Standing for long periods during pregnancy may curb fetal growth: But working up to 36 weeks has no adverse effect, study suggests

ScienceDaily (June 28, 2012) — Standing for long periods during pregnancy may curb the growth of the developing fetus, suggests research published online in Occupational and Environmental Medicine.

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Previous research has indicated that long working hours may increase the risk of birth defects, premature birth, stillbirth and low birth-weight.

The researchers assessed the fetal growth rates of 4680 mums to be from early pregnancy onwards between 2002 and 2006.

Midway through their pregnancy, the women were quizzed about their work conditions and the physical demands of their jobs, including whether these included lifting, long periods of standing or walking, night shifts and long working hours.

Around four out of 10 (38.5%) of the women spent a long time on their feet and 45.5% had to walk for long periods. Heavy lifting was part of the job for just 6%, while around 4% worked night shifts.

The development of their babies was regularly measured throughout pregnancy, using ultrasound, and then again at birth.

The results showed that physically demanding work and long working hours were not consistently associated with restrictions on overall size or birth-weight, or with premature birth.

And working up to 34 or 36 weeks of pregnancy had no adverse impact on fetal development.

But women who spent long periods on their feet during their pregnancy, in jobs such as sales, childcare, and teaching, had babies whose heads were an average of 1 cm (3%) smaller than average at birth, implying a slower growth rate.

Around half the women (47.5%) worked between 25 and 39 hours a week, while around one in four (23%) worked more than 40 hours a week.

And those who worked more than 40 hours a week had smaller babies than those who worked under 25 hours a week.

Babies born to these women had a head circumference that was 1 cm smaller and a weight that was between 148 and 198 g smaller, on average, than babies born to women working under 25 hours a week. These differences were apparent from the third trimester (last three months of pregnancy) onwards.

The authors comment that generally women who are working outside the home have fewer pregnancy complications, birth defects, and stillbirths than women who are unemployed, but that certain aspects of work may not be without risk.

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Dietary fiber alters gut bacteria, supports gastrointestinal health

ScienceDaily (June 28, 2012) — A University of Illinois study shows that dietary fiber promotes a shift in the gut toward different types of beneficial bacteria. And the microbes that live in the gut, scientists now believe, can support a healthy gastrointestinal tract as well as affect our susceptibility to conditions as varied as type 2 diabetes, obesity, inflammatory bowel disease, colon cancer, and autoimmune disorders such as rheumatoid arthritis.

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As these microbes ferment fiber in the intestine, short-chain fatty acids and other metabolites are produced, resulting in many health benefits for the host, said Kelly Swanson, a U of I professor of animal sciences.

"When we understand what kinds of fiber best nurture these health-promoting bacteria, we should be able to modify imbalances to support and improve gastrointestinal health," he said.

This research suggests that fiber is good for more than laxation, which means helping food move through the intestines, he added.

"Unfortunately, people eat only about half of the 30 to 35 grams of daily fiber that is recommended. To achieve these health benefits, consumers should read nutrition labels and choose foods that have high fiber content," said Swanson.

In the placebo-controlled, double-blind intervention study, 20 healthy men with an average fiber intake of 14 grams a day were given snack bars to supplement their diet. The control group received bars that contained no fiber; a second group ate bars that contained 21 grams of polydextrose, which is a common fiber food additive; and a third group received bars with 21 grams of soluble corn fiber.

On days 16-21, fecal samples were collected from the participants, and researchers used the microbial DNA they obtained to identify which bacteria were present. DNA was then subjected to 454 pyrosequencing, a "fingerprinting" technique that provides a snapshot of all the bacterial types present.

Both types of fiber affected the abundance of bacteria at the phyla, genus, and species level. When soluble corn fiber was consumed, Lactobacillus, often used as a probiotic for its beneficial effects on the gut, increased. Faecalibacterium populations rose in the groups consuming both types of fiber.

According to Swanson, the shifts in bacteria seen in this study--which occurred when more and differing types of fiber were consumed--were the opposite of what you would find in a person who has poor gastrointestinal health. That leads him to believe that there are new possibilities for using pre- and probiotics to promote intestinal health.

