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While research has linked moderate drinking to better heart health, a new study suggests that those benefits disappear when drinkers add the occasional binge to the mix.

Pooling data from 14 previous studies of moderate drinkers, researchers found that those who drank heavily every so often were 45 percent more likely to develop coronary heart disease — where plaque buildup in the heart arteries impedes the flow of blood and oxygen.

For comparison, overall, about 8 percent - or about one in 12 — Americans has heart disease, according to the American Heart Association.

Occasional heavy drinking was defined as having five or more standard drinks in a day at least a dozen times per year. “Regular” heavy drinkers — those who averaged at least five drinks per day, were excluded from the analysis.

The findings suggest that bingeing at even irregular intervals may undo any heart benefits of lighter drinking, the investigators report in the American Journal of Epidemiology.

In general, moderate drinking — a drink or two per day — is considered a potentially heart-healthy habit. A number of studies have found that moderate drinkers have lower risks of heart disease than teetotalers do, even when other factors — like education, exercise and other lifestyle habits — are taken into account.

Supporting the idea that moderate drinking itself bestows the benefit, research suggests that alcohol can raise “good” HDL cholesterol, has anti-inflammatory effects in the blood vessels and may make the blood less prone to clotting.

On the other hand, regular heavy drinking may raise blood pressure, promote blood clotting and contribute to heart-rhythm disturbances.

The new findings show that even when people typically drink moderately, occasional heavy drinking may boost heart risks — at least when compared with modest drinking alone, as the study did not look at abstainers.

The study essentially reinforces the message that “not all alcohol consumption is good for health,” lead researcher Michael Roerecke, of the Center for Addiction and Mental Health in Toronto, Canada, told Reuters Health by email.

He added that besides the potential effects of heavy drinking on the heart, alcohol is associated with other health risks, including cancer. Studies have linked drinking — sometimes even at moderate levels — to elevated risks of cancers of the throat, stomach, colon, breast and liver, for instance.

Roerecke and colleague Jurgen Rehm arrived at their findings by combining data from 14 international studies conducted between 1982 and 2006. Four studies compared a total of 2,171 heart disease patients with 3,475 people without heart disease. The other 10 followed participants over time, documenting new cases of heart disease; the current analysis included 1,637 cases of coronary heart disease among more than 50,000 drinkers from those studies.

These types of studies, known as observational studies, cannot prove cause-and-effect. Instead, they reveal associations — in this case, between occasional heavy drinking and a higher heart disease risk versus moderate drinking only.

Still, the findings support what other studies have found to be true of heavy drinking.

Roerecke said it is best for drinkers to avoid binges altogether — not only because of the possible heart effects, but also because of more-immediate risks, like accidents and violence.

Experts also generally stress that there are numerous ways, other than moderate drinking, that people can guard their heart health. That includes exercising regularly, not smoking and eating a balanced diet rich in fruits, vegetables, high-fiber grains and heart-healthy unsaturated fats.

SOURCE: American Journal of Epidemiology

Vitamin B12 helps maintain healthy blood and aids in making important proteins. People who don’t get enough can have memory problems or confusion, and are at greater risk of developing anemia, Children’s Hospital Boston says.

The hospital mentions these dietary sources of vitamin B12:
Poultry.
Seafood and fish.
Meat.
Eggs.
Cheese, yogurt and milk.
Foods that are fortified with vitamin B12, such as certain breakfast cereals.

New York City, which has banned smoking and artificial trans fats in restaurants under Mayor Michael Bloomberg, is taking on another enemy of healthy living: salt.

The city’s Health Department announced on Monday that it is coordinating a nationwide effort to reduce salt in restaurant and packaged foods by 25 percent over five years.

The National Salt Reduction Initiative, a coalition of cities and health organizations, hopes the food industry will back its campaign to combat high blood pressure, heart attacks and strokes by voluntarily reducing the sodium in the U.S. food supply.

The announcement met with mixed reaction. Many food makers have already begun to cut salt content and said the reduction targets were reasonable, but some critics called it another attempt to regulate what should be a free choice.

Bloomberg, who has just begun his third term as mayor, has crusaded for healthy living. Apart from the smoking and trans fat bans, the city required chain restaurants to post calorie counts of their menu items and started ad advertising campaign against sugary drinks.

