PreDisease.com Blog

Meridia, a popular weight loss drug, must now come with a stronger warning on its label, following the results of the Scout trial, a study of 10,000 individuals taking Meridia (sibutramine) to manage their weight. The participants of the study all had type 2 diabetes or cardiovascular disease. The results of the Scout trial showed an increase in the risk of myocardial infarction (heart attack), stroke, and other cardiovascular problems.

Following the release of the results of the trial, Europe has banned the sales of medication containing sibutramine, including Meridia, one of the most popular. In the US, however, it has only been recommended that the drug be labeled with the stronger warning. Patients who have a history of the following conditions should not take Meridia or any other drugs containing sibutramine:

• Previous heart attack
• Previous stroke
• Heart arrhythmia
• Coronary artery disease
• Peripheral artery disease
• Uncontrolled hypertension (high blood pressure)

Meridia is prescribed for patients with a BMI of 30 or more, or a BMI of 27 with risk factors for cardiovascular disease.

Source: Europe Bans Meridia Diet Pill; FDA Strengthens Warning

A study that examined the risk of bone fracture in 2,300 older adults found that taking prescription opioids increased their risk of bone fracture substantially. Furthermore, larger dosages of opioids conveyed a higher risk than lower doses.

What are opioids? Opioids are narcotic analgesics (painkillers) prescribed to treat moderate to severe pain. They may be used as a one-time treatment or may be prescribed for continuous use in certain chronic conditions. Although they are very potent painkillers, they are not without risk, including the risk of becoming addicted. Other side effects may include drowsiness, itching, gastrointestinal upset, constipation and dry mouth. Taking too much of this type of drug can result in respiratory depression, where the rate of breathing slows, low blood pressure, and other dangerous effects.

The study outlining the increased rate of bone fractures in older patients taking opioids serves as a reminder that opioids should be prescribed and taken with caution. Aside from their addictive potential, opioids can cause drowsiness and low blood pressure, increasing the risk for falls. The potential for these side effects combined with an increased risk of bone fracture in older adults using opioids means that older people may need to be particularly cautious when using opioids to control pain.

Source: Prescription Painkillers Increase Risk of Bone Fractures, Study Finds

More and more studies are pointing to the fact that vitamin D is important in disease prevention. Scientists studied the genetic material of 617 people stored in a DNA data bank. They divided the people into three groups: those who were healthy, those who had hypertension, and those who had both hypertension and CHF (congestive heart failure).

What they discovered is that those who suffered from both conditions, high blood pressure and congestive heart failure, had an abnormality in the CYP27B1 gene. This gene is associated with a reduction in the rate at which the body converts vitamin D which has been stored into active vitamin D that the body can readily use. Researchers point out that this means that, in future, they may be able to screen people for this an abnormality in this gene earlier. Knowing that someone has this gene may mean that that person requires more vitamin D from their diet and more daily exposure to UVB rays present in sunlight, although researchers point out that more studies will need to be done to confirm their findings.

Vitamin D has been researched extensively in recent times, and is thought to have a protective effect against certain cancers, autoimmune disorders, insulin sensitivity, depression and hypertension.

Source: American Heart Association (2008). Lack Of Vitamin D May Increase Heart Disease Risk. ScienceDaily.

A new study has found that having obstructive sleep apnea can mean poorer glucose control for type 2 diabetics. Obstructive sleep apnea is estimated to affect more than 18 million people in the US. In obstructive sleep apnea, the sufferer quits breathing during their sleep for sometimes as long as a minute at a time. This may happen hundreds of times in a night. The person who has obstructive sleep apnea is often unaware they have a problem, but may report feeling tired all the time.

The study included 60 participants, only a few of whom had been diagnosed with obstructive sleep apnea. After testing, 77% of the sample were found to be suffering from obstructive sleep apnea. After testing the participants and measuring a  blood value sensitive for glucose control (Hgb A1C), it was determined that those participants with obstructive sleep apnea had higher numbers, leading the researchers to conclude that obstructive sleep apnea has a detrimental effect on glycemic control.

