Health & Wellness for a LIFETIME
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Archive:
- 2012
- January (11)
- PFC Lowers Antibodies!
- People Don't Stop Smoking After Seing Plaque in Carotids!
- Pharmaceutical Companies and Physicians
- Importance of Vitamin D
- Statin Drugs and Diabetes
- Heart Attacks and Long Distance Running
- Wasted Research Money?
- Nicotine Patch Ineffective
- So How Much Exercise Can You Squeeze In?
- Neti-Pot Problems
- AHA Study: Heart Disease Increasing
- 2011
- December (11)
- Cranberries vs. Antibiotics for UTI
- Antioxidants Reduce Cancer Risk
- Back Surgery: Too Many, Too Costly, Too Ineffective!
- Simvastin (Zocor, Vytorin, Simcor) Danger
- Physicians Rate Insurance Companies
- Anti-coagulant Drug Problems
- Bad News about Stop Smoking Drug
- Antibiotics: Inappropriately Used
- Exercise More Important Than BMI
- Pediatric Antibiotis: Over Prescribed?
- FDA Criticized Dr. Oz But Was It Fair?
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A recent study published in Health Affairs titled, "Survey Shows that at Least Some Physicians Are Not Always Honest With Patients" provides results from a 2009 survey of 1891 practicing physicians nationwide assess how widely phsycians endore and follow honest disclosure with their patients. Here are the results:
- Approximately 33% of physicians did not completely agree with disclosing serious medical errors to patients.
- Almost 20% did not completely agree that physicians should never tell a patient something untrue
- Just over 10% said they had told a patient something untrue over the past year.
- 20% said they had not fully disclosed a medical mistake to patient in the past year for fear of getting sued.
- Nearly 40% did not completely agree that they should disclose their financial relationships with drug and device companies to patients.
Comment: I personally find these results shocking. I always felt that most doctors are honest with high integrity and truly want to help their patients. Looks like ego and fear are standing in the way of some of them. There was an article authored by a medical doctor about three years ago in the NY Times who worked for the drug industry giving lectures on the value of their drugs. In the article, he noted that there are about 200,000 US physcians paid by companies to promote their drugs. Based on the numbers from the Department of Labor, that accounts for about 30% of practicing physcians out hocking drugs. Don't you think that should be disclosed to patients who are being prescribed certain drugs?
High Intake of White Rice Associated with Excess Risk for Type 2 Diabetes
This finding was particularly marked in Asian populations.
White rice — which is almost entirely starch — is the main type of rice eaten worldwide and has a higher glycemic index than other grains. High consumption of foods with high glycemic indexes is associated with excess risk for type 2 diabetes. In this meta-analysis of seven prospective cohort studies, investigators assessed the association between white rice intake and risk for type 2 diabetes mellitus.
Of 352,000 participants, 13,000 developed type 2 diabetes (follow-up range, 4–22 years). Among Asian populations, there was a significant 55% increased risk for type 2 diabetes in the highest category of white rice intake compared with the lowest category. In contrast, among Western populations, a 12% increase in risk was not statistically significant. Combining these populations, each serving per day increment of white rice consumption was associated with an 11% increased risk for type 2 diabetes.
Comment: Although this meta-analysis showed that high intake of white rice was associated with excess risk for type 2 diabetes in Asian populations, the association does not prove that rice is more diabetogenic than other starches. For example, mean white rice intake in Asian populations was far higher (3–4 servings daily) than in Western populations (1–2 servings weekly), and rice comprises a smaller proportion of overall glycemic load in Western than in Asian populations. In any case, people should limit their intake of starchy foods and employ other measures (e.g., exercise, weight control) to lower their risk for type 2 diabetes.
Frequent Use of Nonaspirin NSAIDs May Raise Risk for Inflammatory Bowel Disease
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) are known to disrupt the intestinal epithelial barrier. This disruption may alter the interaction between gut microbes and immune cells and, secondarily, may raise risk for inflammatory bowel disease (Crohn disease [CD] or ulcerative colitis [UC]). To assess this potential relation, researchers analyzed data from 76,795 women participating in the Nurses' Health Study who, in 1990 (when mean age was 57), answered questions about use of aspirin and other NSAIDs.
During 18 years of follow-up, 123 new cases of CD and 117 new cases of UC were documented. Aspirin use was not significantly associated with the incidence of these conditions. Use of other NSAIDs for 
15 days per month showed a small but statistically significant association with incident CD and UC (age-adjusted absolute increases of 6 and 7 cases per 100,000 person-years, respectively, compared with nonuse of NSAIDs). In multivariate analysis, the association failed to meet significance for CD but remained significant for UC.
Comment: Frequent use of nonsteroidal anti-inflammatory drugs, but not of aspirin, was associated with a small increase in absolute risk for incident ulcerative colitis in this study. However, as the authors note, the magnitude of this risk was so small that it probably should not influence decisions about prescribing NSAIDs. One possibility, dismissed as unlikely by the authors, is that some of these cases represented NSAID enteropathy (which can occur in the small bowel and colon) and not inflammatory bowel disease. However, it is a known fact that NSAIDs can cause liver and kidney problems. Now we can add IBD to the list. So are you better off with or without NSAIDs?
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Featured in Journal Watch: Value of Asking About Family History of Heart Disease
Systematically asking primary care patients to report such histories substantially increased the percentage identified as having high CV risk.
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