Care Chain Health Management Strategic Supply

NEW YORK (Reuters Health) - Each serving of whole-grains may lessen heart failure risk by 7 percent among middle-aged African-American and white men and women, according to findings from a long-term study.

Conversely, each serving of high-fat dairy and egg appear to increase heart failure risk by 8 and 23 percent, respectively, Dr. Jennifer A. Nettleton, of the University of Texas Health Sciences Center in Houston, and colleagues found.

"A refined grain here, a full fat yogurt there, and the occasional egg aren't going to result in heart failure, but a continued pattern of such behaviors could," Nettleton told Reuters Health.

Heart failure is a chronic disease in which the heart gradually loses its ability to pump blood efficiently, leaving organs starved for oxygen.

On 3 occasions over the 13-year study, Nettleton's group assessed the dietary intake of 14,153 adults, aged 45 to 64 years, who did not have heart failure in 1987 when the study began. About half the participants were women and a quarter were African-American,

Overall, 1,140 of the participants were hospitalized for heart failure during the study period, the researchers report in the Journal of the American Dietetic Association.

After accounting for factors that impact heart failure risk such as calorie intake, lifestyle, cardiovascular disease, diabetes, and high blood, the researchers found lower heart failure risk associated with greater intake of whole grains, and higher risk associated with greater amounts of eggs and high fat dairy.

The associations held independently of intake of red meat, fruits and vegetables, fish, and nuts. In this study these foods showed no association with heart failure risk likely because there were too few heart failure cases to detect the heart benefits previously linked with eating fish, fruit and vegetables, and nuts, Nettleton said.

However, findings from the current study are consistent with current dietary recommendations to minimize saturated fat intake from meat and high fat dairy products, and eat at least 3 whole grains each day, Nettleton said.

SOURCE: Journal of the American Dietetic Association, November 2008

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Men at higher-than-average risk of prostate cancer are more likely to seek regular screening if they are married or live with a significant other, a new study finds.

Researchers found that among more than 2,400 men ages 40 to 79, those with a family history of prostate cancer were more likely to be regularly screened for the disease over a decade. However, a closer look at the data showed that this was only true of men who lived with a wife or partner.

In fact, higher-risk men who lived alone were less apt to seek screening than those with no family history of prostate cancer.

The American Cancer Society recommends that men with a family history of prostate cancer get screened for the disease starting at age 45. However, some studies have found that these men are no more likely to seek screening than those without a family history.

These latest findings, published in the journal Cancer Epidemiology, Biomarkers and Prevention, suggest that partners play a big role in getting men to submit to prostate cancer screening.

"In terms of motivating people to get screened, there may be benefit in targeting wives or significant others as well as men," lead researcher Lauren P. Wallner, of the University of Michigan in Ann Arbor, noted in a written statement.

The results are based on 2,447 white U.S. men who were taking part in a long-term men's health study. The researchers used medical records to find out how frequently the men sought prostate cancer screening over roughly a decade; screening included digital rectal examinations and blood tests for prostate-specific antigen (PSA), a protein that can signal prostate cancer.

In general, Wallner's team found, men with a family history of prostate cancer were 40 percent more likely than those without such a history to frequently seek screening. But when the researchers considered marital status, they found that family history was a motivator only for married or co-habitating men.

On the other hand, men who said they were "worried or concerned" about developing prostate cancer had higher rates of frequent screening regardless of their marital status.

The findings, the researchers write, "provide insight as to how to better promote the benefits of early detection among high-risk men."

Still, they add, more research is needed to see what factors other than marital status motivate men to get screened.

SOURCE: Cancer Epidemiology, Biomarkers & Prevention, December 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Strategies introduced in the late 1980s for protecting fertility in patients undergoing cancer treatment may have indeed helped boost reproduction rates modestly among survivors of certain types of cancer, new research from Norway suggests.

However, overall, female cancer survivors remain about half as likely as women who had never been diagnosed with the disease to have a child within the 10 years following their diagnosis, the researchers found. For male cancer survivors, reproduction rates were about 30 percent lower than among their healthy peers.

"There is much left to be done to improve post-diagnosis reproduction, in particular in women," Dr. Sophie Dorothea Fossa of The Norwegian Radium Hospital in Oslo and her colleagues conclude in a report in the Journal of Clinical Oncology.

Studies to date on reproduction among cancer survivors have been small, and most don't compare these individuals to controls who were never diagnosed with cancer.

In the current investigation, Fossa and her team matched 6,071 men and women who had been diagnosed with cancer between the ages of 15 and 45 and received treatment between 1971 to 1997 to 30,355 healthy controls. All study participants were born after 1950.

The researchers calculated the 10-year post-diagnosis cumulative reproduction rates, which is the percentage of people who had children within a decade of cancer diagnosis. They measured fertility for the controls for the 10 years beginning at the time of diagnosis of the age-matched patient corresponding to them.

The 10-year post-diagnosis reproduction rates were always lower for cancer patients than for controls, although the difference was not as great for people who had no children before being diagnosed with cancer. "This might reflect the former patient's desire to have at least one biologic offspring despite possible concerns for the mother's or infant's health," Fossa and her colleagues note.

