Are Multivitamins Just a Waste of Money?

Are Multivitamins Just a Waste of Money?

About one in three Americans take a multivitamin. Is that helpful, harmful, or just a harmless waste of money? In 2011, the Iowa Women’s Health Study reported that multivitamin use was associated with a higher risk of total mortality, meaning that women who took a multivitamin appeared to be paying to live shorter lives. But this was just an observational study—researchers didn’t split women up into two groups and put half on multivitamins to see who lived longer. All they did was follow a large population of women over time, and found that those that happened to be taking multivitamins were more likely to die. But maybe they were taking multivitamins because they were sick. The researchers didn’t find any evidence of that, but ideally we’d have a randomized, double-blind, placebo controlled trial, where thousands were followed for over a decade, with half given a multivitamin and half a placebo. That’s what we got the following year in 2012 with theHarvard Physicians’ Study II. And after a decade, the researchers found no effect on heart attack, stroke, or mortality.

The accompanying editorial concluded that multivitamins are a distraction from effective cardiovascular disease prevention. The message needs to remain simple and focused: heart disease can be largely prevented by healthy lifestyle changes.

The researchers did, however, find that for men with a history of cancer, the multivitamin appeared to be protective against getting cancer again, though there was no significant difference in cancer mortality or cancer protection in those who’ve never had cancer before. Still, that’s pretty exciting. It is just one study, though. Ideally we’d have maybe 20 of these placebo-controlled trials and then compile all the results together. That’s what we got in 2013—a meta-analysis of randomized controlled trials that analyzed twenty-one trials and more than 90,000 individuals. The analysis found no influence on mortality either way. Some found more cancer mortality, some found less cancer mortality, but all in all it was a wash.

And that was heralded as good news. After the Iowa Women’s Health Study came out we were worried multivitamins could be harming millions of people, but instead they don’t appear to have much effect either way. The accompanying editorial asked whether meta-analyses trump observational studies. The Iowa Women’s Health Study followed tens of thousands of women for nearly 20 years. What if we put all the studies together, the big observational studies along with the experimental trials? And that’s what we got in December 2013. The reviewfor the U.S. Preventive Services Task Force, highlighted in my video, Should We Take a Multivitamin? found that multivitamins appear to offer no consistent evidence of benefit for heart disease, cancer, or living longer.

But aren’t vitamins and minerals good for us? One explanation for this result could be that our bodies are so complex that the effects of supplementing with only one or two components is generally ineffective or actually does harm. Maybe we should get our nutrients in the way nature intended, in food.

The accompanying editorial to the December 2013 review concluded that enough is enough. We should stop wasting our money on vitamin and mineral supplements. Americans spend billions on vitamin and mineral supplements. A better investment in health would be eating more fruits and vegetables. Imagine if instead we spent those billions on broccoli?

I’ve previously addressed multivitamins in my videos Are Multivitamins Good For You? and Multivitamin Supplements and Breast Cancer (with a follow-up in my Q&A Is multivitamin use really associated to an increased risk of breast cancer?). I also touched on potential risks in Dietary Theory of Alzheimer’s.

With the exception of vitamins D and B12 (Vitamin Supplements Worth Taking), we should strive to get our nutrients from produce, not pills.

What about fish oil supplements? Check out Is Fish Oil Just Snake Oil?

-Michael Greger, M.D.

Boosting the immune system to treat brain cancer

A-New-Approach-for-Treating-Brain-CancerResearchers identify mechanism implicated in brain cancer and a drug that decreases brain tumor growth.

Researchers at the University of Calgary’s Hotchkiss Brain Institute (HBI) have made a discovery that could lead to better treatment for patients suffering from brain cancer. Despite current treatment strategies, the median survival for patients with the most aggressive brain cancer – called glioblastoma, is 15 months. Less than five per cent of patients survive beyond five years.

HBI member V. Wee Yong, PhD and research associate Susobhan Sarkar, PhD, and their team including researchers from the Department of Clinical Neurosciences and the university’s Southern Alberta Cancer Research Institute, looked at human brain tumour samples and discovered that specialized immune cells in brain tumour patients are compromised. The researchers took this discovery and, in an animal model, identified a drug that is able to re-activate those immune cells and reduce brain tumour growth, thereby increasing the lifespan of mice two to three times. Their discovery will be published December 8th in the prestigious journal Nature Neuroscience.

Our brains normally contain specialized cells, called microglia, that defend against injury or infection. “Microglia are the brain’s own dedicated immune system,” explains Yong. “And in this study, we have formally demonstrated for the first time that these cells are compromised in living brain tumour patients.” As with other forms of cancer, brain tumours start as individual stem-like cells – called brain tumour initiating cells (BTICs). These cells quickly divide and grow, eventually forming a mass, or tumour. Yong and his team have discovered that the tumour disables microglia, permitting the rapid proliferation of BTICs, which ultimately leads to brain tumour growth.

