radical damage to our cell's power plants, called the mitochondria, has been implicated in aging and our declining health as we age. CoQ10 is amazing as it has the ability to act both as a powerful antioxidant and also to provide fuel to the mitochondria. Hundreds of studies document/ confirm/ substantiate  verify CoQ10's benefits for promoting healthy cardiovascular and neurological function. (The gene is involved/ implicated in the mechanism. / to promote healthy cardiac function)


There have been several interesting laboratory and animal studies recently published on the benefits of alpha lipoic acid. In the September 2008 edition of the journal Experimental Neurology, researchers examined the effects of chemo-therapy induced nerve injury. In the study, alpha lipoic acid appeared to prevent damage to nerve cells by reducing mitochondrial toxicity and increasing the production of a mitochondrial protein called frataxin that has strong antioxidant properties.  (The plan is now under legal review. / I will review the payment request this afternoon./ year-end review/ If I could live over, I would do it differently./ It is reported that the drug could promote healthy lung function./ The drug reportedly / supposedly / allegedly could promote healthy lung function. The accident allegedly claimed / killed five persons.)


In the October 2008 edition of The Journal of Nutrition, epidemiologic evidence was reviewed regarding vitamin C. It was noted that vitamin C was essential for formation of collagen and normal bone development. They found in this study that vitamin C might play a protective role for bone health in older men. Vitamin C has so many uses beyond benefits for the immune system. The great scientist Linus Pauling had been proven correct over and over again. He was one of the first to advocate far higher dosages than the absurdly low RDA/DV levels of vitamin C for good health. He reportedly took 10,000 to 20,000 mg per day and lived into his 90s. It is also important to note he is the only person who won two Nobel Prizes, unshared, one for chemistry and one for peace. (He made it better./ He returned the paper uncorrected. I want it back safe and sound.)


Vitamin D continues to be a hot subject/ topic. Last year, Dr. Michael F. Holick, from the Boston University School of Medicine, wrote a wonderful review published in The New England Journal of Medicine on vitamin D deficiency. In the October 2008 edition/issue of Current Diabetes Reports, Dr. Holick reported that vitamin D deficiency, which is common in children and adults, causes rickets, softening of the bones and osteoporosis.


He noted, however, that vitamin D deficiency has been associated / linked/ with an increased risk of developing elevated blood sugar. Blood sugar control and insulin resistance are improved when vitamin D deficiency is corrected, providing that there is adequate calcium supplementation. Dr. Holick indicated that children and adults need at least 1,000 IU of vitamin D per day to prevent deficiency when there is inadequate sun exposure. Other scientists and studies indicate 2,000 to 4,000 IU per day of vitamin D is optimal; this is the dosage range I recommend. (The patient developed fever.)


There have been other studies in the medical literature indicating the benefits of vitamin D supplementation in individuals with known elevated blood sugar. In another study published in the Journal of Internal Medicine from earlier this month, a total of 441 subjects who were obese were evaluated. It was found that those individuals who had relative vitamin D deficiency scored significantly higher showing evidence of poor mood. They noted that there appeared to be a relationship between serum levels of vitamin D and symptoms of poor mood. Supplementation with high doses of vitamin D appeared to promote a healthy mood. (He scored high in the exam./ The pain was evaluated/ assessed/ judged/ measured on a 4-point scale. to promote healthy heart function/ How did you know this? I read about/of it.)


Many of you have been reading about a chemical utilized by the food industry called Bisphenol A (BPA). It is a resin found in the linings of canned food and baby bottles. There are two recent reports indicating possible toxicity with this agent. Canada is now apparently taking a precautionary approach and has decided to take steps to limit human exposure to BPA starting with a ban on baby bottles that use it. (Did you take precautions against fire?)



Regular Hand-Washing Can Prevent Against Colds, Flu


But group's survey finds fewer Americans taking this simple precaution


(HealthDay News) -- Fewer Americans are regularly washing their hands, even though it's one of the best ways to prevent colds and flu, says the fourth annual Soap and Detergent Association (SDA) Clean Hands Report Card.


"Americans should prepare for the onslaught of the cold and flu season. Cleaning your hands regularly throughout the day can help keep you out of the doctor's office or the emergency room," Nancy Bock, SDA's vice president of education, said in an SDA news release. The group has designated Sept. 21-27 as National Clean Hands Week to raise awareness of the need. (The government has designated Sept. 9 as Teachers’ Day./ a designated driver)


The report card, based on a national telephone survey of 916 people conducted in August, gives Americans a C-minus for their hand hygiene habits, the same score they had in 2006. (My teacher gave me A-plus for my performance./ Speaking English is a must/ plus. mode 23A plus)


Here are some of the findings:



Only 85 percent of respondents said they washed their hands after going to the bathroom, down/up from 92 percent in 2006. (56% of the students took the course, up from/against/compared to 49% of last year.)


46 percent said they wash their hands 15 seconds or less. Fifteen to 20 seconds of hand washing with soap is recommended by the U.S. Centers for Disease Control and Prevention and the SDA.


39 percent of respondents said they seldom or never wash their hands after coughing or sneezing, compared to 36 percent in 2006.


35 percent said they don't wash their hands before eating lunch, compared to 31 percent in 2006.


37 percent wash their hands fewer than seven times on an average day.


Only 56 percent of respondents knew that hand washing is the most effective way to prevent colds.


Teachers are one group that does understand the importance of hand washing, suggests a separate survey conducted during the 2008 National Education Association Expo in Washington, D.C., the SDA said. The survey of 230 teachers found that 97 percent knew that washing hands is the best way to prevent colds and flu, and 91 percent always or frequently clean their hands before eating lunch.


The SDA outlined how to wash hands to effectively remove germs:



Wet hands with warm running water before applying soap.


Rub hands together to make a lather. Do this away from running water so the lather isn't washed away.


Wash the front and back of your hands, between your fingers and under the nails. Wash for at least 15 to 20 seconds.


Rinse hands well under warm running water.


Dry hands thoroughly with a clean towel or air dryer.


Hand sanitizers or hand wipes are useful alternatives if soap and water aren't available for washing your hands.



Guidelines for use


(HealthDay News) -- Women should be cautious about exposure to any chemicals during pregnancy, even to hair dyes and treatments.


Here are guidelines for pregnant women about the use of these products, courtesy of the American Pregnancy Association:



Try to avoid treatments that straighten, bleach, perm or color hair until the second trimester.


Make sure that any treatment is applied in a well-ventilated area. Treatment should be applied in a well-ventilated area.


Don't leave hair chemicals in longer than necessary. (You should not stay in confined space longer than necessary.)


Make sure your hair and scalp are thoroughly rinsed with water after the treatment.


Always wear gloves when applying these chemicals yourself, and always follow manufacturer directions carefully.


Try testing on a small patch of hair first, to monitor for any allergic reaction.


Satisfying Food Cravings


Allow yourself a little to prevent eating a lot (Allow 30 min for the trip.)

 You may have that problem at one time or another. / It’s the other way round. /Allow 30 minutes for preparatory work. / You can’t draw a parallel between the two things./ I don’t want to draw a parallel between fight between two persons and war between two countries.


(HealthDay News) - Food cravings are common, and most people have them at one time or another.


The Cleveland Clinic offers these facts to help you satisfy your cravings without wrecking your weight:

(I have been on diet for two months. This dinner party wrecked the havoc./ He tried to wreck the friendship between you and me./ The accident wrecked his health. )


Satisfying a food craving can help improve your mood, relax you and give you more energy.


Women are likely to crave certain foods during certain times of the year and month, and are more likely to be happy when they've satisfied their cravings.


Don't deny yourself something that you are craving. Instead, allow yourself a small portion.


Denying yourself a small treat that you crave can lead to an intensified craving, and eventually binge eating Satisfying Food Cravings


 Denying yourself a small treat that you crave can lead to an intensified craving, and eventually binge eating.


Take care of your craving shortly after it starts. The more time you have to think about it, the stronger the craving probably becomes and the more likely you are to binge eat./ The more time you allow for the trip, the less you will worry.


-- Diana Kohnle



Watching your diet can help


(HealthDay News) -- Stomach pain can be caused by factors including diet and lifestyle, illness and infections.


According to the U.S. National Library of Medicine, the following actions can help prevent many stomach aches:



Eat smaller, more frequent meals instead of only a few large ones.


Choose healthy, well-balanced meals that are high in fiber and rich in fruits and vegetables.


Avoid foods that cause gas.


Drink lots of water each day.


Get plenty of regular exercise.



Fish Oil Boosts Cardio Function & More


There was a significant study on the health benefits of fish oil just published in the prestigious British journal The Lancet. In this study, researchers from Italy examined the effects of fish oil in patients with poor heart function. Almost 7,000 patients with known poor heart function participated in the randomized double-blinded, placebo-controlled trial. Half of the patients were given 1 gram a day of omega-3 fatty acids while the other half was given placebo. The patients were then followed for almost four years on average.


It was found that those patients given omega-3 had a relative reduction in mortality by 9% and an 8% relative reduction in hospital admissions for cardiovascular reasons compared to those individuals who were given placebo. The study was so important that it caught the attention of The Wall Street Journal. A spokesperson for the European Society of Cardiology, who was not involved in this research, commented this reinforces the idea that patients with poor heart health should consider additional ideas beyond drugs alone.


The journal Cancer Letters also published a very positive article in its October 2008 edition noting that both omega-3 and omega-6 highly unsaturated fatty acids are necessary for human health. Presently, our western diet contains a disproportionate amount of omega-6 and a relatively low amount of omega-3, resulting in a high omega-6/omega-3 ratio that is thought to contribute to poor cardiovascular health, inflammation and abnormal cellular growth. The article explained that studies in human populations have linked high consumption of fish or fish oil to reduced risk of abnormal cellular growth in the prostate, colon and breast.


There was a nice review article published in the October–November 2008 edition of the journal Advanced Drug Delivery Review concerning lipoic acid in regard to cognitive health. The authors of the paper state that despite extensive research into the pathogenesis of poor cognitive health, neuroprotective treatment, particularly for the early stages, remains unavailable for clinical use. They further note that lipoic acid may actually fulfill the goal of promoting good cognitive health. (The drug is showed to boost the cognitive ability in the elderly./ 1 mg/day of penicillin/ )


Lipoic acid has been shown to have a variety of properties that can interfere with or inhibit the progression of poor cognitive health. The authors explain that lipoic acid increases acetylcholine production through certain enzyme systems. Lipoic acid helps chelate transition metals, thus inhibiting the formation of free radicals. It also helps scavenge reactive oxygen species.


The authors also said that data from cell cultures and animal models suggest lipoic acid could be combined with nutraceuticals, such as curcumin, EGCG from green tea and DHA (from fish oil) to synergistically decrease oxidative stress and inflammation which appears to play a significant role in the development of poor cognitive health. I could not agree more with them based on my review of hundreds of studies on these powerful nutrients.


In a completely unrelated topic, I came across an interesting article that just published in the Mayo Clinic Women's HealthSource. As you know, there are millions of people in this country who are overweight and/or obese. However, the article indicates that there are people with normal body mass indexes (BMI) who may have issues with obesity. Authors Dr. Francisco Lopez-Jimenez and his colleagues reported that people with normal BMIs, but with excessive body fat, were more likely to have high cholesterol, excess belly fat and other characteristics of the metabolic syndrome. These symptoms put people at greater risk of developing poor heart function and elevated blood sugar. The baby has a disproportionately big head./ Your problem was caused by sedentary living. / I want to remove my excess belly fat. / to stop the development of poor heath/ The two drugs can synergistically elevate the blood pressure.


Amazingly, Dr. Lopez-Jimenez found that in a sample of 2,127 men and women with normal BMIs, 61% had what he described as "normal weight obesity." He noted that sedentary living is usually the factor responsible for causing muscle mass to dwindle as fat accumulates. Dr. Lope-Jimenez and his colleagues are now investigating what people with "normal weight obesity" can do to replace their excess body fat with lean mass. Clearly exercise of at least 30 minutes every other day is extremely important along with a healthy diet. Also, Atkins proved reducing sugar and simple carbs has amazing benefits for promoting healthy BMI/weight.





Heavier People Have Heart Attacks Earlier


12 years sooner for the most obese, new research finds


(HealthDay News) -- The fatter you are, the more likely you are to have a heart attack earlier in life, a new study shows. (The thinner you are, the more likely you are to have a healthy heart.)

