Thursday, May 2, 2013
WEDNESDAY, May 16 (HealthDay News) -- The widely prescribed antibiotic azithromycin may slightly raise the risk of death in patients with heart disease, a new study suggests.
Several antibiotics have been tied to an increased risk of sudden death among heart patients, and recent reports have suggested azithromycin (Zithromax) might be part of that group, said the researchers, from Vanderbilt University School of Medicine.
"For patients with elevated cardiovascular risk, the cardiovascular effects of azithromycin may be an important clinical consideration," said study author Wayne Ray, a professor of preventive medicine at the school. "All antibiotics have risks and benefits, which must be considered in the prescribing decision."
When patients and their doctors consider an antibiotic, they should weigh the heart risks of azithromycin against the severity of the infection and the effectiveness of alternative antibiotics, Ray said.
"We found that amoxicillin, often used for similar indications as azithromycin, conferred no cardiovascular risk," he noted.
For the study, published in the May 17 issue of the New England Journal of Medicine, Ray‘s team collected data on nearly 348,000 Medicaid patients taking azithromycin, as well as people taking other antibiotics.
The sample size included more than 1.3 million patients taking amoxicillin (Amoxil, Moxatag, Trimox, Wymox), more than 264,000 people taking ciprofloxacin (Cipro), and nearly 194,000 patients taking levofloxacin (Levaquin). Another 1.3 million people not taking antibiotics were also included in the study.
Over a five-day period, people taking azithromycin had a slightly increased risk of sudden cardiac death, compared with those not taking any antibiotics. Patients taking amoxicillin had no increase in death risk, the study authors said.
The researchers calculated the absolute risk at 47 cardiovascular deaths for every 1 million prescriptions for azithromycin. Those at highest risk were patients with the most serious cardiovascular disease.
The risk of cardiovascular death was significantly higher with azithromycin than with ciprofloxacin but did not differ significantly from deaths among those taking levofloxacin, the researchers noted.
While the study found an association between the use of azithromycin and potential heart problems, it did not prove a cause-and-effect relationship.
Dr. Gregg C. Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center and co-director of the UCLA Preventative Cardiology Program, said that "certain antibiotics, such as erythromycin, have been demonstrated to increase the risk of cardiac arrhythmias [an irregular heartbeat] and sudden death."
Azithromycin has generally been considered not to increase the risk of arrhythmias, he added.
Although the new study revealed a slightly increased risk for cardiovascular death among heart patients taking azithromycin, an earlier rigorous trial found no risk, Fonarow noted.
"Further studies are needed to determine whether the findings from this observational analysis can be confirmed or not," he said.
For more on azithromycin, visit the U.S. National Library of Medicine.
Copyright © 2012 HealthDay. All rights reserved.
Living on a budget is common place these days, from our college students, to singles, to hard working families. We are all trying to stay healthy while watching where our money goes. Truth is you can have it all by purchasing some staple foods that can keep you healthier without breaking the bank. Take a look at our 7 favorite healthy supermarket must haves to add to your wagon before you head to the check out.
1. Oatmeal – This high fiber breakfast cereal is packed with nutrition. This whole grain complex carbohydrate will provide longer lasting energy while the fiber will help to lower cholesterol. Perfect any time of day, can be made with water or milk, can be used to bread chicken, make into healthy muffin, or added to yogurt for a parfait. Price: $1.45 for 42 ounce container.
2. Potatoes – Who knew that eating a potato with the skin can give you almost half a days vitamin C? Not to mention it is packed with loads of potassium. The resistant starch found in the white potato takes longer to be digested, allowing it to be a very filling food, without packing on the pounds. Baked and topped with veggies and melted part skim cheese for a great meal or snack. Price: $2 for a 3 lb bag.
3. Eggs – Touted as the perfect protein, eggs are a sure pick. Along with protein, they are full of choline, which enhances brain development, and antioxidants lutein and zeaxanthin, which protect the eyes as we age. Hard boil as a snack or load up with veggies as a meal any time of day. Price: $2.29 for a dozen.
4. Broccoli – Calcium, folate, potassium, fiber, vitamins A and C, need we say more?This bright green vegetable is rich in antioxidants and low in calories. It is perfect raw with a dip, steamed aside your main dish or thrown into an omelette for a delicious taste. With this vegetable you can’t go wrong! Price: $1.50 a lb.
