The Big fight

A study in diabetes care reported that a low-fat vegan diet may be better at managing Type 2 diabetes than traditional diets.

A vegan diet is plant-based and consists of vegetables, fruits, grains, and legumes and avoids animal products, such as meat and dairy. However, people are on a vegan diet are at risk for vitamin B12 deficiency. Which is the reason a recent study by some Mumbai-based researchers claimed that vegetarians are at a higher risk for developing coronary artery disease. The vitamin B12 8212; found in animal foods like dairy, eggs, meat, poultry, fish etc 8212; helps keep down homocysteine an artery damaging amino acid levels. Vegetarians by that logic have low vitamin B12 levels and therefore are 8220;at risk8221;.

Fishing for proof

Fish for long had raised the bogeys of lead and mercury poisoning, never mind the good effects of Omega 3 fatty acids. Over decades, studies have reported that seafood exposes people to large amounts of dioxins, polychlorinated biphenyls PCBs and other harmful organic chemicals. Even now, because of methyl mercury concerns, FDA guidelines advise women who are nursing, pregnant or plan to become pregnant, as well as children age 12 and younger, to refrain from eating swordfish, shark, tilefish and king mackerel. But two new studies in October pointed to significant benefits from fish 8212; for both young and the old. In adults, the death rate from heart disease was 36 per cent lower among those who ate fish twice a week compared with those who ate little or no seafood, said a study by Harvard School of Public Health researchers in the Journal of the American Medical Association. A second report released by the Institute of Medicine IOM echoed the conclusion that the heart benefits of eating seafood outweigh the risks and said infants also benefit from the healthy fats found in seafood. As for pregnant women and the other risk groups, they can safely consume up to 12 ounces of other fish per week, the researchers said, but they should also limit white albacore tuna to six ounces a week because of its high levels of methyl mercury, which can be toxic to the brain and hearing.

Coffee? Too complicated

One large study of 128,000 men and women showed no increase in the risk of heart disease from drinking filtered coffee. The findings 8212; published on May 2 in the journal Circulation indicated that it didn8217;t matter how much coffee participants drank.

But another study of 4,000 coffee drinkers published in March in the Journal of the American Medical Association held that two or more cups of coffee a day can increase the risk of heart disease in people with a specific genetic mutation that slows the breakdown of caffeine in the body.

Conversely, a cup a day helps prevent cirrhosis of the liver, some researchers said. A large study found that one cup of coffee per day cut the risk of alcoholic cirrhosis by 20 per cent. Four cups per day reduced the risk by 80 per cent.

8220;One study makes headlines and people think it is the truth. Whether coffee has any such benefits needs to be seen,8221; said Ishi Kosla, clinical nutritionist and director, Whole Foods.

Friend of the heart

A large data analysis by Cleveland Clinic released in November, reported that blood clotting is four to five times more likely to occur in patients getting drug-coated heart devices known as stents, compared to the older bare-metal variety. Stents are tiny wire-mesh devices used to prop open heart arteries and keep them free of clots that can lead to heart attacks. The analysis came a week before a US Food and Drug Administration panel of experts met to discuss stent thrombosis, or potentially fatal blood clotting long after the devices are implanted. The study in the American Journal of Medicine said that trials using the stents found a small, but real hazard of late stent thrombosis with drug-eluting stents more so than with bare-metal stents. Soon enough, shares of companies that manufacture drug-coated stents fell.Thankfully, a week later, FDA ruled that the benefits of drug coated stents outweigh any risk they might have.

Ethics question in HIV trials

A debate over clinical trials in developing countries moved suddenly into public domain, when an editorial in the New England Journal of Medicine criticised studies designed to test the efficacy of anti-retroviral drugs in reducing mother-to-infant transmission of HIV. The editorial objected to the trials because they included placebo-control groups, in which HIV-infected pregnant women were given a dummy pill rather than the drug zidovudine AZT. The criticism was especially pointed because in 9 of the 15 trials then underway, funding had been provided by the US health agencies 8212; the National Institutes of Health NIH and the Centers for Disease Control and Prevention CDC.

And what about that MS drug?

The death of a woman participating in drug trial raised questions about ethics of the trials but later a study found the drug effective. A commentary in March in Lancet had experts fighting over whether a woman, who died of a rare infection after participating in a trial for the Multiple Sclerosis MS drug Tysabri, should have been included in the study in the first place. The patient was suspected of having MS but showed no symptoms, and was later found not to have had MS. Researchers quickly halted the trial and Biogen Idec and Elan Corporation, the drug8217;s makers, heeded a US Food and Drug Administration advisory and withdrew Tysabri from the market 8212; just three months after its fast-track approval for cases of especially tough-to-treat Multiple Sclerosis. However, a research published in the October issue of the New England Journal of Medicine found the drug to be safe and effective, at least for the short term. And after a long investigation, an FDA advisory committee announced that it will meet to see if marketing of the drug can be allowed.