"Basically, it is showing that as people got progressively more obese, the rate at which they had heart attacks early went up dramatically," said Dr. Eric D. Peterson, a professor of medicine at Duke University Medical Center's Division of Cardiology and a member of the group reporting the findings.

Cardiologists at several institutions studied data on more than 111,000 people who had heart attacks, looking specifically at body mass index (BMI), a measure of obesity. Someone with a BMI of 30 or above is regarded as obese; a person 5 feet, 7 inches tall who weighs 192 pounds has a BMI of 30.

The average age of a first heart attack for people with a BMI of 18.5 or under was 74.6 years. For people with a BMI of 40 or over, it was 58.7 years. The age at which a first heart attack occurred went up steadily with increasing BMI -- 3.5 years earlier for a BMI of 25 to 30; 6.8 years earlier for a BMI 30 to 35; 9.4 years for a BMI of 35 to 40; and 12 years earlier for a BMI 40 or higher.

"That is a pretty profound difference," Peterson said.

One reason for the difference is that obese people are more likely to have other risk factors for heart disease, such as diabetes, high cholesterol and high blood pressure. "But even after adjusting for those factors, just being heavy added considerable risk," Peterson said.

The findings are published in the Sept. 16 issue of the Journal of the American College of Cardiology.


Another study in the same issue of the journal provided evidence for a mechanism by which obesity increases cardiac risk. Researchers at Leiden University in the Netherlands had obese people with diabetes practice "prolonged calorie restriction," or dieting in layman's terms.

BMI went down. But sophisticated tests such as magnetic resonance imaging and biochemical studies also showed that their bodies were better able to manage blood sugar levels and that there were beneficial effects on heart muscle cells.

"The news here is that heart muscle in obese diabetic individuals can be mobilized by eating less," said Dr. Heinrich Taegtmeyer, professor of medicine in cardiology at the University of Texas Health Sciences Center in Houston and co-author of an accompanying editorial comment.

To be sure, the mechanism by which dieting helps heart cells "is only vaguely understood," Taegtmeyer said. "It gets very biochemical and very molecular." A simple explanation is that caloric restriction activates an enzyme that prevents fat from being deposited in heart cells, he said.

Whatever the mechanism, the new research provides "one more reason not to be fat," Peterson said. Some obese people have taken comfort from studies indicating that they're more likely to survive a heart attack than thinner people, he noted. The new study indicates that the reason for that better survival is the heart attack in fat people occurs earlier in life, when people are otherwise sturdier, he said.

"If you had your choice, you would choose not to have a heart attack in the first place," Peterson said.

Both Peterson and Taegtmeyer cited animal studies showing that strict caloric restriction lengthens life.

"It has been shown in virtually every organism, from yeast to flies to worms to mammals, that caloric restriction heightens life expectancy," Taegtmeyer said. "The heart functions better with caloric restriction."



Apply Bug Spray the Right Way

Careful use is key


(HealthDay News) -- When spending time outdoors -- especially at dawn or dusk -- protective clothing is the best way to guard against insect bites. But you also may need to protect yourself with insect repellent.


The U.S. National Library of Medicine offers these suggestions on how to apply it safely:

To avoid skin irritation, apply the repellent to clothing.

Use only a small amount of repellent on exposed skin, avoid contact with the eyes, and wash it off as soon as you are away from possible insect exposure.

Don't use highly concentrated repellent (DEET), especially on children and pregnant women.

Never inhale or swallow insect repellent.

Don't put a lot of repellent on young children's hands, as they may put them in their mouths or rub their eyes.

Children younger than 2 years old should never wear insect repellent more than once per 24-hour period.

a girl wearing heavy perfume/ a fan wearing face-paint/ apply the oil onto skin / He had three applications today.




Deficiency led to more brain shrinkage, study shows


(HealthDay News) -- Older individuals with low levels of vitamin B12 seem to be at increased risk of having brain atrophy or shrinkage, new research suggests. They only urge caution./ The project is seriously under-resourced./ The project can not continued due to financial restraint.


Brain atrophy is associated with Alzheimer's disease and impaired cognitive function.


Although the study, published in the Sept. 8 issue of Neurology, can't confirm that lower levels of B12 actually cause brain atrophy, they do suggest that "we ought to be more aware of our B12 status, especially people who are vulnerable to B12 deficiency [elderly, vegetarians, pregnant and lactating women, infants], and take steps to maintain it by eating a balanced and varied diet," said study co-author Anna Vogiatzoglou, a registered dietician and doctoral candidate in the department of physiology, anatomy and genetics at the University of Oxford, in England. (Lactating women should eat a balanced and varied diet.)


"It's worth looking at B12 levels. It's a simple blood test," affirmed Dr. Shari Midoneck, an internist at the Iris Cantor Women's Health Center in New York City. "It doesn't hurt to take B12."


Good sources of the vitamin include meat, fish, milk and fortified cereals.


According to the study authors, vitamin B12 deficiency is a public health problem, especially among older people.


This study involved 107 volunteers aged 61 to 87 who were cognitively normal at the beginning of the study. All participants underwent annual clinical exams, MRI scans and cognitive tests and had blood samples taken.


Individuals with lower vitamin B12 levels at the start of the study had a greater decrease in brain volume. Those with the lowest B12 levels had a sixfold greater rate of brain volume loss compared with those who had the highest levels of the vitamin.


Interestingly, none of the participants were deficient in vitamin B12, they just had low levels within a normal range.


"They all had normal B12 levels, yet there was a difference between the higher levels and the lower levels in terms of brain shrinkage, which is new information which could potentially change what we recommend to people in terms of diet," said Dr. Jonathan Friedman, an associate professor of surgery and neuroscience and experimental therapeutics at Texas A&M Health Science Center College of Medicine and associate dean of the College of Medicine, Bryan-College Station campus.


Other risk factors for brain atrophy include high blood pressure, diabetes and high cholesterol.


Not only might B12 levels be a modifiable risk factor for cognitive decline, it might also be a clue to help clinicians assess cognitive problems earlier on.


Right now, it's not clear what the biological mechanisms behind the link might be, nor is it clear whether added B12 would avert brain atrophy. (What is the mechanisms behind the link between high cholesterol and impaired brain function?/ What is the mechanism by which the drug lowers blood cholesterol?/ The underlying mechanism might be …)


"We are doing a clinical trial in Oxford in which we are giving B vitamins [including B12] to elderly people with memory impairment," Vogiatzoglou said. "In this trial, we are doing MRI scans at the start and the end, and so, we will be able to find out if taking B vitamins really does slow down the shrinking of the brain. The trial will be completed in 2009." (I was amazed by the sophistication of the society. spacial)


Too Much, Too Little Sleep Linked to Stroke Risk


Postmenopausal women who slept more than nine hours a night had up to 70% higher risk



(HealthDay News) -- Sleeping either too much or too little appears to heighten the risk of stroke, a new study finds.

And while the researchers said their findings can be applied only to the postmenopausal women in the study, other experts said the same relationship between sleep and stroke risk seems to be universal. (This is universally true.)

The study of more than 93,000 women found that those who regularly slept more than nine hours a night had a 60 percent to 70 percent higher risk of stroke than women sleeping seven hours.

The risk of stroke was 14 percent higher for women who regularly slept six hours or less, compared to those sleeping seven hours a night.

The study, to be published online July 18 in the journal Stroke, was led by Dr. Jiu-Chiuan Chen, an assistant professor of epidemiology at the University of North Carolina School of Public Health.

A number of studies have documented adverse effects of sleep deprivation, Chen said, and this report adds to that evidence.

"There have also been many studies showing a link between abnormally long sleep and an increased risk of cardiovascular disease and high blood pressure," he said.

Similar findings have been seen in studies of other groups of people, said Dr. Adnan I. Qureshi, professor of neurology, neurosurgery and radiology at the University of Minnesota Medical School, who has done some of those studies.

"If you sleep too much or sleep too little, it seems your risk of stroke goes up," said Qureshi. "This is not explained by traditional risk factors such as cholesterol levels or high blood pressure."

It isn't clear why sleep affects stroke risk, but there are several possible explanations, he said. One is that people who report long hours of sleep may have "ineffective sleep," because their periods of sleep are broken up by unnoticed wakenings, sometimes due to the breathing disorder called sleep apnea.

"Or you may be looking at a psychosocial profile," Qureshi said. "People who have depression tend to sleep longer."

As for too-brief sleep, "in experimental models, it has been shown that if you do not get enough sleep, the risk that you will die increases," he said. "Both sleep and the quality of sleep are important for survival."

There might be some factors specific to postmenopausal women, said Sylvia Wassertheil-Smoller, head of the division of epidemiology at Albert Einstein College of Medicine in New York City.

"Women who sleep less than six hours, all kinds of things happen to the hormonal system," she said. "Lots of studies clearly show that it is detrimental, that lots of stress hormones get released."

And sleeping longer than normal might be related to depression, Wassertheil-Smoller said, in agreement with Qureshi.

"People who are depressed tend to sleep longer," she said. "Depression is related to an increased risk of cardiovascular disease and stroke."  (Smoking is related to an increased risk of cardiovascular disease and stroke.)

Simply setting the clock to sleep an allotted amount of hours is not a solution to the problem, Wassertheil-Smoller said. "If a woman is not sleeping long enough, she can try stress reduction and other methods to get more sleep," she said. "If a woman is habitually sleeping more than nine hours, she can discuss it with her doctor. She should also act to lower the known risk factors for stroke, especially high blood pressure."


Study rules out the effect of one genetic variation


(HealthDay News) -- A British study adds more evidence for the link between dietary salt intake and high blood pressure. Our study adds more evidence for the association between exercise and blood sugar./ That possibility has been ruled out.

The study, which included researchers at the University of Cambridge, looked at one possible genetic factor that might make people more or less vulnerable to the effects of salt intake on blood pressure -- variants of a gene for angiotensinogen, a molecule that can raise blood pressure by tightening arteries. (Scientists showed that the gene make people vulnerable to common cold. / These genes predispose people to heart diseases. )

But the study of more than 11,000 European men and women found no relationship between variant forms of the gene and the effect of salt on blood pressure. The people who took in and excreted more salt had higher blood pressure, regardless of genetics, according to the report in the August issue of the American Journal of Clinical Nutrition. (In the August issue of Journal of HUST, a paper demonstrated that the presence of the gene was associated with development of diabetes.)

"It is a carefully done study that strongly confirms the relationship between salt and hypertension [high blood pressure]," said Dr. Mordecai P. Blaustein, a professor of physiology and medicine at the University of Maryland School of Medicine who has done research on the mechanism by which too much salt causes high blood pressure.

"The power of this study is that it includes a very large cohort," said Blaustein, who is also director of the Maryland Center for Heart, Hypertension and Kidney Disease. "Also, they directly measured salt excretion."

Dr. Paul R. Conlin, an associate professor of medicine at Harvard Medical School, who wrote an accompanying editorial in the journal, added: "The study clearly showed that people who had elevated salt intake were the ones who had high blood pressure. That was independent of the genotype for this specific gene."

But, Conlin added, it would be an "oversimplification" to say that the angiotensinogen gene is the only gene that might influence blood pressure through salt intake. "It is clear that this is the tip of the iceberg," he said. "The hypothesis they tested was reasonable, but they only tested one gene." It would be an oversimplification to say that white is bad.

Other researchers have identified genes that predispose people to high blood pressure, but they are "very uncommon," Conlin said. "The vast majority of the people we know who have high blood pressure do not carry a gene that we know of."

People shouldn't think about their genes when they salt their food, Conlin said. "You can't worry about your genotype because you can't do anything about it," he said. "This study reaffirms that salt intake has a significant effect on blood pressure, and that is clearly something that you can control."

Left untreated, high blood pressure increases the risk of coronary heart disease, heart attack and stroke.


Power: Forcefulness; effectiveness:


a novel of unusual power. 极具说服力的小说

a paper of ununsual power/ The power of the study is that it included a large cohort.



Antihistamines, immune therapy among ideas that could lead to new treatments, experts say


(HealthDay News)-- New reports on very different approaches to treating Alzheimer's disease could one day lead to better therapies for the mind-robbing condition, experts say.

A trio of studies that were presented Wednesday at the Alzheimer's Association 2008 International Conference on Alzheimer's Disease in Chicago noted progress made on three different treatment fronts. 领域

The first involves a drug called Dimebon, with positive results being reported from tests in Russia. Dimebon is an antihistamine, and data from the Russian trials indicated that Dimebon might have value in treating Alzheimer's. 具有价值

This buttressed American research reported earlier this year that showed improvements in Alzheimer's patients given Dimebon in a controlled study. The drug is believed to prevent the death of brain cells.