What is meaningful about this research is that treating obstructive sleep apnea could improve control for those who have concurrent type 2 diabetes. This could mean fewer complications for diabetics and less dependency on medication to control blood sugar levels. Obstructive sleep apnea can be treated with weight loss, oral appliances, positional therapy, or continuous positive airway pressure (CPAP). Losing weight will often cure sleep apnea and will often improve glycemic control in type 2 diabetes.

Source: The Relationship Between Obstructive Sleep Apnea and Diabetes

Women who are an unhealthy weight during pregnancy may be putting themselves and their unborn babies at risk. More than half of non-pregnant women of childbearing age are considered overweight or obese. Gaining too much weight during pregnancy can lead to complications for both mother and baby.

Complications for babies can include neural tube defects, such as spina bifida, heart defects and the risk of having more than one health problem at birth, or multiple anomalies. In addition, babies born to overweight mothers are more likely to be obese when they grow up.

For overweight pregnant mothers, health risks can run the gamut from high blood pressure to preeclampsia, increasing the risk of a cesarean birth, the necessity of inducing labor, and hemorrhage. In addition, being overweight or obese during pregnancy increases the risk of gestational diabetes. Having diabetes during pregnancy is one of the risk factors for the development of type 2 diabetes later on.

There is a definite relationship between obesity in pregnancy and obesity in the offspring of overweight women. By entering pregnancy at a healthy weight, women can reduce the risk of their children becoming obese, lowering their future risk of diseases related to obesity, such as heart disease and diabetes.

Source: Overweight Pregnant Women May Be Putting Their Infants At Risk

Most of us associate high cholesterol levels with advancing age. Cholesterol is something you are not supposed to have to worry about until middle to late adulthood. This is not necessarily the case: a new study has shown that many teens have high cholesterol levels, predisposing them to the risk of heart disease at a younger age.

A study of 3,125 teens found that an astonishing 20% of the subjects, aged 12 to 19, had abnormally high lipid or cholesterol levels. Males were affected more often than females. In some cases high levels correlated with the teen being overweight, but even some of the normal-weight teens (14.2%) had unhealthy levels. Being overweight would likely lead to screening of cholesterol and lipid levels for some of the teens, but those of normal weight would likely not be tested on a routine basis.

The study pointed to the need for health care professionals and parents to be aware of the risks of these high levels, and to encourage teens to modify their risk factors early. Exercising and weight reduction, as well as watching their diet, should be counseled. For teens who have a positive family history of heart disease, this may be even more important.

Source: Prevalence of Abnormal Lipid Levels Among Youths — United States, 1999—2006 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5902a1.htm

Cholesterol is a substance that is needed in the body in order for it to function properly. Its role is to produce hormones, vitamin D and acids used to aid your body in digesting fat. Our bodies generally produce enough cholesterol naturally, without us having to worry about whether we get enough of it from the foods we eat. In fact, many of us get too much cholesterol from our diet which can cause problems such as atherosclerosis, or hardening of the arteries, leading to heart disease. This is because excess cholesterol and fat line the arteries that supply our hearts, choking off the heart’s supply of oxygen-rich blood.

Perhaps you have heard the terms “good” and “bad” applied to cholesterol. LDL (low density lipoproteins) are proteins that carry the bulk of the cholesterol in the blood, so having too high a level of LDL means that your risk of developing heart disease may be higher. HDL, or high density lipoproteins, carry cholesterol in the body back to your liver which disposes of it; therefore, this lipoprotein is the “good” cholesterol because it helps to lower the amount of cholesterol that can build up in the arteries. You may have also heard of triglycerides. Trigycerides alone are not necessarily problematic, but some trigycerides are associated with lipoproteins that carry cholesterol, so high triglyceride levels may be a sign of a problem with cholesterol.