Companies are aware of the push to reduce salt and the New York initiative represents a challenge, said Tom Forte, an analyst at Telsey Advisory Group, an equity research firm.

The restaurant industry will change its offerings if demand is there, but there is “not a lot of proof” previous measures in New York caused any major shifts in consumer behavior, Forte said.

The effort targets restaurants and packaged food because only 11 percent of the sodium in Americans’ diets comes from their saltshakers. Nearly 80 percent is added to foods before they are sold, the Health Department said.

High blood pressure, heart attacks and stroke kill 23,000 New Yorkers and 800,000 Americans per year, costing untold billions in healthcare expenses, the Health Department said. Salt intake has been increasing steadily since the 1970s, with Americans consuming about twice the recommended limit of salt each day.

“Consumers can always add salt to food, but they can’t take it out,” said New York City Health Commissioner Thomas Farley.

But J. Justin Wilson of the Center for Consumer Freedom, an industry-funded group that lobbies against restrictions on smoking, alcohol and the restaurant and food industries, called the initiative “paternalistic” and warned that if the City doesn’t get its way, it may try to make the proposals obligatory.

“First it was trans fats, then it was mandatory labeling. The City’s Board of Health knows best.”

Food manufacturers said the proposals are reasonable and have been a part of their strategy for some time.

“Kraft Foods is supportive of the overall goal of New York City’s sodium reduction initiative,” said Susan Davidson of Kraft Foods Inc.

The New York City Health Department’s Dr. Sonia Angell said the sodium cuts are “not about banning any single product” but making sure the mix of high and low sodium products is balanced so that it packs “a lower wallop of sodium for all of us.”

The city vowed to solicit additional comments from the food industry and consumer organizations until February 1. For the proposed salt reduction targets, click on: http://www.nyc.gov/html/doh/html/cardio/cardio-salt-initiative.shtml

(Reporting by Basil Katz; editing by Daniel Trotta and Anthony Boadle)

As a major organization of pediatricians considers revising its recommendations on circumcision of newborn boys, two new reviews of existing research offer conflicting conclusions about the bitterly debated procedure.

One review, from Australia, says there’s no evidence that infant circumcision will reduce the risk of sexually transmitted disease later in life, and it warns of significant psychological harm. But another from the United States gives more weight to findings from Africa that show the procedure, when it’s performed on adult men, makes a major difference in preventing such diseases as AIDS.

The findings come as the American Academy of Pediatrics debates updating its recommendations regarding circumcision among newborns. The academy now takes a neutral stance.

In general, “there is still a lot of uncertainty surrounding the risks and benefits of circumcision,” said Dr. Douglas S. Diekema, a pediatrician at the University of Washington who’s familiar with both reviews and serves on a task force working on the academy’s recommendations.

“There are some clear benefits to circumcision,” he said. “There are some risks to circumcision, although the significant ones appear to be rare.”

Not so, write the Australian researchers, who examined eight studies for a review in the latest issue of the Annals of Family Medicine. Two studies involved neonatal circumcision, and six involved older males, roughly 14 to 49 years old.

The review’s lead author, researcher Caryn Perera of the Royal Australasian College of Surgeons, said the risk of major complications ranges from 2 percent to 10 percent. “These may be considered unacceptable for an elective procedure,” she said.

Parents who think circumcision has medical benefits should be aware that there’s “a lack of consensus and robust evidence” on that, she added.

Though African studies have linked circumcision in adult men to lower rates of sexually transmitted diseases, including the virus that causes AIDS, Perera said that only future studies will tell if those findings are applicable to the Western world, where AIDS is much less prevalent.

And there’s more to consider, Perera said. She said that circumcision poses problems from a mental point of view, potentially causing “significant anger or feeling incomplete, hurt, frustrated, abnormal or violated.”

As to whether circumcision reduces sexual sensitivity, Perera said there’s no evidence that it affects sensation when performed on adults. The highest-quality studies, known as randomized controlled trials, don’t report whether infant circumcision affects sensation, she said.

A review in the January issue of Archives of Pediatrics & and Adolescent Medicine, which examined three studies, took a different tack. It says that risks of complications from circumcision are less than 1 percent, and “serious long-term complications are extremely rare.”