Researchers at the University of California, Los Angeles, studied 183 people who had mild to moderate Alzheimer's disease. Mental function remained stable in those taking the drug, while it declined in those given a placebo. Mental function also stabilized in people who were first given a placebo after they began taking Dimebon.

Another trial used the body's immune system to prevent the mental deterioration suffered by people with Alzheimer's disease. The immune attack is aimed at the deposits of beta-amyloid protein that accumulate in the brains of patients.

"The idea has been around for almost a decade now," Nixon. "The initial notion was to use the vaccine approach to prevent amyloid deposition, injecting amyloid so the body would attack the deposits. Now we are into phase two, injecting the antibody itself." 想法

Researchers at Eli Lilly & Co. reported on 52 people with mild to moderate Alzheimer's. Some were given weekly injections of a monoclonal antibody that binds to beta amyloid, while others were injected with a placebo.

Detailed measurements showed an increased level of beta amyloid in both blood and cerebrospinal fluid after 12 weeks in those getting the antibody, an indication that the beta amyloid in the brain might be starting to dissolve, the researchers said. New studies of the therapy are planned.

Nixon viewed the results with "tempered optimism." One interesting finding was the response to the therapy was greatest in people who did not have a known genetic marker for Alzheimer's risk, he said. "What is the significance of this? Why do carriers not respond?" Nixon asked. The answer might help explain Alzheimer's disease better, he said.

A third study using a broad spectrum of antibodies was reported by a team at WeillCornellMedicalCollege in New York City. The treatment, originally developed by Baxter International to treat autoimmune conditions, was given to 24 people with mild to moderate Alzheimer's disease in a set of trials extending as long as 18 months. Statistically significant increases in mental function were seen in those getting the treatment, the researchers said. A large-scale, 18-month follow-up trial will be done. The patients getting the treatment showed substantial improvement. /The significance is that .../ The doctors at Tongji Hospital reported on 34 subjects with mild headache. / They are now into phase three./ The idea has been around for many years. / the physical deterioration suffered these patients. / Our findings buttressed their conclusion. /The first trial involved the drug called Demonide. / The study may lead to better therapies for mind-robbing conditions. / A progress made in another treatment front was ….


Sudden Hearing Loss May Portend Stroke



It could foreshadow trouble by as much as 2 years, Taiwanese study suggests


(HealthDay News) -- Sudden hearing loss may foreshadow a stroke by as much as two years, say Taiwanese researchers.


The researchers analyzed five years of follow-up data on 1,423 patients hospitalized for an acute episode of sudden hearing loss and found they were more than 1.5 times more likely to suffer a stroke than a control group of 5,692 patients hospitalized for an appendectomy.


The findings, published in the current issue of Stroke, haven't been duplicated in other research and should be interpreted with caution.


"To the best of our knowledge, no study has investigated the incidence or risk of cerebrovascular diseases developing following the onset of sudden sensorineural hearing loss," lead investigator Herng-Ching Lin, a professor at Taipei Medical University School of Health Care Administration, said in a prepared statement.


"But because this is the first time any association has been suggested, and because there were many limitations in the data, the results need to be interpreted cautiously until additional independent studies are performed," Lin said.


One limitation was the lack of a clear definition for sudden sensorineural hearing loss in the database reviewed by the researchers.


"Secondly, the database did not contain information regarding severity of hearing loss, extent of hearing recovery, tobacco use, body-mass index and the medical history of cardiovascular disease and atrial fibrillation -- all of which can contribute to stroke risk," Lin said.


Even so, the researchers recommended that all hearing loss patients have a comprehensive neurological exam and blood testing to assess their stroke risk.



And doctors need to be aware of the connection, study says


(HealthDay News) -- The relationship between diabetes and depression apparently cuts both ways (两方面都起作用): Not only are people with treated type 2 diabetes at a heightened risk for developing depression, individuals with depression are also at risk for developing diabetes.


The research revelation suggests that both doctors and patients need to be more aware of the dual risks.


"Doctors should have their sensitivity increased toward picking up on the potential for more of their diabetes patients and more of their depression patients having susceptibility to the other disorder," said Dr. Stuart Weiss, assistant clinical professor of medicine at New York University School of Medicine.


Type 2 diabetes and clinical depression tend to go hand in hand, the study authors said, although the question has been, which comes first?


"There have been studies that show people with diabetes are twice as likely to have symptoms of depression as those who don't, and it could either be because depression itself leads to the development of type 2 diabetes or it could be that having diabetes leads to the development of depression," said study lead author Dr. Sherita Hill Golden, an associate professor of medicine and epidemiology at Johns Hopkins University School of Medicine.


"There are several studies showing that depression and depressive symptoms lead to the development of type 2 diabetes, but only a couple of studies showing that diabetes itself leads to depression. We wanted to look to see whether or not we could tease out the chicken-and-egg situation," she said.


Previous studies have also found that treating depression can help extend the lives of people with diabetes.


The authors of the new study performed two analyses, both using information from participants in the Multi-Ethnic Study of Atherosclerosis trial.


The first analysis involved 5,201 individuals without type 2 diabetes at the start of the trail and found that treated type 2 diabetes was associated with a 54 percent increased risk of developing depressive symptoms over 3.2 years. Persons with untreated diabetes were not at risk of developing depression.


Interestingly, people with pre-diabetes or untreated diabetes were about 25 percent less likely to develop depressive symptoms than people with normal fasting blood sugar levels, the researchers said.


"That was a little bit of a surprise," Golden said. The study authors aren't sure why this was so, but suggest that maybe the monitoring associated with treating diabetes might contribute to depression.


The second analysis included 4,847 participants and found that elevated depressive symptoms were associated with a 42 percent greater likelihood of developing diabetes during the follow-up period. The stronger the depressive symptoms, the higher the chance of developing diabetes. After adjusting for such factors as being overweight, not exercising and smoking, the risk of developing diabetes was still 34 percent higher in patients with depression.


"Those with depression are more likely to consume more calories, be less physically active and are more likely to smoke, so they just have poor overall health behaviors in general," Golden said. "That seems to be one component of treating depression that needs to be addressed."


The findings, published in the June 18 issue of the Journal of the American Medical Association, indicate that integration of care may be helpful to these patients, Golden said.


"For people who are being treated for symptoms of depression, it's important also to think about some treatment modalities that can also help them adopt healthy behaviors," she said. "And certainly among people who have treated diabetes and who are at risk of developing depression, we need to be aware of that increased risk."


Golden serves on the Merck & Co.'s clinical diabetes advisory board; the study was supported by the U.S. National Institutes of Health.



Red Yeast Rice & CoQ10 May Boost Cardio Health


Thirty years ago this month, I graduated from Thomas Jefferson University Medical School in Philadelphia. Medical students back then were not taught anything about nutrition. In fact, perhaps the only thing that we really learned regarding various minerals and vitamins came from introductory biochemistry lectures on the biochemical reactions in cells. Mainstream medicine has come a long way since then, my alma mater in particular.


At some point, Jefferson moved into complementary medicine, setting up an integrative medicine center. In fact, it just reported on an excellent study1 in the June 15th edition of the American Journal of Cardiology. Almost 5,000 patients in mainland China who suffered a previous myocardial infarction participated in a multi-center, randomized double-blinded placebo controlled trial. The ages of these patients ranged from 18 to 70 years old. A total of over sixty hospitals participated. The group was randomized to receive either 600 mg a day of Chinese red yeast rice extract along with some other nutrients or placebo for approximately 4½ years.


At the end of the trial, it was found that over 10% of the patients in the placebo group had suffered either a non-fatal heart attack or death from coronary artery disease versus 5.7% in the red yeast rice group (over 50% reduction). Supplementation with the red yeast rice extract significantly decreased cardiovascular death by 30% and, interestingly, total mortality by 33%. Additionally, the need for coronary artery surgery was decreased by one third. In general, the red yeast rice was well-tolerated. Dr. Capuzzi, director of the cardiovascular program in integrative medicine at Jefferson, indicated, "It's very exciting because this is a natural product and has very few adverse effects, including no abnormal blood changes."


He further noted that people from the Far East had been taking Chinese red yeast rice for thousands of years, but no one to date had studied it clinically in a double-blinded manner against a placebo group. Dr. Capuzzi did indicate, however, that the red yeast rice extract utilized in this study is not similar to over-the-counter supplements found at your average health food store in the United States.


This was a wonderful study. Although it is true that the red yeast rice sold over-the-counter in the United States is not officially reported as being standardized, numerous customers have given very positive reviews on the red yeast rice products. It seems that red yeast rice is far safer than typical statin drugs, which may cause abnormalities in liver function, as well as contribute to muscle and nerve damage. I do recommend consuming coenzyme Q10 with red yeast rice, as you also should with statin drugs, because both can lower the body's natural ability to produce coenzyme Q10.


Coenzyme Q10 also promotes good cardiovascular function and health. I recommend 200 – 400 mg per day of Coenzyme Q10 for cardiovascular health and 1,200 mg per day for neurological health concerns.


In the June 9, 2008 edition of the Archives of Internal Medicine, researchers from the Department of Nutrition at the Harvard School of Public Health reported on the results of a prospective study2 regarding plasma concentrations of vitamin D and associated risk of coronary artery disease. Over 18,000 men, between the ages of 40 to 75 years old, were followed in the Health Professionals Study. At the time of the study, they were free of diagnosed cardiovascular disease. Blood samples were measured between 1993 and 1999. During ten years of follow up, 454 of these men developed non-fatal heart attacks or fatal coronary artery disease.


After adjusting for other variables, it was found that men who were deficient in vitamin D were at a 142% increased risk of myocardial infarction compared to those who had sufficient levels of vitamin D in their blood. Even men with intermediate levels of vitamin D in their blood had some elevated relative risk. To reach the higher levels of vitamin D providing optimal protection would require 3,000 IU per day of vitamin D3, far higher than most multi-vitamins that only contain the DV/RDA of 400 IU.


People with low vitamin D levels may face an increased risk for peripheral artery disease (PAD). PAD occurs when arteries in the legs become narrowed or clogged with fatty deposits, reducing blood flow to the legs. PAD affects about 8 million Americans and is associated with significant disease and death. The most recent study3 regarding vitamin D and PAD was published in the June 2008 edition of Arteriosclerosis, Thrombosis, Vascular Biology.


In the study, data was analyzed from over 4,800 participants in the National Health and Nutrition Examination Survey 2001 to 2004. Participants with the lowest vitamin D levels were 2.18 times more likely to have PAD than were participants in the highest vitamin D levels after adjustment for age, gender, and race. For each 10 nanogram per milliliter decrease blood vitamin D level, there was a 35% increase in the prevalence of PAD, the investigators report.


In the June 2008 issue of The Archives of Ophthalmology, there is a terrific study4 on age-related macular degeneration (AMD). Researchers from the University of Melbourne in Australia pooled the data from nine previous studies. The meta-analysis involved almost 89,000 participants and over 3,200 people with AMD. The authors of the study noted that high dietary intake of omega-3 EPA was associated with a 23% reduction in the risk of early AMD, whereas DHA was associated with a 30% reduction.


Furthermore, it was discovered that high intake of dietary omega-3 was associated with a 38% reduction in the risk of developing advanced AMD. The researchers noted that there have been no randomized clinical trials to date that have evaluated the potential effects of omega-3 fatty acids in regard to the reduction of incidence or risk of AMD and that the results of the meta-analysis should be treated with caution.


Although researchers, as a general rule, tend to err on the side of caution when it comes to nutrition (but not drugs), omega-3 fatty acids offer tremendous health benefits aside from their potential benefit with AMD. Omega-3 fatty acids appear to reduce inflammation, reduce risk of sudden death presumably by decreasing incidence of cardiac abnormal rhythm and appear to be beneficial for healthy joint function, brain function, mood and immunity.


The studies presented above further reinforce the importance of proper nutritional supplementation. Vitamin D and fish oil (the best source of omega-3 EPA and DHA), in my opinion, have gone from almost relative obscurity to major prominence as potential life-saving and life enhancing nutrients. I know numerous doctors who now recommend these nutrients to their patients. The problem is, many times they fail to inform their patients about the optimal dosages and forms of nutrients.


Vitamin D Deficiency Puts 40% of U.S. Infants and Toddlers At Risk


About 12 percent already are deficient, study finds


(HealthDay News) -- At least 40 percent of American infants and toddlers aren't getting enough vitamin D, according to researchers from Children's Hospital in Boston.