"For example, one type of bacteria that thrived as a result of the types of fiber fed in this study is inherently anti-inflammatory, and their growth could be stimulated by using prebiotics, foods that promote the bacteria's growth, or probiotics, foods that contain the live microorganism," he said.

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Going gluten-free: Is the diet a good fit for everyone?

ScienceDaily (June 28, 2012) — One of the latest trends in the food market and among celebrities is going gluten-free. Snack giant Frito-Lay has announced it will introduce new gluten-free labels and products, and Miley Cyrus has credited her recent weight loss to a gluten-free diet.

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Experts at Kansas State University say going gluten-free may be a good choice for some individuals, but that just because a product's label says it's gluten-free doesn't means that it's healthy.

Going gluten-free was an obvious choice for Kathryn Deschenes, a Kansas State University master's student in food science from Ellsworth. She has celiac disease, which runs in her family. The disease is a digestive disorder triggered by eating gluten, a protein found in wheat, barley and rye. Those with celiac disease often experience symptoms like nausea and diarrhea.

"It can have funny symptoms like depression, acid reflux and it can stunt children's growth," Deschenes said.

For the 1 percent of the population with celiac disease, giving up gluten products usually takes away those symptoms. Deschenes went gluten-free in high school and likes the recent gluten-free trend.

"It's been beneficial for the market," she said, adding that it means more companies are producing gluten-free products and labeling their products as such.

But are products labeled "gluten-free" healthier?

Take a good hard look at those labels, recommends Mark Haub, associate professor and interim head of Kansas State University's department of human nutrition in the College of Human Ecology. Haub studies whole grains and dietary fiber.

"Just because a product says it's gluten-free doesn't mean it's healthy," he said.

The gluten-free product likely contains as many calories as gluten options, Haub said, because a gram of sorghum, corn or rice flour appears to be metabolically similar to a gram of wheat flour.

Haub said that gluten isn't bad for the average person.

"People have been eating wheat, rye and barley for thousands of years, and there are people who live to be 100 who eat wheat products and don't seem to exhibit any types of health issues," he said.

Gluten-free diets are now being adopted by people without celiac disease. Haub said as long as they do their research about the diet, he's fine with the trend.

"I'm totally supportive of people selecting and choosing lifestyle habits that best suit their needs and preferences, and this would fit that category," he said.

If someone eats more varieties of vegetables and fruits and engages in portion control of other foods, then this type of gluten-free living may elicit health benefits, he said.

Deschenes cautions that gluten-free is not necessarily a weight-loss program and can be a bad diet if you aren't aware of the things it lacks, such as a sufficient amount of fiber.

To help add more fiber to her diet, Deschenes buys breads with more fiber. She also said you can add flax seed to your diet, which is high in fiber.

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Why does a diet high in DHA improve memory?

ScienceDaily (June 28, 2012) — We've all heard that eating fish is good for our brains and memory. But what is it about DHA, an omega-3 fatty acid found in fish, that makes our memory sharper?

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Researchers with the Faculty of Medicine & Dentistry discovered a possible explanation and just published their findings in the peer-reviewed journal Applied Physiology, Nutrition, and Metabolism.

Principal investigator Yves Sauve and his team discovered lab models fed a high-DHA diet had 30 per cent higher levels of DHA in the memory section of the brain, known as the hippocampus, when compared to animal models on a regular, healthy diet.

"We wanted to find out how fish intake improves memory," says Sauve, a medical researcher at the University of Alberta who works in the department of physiology, the department of ophthalmology and the Centre for Neuroscience.

"What we discovered is that memory cells in the hippocampus could communicate better with each other and better relay messages when DHA levels in that region of the brain were higher. This could explain why memory improves on a high-DHA diet."

Sauve noted it is a key finding that when a diet is supplemented with DHA, that additional stores of the omega-3 fatty acid are deposited in the brain. His team confirmed this finding, a discovery other labs have noted as well.

Supplementing your diet with DHA, such as increasing fish intake or taking supplements, could prevent declining DHA levels in the brain as we age, says Sauve.

This research was funded by Alberta Innovates -- Health Solutions.

Earlier this year, Sauve and other colleagues discovered DHA prevents the accumulation of a toxic molecule at the back of the eye that causes age-related vision loss. He is continuing his research in this area.