Dr. Matthew Golden, an associate professor of medicine at the University of Washington Center for AIDS and STD, said the ideal study would randomly assign thousands of infants to either get circumcised or not get circumcised and then follow them for decades. But “that trial is never getting done, nor should it be done,” Golden said.

For now, he said, when it comes to circumcision, “we know it’s pretty safe, and we have a lot of evidence for some benefit.”

SOURCES: Douglas S. Diekema, M.D., pediatrician, University of Washington, Seattle; Caryn Perera, B.A., researcher, Royal Australasian College of Surgeons, Adelaide, South Australia; Matthew Golden, M.D., M.P.H., associate professor, medicine, University of Washington Center for AIDS and STD, Seattle; January/February 2010 Annals of Family Medicine; January 2010 Archives of Pediatrics & Adolescent Medicine

U.S. researchers may have found a way to overcome resistance to hormone-blocking breast cancer drugs, extending the life of treatments that keep the disease in check.

They said the drug Nexavar or sorafenib, made by German drugmaker Bayer and its development partner Onyx Pharmaceuticals, helped re-sensitize breast cancer to treatment with aromatase inhibitors, drugs given to post-menopausal women with hormone-sensitive breast cancers.

“Hormone-receptor positive breast cancers eventually become resistant to hormonal therapy,” said Dr. Claudine Isaacs of Georgetown University in Washington, who presented her findings at the American Association for Cancer Research’s San Antonio Breast Cancer Symposium.

“There has been a great deal of interest in trying to figure out how we might overcome that resistance or stop the cancer cells from figuring out how to circumvent that hormonal therapy,” Isaacs said in a telephone interview.

She said Nexavar, a drug approved for liver and kidney cancer, acts on a lot of cancer-related genes and it also acts to inhibit new blood vessels from forming.

The researchers studied the drug in 35 post-menopausal women with advanced breast cancer resistant to treatment with aromatase inhibitors.

Women in the trial, funded with a grant by Bayer, continued to take the aromatase inhibitor, but they also took Nexavar.

“These women all had disease progression. Twenty-three percent of the women in the study had a clinical benefit from it. It means they either had shrinkage of their tumors or it stayed stable,” Isaacs said.

Isaacs said the finding suggests the drug somehow circumvents the mechanism used by the cancer to resist the effects of the aromatase inhibitors.

“It puts the brakes on it so it didn’t grow for at least six months,” she said.

The treatment was not without side effects. Many women in the study developed a rash called hand-foot syndrome, which causes redness, peeling and some tenderness on the palms of the hands and soles of the feet.

It also caused elevated blood pressure in 11 percent of the women, but Isaacs this could be overcome by putting women on blood pressure drugs before taking Nexavar.

She said the findings were strong enough to inspire the drug companies to start a large, late-stage study to see if it has a significant benefit for women.

Aromatase inhibitors include anastrozole, made by AstraZeneca under the brand name Arimidex, and exemestane, made by Pfizer Inc, under the brand name Aromasin.

Breast cancer is the second-leading cause of cancer death among U.S. women, after lung cancer. It kills 500,000 people globally every year.

Most American women know that age is an important factor in the success of fertility treatments, finds a new survey of 763 women, aged 18 and older, including 125 women who’ve had fertility treatment.

The HealthyWomen poll found that 88 percent of respondents were under age 35 when they first sought medical advice about their fertility.

The survey asked women about their views and priorities when it comes to having children, and their experiences when seeking medical help to treat fertility problems.

Fifty percent believed fertility problems are equally likely to be a female or male issue, while just 5 percent believed men are more likely to be infertile. In fact, infertility is a female problem in 40 percent of cases, a male problem in 40 percent of cases, and a combined or unexplained problem in 20 percent of cases, according to HealthyWomen.

The majority of women knew that risk factors for infertility in women include medical conditions affecting the reproductive system (83 percent), age (83 percent), complications from sexually transmitted diseases (80 percent) and ovulation problems (79 percent). But they were less aware of other factors.