Twelve percent of the youngest children in the United States are already deficient in vitamin D, and another 28 percent are at risk for vitamin D deficiency, according to the study, which appears in the June issue of the Archives of Pediatrics and Adolescent Medicine.


Because human breast milk lacks sufficient vitamin D, the number of babies in the research sample being breast-fed were important to the findings.


"These data underscore the fact that breast-fed infants should be supplemented with vitamin D," said study author Dr. Catherine Gordon, director of the bone health program at Children's Hospital in Boston. She added that mothers who are breast-feeding often need vitamin D supplements as well.


Breast-feeding is a known risk factor for low vitamin D levels in infants, which is why many pediatricians routinely recommend vitamin D supplementation for breast-fed infants. Other factors that may contribute to low levels of vitamin D include not drinking enough vitamin D-fortified milk (for toddlers), staying out of the sun or using sunscreen.


Vitamin D, also known as the sunshine vitamin, is produced naturally when the body reacts to sunlight. However, the use of sunscreen and advice to stay out of the sun -- which is important for preventing skin cancer -- may also be reducing levels of vitamin D in people. Few foods naturally contain vitamin D, which is essential for strong bones because it helps the body absorb calcium.


In addition to helping maintain bone health, Gordon said that vitamin D also appears to play a role in maintaining the immune system and that people with low levels of vitamin D may be more susceptible to autoimmune diseases, such as type 1 diabetes and multiple sclerosis, and to certain cancers.


Previously, Gordon and her colleagues studied vitamin D levels in adolescents and found very high levels -- about 42 percent -- of vitamin D deficiency in teens. That finding made them interested in assessing levels in younger children.


The current study included 380 children between 8 and 24 months old. About 80 percent were from urban areas, and the majority of the youngsters were black or Hispanic, according to the study. However, the study made no association between skin pigmentation and vitamin D levels.


For this study, the researchers defined severe vitamin D deficiency as blood levels of less than 8 nanograms per milliliter (ng/mL), vitamin D deficiency as less than 20 ng/mL and suboptimal as less than 30 ng/mL. Gordon said there is some debate within the medical community about what truly signifies vitamin D deficiency, but that they felt current evidence supports the levels they used, and less than 20 ng/mL is the level her hospital uses as a cut-off point.


In an accompanying editorial, Dr. James Taylor, a professor of pediatrics at the University of Washington, said that although he believed the study was well done, Gordon and her colleagues used a "higher cut-off" than what has been used by other researchers.


But, he added, because Gordon's team found X-ray evidence of low bone density in children who fell into their category of low levels of vitamin D, "it might be that this might be an indication of long-term problems. If this is the case, then Gordon and colleagues might have picked the right definition. However, it might be that for many of the children with osteopenia [low bone density], the changes are transient and not indicative of disease. Time and more research will tell."


The key findings from the study, according to Gordon are:

Breast-feeding without vitamin D supplementation is a risk factor for vitamin D deficiency.

A higher body- mass index was associated with a risk of vitamin D deficiency.

There was no association between the seasons -- an indication of possible sun exposure -- and vitamin D deficiency.

There was no association between skin pigmentation and vitamin D deficiency.

Consumption of vitamin D-fortified milk confers protection against deficiency.



Gordon said it's very difficult to consume too much vitamin D, so she recommends vitamin D supplements for breast-feeding infants and lactating mothers. She also recommends a multivitamin containing vitamin D for older children.


Taylor wasn't as convinced about the need for routine supplementation, however. "I think that more research is needed before routine vitamin D supplementation is recommended for all children," he said.




ALA May Contribute to a Longer, Healthier Life


 Green Tea May Help Brain Cope With Sleep Disorders


 Study in rats finds polyphenol compounds affect areas involved with learning and memory


(HealthDay News) -- Green tea may counter the cognitive problems that come with obstructive sleep apnea (OSA), a new study suggests.


Green tea polyphenols (GTP) appear to negate the increased oxidative stress that affects brain tissue in areas involved in learning and memory in people with OSA, reports the study, published in the second issue for May of the American Journal of Respiratory and Critical Care Medicine. GTPs are known to possess antioxidant properties.


The conclusion is based on giving drinking water laced with GTP to rats intermittently deprived of oxygen during 12-hour "night" cycles -- a condition that mimics the intermittent hypoxia (IH) that humans with OSA experience. The rats that drank green tea-treated water performed significantly better in a maze than rats that consumed plain water.


"GTP-treated rats exposed to IH displayed significantly greater spatial bias for the previous hidden platform position, indicating that GTPs are capable of attenuating IH-induced spatial learning deficits," lead author Dr. David Gozal, director of Kosair Children's Hospital Research Institute at the University of Louisville, said in a prepared statement. He added that GTPs "may represent a potential interventional strategy for patients" with sleep-disordered breathing.


"OSA has been increasingly recognized as a serious and frequent health condition with potential long-term morbidities that include learning and psychological disabilities," Gozal said. "A growing body of evidence suggests that the adverse neurobehavioral consequences imposed by IH stem, at least in part, from oxidative stress and inflammatory signaling cascades."





Several weeks ago, Barbara Walters did a special program entitled, "Live to be 150…Can You Do It?" Shortly after this program aired, I wrote a newsletter examining resveratrol, which some researchers propose may help prolong life. During her program, Barbara Walters discussed with scientists the theory that caloric restriction could extend life. This has been shown in many animal species, where reducing caloric intake can increase lifespan up to about 30%. Whether this can occur in humans has yet to be clearly determined, but there are many people in this country and throughout the world who adhere to a program of caloric restriction as a way to combat aging.


Followers of caloric restriction try to reduce their total intake of calories to a level of about 20% to 40% lower than typical consumption, but still obtain all of the necessary vitamins and nutrients. I happen to know someone who is a strong advocate of this. I have seen his blood work and it is nothing short of fantastic in terms of total cholesterol, HDL and so on. Caloric restriction, however, takes a tremendous amount of willpower and, for most people in this country who live on high caloric fast food laden with fat, sugar and salt, a caloric restriction diet would not be palatable.


It is with extreme interest that a study was published last month in the journal Mechanisms of Ageing and Development discussing lipoic acid supplementation as a way to mimic the effects of dietary caloric restriction. The researchers out of England noted that although dietary caloric restriction extends survival in a range of species, the exact mechanism as to how this occurs is not known. In the study, a group of rats that initially had dietary restriction feeding were switched to ad libitum (as much as desired) feeding with a diet supplemented with alpha lipoic acid.


It was found that the rats had extended survival characteristics similar to those of rats with dietary restriction. Interestingly, when another group of rats that could eat as much as they wanted were also supplemented with alpha lipoic acid and then switched to dietary restriction without supplementation, the beneficial effect of caloric restriction to extend survival did not occur. The researchers concluded that ad libitum feeding with a diet supplemented with alpha lipoic acid can act to mimic the effects of dietary restriction to extend survival.


I know that those of you who love to eat (and there are a lot of you) can certainly appreciate this study. Popping some extra alpha lipoic acid is a lot easier than cutting your diet down to 1,200 calories a day. However, I would strongly caution that whether this works in humans to extend life is a big question mark. Alpha lipoic acid is one of my favorite nutrients because there are now so many studies in humans indicating a dose of 600 mg per day is safe and provides numerous benefits for the body. It appears to promote healthy blood sugar as we age and also act as a universal antioxidant, both water and fat soluble, to protect cells against free radicals.


There have been other studies in the medical literature noting rats that were fed a combination of alpha lipoic acid and acetyl-L carnitine actually had regeneration of brain tissue along with more youthful behavior and activity. Alpha lipoic acid and acetyl-L carnitine have long been regarded as potential anti-aging nutrients.


There are two additional studies I would like to mention just published in the May 2008 edition of The American Journal of Clinical Nutrition. In the first study out of France, researchers analyzed the relationship between fatty acids in the blood stream and the severity of poor mood in a group of elderly individuals with an average age of almost 75. Compared to controlled subjects, it was found that those individuals with the lowest levels of EPA (an omega 3 essential fatty acid) in their blood stream were more likely to have poor mood. Conversely, those with higher levels of EPA had a generally lower severity of poor mood, especially those taking anti-depressants.


The last study concerns vitamin B6. Researchers from Tufts University reviewed the data collected in a 2003-2004 Health and Nutrition Examination Survey known as NHANES. It was previously thought that B6 deficiency is rare in the United States. B6 has been linked to healthy heart function and immune function. It was found that in a group of over 7,800 men and women, nearly a quarter of them who did not take any supplementation had blood levels of B6 that were deemed to be deficient. In those individuals who took some supplementation, 11% were noted to have a deficiency of B6. Interestingly, in women who reported using oral contraceptives, they were much more likely to have extremely low levels of B6 in their blood stream.




Larger Skin Lesions More Likely to Be Melanoma


Study backs current skin cancer-screening guidelines


(HealthDay News) -- Skin lesions larger than six millimeters in diameter are more likely than smaller lesions to be melanoma skin cancer, a new study suggests.


The finding supports the current widespread use of diameter guidelines to screen for melanoma, researchers say.


This "ABCDE" screening method is based on five features characteristic of melanoma: asymmetry, border irregularity, color variegation, diameter larger than six millimeters, and changes in a lesion.


However, some experts have argued that strict adherence to the diameter guideline will cause doctors to miss smaller melanomas, according to background information in the study.


In this study, researchers at the New York University School of Medicine, New York City, studied more than 1,300 patients undergoing biopsies for 1,657 pigmented skin lesions or markings suggestive of melanoma. Of those lesions, 804 (48.5 percent) were larger than six millimeters in diameter and 138 (8.3 percent) were diagnosed as melanoma.


Invasive melanomas (which have penetrated deeper into the skin) were diagnosed in 13 of 853 lesions (1.5 percent) that were six millimeters or smaller in diameter and in 41 of the 804 (5.1 percent) of lesions that were larger than six millimeters. In situ melanomas (those that remain in the skin's outer layers) were diagnosed in 22 of the 853 (2.6 percent) of lesions six millimeters or smaller and in 62 of the 804 (7.7 percent) of lesions larger than six millimeters.


"With each one-millimeter diameter range from 2.01 to six millimeters, the proportion of melanomas did not vary significantly, remaining stable at 3.6 percent to 4.5 percent," the study authors wrote. "However, we observed a nearly 100-percent increase in the proportion of melanomas when comparing the 5.01- to six-millimeter category (4.3 percent) to the 6.01- to seven-millimeter category (8.3 percent)."


The study was published in the April issue of the journal Archives of Dermatology.


"We recommend that a diameter criterion of larger than six millimeters remain a part of the ABCDE criteria," the researchers concluded. "We do not recommend downward revision of the D criteria at this time. In the United States, rates of melanoma and nonmelanoma skin cancers have markedly increased, and skin biopsy rates have more than doubled in 20 years. In an era that demands greater data to support clinical decision making, the ABCDE criteria are valuable evidence-based guidelines to aid physicians in decisions regarding the biopsy of pigmented lesions of the skin."



In the May 2008 edition of the European Journal of Pharmacology, there was an article published on the health effects of quercetin. Quercetin is a member of the flavonoid family found in onions, green tea, red wine, apples and many other foods. Yes it is true, an apple a day helps keep the doctor away in part due to their quercetin content. Flavonoids are largely responsible for the colors that we see in our fruits, vegetables and flowers. Flavonoids provide many health promoting benefits, not only acting as antioxidants, but also acting as an anti-histamine and anti-inflammatory.

(The agent possesses some health-promoting effect./ It can help reduce the production of harmful substances in part due to its high vitamin C content.)

There were two very interesting articles recently published on quercetin. In the April 2008 edition of the Journal of Biological Chemistry, researchers noted that consumption of flavonoid rich diets appear to reduce the risk of poor cardiovascular function. However, the exact mechanism of how flavonoids and in particular quercetin work is uncertain. In the study, a monoclonal anti-body was produced, targeting the quercetin molecule. It was found that there was significant uptake of this anti-body within a particular cell known as the macrophage. Macrophages work in the body to help clean up debris associated with various diseases. In the experimental study, these macrophages were found in the area of inflamed and injured arteries and are postulated to be involved in the mechanism of reducing the risk of poor cardiovascular function. (The Vitamin C-rich food can ease the damage of inflamed arteries./ The protein is postulated to be involved the immune reaction to the infection./ In the May 2008 edition of Journal of HUST. After adjusting for other factors, such as age and sex, the total level of CRP was significantly higher in treated subject than in untreated ones.)