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What you eat can prevent arsenic overload

ScienceDaily (June 29, 2012) — Millions of people worldwide are exposed to arsenic from contaminated water, and we are all exposed to arsenic via the food we eat. New research published in BioMed Central's open access journal Nutrition Journal has demonstrated that people who ate more dietary vitamin B12 and animal protein had lower levels of arsenic (measured by deposition in toenails). Total dietary fat, animal fat, vegetable fat and saturated fat were also all associated with lower levels of arsenic, while omega 3 fatty acids, such as those found in fish oil, were associated with increased arsenic.

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Long term exposure to high levels of arsenic is known to cause skin lesions, cancer and cardiovascular disease, and also affects fetal development. Even low concentrations of arsenic are potentially dangerous. Arsenic is found in some water supplies, but more people are exposed via their diet. Staples such as rice contain arsenic, especially the toxic inorganic forms, while fish, although high in total arsenic, contains organic forms which are thought to be less toxic.

Inside the body arsenic is methylated to aid excretion in urine but arsenic also has an affinity for keratin and can be deposited in hair and nails as they grow. Consequently levels of arsenic preserved in nails or hair can be used as a biomarker for arsenic exposure over periods of months to years.

Researchers from Dartmouth College and the Geisel School of Medicine at Dartmouth looked at the levels of arsenic in toenails of residents of New Hampshire who all use private groundwater wells as their household water source.

Results of the study showed that arsenic in nails was positively associated with both alcohol and omega 3 fatty acids, however, lower levels of arsenic were found for people who ate greater amounts of vegetable and animal fat. Prof Kathy Cottingham, who directed the study, explained, "While there may be a direct interaction between fats and arsenic preventing absorption or binding to keratin in nails, the results may simply reflect dietary preference, with people who eat a diet rich in fats not eating foods high in arsenic, such as rice."

Joann Gruber, who led the study, noted that, "Humans can be very efficient at removing arsenic from the body. Improved methylation reduces the amount of inorganic arsenic circulating in the body. Surprisingly, we didn't see a reduction in toenail arsenic with other dietary factors known to be necessary for arsenic methylation such as folic acid. This may be because the population we sampled had adequate amounts of these factors in their diet."

The authors are currently working on similar studies in children, through the Children's Environmental Health and Disease Prevention Center at Dartmouth.

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Easter Island drug raises cognition throughout life span in mice

ScienceDaily (June 29, 2012) — Cognitive skills such as learning and memory diminish with age in everyone, and the drop-off is steepest in Alzheimer's disease. Texas scientists seeking a way to prevent this decline reported exciting results this week with a drug that has Polynesian roots.

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The researchers, appointed in the School of Medicine at The University of Texas Health Science Center San Antonio, added rapamycin to the diet of healthy mice throughout the rodents' life span. Rapamycin, a bacterial product first isolated from soil on Easter Island, enhanced learning and memory in young mice and improved these faculties in old mice, the study showed.

"We made the young ones learn, and remember what they learned, better than what is normal," said Veronica Galvan, Ph.D., assistant professor of physiology at the Barshop Institute for Longevity and Aging Studies, part of the UT Health Science Center. "Among the older mice, the ones fed with a diet including rapamycin actually showed an improvement, negating the normal decline that you see in these functions with age."

The drug also lowered anxiety and depressive-like behavior in the mice, Dr. Galvan said. Anxiety and depression are factors that impair human cognitive performance. Lead author Jonathan Halloran conducted scientifically reliable tests to accurately measure these cognitive components in the rodents.

Venturing into the open

Mice are burrowers that prefer tunnels with walls. To observe behavior, Halloran used an elevated maze of tunnels that led to a catwalk. "All of a sudden the mice are in open space," Halloran said. "It's pretty far from the floor for their size, sort of like if a person is hiking and suddenly the trail gets steep. It's pretty far down and not so comfortable."

Mice with less anxiety were more curious to explore the catwalk. "We observed that the mice fed with a diet containing rapamycin spent significantly more time out in the open arms of the catwalk than the animals fed with a regular diet," Halloran said.