“We refer to this as the battle for the brain, in which early on in the disease, the microglia are trying to destroy the brain tumour initiating cells,” says Yong. “But over the course of time, the tumour disables the microglia and we start to see more initiating cells and more rapid tumour growth. We have sought to tip the battle in favour of the brain to suppress the tumour.”

In addition to discovering this mechanism, Yong and Sarkar also identified a drug – amphotericin B (AmpB) – to reactivate microglia that in an animal model, showed a significant reduction in brain tumour growth. “This drug was able to re-activate the disabled microglia,” says Sarkar, “thus restoring the body’s natural defense mechanisms and restricting the growth of brain tumour initiating cells.”

The drug they identified is a powerful agent that is already used clinically to treat severe fungal infections of the brain and spinal cord. “It’s a rather harsh medication,” says Yong. “But we have demonstrated that this drug can be used in very small doses where it is not only well tolerated, but it is also effective in re-programming microglia.” Yong and Sarkar hope this discovery will lead to clinical trials and ultimately to a new standard of care for brain tumour patients.

The finding has already garnered attention from researchers across Canada, including internationally recognized brain tumour scientist and neurosurgeon Dr. James Rutka. “This research is highly significant as it implies that a commercially available drug, amphotericin B, which has never been used before for patients with gliomas, may be a novel treatment to consider in future trials of patients with this frequently lethal cancer,” says Dr. Rutka, Professor and Chair, Department of Surgery, University of Toronto.

The funding was provided by Alberta Innovates – Health Solutions/Alberta Cancer Foundation. V. Wee Yong is a Canada Research Chair in Neuroimmunology.

Source: Innovations Report

Nearly 50 percent of physicians believe diversion of ADHD stimulant medications among teens is a problem

Stress

Two recent studies examined physicians’ perceptions and knowledge of diversion of stimulant medications for Attention Deficit Hyperactivity Disorder as well as practices physicians use to prevent diversion among their patients prescribed these medications.

The results showed that while almost half of all physicians surveyed believe diversion is common among teens with ADHD, the majority never received training on the topic. Furthermore, about one-third of physicians rarely counsel teens about the health and legal consequences of diverting stimulating medication and don’t feel qualified to do so.

“Diversion of stimulation medications for ADHD by high school and college students is widespread as those with ADHD are often sharing pills with their peers, who don’t have the condition, to try to improve their academic performance,” said Andrew Adesman, MD, senior investigator and chief of developmental behavioral pediatrics at Cohen Children’s Medical Center of New York. “Many pediatric colleagues don’t feel adequate in counseling their ADHD patients about diverting stimulant medications or are unfamiliar with some of the legal and health consequences of non-ADHD patients taking an unprescribed controlled substance.”

The survey analyzed responses from 815 physicians who specialize in ADHD — child neurologists, child psychiatrists and developmental pediatricians. In the past 12 months, 59 percent of physicians suspected some of their teen ADHD patients were diverting their medications and 54 percent believed some patients were exaggerating symptoms to obtain stimulation medications to divert. When evaluating teens for an initial diagnosis of ADHD, 66 percent of doctors suspected that some patients were trying to obtain stimulant medication to improve academic performance. Surveyed doctors also believed patients wanted the medication to either lose weight (40 percent), get high (38 percent) or divert their stimulant medication to others (39 percent).

The study also showed that the majority of physicians received no training on prevention of prescription drug diversion in medical school (73 percent), residency (57 percent) or fellowship (51 percent).

When physicians were asked if there is a difference in the legal consequence of selling vs. giving away stimulant medication, 19 percent chose the wrong answer and 36 percent were unsure. Dr. Adesman said that “in the eyes of the law, there is no difference between someone giving away a pill or selling one; they are both prosecuted as unlawful distribution of a controlled substance.”

As far as health risks, he also noted that, “A patient taking an ADHD medication has been titrated up to a certain dose over time. If someone else takes another person’s dose it can be risky because there is no health history and medication naiveté can lead to potential risks, especially if there is an underlying heart condition.

“While many prevention strategies can be used to prevent diversion of stimulant medication- informational brochures, a medication contract, pill counts, limiting pill quantities, counseling and other methods, our research showed that while doctors are encouraged to use many of these strategies, most MDs don’t believe the strategies to be effective,” Dr. Adesman said. “It is important that physicians treating patients with ADHD are continually educated about stimulant diversion problems and become active in mitigating this from happening.”