In another study published in the April 2008 edition of the journal Nutrition, researchers studied the effects of a particular protein in the body called C-reactive protein (CRP). CRP is a marker for chronic inflammation and a particular risk factor for poor cardiovascular function. Dietary data was reviewed involving over 8000 adults with estimation of flavonoid intake. After adjusting for other factors, total flavonoid intake appeared to be statistically inversely associated with serum CRP levels. Those individuals with the highest flavonoid intake appeared to have the lowest CRP levels. The authors of the study suggested that intake of flavonoid rich foods may thus reduce inflammation-mediated poor health. (2000 mg a day is recommended for other health concerns.)


Aside from the cardiovascular benefits, quercetin has been shown in clinical studies to promote healthy cholesterol levels, improve immune function, prostate health, joint function and even allergies. The generally recommended dose for adults for quercetin for general health benefits is 200 mg to 500 mg daily and for allergy concerns and other health concerns up to 1000 mg to 1500 mg a day can be consumed. There does not appear to be any adverse effects from consuming quercetin.


Research Validates Vitamin Benefits


In last week's newsletter, I commented about the media bias regarding the unfair reporting of vitamin news. A couple of days after that newsletter came out, a very favorable study on vitamin E was presented at the American Academy of Neurology's annual meeting in Chicago. One of the top executives at Vitacost wondered out loud if the media would pick up on this very positive news. Well, sure enough they didn't. So even though you probably didn't hear about it on your local TV station, or read about it in your morning paper, I will share the results of this study with you now. (I am just thinking out loud!/ I wondered out loud if he would commit suicide.)


In the study, 847 people with an average age of 74 experiencing cognitive loss were followed for about 4.9 years. These patients were instructed to take 2,000 units of vitamin E daily. At the end of the study, researchers found that those patients who consumed vitamin E with or without a standard drug to help memory were associated with a 26% reduction in all-cause mortality compared to those individuals who did not take vitamin E. Lead researcher, Dr. Pavlik, noted that the patients who took the memory enhancing drug, but without the vitamin E, did not show any improvement in survival. The data from this study are in line with the results previously reported in a 1997 study published in the New England Journal of Medicine which showed that a high dose of vitamin E slowed the progression of memory loss in individuals with poor cognitive functioning. (memory-enhancing drug/ The patients who consumed the plant were associated with a 30% increase of survival.)


MSM is a very important supplement utilized by many for promoting healthy joints. In the April 2008 edition of the journal Osteoarthritis Cartilage, six studies were reviewed concerning MSM in 681 patients with poor joint health. The MSM trials were said to provide positive, but not definitive, evidence that MSM is superior to placebo in the treatment of mild to moderate poor joint health of the knee. I find it amazing how researchers will never admit that a supplement has "definitive" proof of benefits even after numerous positive studies are published. Along with MSM, I recommend glucosamine and chondroitin sulfate for healthy joint function. (We have to take these food for most vitamins.)


If we all wait for the so-called experts and the government to offer their final "definitive" advice, we would still be taking just A-B-C vitamins and minerals at the inadequate RDA/DV levels for most nutrients. This would exclude important and beneficial nutrients such as coenzyme Q10, alpha lipoic acid, resveratrol, grape seed and so many others. In fact, there was a recent study in Advances in Experimental Medicine and Biology indicating that resveratrol kills pancreatic cancer cells. As you probably know, pancreatic cancer is one of the most deadly, with most patients dying within about six months of diagnosis. A diet high in sugar and soda doubles the risk of pancreatic cancer, and smoking also increases the risk. I recommend 200 mg of resveratrol daily to promote healthy aging and cell benefits.


For those you who have read my past newsletters, you know how excited I am about green tea. And I am happy to report on yet another study that continues to prove the health benefits of green tea. At the 121st Annual Meeting of the American Physiological Society, researchers stated that the epigallocatechin gallate (EGCG) found in green tea significantly inhibited breast tumor growth in mice. Past epidemiological studies have suggested that green tea and its extracts such as EGCG may protect against the progression of cancers, including breast cancer. However, this new study sheds light on the possible anti-cancer mechanisms of EGCG and green tea.


In the five-week study researchers divided female mice into two groups. One group received EGCG in drinking water, while the other group received no EGCG in the drinking water. The dose of EGCG was approximately equal to 50-100 mg per kg per day. During the second week of the study, the researchers injected the mammary glands of the mice with mouse breast cancer cells. At the end of the study, tumors in the mice given EGCG were 66 percent smaller and weighed 68 percent less than tumors in mice not given EGCG. Additionally, levels of vascular endothelial growth factor (VEGF), a protein found in a variety of breast cancer types, were significantly lower in the EGCG mice, compared to the control mice, indicating that green tea may exert its inhibitory effect by altering levels of this protein.


There have been countless studies published about green tea and its numerous health benefits. I recommend that you choose a good multi-vitamin and/or green tea extract supplement that contains 500 mg – 1,000 mg per day with standardized green tea containing at least 45% EGCG to promote your good health.


Finally, there was another recent study published in the April 2008 edition of the journal Phytotherapy Research6 on the benefits of Pycnogenol in patients with poor joint health. 156 patients with poor joint health participated in a double-blinded placebo controlled study with half of the group receiving 100 mg. Pycnogenol daily and the other half receiving placebo. At the end of the 3 month trial, those individuals given the Pycnogenol had significant improvement in joint health. The use of anti-inflammatory drugs by the supplemented group decreased by 58% in the Pycnogenol group versus 1% in the placebo group.


(There was a recent study published in April, 2008, …./ The patients given the drug and those not given the drug/ is 30% greater than )


Studies Refute Recent Vitamin Controversy




By Dr. Allen S. Josephs



The press is at it again. Current headlines scream "vitamin pills increase risk of early death." At the center of this controversy is research recently conducted by Dr. Goran Bjelakovic of Copenhagen University in Denmark. This research, which involved a review of 67 studies on 230,000 healthy people, reportedly found "no convincing evidence" that any of the antioxidants studied helped prolong life expectancy but, in point of fact, actually increased mortality.


If this information seems vaguely familiar, it should be. It was a lead story back in early 2007 when the meta-analysis appeared in the Journal of the American Medical Association (JAMA). It was noted that vitamin A, E and beta carotene may increase mortality risk by 16%. Vitamin C did not seem to have any clear effect. Little mention, however, was made of the fact that the mineral selenium is actually associated with a decrease of cause mortality by 9%.


When this came out, I wrote an entire newsletter critiquing the details and deficiencies of the report. Without rehashing my entire newsletter from last year, I feel it is important enough to repeat portions of it:


"The authors of this paper further seemed to stack the deck against vitamins. They had reviewed a total of 815 different trials but included only 68 of them in their final analysis. There were over 400 trials that they reviewed in which the mortality rate was zero in both the vitamin group and the control group. They decided to exclude these over 400 trials because there was zero mortality. If indeed they were trying to determine is there was truly some increased risk of mortality associated with vitamins, why not include the over 400 trials that showed no mortality whatsoever. Furthermore within the 68 trials they decided whether they were low bias or high bias trials based on the way each study was conducted. When they looked at all 68 trials together they reported no significant effect on mortality. However when they selected out the 47 trials that they considered low bias (involving over 180,000 participants) that is when they saw some increased risk of mortality with some of the vitamins.


As I read through this meta-analysis I could not help but feel that there was tremendous bias in putting together this paper. It is important to point out Denmark is in the European Union and their doctors and government tend to be very anti-vitamins and biased against supplements based on their absurd regulations. And of course the main stream press picked up on this study making the sweeping comment that vitamins will kill you. The press is not interested in reporting the fair and balanced facts but rather sensational headlines. I do not believe that anyone in the vitamin/nutrition business is advocating that you take only vitamin A, vitamin E and beta carotene as your nutritional supplements. Some of the best health enhancing nutrients available were not analyzed in this paper such as alpha lipoic acid, coq10, omega-3 essential fatty acids, ginkgo, green tea, grape seed just to name a few. At the present time there are many cancer centers throughout the United States including the National Cancer Institute that are studying nutrients like soy, green tea and curcumin for their health benefits."


Since that meta-analysis came out last year there have been many wonderful studies on the benefits of vitamins/nutrients. The prestigious New England Journal of Medicine1 did a fabulous review article last July on the attributes of Vitamin D. Evidence indicates that at 2,000 – 4,000 IU per day of vitamin D3, a person can reduce various cancer risks by 50%. This reminds me of the JAMA2 study published over 10 years ago that indicated 200 mcg per day of selenomethionine will reduce overall cancer mortality by 50%. One of the problems with many studies is that they use the wrong form and even the wrong levels of a nutrient. For example, read the label of most mass market multi-vitamins, they contain the lowest quality form of selenium and at levels that are a fraction of the proven 200 mcg per dose in the JAMA study.


Another prime example of the many favorable studies published within the past year not mentioned in the media is the American Journal of Clinical Nutrition3, which reported last June on a four year randomized placebo controlled trial in post menopausal women given supplemental calcium and vitamin D. The study concluded that those women given the supplements had a substantial reduction in all cancer risk.


In fact as I write this, two new studies are hitting the news wires, one was presented at the American Heart Association meeting by Albert Einstein College of Medicine4 suggesting those with the lowest vitamin D levels have a 80% higher risk of peripheral artery disease (PAD). Those with PAD have a 4 – 5 times greater risk of heart attack and stroke. The second study5 , published in the February 2007 online edition of Clinical Pharmacology & Therapeutics, indicated women who take prenatal vitamins lowered the risk of leukemia, brain tumors and neuroblastoma by as much as 47% in their children.


AARP magazine has the largest circulation in the world, with over 24 million readers. Its May/June 2008 edition features a study on Pycnogenol, the amazing supplement derived from pine bark, as it relates to those who suffer from poor joint health. The study in Nutrition Research indicated a 150 mg per day dosage improve physical function by 52%, reduced pain by 43% and stiffness by 35%.


The bottom line is that most people's diets are lacking even the RDA/DV levels of vitamin, minerals, essential fatty acids, fiber and other life saving nutrients. Most people also fail to consume adequate amounts of antioxidants, fruits and vegetables. To promote optimal health, research supports the notion that nutrient supplementation is safe and effective, but remember to that you must choose your products wisely by using the best forms, levels and combinations of these nutrients available.


The following is my recommendation for a foundational formula, when researched as to what multi-vitamin to consume, with a range of up to 2 – 5X of certain items such as vitamin D, lutein, green tea, alpha lipoic acid, carnitine and others. Clearly the fruits, vegetables and mushrooms can be safely taken up to the 1,000 + mg range, whereas copper should be preferably 1 mg but no more than 2 mg, which is the RDA/DV:



Low Vitamin D Levels Linked to Leg Artery Blockages



Dear Dr. chaoh yu,



But doctors are divided on whether supplements are a good option (People in this country are divided over the issues.)


(HealthDay News) -- New research has discovered that people with low blood levels of vitamin D were found to have a higher incidence of peripheral arterial disease (PAD), potentially dangerous blockages in the leg arteries.


The study of nearly 4,900 American adults found more than double the incidence of PAD among those with the lowest levels of vitamin D compared to those with the highest levels. (More than double the students took part in the campaign than previous year.)


The finding was presented Wednesday at the American Heart Association's Arteriosclerosis, Thrombosis and Vascular Biology annual conference, in Atlanta.


One previous study found an association between low vitamin D levels and heart disease, said study author Dr. Michal Melamed, an assistant professor of medicine, epidemiology and population health at Albert Einstein College of Medicine in New York City.


"But in that study they found only eight cases of PAD," she said. "In our analysis, we have more than 400 people with PAD."


Vitamin D is made when the body is exposed to sunlight. It is converted to a hormone that makes bones stronger. A severe deficiency can cause rickets in children. The link to blood vessel problems has emerged in recent years.


"The underlying mechanism isn't quite known," Melamed said. "But the study definitely speaks to the fact that it is an association that needs to be further explored."


Current guidelines recommend a vitamin D intake of 400 International Units a day for people aged 50 and older. In addition to sunlight, other sources of the vitamin are salmon, sardines, cod liver oil, fortified milk and some fortified cereals.


Exposure to sunlight "always calls for a balance," Melamed said, because overexposure raises the risk of skin cancer. "I would recommend about 10 to 15 minutes of direct exposure, then putting on sun block," she said.