“Many factors and conditions can affect a woman’s ability to conceive naturally. Some of these include being overweight or underweight, and chronic health conditions such as diabetes and thyroid disorders, substance abuse, alcohol consumption and some medications,” Elizabeth Battaglino Cahill, executive director of HealthyWomen, said in a news release. “It is important that a woman work closely with her health care provider to determine the best plan for maintaining optimal health while trying to conceive a child while also assessing her partner’s health and possible fertility issues.”

Of the respondents who had fertility treatments, 88 percent found it emotionally challenging, 84 percent found it stressful, 60 percent reported a negative impact on their self-esteem, 79 percent said they felt hopeful, 76 percent said their partners were supportive and 33 percent said the fertility treatments had a positive impact on their relationship.

A history of juvenile delinquency raises a man’s risk of dying or becoming disabled by the time he is 48 years old, according to U.K. researchers.

The findings are from a study that began following 411 South London boys who were 8 to 9 years old in 1961. Among those who at age 10 displayed antisocial behavior (such as skipping school or being troublesome or dishonest) and who also were convicted of a crime by the age of 18, one in six (16.3 percent) had died or become disabled by the time they turned 48.

That’s nearly seven times higher than the one in 40 (2.6 percent) death or disability rate among men who stayed out of trouble when they were young, the study authors noted in their report in the December issue of the Journal of Public Health.

“We were surprised to see such a strong link between these early influences and premature death, and this indicates that things that happen in families at age 8 to 10 are part of a progression towards dying prematurely,” study leader Jonathan Shepherd, director of the Violence and Society Research Group at Cardiff University in Wales, said in a news release from the journal’s publisher.

“It was also surprising that the increase was not limited to substance abuse or other mental health problems known to be linked with an antisocial lifestyle, but included premature death and disability from a wide variety of chronic illnesses such as heart disease, stroke, respiratory disease and cancer,” Shepherd added.

“At this point, we don’t know exactly why delinquency increases the risk of premature death and disability in middle age, but it seems that impulsivity — or lack of self-control — in childhood and adolescence was a common underlying theme,” Shepherd said. “It may be that the stresses and strains of an antisocial lifestyle and having to deal with all the crises that could have been avoided with more self-control take their toll.”

The finding “fits with the biological evidence of the effects of chronic stress on illness,” he said.

The cornea is the tissue at the front of eye that helps focus light. A corneal abrasion occurs when that tissue is cut or scratched.

The American Academy of Family Physicians offers these suggestions to help prevent a corneal abrasion:
Always use safety eye wear any time you’re working with machines that expel wood, sawdust, metal, etc.
Cut your fingernails to avoid scratching your eye. Keep babies’ and children’s nails trimmed, as well.
Keep all tree and shrub branches, especially those at eye level, trimmed.
Be careful when putting contact lenses in your eyes. Make sure the lenses are cleaned properly each day, and never sleep with them.

Aspirin alone proved as effective as aspirin plus the blood clot preventer Plavix in keeping coronary artery bypass grafts open during the first year after surgery, according to a study released on Monday.

The study was designed to see if the addition of Plavix — already a $9 billion a year seller for Bristol-Myers Squibb Co and Sanofi Aventis — to standard aspirin therapy would help further reduce vein narrowing or blockages after coronary artery bypass surgery.

“We found no significant difference in the amount of vein graft thickening, or the number of blocked bypasses, cardiovascular events or bleeding events in the 113 surgery patients treated with either aspirin and clopidogrel (Plavix) or aspirin alone,” said Dr Alexander Kulik, a cardiovascular surgeon who led the study.

The data were presented at the American Heart Association scientific meeting in Orlando.

The success rate after one year was 93.2 percent for aspirin alone and 94.3 percent for patients on aspirin plus Plavix, a difference not considered to be statistically significant.

More than 90 percent of patients in the trial were also taking cholesterol lowering statins — standard therapy for heart patients.

While the duel clot-preventing therapy of aspirin and Plavix is standard during and after artery-clearing angioplasty procedures, some surgeons have begun using the combination after bypass surgery in the belief that it might improve outcomes, Kulik explained.

This study failed to validate that theory, Kulik said.

“The good news is that patients and their doctors can expect more than 90 percent of vein grafts to remain open one year after surgery with the use of aspirin and statins,” he said.