5. Beans – Garbanzo, kidney, black. red and pintos are among the most common varieties. Beans are packed with protein, fiber, magnesium and iron. Great to throw atop a salad, add to rice for the perfect protein or throw in to make a delicious chili. Dried are cheaper but even the canned ones make the low price grade. Price: $ .02 per ounce for dry and $.04 per ounce for canned.
6. Peanut butter – Remember when you were a kid and eating was simple. Everyone was happy with a good old pb and j sandwich. In fact peanut butter packs great nutrition into just 2 tablespoons. It is packed with protein, vitamin E and manganese. All the fat contained is unsaturated so it is safe for the heart. PB on an apple, on crackers, in a shake or on the spoon. It always hits the spot. Price: $ .15 per serving ($2.40 a jar)
7. Bananas – Monkey see, monkey do. Looks like we are onto something. Bananas are packed with potassium, carbohydrate, vitamin B6 and vitamin C. Take them on the go, slice up into your yogurt or add to milk to make a a shake. Price: $.19 a banana.
Marlo Mittler, MS RD is a Registered Dietitian, Nutrition Consultant, journalist and public speaker specializing in nutrition, wellness and healthy lifestyles. Marlo has been in practice for over 15 years, specializing in Pediatrics, Adolescents and Family Nutrition. Marlo, has appeared nationally on FOX, ABC, NBC and CBS News.
A federal judge has ordered the U.S. Food and Drug Administration to make the so-called "morning-after pill" -- an emergency contraceptive -- available to all women regardless of age. The judge from the Eastern District of New York gave the FDA 30 days to remove age restrictions on the sale of emergency contraception, such as Plan B One-Step. Until now, girls 16 and younger needed a doctor‘s prescription to get the pill, which typically works if taken within 72 hours after intercourse.
Other brands of emergency contraception include Next Choice and Ella. The judge‘s decision, is the latest step in a 10-year, controversial debate about who should have access to the drug and why. Plan B prevents implantation of a fertilized egg in a woman‘s uterus through use of levonorgestrel, a synthetic form of the hormone progesterone used for decades in birth control pills. Plan B contains 1.5 milligrams of levonorgestrel, more than "the Pill" contains. It is considered a form of birth control, not abortion. The Obama administration had no immediate comment on the judge‘s ruling.
Women‘s health advocates praised the decision by Judge Edward Korman in Brooklyn. "Lifting the age restrictions on over-the-counter emergency contraception is a significant and long-overdue step forward for women‘s health that will benefit women of all ages," Eric Blankenbaker, a spokesman for Planned Parenthood Federation of America, said in a statement Friday. "When a woman fears she might become pregnant after her contraceptive has failed or she has had unprotected sex, she needs fast access to emergency contraception, not delays at the pharmacy counter," he said.
Planned Parenthood called the ruling "good policy, good science, and good sense." The National Latina Institute for Reproductive Health also came out in favor of the court ruling, noting it will benefit Hispanic and other immigrant women. "For Latinas in particular, expanded access to emergency contraception is critical for making the best decisions for our families and ourselves. For too long, this important backup birth control method has been kept behind the counter and out of reach," institute spokeswoman Erin White said in a statement. Minority women in the United States often face significant barriers to health care and suffer from the highest rates of unintended pregnancies, White said.
But not everyone was pleased with Korman‘s ruling. "This is a political decision, made by those who stand to profit financially from an action that puts ideology ahead of the nation‘s girls and young women," said Janice Shaw Crouse, director and senior fellow at the Beverly LaHaye Institute, the think tank for the conservative women‘s group Concerned Women for America. "It is irresponsible to advocate over-the-counter use of these high-potency drugs, which would make them available to anyone -- including those predators who exploit young girls," Shaw Crouse said.
In his ruling, Korman was dismissive of the government‘s arguments and, in particular, previous decisions by U.S. Health and Human Services Secretary Kathleen Sebelius that required girls under 17 to get a prescription for the emergency contraceptive. Korman wrote that Sebelius‘ actions "with respect to Plan B One-Step . . . were arbitrary, capricious, and unreasonable." In 2011, Sebelius overruled a recommendation by the FDA to make the drug available to all women without a prescription. The FDA said at the time that it had well-supported scientific evidence that Plan B One-Step is a safe and effective way to prevent unintended pregnancy.