Supplements aren't recommended by Dr. Thomas J. Wang, an assistant professor of medicine at Harvard Medical School and Massachusetts General Hospital, who led the earlier study.


"There have been a number of very intriguing population findings, but we still don't know if supplementation will affect the risk of cardiovascular disease," Wang said. "A clinical trial would be needed to see if supplementation could avert risk. We know that the things to prevent vitamin D deficiency include sunlight and proper diet."


But Dr. Denise Teves, an endocrinologist who is an assistant professor of medicine at the Medical College of Wisconsin, said a case could be made for vitamin D supplements for some people.


"I recommend supplements for some patients who come to me with metabolic bone disease," she said. "Most have insufficient vitamin D."


Existing guidelines might fall short of what is needed for some people, Teves said.


"The current guidelines do call for 400 units a day," she said. "But in the last two or three years, many endocrinologists have been recommending at least 800 units a day. I have seen many students in Wisconsin in the wintertime with low vitamin D levels."


It's best to consult a doctor about taking large amounts of a vitamin D supplement, Teves said.



Study suggests brains of patients get stuck in memory-deletion mode


Memory loss, where the brain deletes inconsequential information, is in a hyperactive state in people with Alzheimer's disease, a new study suggests.


Researchers at California's Buck Institute for Age Research analyzed human brain tissue and found that people with Alzheimer's disease (AD) showed more signs of cleavage of a molecule called amyloid precursor protein (APP) than people without the disease.


But when they analyzed the brains of younger people without Alzheimer's, the researchers were surprised to find that they had about 10 times as much APP cleavage as Alzheimer's patients. However, younger brains make memories faster than they lose them.


The Buck Institute team believes that the malfunction of a biochemical switch associated with APP cleavage causes the brains of Alzheimer's patients to get stuck in the process of deleting memories. They added that this suggests the disease affects the plasticity or malleability of the brain.


The study was published in the March 7 issue of the Journal of Alzheimer's Disease. (The article appeared in the March 30 issue of the Journal of HUST.)


"Young brains operate like Ferraris -- shifting between forward and reverse, making and breaking memories with a facility that surpasses that of older brains, which are less plastic," research group leader Dr. Dale Bredesen said in a prepared statement.


"We believe that in aging brains, AD occurs when the 'molecular shifting switch' gets stuck in the reverse position, throwing the balance of making and breaking memories seriously off kilter," Bredesen said. (This will throw the balance of buying and selling off kilter./ It is this clog that throws the balance flowing in and out of kilter.)


Researchers at the Buck Institute are focusing on nerve signaling and efforts to "disconnect" the molecular mechanism that causes this hyperactivation of memory loss in people with Alzheimer's. They're also investigating the mechanisms that support brain cell connections that play a critical role in memory making.


About 5.1 million Americans have Alzheimer's, which costs the country $148 billion a year.


(About 1 million Chinese suffer from hepatitis B, which costs the country RMB 1 billion a year.)



Diagnosis Of Dementia Brings Relief, Not Depression



When it comes to a diagnosis of Alzheimer's disease, what you don't know may not kill you, but knowing the truth as soon as possible appears to be the better approach - one that may improve the emotional well-being of both patients and their caregivers, suggests new research from Washington University in St. Louis. Medical advances have made it possible to diagnose Alzheimer's at very early stages, but a 2004 review of research found about half of all physicians were still reluctant to inform patients of an Alzheimer's diagnosis. While many physicians fear a dementia diagnosis would only further upset an already troubled patient, this follow-up study found quite the opposite.


"We undertook this study because we wanted there to be some data out there that addressed this question and that we could show to physicians and say, 'Most of the people don't get depressed, upset and suicidal. So, this fear that you have about telling them and disturbing them is probably not legitimate for most people,'" says Brian Carpenter, Ph.D., associate professor of psychology in Arts & Sciences at Washington University.


The study, published in the current Journal of the American Geriatrics Society, is co-authored by Carpenter and colleagues in the Division of Biostatistics, the Department of Neurology and the Alzheimer's Disease Research Center at the University's School of Medicine.


In their study, they followed 90 individuals and their caregivers as they came to the Alzheimer's Disease Research Center for an evaluation. Sixty-nine percent eventually got a diagnosis of Alzheimer's disease, but no significant changes in depression were noted and anxiety decreased substantially.


"The major finding is that both patients and their families feel relief, not increased anxiety, upon learning the diagnosis," says study co-author John C. Morris, M.D., the Harvey A. and Dorismae Hacker Friedman Distinguished Professor of Neurology and director of the Alzheimer's Disease Research Center.


"Nobody wants to hear the diagnosis of Alzheimer's disease, but even that is preferable to recognizing there's a problem and not knowing what it is. At least having the diagnosis allows people to make plans for the future, including treatment as appropriate."


One reason an Alzheimer's diagnosis can be comforting to both family members and patients, suggests Carpenter, is that it provides an explanation for what's been going on with the patient. Caregivers, he notes, are often quick to attribute symptoms of dementia to the person, rather than the disease, and patients wonder if they are going "crazy." This study confirms that most patients, regardless of their degree of impairment, tend to experience a sense of relief after getting their diagnosis.


Patients in this 2007 study came from the Alzheimer's Disease Research Center at Washington University. Individuals calling the Center were informed of the study and could choose to participate. Subjects were then interviewed prior to their appointment at the Center and questioned about their mood, family history and expectations for their upcoming exam. After extensive neurological examination, a diagnosis was delivered to the patients and their caregivers and videotaped for the purposes of the study. Patients and caregivers were then called two days after their appointment and asked the same questions about mood, anxiety, and the results of their diagnosis. This study is one of the first where caregivers have also been asked about mood and emotions. "In this current study, we were interested in gauging psychological reactions shortly after receiving the diagnosis," Carpenter says. "That's why we did the follow-up phone call within a couple of days of their evaluation." Most clinical practice guidelines instruct physicians to tell patients when they suspect Alzheimer's or dementia.


"It's just taking awhile for the clinicians to catch up," says Carpenter.


Carpenter thinks that the number of physicians not telling their patients has gone down since the 2004 study due to a greater public awareness about Alzheimer's.


"We're probably where we were at 10 or 15 years ago with cancer. Years ago when people had cancer their doctors didn't tell them. But we know now that that's improper, and that everybody needs to know if they have cancer. We're going to get there with Alzheimer's disease. [People] are not aware that when you tell the person they're not going to have some sort of catastrophic emotional reaction. The word will get out eventually," says Carpenter.


And there is good reason to spread the word. Earlier diagnoses allow for earlier intervention to delay the effects of Alzheimer's and dementia. Medications currently on the market can delay symptoms in a minor way, in some patients, and may delay institutionalization.


(We are where we were at 10 or 15 years with our economic reform./ I got a 100 with my English. I will get there with my maths.)


"There are some real practical and financial advantages of even these small incremental gains that we're getting from the medications now. If you can get an extra three to six months in your own house before you have to go to a nursing home, that's a big deal," says Carpenter.


And perhaps more importantly, providing a diagnosis as early as possible gives people a chance to prepare for what is coming. "They know that things are going to get worse rather than better and they know that there's going to come a time when they're not going to be able to do the things they can do now, says Carpenter. "They can get ready for what's coming and we can connect them to support services. We can get their family ready ...so they'll be better prepared."

(There’s going to come a time when I am not able to support you.)



Natural Ways to Protect Prostate Health

An enlarged prostate, which is accompanied by urinary frequency and difficulty fully emptying the bladder, plagues literally tens of millions of older men. In fact, frequent visits to the bathroom at night for men over the age of 60 to 65, are extremely common.

There are several nutrients that have shown benefit to optimize healthy prostate function. In the February 2008 edition of The Journal of Urology1, 92 Chinese men between the ages of 49 to 75 with lower urinary tract symptoms were randomly assigned to receive placebo or a product containing saw palmetto. It was found that the group that was given the saw palmetto after the twelve-week intervention had improvement in urinary flow and other objective signs of improved urinary function. (They were assigned to receive placebo or a self-made herbal medicine.)

Another interesting study published in the January 2006 edition of the journal Urology2 examined the effects of pollen extract. Sixty patients between the ages of 20 and 55 who had inflammation of the prostate/chronic pelvic pain were randomly assigned to receive this product or placebo for six months. Those individuals given the pollen extract were found to have a superior effect compared to placebo in providing benefits for prostate health. (provide benefits for prostate health/ The patients with urinary difficulty and frequency given the new drug were found to have better effect compared to placebo in providing benefits for heat health.)

The nutrient pygeum africanum, a phytosterol similar to saw palmetto, has also been studied and findings published in the February 2007 edition of the journal Endocrine3 noted that this extract appeared to have a significant role in the regulation of abnormal cellular growth in the prostate. There was also a study published in the journal European Urology4 in January 2007 that followed over 2,300 men with urinary difficulties in six European countries. Various forms of intervention were prescribed, including drugs. It was found that supplementing with pygeum africanum showed significant improvement in 43% of patients on this phyto-therapy.

Another nutrient that appears to optimize healthy prostate function is an herb called stinging nettle. In September 2007, there was a review on this nutrient published in Alternative Medicine Review5 indicating that at least four double-blinded clinical trials confirmed the efficacy of nettle root to optimize prostate function. The authors indicated that nettle root has also been successfully used for promoting healthy joints, nerves and cardiovascular function. (To promote healthy cardiovascular function)


More Elderly Americans Living With Heart Failure

Incidence has declined, but survival gains place burden on Medicare, analysis finds

(HealthDay News) -- While the number of elderly Americans newly diagnosed with heart failure has declined, the number of those living with the condition has increased, new research finds.

The Duke University study analyzed data on 622,789 Medicare patients, aged 65 and older, diagnosed with heart failure between 1994 and 2003. It found that the annual occurrence of heart failure decreased from 32 per 1,000 person-years (years of observation time during which each person is at risk to develop the disease) in 1994, to 29 per 1,000 person-years in 2003.

When the researchers looked at specific age groups, they found a sharper decline among people aged 80 to 84 (from 57.5 to 48.4 per 1,000 person-years), and a slight increase among those aged 65 to 69 (from 17.5 to 19.3 per 1,000 person years).

Between 1994 and 2003, the number of people living with heart failure increased, from about 140,000 to 200,000. More men than women live with the condition.

"The proportion of [Medicare] beneficiaries with a heart failure diagnosis increased from 90 per 1,000 in 1994 to 120 per 1,000 in 2000, and remained at about 120 per 1,000 through 2003," the authors wrote.

The findings are published in the Feb. 25 issue of the Archives of Internal Medicine.

"Although the incidence of heart failure has declined somewhat during the past decade, modest survival gains have resulted in an increase in the number of patients living with heart failure," the researchers concluded. "Identifying optimal strategies for the treatment and management of heart failure will become increasingly important as the size of the Medicare population grows."

Almost 5 million people in the United States have heart failure, which kills more than 300,000 patients a year. Since it's primarily a disease of older people, it places a significant and increasing burden on Medicare, said the study authors, who noted that the number of people aged 65 and older hospitalized for heart failure increased by more than 30 percent from 1984 to 2002.


Zinc is a mineral that the body needs to help the immune system, in wound healing, and in the breakdown of carbohydrates. Second only to iron in its concentration in the body, zinc is found in protein-rich foods such as meat, peanuts and peanut butter, and legumes.

If you're not getting enough zinc, here's a list of possible warning signs,

courtesy of the U.S. National Library of Medicine:
Slow growth rate.
No appetite.
Slow-healing wounds, lesions on the skin, and persistent infections.
Hair loss.
Abnormalities in your ability to taste and smell.
Difficulty seeing in the dark.
Insufficient hormone production in men.


Translation exercise:

Second only to Wuhan, Tianjin is one of the biggest cities in China.