People taking the acid reflux drugs Prilosec or Protonix in combination with blood thinners such as Plavix have a higher risk for death after angioplasty than people who don’t take the two popular antacids, a new study has found.

The people in the study, which is to be presented Monday at the American Heart Association’s annual meeting in Orlando, Fla., were undergoing what doctors call “percutaneous coronary intervention,” or PCI, a common procedure used to widen a narrowed artery. PCI typically involves balloon angioplasty followed by the insertion of a drug-emitting stent, a tiny mesh tube, to keep the vessel open.

Study author Dr. Joseph Sweeny, an assistant professor of medicine at Mount Sinai Medical Center in New York City, said that the clinical implications for users of these reflux drugs — called proton pump inhibitors (PPIs)– remain unclear.

“It’s a moving target,” Sweeny said, adding that, “although certain confounders are going to be at play that do cause limitations of the study, in my opinion the data speaks for itself. We found an overall increased mortality in this patient population that takes a PPI with clopidogrel [Plavix]. The problem was I was not able to look at specific cause of mortality.”

One expert agreed that the study, while interesting, does not prove cause-and-effect.

“All this shows is that people taking PPIs have a worse outcome than those not taking PPIs,” said Dr. Chet Rihal, director of the Mayo Clinic’s catheterization lab in Rochester, Minn. “This does not prove there’s causation. That would be like saying that carrying matches is associated with lung cancer. It is associated, but it doesn’t mean it causes lung cancer.”

“These data do not show that patients should stop taking PPIS, and, in fact, it would be dangerous for patients to stop PPIs or other medication without a physician’s advice,” Rihal said.

The mortality increase shown by the study is not surprising, he added. “People who are older are the ones who get stents and tend to get ulcers and stomach problems [warranting use of PPIs] so we would expect them to have a worse prognosis,” Rihal said. “Whether it’s due to medical problems or whether it has something to do with a drug-drug reaction is unclear.”

PPIs are frequently given with aspirin and Plavix after an angioplasty procedure to reduce the chances of gastrointestinal bleeding. Many people also take PPIs for various gastrointestinal conditions, including acid reflux, gastric ulcers and stomach bleeding.

For the study, Sweeny and colleagues looked back at records of more than 8,300 people who underwent the procedure between April 2003 and June 2007. They were followed for an average of two years.

During the study period, 17 percent of them took a PPI. All of the patients also took both aspirin and Plavix, the researchers said.

Overall, people taking a PPI had a 30 percent higher risk for dying after their PCI procedure than did people who were not taking a PPI. Two drugs in the class appeared to contribute most of the added risk: Omeprazole (Prilosec) was associated with 72 percent higher risk for death after PCI, and pantoprazole (Protonix) was linked to a 54 percent increased risk, the study found.

Two other common PPIs — esomeprazole (Nexium) and lansoprazole (Prevacid) — did not show a heightened risk. There wasn’t enough data to rank a fifth drug, Aciphex (raberprazole), according to the study.

Sweeny could not say why Nexium and Prevacid were exempt from the effect. “It’s a very heterogenous interaction and depends on how a specific population metabolizes that drug,” he said.

People taking PPIs along with a blood thinner also had a small risk for developing blood clots after insertion of a stent, the team found.

The findings add to a lively back-and-forth about the dangers — or lack thereof — of combining antacids with blood thinners, with studies over the past few years coming down on both sides of the debate.

But according to Rihal, there may actually be an answer to this question, though not from the current study. He pointed to an earlier study that demonstrated an interaction between the two types of drugs, but only in a test tube.

When it came to replicating those findings in humans, however, no extra problems showed up in people taking PPIs compared with those not taking them. This was later confirmed by another study, Rihal said.

“That was actually the best-done study of them all,” he said.

One problem with the Mount Sinai study, Rihal said, is that it does not indicate why people were taking the antacids.

PPIs, used by millions of Americans, have also been linked to a number of other health risks, including an increase in hip fractures, diarrhea and community-acquired pneumonia.

Former American Heart Association (AHA) president and current spokesman Dr. Sidney Smith said that new AHA/American College of Cardiology recommendations regarding PPIs would be announced Wednesday at the Orlando conference.