Story Source:

The above story is based on materials provided by North Shore-Long Island Jewish (LIJ) Health SystemNote: Materials may be edited for content and length. / Science Daily / Photo Credit: Huffington Post

 

The Legacy of HeLa

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by Lisa Winter

Henrietta Lacks was integral to the formulation of the polio vaccine, cloning, mapping genes, biomedical ethics, the field of virology, and many other facets of modern medicine. But, she never looked down a microscope. She never invented anything. She never authored a scientific paper. She was not a scientist of any kind. Why is she featured on this website? In 1951, before she lost her fight with cervical cancer, samples were taken from her body, and that cell line is still alive today.

Traditionally, human cells had been difficult to culture. They died after a few short days, prohibiting long term experiments. However, when Dr. George Gey of Johns Hopkins University collected cells from Henrietta Lacks (and abbreviated the tube as HeLa), a lineage of cancer cells was discovered that had incredible resilience. The cells grew so quickly and readily, they were able to be distributed to scientists around the world for experimentation free of charge — without Henrietta’s knowledge or consent. At the time, bioethical standards were starting to come together. While informed consent may have been recommended, it was not required. The samples which had an abnormal longevity were eventually sent to laboratories around the world without the knowledge or consent of Henrietta or her family.

Why are these cells considered “immortal”? When DNA replicates, the telomeres at the end of chromosomes shorten with every round. After about 50 divisions, typical human cells reach what is known as the Hayflick Limit, where the telomeres have become too short to divide, and the cell undergoes apoptosis. Cancer cells do not respond in the same way. This, combined with the natural strength of Henrietta’s cells, has resulted in a cell lineage that has remained hardy throughout the years.

As of today, Henrietta’s cells have lived outside her body for over 60 years; twice as long as they lived inside her body. There are now other long lasting human cell lineages studied by scientists, but HeLa cells were the first, and continue to be the most popular.

As genomic sequencing has become more commonplace, questions about the Lacks family’s privacy have come to the forefront. Earlier this year, papers published HeLa’s genome without first getting authorization from the family. After months of negotiations, it was announced last month that research dealing with the sequence can continue. The only caveat is that the work has to promote the greater good for humanity and researchers must do whatever they can to ensure the Lacks’ privacy.

Read more at http://www.iflscience.com/health-and-medicine/legacy-hela#gl6OFxK6UtRuvut2.99

Drug-antibody pair has promising activity in non-Hodgkin lymphoma

A toxin linked to a targeted monoclonal antibody has shown “compelling” antitumor activity in patients with non-Hodgkin lymphomas who were no longer responding to treatment, according to a report from Dana-Farber Cancer Institute.

The ongoing open-label phase 2 study presented at the American Society of Hematology (ASH) meeting was designed to test the activity of
brentuximab vedotin (Adcetris) in relapsed or refractory non-Hodgkin lymphoma (NHL) including B-cell cancers such as diffuse large B cell lymphoma (DLBCL).

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The antibody-toxin compound has been approved for treatment of relapsed or refractory Hodgkin lymphoma and anaplastic T cell lymphoma, and its success prompted the trial in NHL, said Eric Jacobsen, MD, of Dana-Farber, senior author of the study. First author is Nancy Bartlett, MD, of Washington University School of Medicine.
To date, the trial has enrolled 62 patients with B-cell lymphomas, including 44 diagnosed with DLBCL. Most the patients were no longer responding to previous therapy, and 23 percent had never responded to any treatment.

Forty percent of the 43 evaluable DLBCL patients had an objective response to the drug with a median duration of 36 weeks, including some of more than eight months. Seven had complete remissions and 10 had partial remissions. In the other B-cell lymphoma patients, 22 had an objective response. Continue reading

A Common Liver Drug Could Be Key to Curing Parkinson’s

The tragedy of Parkinson’s, which progressively robs patients of their physical abilities, is that while certain drugs, therapies and devices can restore some quality of life, so far we haven’t found a way to stop brain cells from dying. Now, researchers in the UK and Norway have found a drug that could keep brain cells functioning normally — and it’s been used to treat liver disease for years.

Since UDCA has been in use for many years, researchers can move directly to clinical trials to determine the drug’s safety and optimum dosage in Parkinson’s patients. And for the first time, researchers can point to compounds that tackle the cellular cause of the disease, rather than simply treating the symptoms as they appear. [The University of Sheffield via ScienceDaily]

Toward broad-spectrum antiviral drugs for common cold and other infections

Scientists are reporting progress in the search for the first broad-spectrum drugs to combat human rhinoviruses (HRVs), which cause humanity’s most common infectious diseases. Their study on these potential drugs for infections that include the common cold appears in the journal ACS Medicinal Chemistry Letters.

 

Angus MacLeod and colleagues note that although many HRV infections cause mild disease, they can lead to dangerous complications for millions of people with asthma and chronic obstructive pulmonary disease.

Previous potential drugs for HRV either didn’t work or caused unacceptable side effects, leaving only one potential drug still under development in clinical trials. MacLeod’s team set out to find new antiviral candidates to meet this serious health challenge.

Continue reading