Here is the information you need, courtesy of Library of Tongji Medical College, HUST





Resveratrol: Potent Antioxidant for Heart and Mind

 Resveratrol is an antioxidant found in highest concentration within Japanese knotweed, and then grape skin. Lower concentrations occur in red wine, purple grape juice, peanuts, cranberries, blueberries, bilberries and some pines. Resveratrol is produced by grapes and other plants in response to fungal infections, injury, and stress and is part of their natural defense system. The amount of resveratrol in red wine varies with geographic origin, cultivation conditions, exposure to fungal infections and the amount of time of mixing of red wine with the grape skin. The amount of resveratrol in red wine has a wide range, from less than half a milligram per liter to more than 20 mg per liter.Red wine contains powerful polyphenol antioxidants: resveratrol, anthocyanins (also found in grape skin which gives it a red color), proanthocyanidins (found in grape seeds), catechins and quercetin. The observation that people in France eat a lot of saturated fat yet have low rates of heart disease has been called the French paradox. Drinking red wine regularly may perhaps explain the protection French people have from heart disease. Resveratrol has recently become very popular as a nutritional supplement due to the extensive and exciting research that has been done in the last few years in vitro (in test tubes) and in animals. For example, resveratrol has been shown to have anti-inflammatory as well as anti-viral effects and protects the skin from ultra-violet (UVB) damage.Studies in mice and rats have shown that resveratrol prevents prostate cancer, colon cancer and breast cancer1. Resveratrol has been shown to protect against many stages of cancer including tumor initiation, tumor promotion, tumor progression and metastasis. It was reported that 3% of people regularly drinking 3 or more glasses of red wine per week had colon polyps or colon cancer whereas 9% of people regularly drinking 3 or more glasses of white wine per week (which is fermented more briefly with grape skin and has much smaller amounts of resveratrol) had colon polyps or colon cancer. The incidence of colon polyps or colon cancer in white wine drinkers was similar to non-wine drinkers.Resveratrol, as well as red wine or purple grape juice, has been shown to protect the brain and cognitive function in mouse models of Alzheimer's disease, whereas ethanol (with the same percentage of alcohol as in the red wine) or water had no protective effect2. Thus the alcohol in the red wine was not responsible for the protective effects on the brain and cognitive function. One of the mechanisms of Alzheimer's disease is the high production of amyloid-beta (Abeta) peptides, which subsequently induces brain damage. Resveratrol induces a sirtuin protein (called SIRT1) which has been found to protect neuronal cells against Abeta-induced free radical damage to DNA as well as cell death. Resveratrol induces the degradation of dangerous Abeta peptides3. This has led to the hypothesis that resveratrol may be useful in preventing aging-related neurodegenerative disorders such as Alzheimer's disease.For elderly Chinese people, light to moderate drinking of alcohol was associated with a 37% reduction in the risk of Alzheimer's disease, as well as a 69% reduction in the risk for vascular dementia (from multiple small strokes) when compared to non-drinking4. In contrast, excessive drinking was associated with a higher risk for dementia. Light to moderate wine drinking was associated with a significantly lower risk of dementia4. Light to moderate beer drinking was associated with a significantly higher risk of dementia as compared to non-drinkers of beer4. In a French study, people who drank 3 to 4 glasses of wine per day had a 72% reduction in the risk for Alzheimer's disease whereas people who drank less than one glass of wine per day had a 45% reduction5.Sirtuin proteins (called SIR2 in humans and SIRT1 in other mammals) regulate gene silencing, DNA repair, mitochondrial function, aging and programmed cell death. Approximately 95% of our cellular energy is produced in mitochondria with the final end-product being adenosine triphosphate (ATP) which is the chemical storage for energy. Resveratrol treatment of mice improved mitochondrial number and energy production as well as increased aerobic capacity shown by increased running time and consumption of oxygen in muscle fibers6,7.A major side effect of mitochondrial generation of ATP for energy is the generation of dangerous free radicals. Resveratrol up-regulates the powerful mitochondrial antioxidant manganese superoxide dismutase (MnSOD), which is a major cellular antioxidant exclusively located inside mitochondria. Incubating a human cell line in vitro with resveratrol for two weeks increased MnSOD protein level 6-fold and activity 14-fold whereas there was no effect or decreased activity of the other major cellular antioxidants (glutathione peroxidase, catalase and CuZnSOD)8. Increasing MnSOD antioxidant activity may provide a critical level of protection from free radical damage to mitochondria. One of the major concepts for aging is the theory of free radical damage in which aging has been shown to be associated with a loss of mitochondrial function. Thus resveratrol may, in part, extend lifespan by up-regulating MnSOD and thus protecting mitochondrial energy production from free radical damage.In animal studies, resveratrol has been shown to protect the cardiovascular system by a large number of mechanisms including inhibition of the oxidation of low-density lipoprotein (LDL) cholesterol (which is the initial step leading to atherosclerosis), protection and maintenance of intact endothelium (the cells lining the inside of arteries), promotion of arteriolar (small arteries) vasorelaxation, inhibition of platelet aggregation and protecting against ischemia-reperfusion injury (thus decreasing the size of heart attacks). Endothelial progenitor cells are adult stem cells manufactured in bone marrow, which circulate in the blood and then differentiate into endothelial cells that repair the inner lining of arteries. Patients with diabetes, hypertension, elevated LDL cholesterol, or cardiovascular disease have decreased number of circulating endothelial progenitor cells9. Resveratrol increases the number and function of endothelial progenitor cells at doses achievable by moderate red wine intake10.Several epidemiological studies in humans report that mild to moderate consumption of red wine is associated with decreased cardiovascular disease and death as well as reduced total mortality from all causes. In some of the studies, drinking wine appeared to lower cardiovascular disease and mortality more than drinking spirits and beer. The Zutphen study in Holland of middle-aged men reported that men who drink about half a glass of wine (1.5 ounces or about 30 ml) daily had the lowest rates of death with a 48 % reduction of cardiovascular death and a 40% reduction in death from any cause as compared to non-wine drinkers11. Moreover, drinking wine was associated with a life expectancy of more than two years longer than drinking other alcoholic beverages. Drinking wine was associated with a life expectancy 3.8 years longer than non-drinkers11.In another study, thirty men with coronary heart disease who were given a red grape polyphenol extract had improved endothelial-dependent arterial dilatation as shown by a 73% improvement in flow-mediated dilatation of their brachial artery in their arm after 60 minutes12. This suggests that red grape extracts may also have beneficial effects in humans.Mice fed a high fat diet together with resveratrol had a 30% lower risk of death as compared to mice fed only a high fat diet. Resveratrol opposed the alteration of 144 out of 155 gene pathways induced by the high-fat diet7. Mice and rats fed a high-fat diet had deleterious changes in their blood glucose and insulin levels whereas animals given a high-fat diet together with resveratrol had glucose levels (and sometimes insulin levels) similar to mice and rats on a regular diet7,13. The obese rats receiving resveratrol also lost weight and had better postischemic cardiac function as shown by a 83% reduction in ventricular fibrillation and a 20% reduction in infarct size (the size of dead heart tissue)13. This has raised the question whether resveratrol may be useful in preventing or treating diabetes.One of the most exciting aspects of resveratrol is its effects on anti-aging and life extension started by a Harvard University study in 2003 which reported that resveratrol increased the lifespan of yeasts by up to 70%14. Resveratrol increased the lifespan by greater than 50% of a short-lived fish15. Resveratrol has also been shown to increase the lifespan of worms. High doses of resveratrol were used in these studies and it remains to be determined whether doses of resveratrol achievable by moderate red wine consumption might also prolong life span.Animals given resveratrol have modulation of expression and activity of most of the genes which are modulated by calorie restriction. This is important because calorie restriction is a scientifically proved method for life extension that has been studied in several species of mammals. Calorie restriction has been shown to favorably modulate expression of many genes and to increase life span in yeast, worms, fruit flies, fish, mice, rats and dogs. Calorie restriction has also been shown to give similar modulation of gene expression in monkeys and humans. These studies were done with moderately severe calorie restriction together with optimal nutrition. Very few people are willing or able to maintain moderately severe calorie restriction. Studies are needed to determine whether resveratrol treatment in humans can favorably modulate gene expression similarly to calorie restriction.The observations in humans that red wine is associated with marked reductions of Alzheimer's disease, cardiovascular disease and death as well as an increase of lifespan are impressive. Many, if not most, of the beneficial effects of red wine are probably due to the powerful polyphenol antioxidants (resveratrol, anthocyanins, proanthocyanidins, catechins and quercetin) rather than the alcohol. I recommend a daily intake of polyphenol antioxidants from red grapes.The question then arises as to whether you should drink alcohol and, if so, then which alcohol and how much. Please remember that drinking alcohol is associated with complications including liver cirrhosis, an increased risk of breast cancer and car accidents, and that excessive alcohol drinking may lead to strokes and dementia. If you do drink alcohol, then drinking red wine with its powerful polyphenol antioxidants may be the best choice, with mild consumption of half a glass to one glass daily. Drinking wine has been popular for thousands of years. The Biblical Book of Psalms reads "wine that maketh glad the heart of man."Another option is to drink purple grape juice. Purple grape juice has a similar total concentration of antioxidants as well as similar types and individual concentrations of polyphenol antioxidants as found in red wine. One exception is resveratrol in which purple grape juice has about half the concentration as compared to red wine. Fruit juices are tasty and useful for obtaining antioxidants. Purple grape juice has more polyphenol antioxidants than cranberry or cloudy apple juice; followed by the lower polyphenol antioxidant content in pomegranate, grapefruit, pineapple or tomato juice; even lower polyphenol antioxidant content in orange juice and clear apple juice; and with white grape juice having the lowest polyphenol antioxidant content. In the KAME project in Seattle, 1,836 Japanese-American people over 65 years of age who did not have Alzheimer's disease at the onset of the study were followed for ten years. Those who drank three or more glasses of fruit and vegetable juices a week had a 76% reduction in the risk of developing Alzheimer's disease as compared to those who drank juices less than once a week16.


Suggestions to try (Health Day News) - Your job can be a great source of stress, which can significantly impact your physical and emotional health. The AARP offers these suggestions for handling stress on the job: Set up regular evaluations and meetings with your manager to establish expectations, goals and discuss your workload. Build your prioritization and time management skills, so that you avoid having to always work overtime, or take work home with you. Allow yourself free time away from work to relax and do things you enjoy. Take advantage of any flexible work schedules, long lunch breaks and exercise opportunities that your employer offers. Don't check email or answer work-related calls at home, unless it can't be avoided. Recognize when it's time to look for another job if your current one is causing significant stress and unhappiness.


Translation exercise

You should practice to build up your writing skills.

Allow 30 minutes for the trip.



Flu Widespread in U.S., but Vaccine Is Poor Match 

 Widespread flu activity now exists in virtually every state, and many of the infections are being caused by some strains not covered by this year's influenza vaccine, U.S. health officials said Friday. "After relatively low levels of influenza activity in the early part of the season, since January, influenza activity has been picking up in the nation," Dr. Joe Bresee, chief of the branch of epidemiology and prevention at the U.S. Centers for Disease Control and Prevention's Influenza Division, said during a teleconference. "This season, we are seeing more disease out there and higher rates of hospitalizations and deaths than we've seen in the last couple of years," Bresee added. Much of the increased activity owes to the fact that this year's flu vaccine isn't a match for some of the strains currently circulating in the United States, and some strains are becoming resistant to a common antiviral medication. The CDC reported last week that this year's flu vaccine doesn't match two of the three strains of influenza circulating in the United States. "Slightly more than half of the viruses that we are looking at in our lab are viruses that are different than the vaccine strain," Bresee said. "So, they may not be well covered by the vaccine." The virus strain most common in the United States right now is the influenza A H3N2 strain, and it's one strain not included in this year's vaccine. Also, this year's vaccine is not well matched against influenza type B, Bresee said. The World Health Organization announced Thursday its recommendation for next year's flu vaccine, and it includes vaccine against the H3N2 strain and other strains not in this year's vaccine, Bresee said. Complicating matters, some of this year's influenza type A virus is showing resistance to the antiviral drug Tamiflu. Overall, 8.1 percent of the influenza type A viruses tested by the CDC are resistant to Tamiflu. In past years, less than 1 percent of the viruses have been resistant to the drug, Bresee said. "This represents a real increase in resistance," he said. Forty-four states reported widespread flu activity this week, up from 31 last week. And, as of Feb. 9, 10 children have died from influenza this year. "This is not particularly unexpected," Bresee said. "We may see more pediatric deaths before the season is finished." The children ranged in age from 4 months to 14 years. During the last three years, flu-related deaths among children have ranged from 46 to 74, Bresee said. Even though this year's vaccine isn't a good match for most of the circulating flu virus, the CDC continues to recommend that people get inoculated. The reason: The vaccine still offers partial protection and can reduce the risk of flu-related complications. An estimated 5 percent to 20 percent of the U.S. population suffers from the flu each year. More than 200,000 people are hospitalized from flu complications, and about 36,000 people die from the disease. Some people, such as older individuals, young children, and people with certain health conditions (such as asthma, diabetes or heart disease), are at high risk for serious flu complications, according to the CDC.