Sebelius, however, said she was concerned that very young girls couldn‘t properly understand how to use the drug without assistance from an adult. She invoked her authority under the federal Food, Drug, and Cosmetic Act and directed FDA Commissioner Margaret Hamburg to issue "a complete response letter." As a result, "the supplement for nonprescription use in females under the age of 17 is not approved," Hamburg wrote at the time.
The Mayo Clinic has more about emergency contraception.
MONDAY, Oct 22 (HealthDay News) -- People suffering from type 2 diabetes can see an improvement in both their blood sugar levels and blood pressure if they add beans and other legumes to their diet, Canadian researchers report.
Chickpeas, lentils and beans are rich in protein and fiber, and these may improve heart health. Because they are low on the glycemic index, a measure of sugar in foods, they may also help control diabetes, the researchers explained.
"Legumes, which we always thought were good for the heart, actually are good for the heart in ways we didn't expect," said lead researcher Dr. David Jenkins, the Canada Research Chair in Nutrition and Metabolism at the University of Toronto.
Among diabetics, "not only did their glucose control become better, but -- and this surprised us -- it had a significant effect on blood pressure," he said.
Exactly why legumes have this effect on blood sugar and blood pressure isn't known, Jenkins said. The effect is most likely due to the protein, fiber and minerals they include, he noted.
Jenkins recommends adding more legumes to the diet. "They will do well for you," he said. "They will help you keep your blood pressure down and your blood glucose under control, and help you keep your cholesterol down."
The report was published online Oct. 22 in the Archives of Internal Medicine.
For the study, Jenkins's team randomly assigned 121 patients with type 2 diabetes to eat one cup of legumes a day or whole-wheat products.
Over three months, the researchers found that those eating legumes saw an improvement in their blood sugar of 0.5 compared with 0.3 for those eating whole-wheat products. In addition, those eating legumes saw a reduction in blood pressure of 4.5 mm Hg, compared with a reduction of 2.1 mm Hg among those eating whole-wheat products, they found.
These improvements in blood pressure and blood sugar add up to better diabetes control and a reduced risk of cardiovascular disease, the researchers said.
The study was funded in part by the Saskatchewan Pulse Growers, a nonprofit organization representing pulse-crop farmers in Saskatchewan. Pulse crops include chickpeas, lentils, fava beans and soybeans.
Marion Franz, from Nutrition Concepts by Franz Inc., in Minneapolis, and author of an accompanying journal editorial, said "the study clearly shows that legumes are part of a healthy eating pattern."
Franz noted that patients were able to control blood sugar as well with whole wheat as they did with beans, and it may be easier for people to eat three servings of whole wheat a day rather than a cup of beans a day.
"What's really important for people with type 2 diabetes is not really what they eat, but how much they eat," Franz said. "You can overeat on healthy foods too."
Samantha Heller, an exercise physiologist and clinical nutrition coordinator at the Center for Cancer Care at Griffin Hospital in Derby, Conn., agreed.
"For people with type 2 diabetes, beans as part of an overall healthy diet are a great addition," Heller said. "Not only do legumes have a relatively low glycemic index, they are loaded with fiber, antioxidants, protein, vitamins and minerals."
Beans provide a heart-healthy, nutritious and affordable alternative to less healthy red and processed meats, Heller said. Several studies suggest a link between eating legumes and lower incidence of type 2 diabetes, cardiovascular disease and cancers, along with better weight management, she said.
"While people may not eat a full cup of beans daily, as they did in this small study, including beans in a healthy diet will still provide many health benefits," Heller said. "Beans are great to use in dips, pasta sauce, salads, burritos, soups, stews and even brownies."
Another expert, who does believe in a low glycemic diet, said patients still need individualized eating plans.
"There is no standard recommendation with a low glycemic diet," said Dr. Minisha Sood, an endocrinologist at Lenox Hill Hospital in New York City. "It is more beneficial to my patients to tailor diet recommendations."
Sood said she looks for specific problem areas, such as portion control or snacking. No single diet or food fits all patients.
"Dietary recommendations should be based on a patient's lifestyle, food likes and dislikes," she noted. "It really requires in-depth nutritional counseling."
Although the study found an association between eating legumes and decreased blood sugar and blood pressure, it did not prove a cause-and-effect relationship.
For more information on a healthy diabetic diet, visit the U.S. National Library of Medicine.
Copyright © 2012 HealthDay. All rights reserved.