Many factors relate to how your body handles lipoproteins and cholesterol. Age, sex, weight, exercise, diet and heredity can all play a role in how your body metabolizes cholesterol. It is important to know your risk factors for heart disease, and managing your cholesterol and triglyceride levels can go a long way towards preventing heart disease.

Back pain is a common problem, estimated to affect up to 80% of the adult population at some point in their lives, and is the second most common reason for visits to the doctor. It is also a common reason for missing work. Yearly, Americans spend somewhere in the neighborhood of $50 million dollars on back pain care. Most back pain is not related to a serious illness, but is instead the result of mechanical strain (ACA, 2010). Back pain not caused by organic disease can result from one or more of the following:

• Aging– Aging results in “wear and tear” on the spine that can result in pain in the neck and back. A previous history of back pain or injury makes it more likely to happen again.
• Occupation– Jobs that require excessive lifting, bending, standing and/or sitting can result in back pain.
• Weight– Being overweight, in combination with lack of exercise, can set the stage for chronic back pain.
• Sports- Many sports can contribute to back pain, especially if no warm up is done prior to engaging in the activity.
• Poor Posture– Slouching and poor lifting techniques can cause back pain, as can sleeping on a surface that is too soft and does not properly support the back.

Treating back pain can involve a combination of treatments, such as rest, application of ice and heat, physiotherapy, massage therapy, strengthening exercises and medications aimed at addressing the pain and inflammation that result from back injury. Weight reduction, attention to posture, proper lifting techniques and taking care to warm up prior to engaging in sports can aid in the prevention and improvement of back pain.

Source: American Chiropractic Association Back Pain Facts and Statistics http://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68

Pre-diabetes can be defined as the condition of having abnormally high blood glucose levels that are not high enough to warrant the diagnosis of type 2 diabetes. It is estimated that 57 million people in the United States are pre-diabetic (NDIC, 2007). How can you tell if you are one of these people?

Some groups of people are at higher risk of developing diabetes. These groups include the elderly, African Americans, those of Asian descent, Native Americans and those of Latin descent. However, pre-diabetes and diabetes can occur in people of all ethnicities and ages. Other risk factors for pre-diabetes and diabetes include a sedentary lifestyle, high blood pressure, a family history of diabetes, being overweight and a history of having had diabetes during pregnancy.

Two common tests that can help determine whether you have an abnormal metabolism are the Fasting Glucose Test and the Oral Glucose Tolerance Test. Abnormal results on either of these tests signal that your body has an impaired ability to metabolize glucose.

A diagnosis of pre-diabetes does not necessarily mean that you are destined to become diabetic. Studies have shown that lifestyle changes, such as regular exercise and weight loss, can prevent the development of diabetes. Knowing your risk factors for diabetes can help you to avoid developing the disease.

Source: National Diabetes Information Clearinghouse (NDIC) http://diabetes.niddk.nih.gov/DM/PUBS/statistics/#pre-diabetes

The symptoms of menopause can be overwhelming for some, including hot flashes, night sweats, menstrual irregularities, fatigue, sleep disturbances and mood swings. These symptoms herald major changes occurring in the body, mainly a decrease in the hormones that regulate menstruation. As if these symptoms weren’t enough to contend with, new research reveals that menopause can signal an end to healthy cholesterol levels for some women.

A study of 1,054 women revealed that, as women entered menopause, total cholesterol levels and levels of LDL cholesterol rose dramatically. This rise in cholesterol levels began one year prior to menopause and continued for one year after the study participants’ last menstrual periods. Risk factors and ethnicity of the participants had no bearing on this rise.

The take-home message of this study is that women going through menopause need to be mindful that the decrease in estrogen levels brought about by menopause can have a broader impact on their health than the annoying, and sometimes unbearable, symptoms mentioned above. Menopause should signal the need to examine personal risk factors for heart disease and stroke, as these risk factors can be somewhat modified through lifestyle changes such as diet and exercise.

Source: J Am College Cardiol. 2009;54:2366-2373 and 2374-2375.