For example, the 10-year post-diagnosis reproduction rate for women who had no children at diagnosis and who were diagnosed before 1988 was 31 percent, compared to 12 percent for women diagnosed before 1988 who already had children and 47 percent for the healthy controls.

For men diagnosed before 1988 who were childless when diagnosed, the 10-year post-diagnosis reproduction rate was 33 percent, compared to 28 percent for men who already had children when they were diagnosed, also before 1988, and 38 percent for controls.

Overall, there was only "minimal improvement" in fertility among cancer patients diagnosed in 1988 and afterwards compared to those diagnosed earlier, the researchers found. Post-1988 fertility-saving strategies may have improved the reproduction rates for some select genital cancers, they note.

"Although fertility-sparing treatment is allowing more patients to have children after cancer, the gains are minimal compared with the elevated rates of childlessness among cancer survivors," Dr. Leslie R. Schover of The University of Texas M.D. Anderson Cancer Center in Houston notes in an accompanying editorial. And while men can bank their sperm before treatment, she adds, "many oncologists neglect to discuss the option or make a referral."

Studies like this one, Schover concludes, "remind us that controlling cancer is necessary but not sufficient to ensure a satisfying quality of life for our patients."

SOURCE: Journal of Clinical Oncology, online December 15, 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Adults with a sibling who's suffered from a mental disorder may themselves be at risk of depression, a new study suggests.

Researchers found that of more than 800 adults followed over decades, those who had a sibling who'd ever suffered from depression, an anxiety disorder or other mental illness were 63 percent more likely to have ever been diagnosed with depression.

They also tended to have poorer psychological well-being in general -- particularly those with a brother who'd been diagnosed with a psychiatric illness.

The findings suggest that a combination of genetics and environment may make these adult siblings more vulnerable to depression, the researchers report in the Journal of Family Psychology.

In some families, the investigators note, these siblings may have a genetic susceptibility to mental health problems -- which, coupled with the stress of a brother's or sister's symptoms, may contribute to depression.

"Our findings highlight the need for families of the mentally ill, specifically siblings, to be more aware of their own mental health needs throughout their lifetimes," lead researcher Dr. Julie Lounds Taylor, of the University of Wisconsin-Madison, noted in a written statement.

The researchers based their findings on data from a long-term health study that has followed roughly 5,800 sibling pairs since their graduation from high school in the 1950s. Taylor's team focused on 83 participants with a sibling who'd ever been diagnosed with a mental health disorder -- most commonly, depression or anxiety -- as well as

268 whose sibling was mildly intellectually impaired (having an IQ lower than 85).

These men and women were compared with a group of 791 study participants whose siblings were free of mental illness or impairment.

Compared with this latter group, Taylor's team found, adults with a sibling who'd suffered from a mental illness were at greater risk of ever being diagnosed with depression.

In contrast, this was not true of those whose siblings had a low IQ, the researchers found. These men and women did, however, tend to be less emotionally attached to their sibling than study participants in the comparison group.

This, Taylor and her colleagues note, may be because siblings of mentally impaired adults often feel they have an "obligatory" type of relationship with their brother or sister. That is, they feel a responsibility to support their sibling, but they don't feel the same emotional closeness that two, more-equal adult siblings might.

"So little is known about the impact that a person with low IQ or mental illness has on the psychological and social development of his or her siblings, especially beyond childhood," Taylor said.

This study, she and her colleagues write, is an "important first step" in understanding that dynamic.

SOURCE: Journal of Family Psychology, December 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Having the so-called metabolic syndrome may raise the risk of chronic kidney disease in people with type 2 diabetes, researchers from China report.

Metabolic syndrome refers to a cluster of risk factors for diabetes and heart disease -- including abdominal obesity, high blood pressure, high blood sugar, low levels of "good" HDL cholesterol and high triglycerides (another type of blood fat). The syndrome is typically diagnosed when a person has three or more of these conditions.

The current study suggests that conventional cardiovascular risk factors are also predictors of kidney trouble, Dr. Peter C. Y. Tong from The Chinese University of Hong Kong noted in comments to Reuters Health. "Hence, physicians should actively assess patients with diabetes for these risk factors and treat them aggressively," Tong said.

Tong and colleagues looked for ties between metabolic syndrome and its components and kidney disease in more than 5,800 Chinese adults with type 2 diabetes.

They found that the risk of developing chronic kidney disease increased as the number of components of the metabolic syndrome increased.

Patients with four components of the metabolic syndrome had a 1.64-fold increased risk of developing chronic kidney disease, while those with five components had a 2.34-fold increased risk, they report in the journal Diabetes Care.

In a "multivariable" analysis, the presence of metabolic syndrome was associated with a 31 percent increased risk of kidney disease compared with people with no evidence of metabolic syndrome.

Addressing the individual components of the metabolic syndrome will not be enough to reduce the risk of kidney disease, Tong noted. However, a "global risk reduction" of high blood sugar, abdominal obesity, high blood pressure and high blood fats should prevent the deterioration of kidney function, the researcher said.

SOURCE: Diabetes Care, December 2008.

Copyright © 2008 Reuters Limited.