The second test measured depressive-like behavior in the rodents. Mice do not like to be held by their tails, which is the way they are moved from cage to cage. Inevitably they struggle to find a way out. "So we can measure how much and how often they struggle as a measure of the motivation they have to get out of an uncomfortable situation," Dr. Galvan said.

Rapamycin acts like an antidepressant

Some mice barely struggle to get free, but if an antidepressant is administered they struggle a lot more. This behavior is very sensitive to the action of antidepressants and is a reliable measure of whether a drug is acting like an antidepressant, Dr. Galvan said.

"We found rapamycin acts like an antidepressant -- it increases the time the mice are trying to get out of the situation," she said. "They don't give up; they struggle more."

The reductions of anxiety and depressive-like behavior in rapamycin-treated mice held true for all ages tested, from 4 months of age (college age in human years) to 12 months old (the equivalent of middle age) to 25 months old (advanced age).

Feel-good chemicals elevated

The researchers measured levels of three "happy, feel-good" neurotransmitters: serotonin, dopamine and norepinephrine. All were significantly augmented in the midbrains of mice treated with rapamycin. "This is super-interesting, something we are going to pursue in the lab," Dr. Galvan said.

Dr. Galvan and her team published research in 2010 showing that rapamycin rescues learning and memory in mice with Alzheimer's-like deficits. The elevation of the three neurotransmitters, which are chemical messengers in the brain, may explain how rapamycin accomplished this, Dr. Galvan said.

Rapamycin is an antifungal agent administered to transplant patients to prevent organ rejection. The drug is named for Rapa Nui, the Polynesian title for Easter Island. This island, 2,000 miles from any population centers, is the famed site of nearly 900 mysterious monolithic statues.

This study became available online June 28 as a manuscript in press in the journal Neuroscience.

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German court circumcision ban meets wave of criticism

Reuters – Thu, Jun 28, 2012 BERLIN (Reuters) - Germany's foreign minister added his voice on Thursday to a chorus of criticism of a court decision to ban the circumcision of young boys for religious reasons, arguing that such traditions must be permitted in a tolerant society.

"Germany is an open-minded, tolerant country where religious freedom is firmly established and religious traditions like circumcision are considered an expression of religious pluralism," Guido Westerwelle told the daily Bild in an interview to be published in its Friday edition.

A court in Cologne ruled on Tuesday that involuntary religious circumcision should be illegal as it could inflict serious bodily harm on people who had not consented to it.

The ruling, which applies only to the area around the western city of Cologne but sparked fears among Muslims and Jews in particular that other German states could copy the ban, said boys can consciously decide to be circumcised later in life.

According to the court ruling, "the fundamental right of the child to bodily integrity outweighs the fundamental rights of the parents".

Westerwelle said the ruling caused "irritation" around the world after being reported in the international media.

The Turkish newspaper Hurriyet's website said Turkish European Minister Egemen Bagis had criticized the German ruling, saying that circumcision was a matter of freedom of religion and conscience.

"If German judges have a problem understanding this issue, we can send our scientific circumcisers, we can give them lessons in how to circumcise," he was quoted as saying.

"We are ready to make any contribution for a country that is a friend and ally. But it is not possible for us to accept this ruling as a fait accompli ... God willing, this verdict will be changed," Bagis said.

The Central Council of Jews in Germany called the ruling an "unprecedented and dramatic intrusion" on religious freedom and the Central Council of Muslims in Germany called it "blatant and inadmissible interference" in the rights of parents.

Germany's two main Christian churches also criticized the Cologne court ruling, the Catholic Episcopal Conference calling it "extremely disconcerting".

"To ban circumcision is a serious attack on religious freedom," said Catholic Bishop Heinrich Mussinghoff.

The Evangelical Church's Hans Ulrich Anke said: "Religious freedom and parents' right to choose how to educate their children have not been weighed against the fundamental right of the child to bodily integrity".

The United Nations' special rapporteur on religious freedom, Heiner Bielefeldt, told German radio the court's reasoning was "nonsense".

(Edited by Stephen Brown, editing by Tim Pearce)

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Four-in-one AIDS drug gets the OK in clinical trial

Four-in-one AIDS drug gets the …

An experimental once-daily pill that combines four drugs to fight HIV is as safe and effective as commonly-prescribed treatments against the AIDS virus, researchers reported in The Lancet Friday.

