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Quick Study: Heart Disease, Osteoporosis and More

By Haleh V. Samiei

Washington Post, July 18, 2000

HEART DISEASE

Diet and lifestyle have a powerful impact on heart disease risk.

·        THE STUDY AND RESULTS Researchers in Boston investigated the relationship between diet and lifestyle and development of heart disease in more than 84,000 women who were participating in a Nurse's Health Study program. The women, who were between the ages of 30 to 55, filled out questionnaires on diet, exercise frequency, body mass index (a measure of weight versus height), smoking status and alcohol consumption at regular intervals for 14 years. Dietary factors studied included consumption of cereal fiber, fish fatty acids, folate, trans fats and foods that excessively increase blood sugar levels, as well as the ratio of polyunsaturated to saturated fats. There were 1,128 incidents of fatal and nonfatal heart attacks during the study period. Women who did not smoke cigarettes, were not overweight, had a healthy diet, exercised moderately or vigorously for half an hour a day and drank moderate amounts of alcohol reduced their chances of developing heart disease by more than 80 percent.

* WHAT'S NEW this is one of few studies to investigate the effects of a combination of lifestyle practices on the risk of heart disease. Most studies focus on a single behavior.

* CAVEATS Much of the study relies on self-reports of diet and lifestyle. In addition, other variables, such as dietary consumption of nuts or the use of aspirin or postmenopausal hormones, could affect the risk of heart disease.

* BOTTOM LINE Women may be able to reduce their chances of developing heart disease significantly through diet and lifestyle modifications.

* FIND THIS STUDY July 6 issue of The New England Journal of Medicine; abstract online at http://www.nejm.org.

BLOOD PRESSURE

Exercise and weight loss can reduce blood pressure.

* THE STUDY AND RESULTS Researchers randomly divided 133 men and women with mildly high blood pressure (130 to 180 over 85 to 110) into three treatment groups for 26 weeks. One group participated in 55-minute exercise sessions three to four times a week; a second group participated in the same exercise sessions as well as a weekly group weight-loss program; and the third group, which served as comparison, was asked to maintain usual dietary and exercise habits for six months. The researchers measured the blood pressure of the participants under many different circumstances, such as while resting during a regular clinic visit, while working, while under mental stress and while exercising. Both active groups lowered their blood pressures, but those participating in the weight management program lowered their blood pressure even more than those participating in the exercise program alone.

* WHAT'S NEW This is the largest, most comprehensive study to look at the effects of exercise and weight loss on the unmedicated blood pressure of both men and women.

* CAVEATS It is difficult to compare this study with others that ran for a different length of time with participants of different weights, different methods of blood pressure measurement or with a different history of medication. In addition, socioeconomic factors may influence how well people adhere to the exercise and weight-loss programs.

* BOTTOM LINE Sedentary, overweight people with mild hypertension may be able to reduce their blood pressure through exercise and weight loss.

* FIND THIS STUDY July 10 issue of the Archives of Internal Medicine or http://archinte.ama-assn.org/.

OSTEOPOROSIS

Exercise during adolescence can improve bone density in adulthood.

* THE STUDY AND RESULTS Women typically gain 40 to 50 percent of their bone mass during adolescence. Researchers compared the effects of exercise vs. calcium intake on the bone minerals of 81 white 18-year-old females participating in the ongoing Penn State Young Women's Health Study. The women provided food and exercise records at regular intervals between the ages of 12 and 18. The researchers collected data on calcium supplementation and total body and hip bone mineral measurements. The young women who exercised more often during teenage years had higher hip bone mineral density at age 18 than those who did not. However, variations in calcium intake--the women in this study consumed between 500 and 1,500 milligrams a day--did not seem to affect hip bone mineral density or total body bone mineral gain.

* WHAT'S NEW This is one of few studies to examine the effect of random exercise programs on adolescent bone gain and bone density. Previous studies looked at athletes and women involved in specific activities.

* CAVEATS The average daily calcium intake of these young women was 919 milligrams a day, which is slightly higher than the national average of 833 milligrams for this age and ethnic group. There is no information available for the effect of calcium intakes below 500 milligrams in this study. The results need to be verified for other ethnic groups.

* BOTTOM LINE Young women can have healthier bones in adulthood by leading an active lifestyle.

* FIND THIS STUDY July issue of Pediatrics; abstract online at http://www.pediatrics.org/current.shtml.

EMPHYSEMA

Reducing both lungs is better in short term than reducing just one.

* THE STUDY AND RESULTS In people with emphysema, the walls of the tiny air sacs in the lung are damaged, often from smoking. This makes the lung lose its elasticity, causing problems with inhaling and exhaling. Researchers believe that lung volume reduction surgery--in which portions of the damaged lung are cut away--may pull the airways open again allowing easier breathing. This study reviews 6 to 24 months of follow-up data on nearly 700 patients who had lung reduction surgery on one or both sides in five different medical centers. While both types of surgery resulted in improvement of emphysema symptoms, patients who had surgery on both lungs had better recoveries as measured by shortness of breath and quality of life.

* WHAT'S NEW This study aims to sort out controversial findings on whether lung reduction surgery on both lungs is superior to just one lung.

* CAVEATS Risks associated with double lung volume reduction surgery are higher than surgery on just one. It is possible that surgery on one lung followed in two to three years by surgery on the other may provide longer relief from symptoms. The patients in the two study groups did not match in terms of age and progression of the disease, perhaps skewing results. Finally, large numbers of patients did not participate in the follow-up tests.

* BOTTOM LINE People with emphysema may have a better short-term recovery from their symptoms by having lung reduction surgery done on both lungs, provided they don't have risk factors such as age that might lead to complications.

* FIND THIS STUDY June issue of the Annals of Thoracic Surgery or http://ats.ctsnetjournals.org/current.shtml.

HEART DISEASE

Triglycerides are no more indicative of heart disease than cholesterol alone.

* THE STUDY AND RESULTS Researchers in San Francisco investigated the value of measuring the levels of a blood chemical called triglyceride along with cholesterol levels in predicting the development of heart disease. They analyzed data from three previous studies involving close to 80,000 people to see who developed heart problems. The triglyceride levels did not provide any additional information on the risk of heart disease in men compared with the warning signs of high cholesterol levels alone. In one study that involved women, however, those with high cholesterol and triglyceride levels were more likely to develop heart disease than those with only high cholesterol, but the researchers noted that the numbers were small.

* WHAT'S NEW The question of whether high triglyceride levels increase the risk of heart disease has long been disputed and is still inconclusive. This study goes beyond that to ask whether screening for high triglyceride levels is a useful test in conjunction with cholesterol screening for prediction and prevention of heart disease. The researchers conclude that it is not.

* CAVEATS It is still possible that treatment of high triglyceride levels, which was not investigated here, may reduce the risk of heart disease. The results obtained for triglyceride levels in women need to be verified in a larger group. In addition, the study combined studies using different variables, which can affect results.

* BOTTOM LINE The use of triglyceride screening does not appear to improve the diagnosis or treatment of heart disease for men.

* FIND THIS STUDY July 10 issue of the Archives of Internal Medicine or http://archinte.ama-assn.org/.

 

 

 


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