Allergy Disorders Linked With Irritable Bowel Syndrome 

There may be a link between allergies and irritable bowel syndrome (IBS) in adults, says a study by researchers at Rush University Medical Center in Chicago. IBS occurs in about 15 percent of the U.S. population. Some studies have suggested that allergen exposure may lead to IBS symptoms in some patients, but the frequency hadn't been examined. In this study, researchers looked at 125 adults and found the likelihood of IBS was much higher in patients with allergic eczema (3.85 times) and seasonal allergic rhinitis (2.67) times. They also found that IBS was 2.56 times more likely in people with depression. "The reported presence of allergic dermatitis was highly correlated to the presence of IBS in our population," the study authors wrote. "In atopic disease, allergic dermatitis is the first step of the 'atopic' march.' In early childhood, AE (allergic eczema) is frequently associated with gastrointestinal dysfunction and food allergy. A clinical history of AE may be a useful marker for patients with gut hypersensitivity and atopic IBS." The researchers also found that asthma and IBS were reported by 12 of 41 patients (29 percent), similar to findings in a previous study. The researchers proposed that "this subgroup of IBS (atopic IBS) be considered separately from patients with IBS without atopic symptoms, because they may have distinct pathophysiologic features and may benefit from specific therapeutic interventions." The study was published recently in the Annals of Allergy, Asthma & Immunology. More information The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about IBS. -- Robert PreidtSOURCE; American College of Allergy, Asthma & Immunology, news release, January 2008


Born to Be Obese?  Dear Dr. chaoh yu, New research suggests brains of heavy individuals may be wired differentlyBy Jeffrey PerkelHealthDay Reporter(HealthDay News) -- The brain circuitry that controls appetite might be wired differently in some people, and that could predispose them to obesity, California researchers suggest. The study was conducted in rats, not humans, and yet it could ultimately lead to novel obesity treatments, said Philip Smith, director of the Office of Obesity Research at the National Institute of Diabetes and Digestive and Kidney Diseases. "It is not just about drugs that modify short-term appetite," he said, "there may be drugs that stimulate development of the appropriate neural pathways. So, it is an exciting, but very early, time in this field." The study was published in the February issue of Cell Metabolism. Sebastien Bouret, an assistant professor of neuroscience at the University of Southern California, and his colleagues examined neural circuits emanating from the appetite, hunger and body-weight control center of the brain -- the so-called arcuate nucleus of the hypothalamus (ARH) -- in a series of rats bred to be either prone to, or resistant to, obesity. The team found fewer neural connections projecting from the ARH in obesity-prone animals than in their leaner counterparts. Surprisingly, Bouret said, this deficiency developed very early in life, before the animals became obese, and appeared to extend into adulthood. "Somehow, these animals are programmed to become obese," Bouret said. "The obesity is hard-wired into the brain." When the researchers then looked at why the brains of obese rats differed from their normal-weight counterparts, they found that the neurons from obesity-prone animals were less responsive to leptin, a hormone that controls the development of these circuits, and which also signals the body's energy status and controls metabolic rate. "This paper presumes to say, these animals must be leptin-resistant, and that is why the pathways are not developing," said Smith. But that doesn't mean they are doomed to a life of severe obesity, said Dr. Barbara Kahn, chief of the Division of Endocrinology, Diabetes and Metabolism at Beth Israel Deaconess Medical Center, in Boston. How they live their lives also matters. "It is important not to 'blame' the obese person or imply that he/she is responsible for being obese," Kahn noted. "Having said that, reasonable, healthy caloric restriction and a safe and sustainable program of physical activity can help limit weight gain and often bring about some degree of weight loss. In addition, healthy eating and regular exercise can reduce the complications of obesity such as type 2 diabetes and cardiovascular disease." At the same time, she added, not everyone can wear a size 4. "There is a certain aspect of genetics that sets somebody in a certain range of possible body weights, and then how that person lives his or her life will determine whether they are at the bottom or top of the range," she explained. Human obesity has both genetic and environmental roots. The rats used in this study, like most humans, developed obesity when fed a high-energy diet. On a normal diet, they were heavier than normal rats, but not yet obese. "This is quite an exciting paper," said Smith, "because it links more closely to human behavior than most rodent models we have seen." The findings also suggest a possible therapeutic approach to combating human obesity. If drugs could be designed to influence the formation of neural circuits during development and targeted to at-risk pregnancies, Smith said, "there is a good likelihood we could have successful interventions that improve the health of the mother, and which have a major impact on disease risk for the infant, during pregnancy." A related study from Boston University researchers in the same journal found that bulking up muscle mass can lead to a general metabolic improvement in obese individuals. "Interventions designed to increase skeletal muscle mass in at-risk human populations may prove to be critical weapons in the fight against obesity and obesity-related comorbidities, including diabetes, heart disease, stroke, hypertension and cancer," an accompanying editorial stated. More information For more on obesity, visit the National Institute of Diabetes and Digestive and Kidney Diseases. SOURCES: Sebastien G. Bouret, Ph.D., assistant professor, neuroscience, University of Southern California, Los Angeles; Philip Smith, Ph.D., co-director, Office of Obesity Research, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md.; Barbara Kahn, M.D., chief, Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, and George R. Minot Professor of Medicine, Harvard Medical School, both in Boston; February 2008, Cell Metabolism



Smokers Sleep Less Soundly  Dear Dr. chaoh yu, They're 4 times more likely than nonsmokers to report lack of restful slumber, study says(HealthDay News) -- Smokers are four times more likely to feel tired when they wake up and they spend less time in deep sleep than nonsmokers do, a new study finds. This may be because smokers experience nicotine withdrawal each night, which may contribute to sleep disturbances, suggest the study authors, whose report appears in the February issue of Chest. "It is possible that smoking has time-dependent effects across the sleep period. Smokers commonly experience difficulty falling asleep due to the stimulating effects of nicotine. As night evolves, withdrawal from nicotine may further contribute to sleep disturbance," study author Dr. Naresh M. Punjabi, of Johns Hopkins University School of Medicine in Baltimore, said in a prepared statement. Punjabi and colleagues studied the sleep patterns of 40 smokers and 40 nonsmokers. They found that 22.5 percent of smokers reported a lack of restful sleep, compared with only 5 percent of nonsmokers. Smokers also experienced a lower percentage of deep sleep and a higher percentage of light sleep. The largest differences in sleep between the two groups occurred at the onset of sleep, which suggests the effects of nicotine are strongest in the early stages of sleep and decrease as the sleep cycle progresses, the researchers said. These findings may help develop more effective ways to help people stop smoking. "Many smokers have difficulty with smoking cessation partly because of the sleep disturbances as a result of nicotine withdrawal," Punjabi said. "By understanding the temporal effects of nicotine on sleep, we may be able to better tailor nicotine replacement to minimize the withdrawal effects that smokers experience, particularly during sleep." More information The American Academy of Family Physicians explains insomnia. -- Robert Preidt


A Daytime Nap Can Boost Memory  Dear Dr. chaoh yu, But the shut-eye only helps with material that was learned well, study suggests By Steven ReinbergHealthDay Reporter(HealthDay News) -- A 45-minute midday nap can help boost your memory and remember facts, but only if you learned them well in the first place, a new study suggests. This type of memory is called "declarative memory" and applies to standard textbook learning and knowledge, in contrast to "procedural memory," which applies to skills. Sleep appears to help "set" these declarative memories and make them easier to recall, the researchers said. "Sleep appears to have an impact on what is learned well, but not so much when one is not motivated to learn," said lead researcher Matthew A. Tucker, a postdoctoral fellow at Harvard Medical School's Center for Sleep and Cognition. For the study, 33 people were trained with certain declarative memory tasks. After the training, 16 took a non-REM nap, while 17 stayed awake and watched a movie. Later the same day, all the participants were tested. The tests included memorizing words, memorizing a maze and memorizing a complex line drawing. Tucker's team found that over three very different declarative memory tasks, taking a nap improved performance compared with staying awake. However, napping only worked for people who had really learned the task well in the first place. "The nap group performed better overall than the awake group, but the difference wasn't significant," Tucker said. "However, when we looked at individual performance during training, we found those who did better during training benefited from napping," he said. In addition, people appeared to perform well on one task only, but not all three, Tucker said. "There is likely a basic level of learning that has to be attained before sleep can have an impact on performance," he said. The findings were published in the Feb. 1 issue of the journal Sleep. Tucker thinks that taking a nap may actually improve one's memory of facts if one is motivated to learn. "There is a lot of data starting to come in that there are benefits from naps on memory," he said. Sara Mednick, an assistant professor at the University of California, San Diego's Laboratory of Sleep and Behavioral Neuroscience, said the new study is further proof of the role of sleep on memory and learning. "This paper is further evidence of how sleep, specifically naps, can be a tool for memory consolidation," she said. "Interestingly, the data shows that not all subjects utilize sleep for consolidation to a similar extent." More information For more on the importance of sleep, visit the National Sleep Foundation. SOURCES: Matthew A. Tucker, Ph.D., postdoctoral fellow, Center for Sleep and Cognition, and the department of psychiatry, Harvard Medical School, Boston; Sara Mednick, Ph.D., assistant professor, Laboratory of Sleep and Behavioral Neuroscience, University of California, San Diego; Feb. 1, 2008, Sleep


Daytime dozing linked to increased stroke risk in elderly 

NEW ORLEANS, Feb.21 — Regular daytime dozing forewarns of a significantly increased risk of stroke in older Americans, researchers reported at the American Stroke Association's International Stroke Conference 2008. Stroke risk was two- to four-fold greater in those with moderate dozing. This suggests that daytime dozing "may be an important and novel stroke risk factor," said Bernadette Boden-Albala, Ph.D., lead author of the study.In this study, dozing refers to a person unintentionally falling asleep.Among 2,153 participants in a prospective study with an average follow-up of 2.3 years, the risk of stroke was 2.6 times greater for those classified as doing "some dozing" compared to those with "no dozing." Those in the "significant dozing" group had a 4.5 times higher risk."Those are significant numbers," said Boden-Albala, an assistant professor of neurology at Columbia University's College of Physicians and Surgeons in New York City. "We were surprised that the impact was that high for such a short period of time."Sleep scientists previously have found evidence that people who experience apnea, brief periods when breathing stops during sleep, have an increased stroke risk. Research indicates that daytime sleepiness can result from sleeping poorly because of nighttime apnea.Researchers studied a community-based cohort as part of the long-term Northern Manhattan Study (NOMAS), which began in 1990 and included men and women ages 40 and older. It's the first effort investigating stroke risk factors in whites, blacks and Hispanics living in the same community.No study participants had suffered a stroke. At study entry, their average age was 73 years and 64 percent were women. The racial-ethnic mix was 60 percent Hispanic, 20 percent black and 18 percent white. In 2004, Boden-Albala and her colleagues began collecting daytime dozing data annually using the Epworth Sleepiness Scale. The Epworth scale asks people to rate their frequency of dozing off during specific situations, such as watching TV, sitting and talking to someone, sitting quietly after a lunch without alcohol and stopping briefly in traffic while driving.Based on the Epworth results, the researchers designated participants as "no dozing" (44 percent), "some dozing" (47 percent) and "significant dozing" (9 percent). In the two years of follow-up, researchers sought to determine the number of strokes and vascular events — which they defined as a heart attack or stroke death caused by vascular problems — among the dozing study members. They detected 40 strokes and 127 vascular events. After controlling for several stroke risk factors — age, race-ethnicity, sex, education, blood pressure, diabetes, obesity and physical activity — they found unexpectedly high stroke risks for the "some dozing" and "significant dozing" groups compared to "no dozing." The risk of a heart attack or vascular death was higher — 1.6 percent for the moderate dozers and 2.6 percent for the significant dozers. The findings were similar for all ethnicities and both genders."Given what's known now, it's worth assessing patients for sleep problems," Boden-Albala said. "And the initial assessment can be something as simple as the Epworth scale. If patients are moderately or significantly dozing, physicians need to think about sending them for further evaluation."These findings, if confirmed by other studies, carry important public health implications as well."Studies demonstrate that we are not getting enough sleep, so we're tired," Boden-Albala said. "But the real question is, what are we doing to our bodies? Sleepiness obviously puts us at risk of stroke."Co-authors are Carl Bazil, M.D.; Yeseon Moon, M.S.; Janet De Rosa, M.P.H.; Mitchell S. Elkind, M.C.; Myunghee C. Paik, Ph.D.; and Ralph L. Sacco, M.D.The National Institute of Neurological Disorders and Stroke funds the NOMAS study. 



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