Doctors tested the new drug, called Quad, for the third and final phase in which new pharmaceutical products are vetted for safety and effectiveness.

Publication in the British journal follows a recommendation in May by a US Food and Drug Administration (FDA) advisory panel to approve Quad for previously untreated adults infected with HIV-1. A final decision is expected by August.

The first trial entailed testing Quad against a three-in-one pill, Atripla, which since 2006 has been a standard treatment for the human immunodeficiency virus (HIV).

Researchers enrolled 700 patients in centres in North America and assigned them randomly to either Quad or Atripla.

After 48 weeks of treatment, 88 percent of Quad patients had suppressed viral loads to below detectable levels, against 84 percent in the Atripla group.

Side effects were infrequent but similar in both groups. Among Quad patients, mild nausea was the more common adverse event, whereas with Atripla, symptoms were likelier to be dizziness, abnormal dreams or insomnia and skin rashes.

In the second trial, 708 patients were enrolled in Australia, Europe, North America and Europe.

Patients were either given Quad or a widely recommended therapy comprising the molecules atazanavir (ATV), boosted by ritonavir (RTV), together with emtricitabine (FTC) and tenofovir disoproxil fumarate, or TDF.

After 48 weeks, 90 percent of the Quad group had viral levels below detectable levels compared to 87 percent in the other drug group.

Only 3.7 percent of patients in the Quad group stopped treatment because of side effects, compared with 5.1 percent in the other group. On the other hand, the number who reported kidney complications in the Quad group was relatively higher.

Quad comprises FTC and TDF, along with a drug called elvitegravir (ETV), which is designed to inhibit HIV replication. The fourth ingredient is a "pharmacoenhancer" called cobicistat to boost the effectiveness of ETV.

The movement towards a single once-daily pill to suppress HIV has a huge benefit for patients, say AIDS researchers.

When the first antiretroviral drugs emerged in the 1990s, patients had to take a dozen tablets a day or more, a "pill burden" that meant many forgot to follow the entire treatment.

"Patient adherence to medication is vital, especially for patients with HIV, where missed doses can quickly lead to the virus becoming resistant," said Paul Sax of Harvard Medical School, who led the first study in Friday's Lancet.

"Our results provide an additional highly potent, well-tolerated treatment option, and highlight the simplicity of treatment resulting from combining several antiretrovirals in single pill."

Quad is made by the US pharmaceutical giant Gilead Sciences, which also funded the trials, a practice that is relatively common in drug development.

Clinical tests for new drugs have to go through a three-phase process that is scrutinised by independent assessors and government regulators for safety and objectivity. Publication of the research in a peer-reviewed journal is a final step in the procedure.

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German verdict to delay circumcision, not ban it, jurist says

Reuters – Fri, Jun 29, 2012 PARIS (Reuters) - A widely criticized German court verdict on religious circumcision this week aims only to delay the act, not ban it, and is not directed against any faith, a jurist with a leading role in the legal debate said on Friday.

The operation does serious bodily harm and only males old enough to consent to it freely should undergo it, said Holm Putzke, law professor at Passau University in southern Germany.

Using arguments Putzke has published in recent years, a court in the western city of Cologne ruled on Tuesday that the circumcision there of a Muslim boy who suffered post-operative bleeding had violated a German law against causing bodily harm.

Jewish, Muslim, Catholic and Protestant leaders in Germany denounced the ruling as a serious intrusion on religious freedom. Even Germany's foreign minister spoke out, saying such faith traditions must be allowed in a tolerant modern society.

"I can understand that this verdict has irritated people around the world, but this irritation can be resolved if people look at the reasons for it," Putzke told Reuters by telephone.

"Nobody wants to ban religious circumcision in Islam and Judaism, not at all," he said. "It should just be decided by those who undergo it."

Some German media initially reported the verdict applied only to Jews, which may have added to the emotion of some first reactions, he said. Suggesting opposition to circumcision was aimed against Jews was dishonest, he said.

Germany is home to about 4 million Muslims and 120,000 Jews.

Jews circumcise male infants eight days after birth to recall their covenant with God. The time for Muslim circumcision varies according to family, region and country.

The Cologne court ruling said the four-year-old boy in the case was not old enough to consent to have part of his body removed permanently and his parents should have let him decide when he got older. It gave no minimum age for this.

LIVELY DEBATE AMONG DOCTORS

Putzke said an article he published five years ago in a German medical journal led to lively debates among doctors, especially those called on to perform circumcisions.

"It quickly became clear that a large majority of doctors in clinics objected to medically unnecessary circumcisions," he said. "They said they went against the Hippocratic Oath."

The doctor who treated the boy for post-operative bleeding reported the case to the police, leading them to bring charges against the person who performed the faulty circumcision.

The Cologne judge consulted academic articles in legal and medical journals before making his decision, Putzke said.

"This is not simply a verdict from some misguided court," he added. "Somebody sat down and thought long and hard about the fundamental legal rights involved."

The verdict, which is valid only in the Cologne area, could "send a signal," he said, but it was not clear if other courts would follow this example. He did not know of any similar cases before other courts in Germany.

Putzke said he began studying the issue of circumcision and children's rights after his law professor pointed out to him and other students that violence against children was widely condemned in all cases but these.

"Even the Muslim students were surprised by this," he said.

He hoped religious communities would be open to debating the issue and not refuse to consider any change to their traditions.

Putzke expressed surprise that many people had written to him after the court verdict was announced to support his view.

"I've received thousands of emails in the past few days, from all over the world," he said. "The most remarkable thing is that the emails from Israel were the most balanced and moderate."

(Reporting By Tom Heneghan; Editing by Jon Boyle)

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Supreme Court Ruling Sets Stage for Full Rollout of Health-Care Reform Law

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Health Tip: Is Your Pregnancy Higher Risk?

HealthDay – Fri, Jun 29, 2012 (HealthDay News) -- If you're pregnant, a series of physical and demographic factors may dictate that your pregnancy is "high-risk" and requires special care.

The Womenshealth.gov website offers these examples of factors that can make a pregnancy high-risk:

Being young or being older than age 35.Being underweight or overweight.Having had complications during a prior pregnancy.Having had at least one chronic health problem before pregnancy, such as diabetes, high blood pressure, cancer, HIV or an autoimmune disorder.Expecting twins or triplets, etc.

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Study of Retired NFL Players Finds Evidence of Brain Damage

HealthDay – Fri, Jun 29, 2012 FRIDAY, June 29 (HealthDay News) -- Tests performed on a group of retired NFL players revealed that more than 40 percent suffered from problems such as depression and dementia, adding to a growing pile of evidence that repeated sports-related head traumas can lead to lasting neurological issues.

Analyzing 34 ex-professional football players (average age 62) on benchmarks such as memory, reasoning, problem-solving and behavior, researchers from the Center for Brain Health at the University of Texas at Dallas found that 20 tested normal while the rest suffered from depression, various deficits in memory/thinking or a combination of these issues. Twenty-six of the players also underwent MRI scans.

"We picked up that many guys were depressed but didn't know it," added study author Dr. John Hart, medical science director at the center. "The cognitive impairments . . . were more than what's expected for their ages. A lot had damage to their brain's white matter, so for us it's a real clue or marker to look for."

Hart is scheduled to present the findings Friday at the National Athletic Trainers' Association (NATA) annual meeting in St. Louis. Research presented at scientific meetings should be considered preliminary until it is published in a peer-reviewed medical journal.

An estimated 300,000 sports-related concussions occur in the United States each year, and mounting attention is being paid to the neurological toll of those injuries on former professional athletes. In June, a massive bundle of lawsuits representing more than 2,100 National Football League players was filed against the league, claiming that the NFL hid information linking football-related head injuries to permanent brain damage.

Hart's study involved ex-NFL athletes hailing from the North Texas region. For comparison purposes, the researchers also looked at the brains of 26 people with no signs of mental deficits, selected from the general population and matched for age, education and IQ.

Of the eight former players who were found to have depression -- the finding that most surprised Hart -- most didn't exhibit the mood issues such as sadness that are typically associated with the condition, he said.

Instead, "there was a lack of energy, initiative or sex drive and disrupted sleep, with weight gain or loss," Hart said. "They would ruminate or get anxious about stuff, but they weren't crying. They were shocked or surprised

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