Sug­ary soft drinks in­crease risk of de­vel­op­ing gout, says study

The Weekend Australian - Travel - - Health -

THE PULSE

Com­piled by Dr Chris­tine White SUG­ARY soft drinks could be harm­ing more than our waist­lines. In the Bri­tish Med­i­cal Jour­nal this week, a new study has found that men who drink sugar-sweet­ened soft drinks are more likely to de­velop gout — an ex­tremely painful joint dis­ease caused by ex­cess uric acid in the blood. The usual di­etary ad­vice for gout suf­fer­ers is to re­strict in­take of meat and al­co­hol, but the au­thors sug­gest that soft drinks should now be added to the list. The study in­volved 46,393 men aged 40 years and over with no his­tory of gout. At the start of the study, and then ev­ery two years, par­tic­i­pants com­pleted a di­etary sur­vey and were given a med­i­cal ex­am­i­na­tion. Over the fol­low­ing 12 years, there were 755 cases of gout. The risk of de­vel­op­ing the dis­ease was 85 per cent higher among men who con­sumed two or more serv­ings of sugar-sweet­ened soft drinks per day com­pared to those who con­sumed less than one serv­ing per month. Diet soft drinks were not as­so­ci­ated with an in­creased risk of gout. BMJ 2008;doi:10.1136/bmj.39449.819271.BE (Choi HK, et al) FO­LATE— a form of vi­ta­min B found in green leafy veg­eta­bles and of­ten added to break­fast ce­re­als and bread — may be just as im­por­tant for the el­derly as it is for de­vel­op­ing ba­bies. New re­search in the Jour­nalof Neu­rol­ogy,Neu­ro­surgeryandPsy­chi­a­try has shown that fo­late de­fi­ciency may triple the risk of de­men­tia in older peo­ple. Re­searchers re­cruited 518 peo­ple aged over 65. At the be­gin­ning and end of the two-year study, blood sam­ples were tested for lev­els of fo­late and other nu­tri­ents, and par­tic­i­pants were as­sessed for signs of de­men­tia. At the start of the study, 3.5 per cent of par­tic­i­pants were fo­late de­fi­cient, and all were free from de­men­tia. Over the next two years, 45 peo­ple de­vel­oped the dis­ease. Those who were fo­lat­ed­e­fi­cient at the start of the study were nearly 3.5 times more likely to de­velop de­men­tia than those with nor­mal lev­els. The find­ings sug­gest that fo­late sup­ple­ments could help to pro­tect the brains of el­derly peo­ple with poor nu­tri­tion. JNeu­rolNeu­ro­surgPsy­chi­a­try 2008;doi:10.1136/jnnp.2007.131482 (Kim JM, et al) EM­PLOY­ERS are re­quired to train their em­ploy­ees in how to han­dle heavy loads, but a new study in the Bri­tishMed­i­calJour­nal has found that such train­ing does noth­ing to pre­vent back in­juries. Re­searchers ex­am­ined the re­sults of 11 sep­a­rate stud­ies, in­volv­ing a to­tal of 18,492 peo­ple. Eight stud­ies were con­ducted with health work­ers who han­dled pa­tients, and three stud­ies in­volved bag­gage han­dlers or postal work­ers. Each of the stud­ies had one group that re­ceived stan­dard train­ing in lift­ing and mov­ing heavy loads. Those in the con­trol groups ei­ther re­ceived no train­ing, min­i­mal train­ing or phys­i­cal ex­er­cise, or were given a belt to sup­port their back while lift­ing. Com­pared to the con­trol treat­ments, stan­dard train­ing had no ef­fect on the in­ci­dence of back pain in work­ers. The au­thors con­clude that more re­search is needed to dis­cover how stresses at work can lead to back pain, and to de­velop new meth­ods of back in­jury pre­ven­tion. BMJ 2008;doi:10.1136/bmj.39463.418380.BE (Mar­timo KP, et al) DRUGS could soon be de­liv­ered pain­lessly through the skin, with sci­en­tists de­vel­op­ing a new type of patch cov­ered with tiny nee­dles. In the Pro­ceed­ing­soft­heNa­tion­alA­cade­myof Sci­ences this week, they claim that the ‘‘ mi­cronee­dle’’ patch could be used to de­liver drugs and vac­cines that can­not nor­mally cross the skin’s tough outer layer. Re­duc­ing the need for stan­dard in­jec­tions would not only please nee­dle-pho­bic pa­tients, but also de­crease the risk of trans­mit­ting in­fec­tious dis­eases, say the au­thors. They used the mi­cronee­dle patches to pain­lessly punch a grid of 50 mi­cro­scopic holes in the skin of six vol­un­teers. A gel con­tain­ing the anti-ad­dic­tion drug nal­trex­one was then ap­plied to the same area of skin. Over the next 72 hours, blood lev­els of the drug were as high as that seen with oral de­liv­ery, but us­ing a lower dose and with fewer side ef­fects. Three con­trol pa­tients who re­ceived the gel with­out the mi­cronee­dle patch had no nal­trex­one in their blood. ProcNatlA­cadS­ciUSA 2008;105:2058-2063 (Wer­mel­ing DP, et al) PAR­ENT­ING lessons do not im­prove tod­dler be­hav­iour, ac­cord­ing to a new Aus­tralian study in the Bri­tishMed­i­calJour­nal . Led by doc­tor Harriet His­cock from the Cen­tre for Com­mu­nity Child Health at the Royal Chil­dren’s Hospi­tal in Melbourne, the re­search team de­signed a par­ent­ing pro­gram that aimed to pre­vent child be­hav­iour prob­lems, such as de­fi­ance and ag­gres­sion, as well as im­prove par­ent­ing and ma­ter­nal men­tal health. A to­tal of 733 moth­ers of eight­month-old in­fants par­tic­i­pated in the study and were ran­domly as­signed to re­ceive ei­ther the pro­gram (three ses­sions at ages eight to 15 months) or usual care from their lo­cal ma­ter­nal and child health cen­tre. By age 24 months, par­ents on the pro­gram were less likely to re­port abu­sive par­ent­ing and un­rea­son­able ex­pec­ta­tions of their child, but there was no im­prove­ment in ma­ter­nal dis­tress or tod­dler be­hav­iour. Fur­ther stud­ies are needed to as­sess whether such pro­grams can im­prove be­hav­iour in later child­hood. BMJ 2008;doi:10.1136/bmj.39451.609676.AE (His­cock H, et al) BLOOD pres­sure drugs known as cal­cium chan­nel block­ers could also re­duce the risk of Parkin­son’s dis­ease, con­cludes a study in the latest is­sue of Neu­rol­ogy . The study in­volved 7374 men and women aged over 40. Half of the group had Parkin­son’s dis­ease and the other half did not. Those who were cur­rently longterm users of cal­cium chan­nel block­ers to treat high blood pres­sure had a 23 per cent lower risk of Parkin­son’s dis­ease com­pared to nonusers. There was no such ef­fect among peo­ple tak­ing other blood pres­sure drugs such as ACE in­hibitors and beta block­ers. Ac­cord­ing to th­ese find­ings, dis­cov­er­ing how cal­cium chan­nel block­ers pro­tect against Parkin­son’s dis­ease could lead to new treat­ments. Neu­rol­ogy 2008;doi:10.1212/01.wnl. 0000303818.38960.44 (Becker C, et al) Want to know more? Items are ref­er­enced where pos­si­ble. A ref­er­ence such as ‘‘ 2007;35:18-25’’ means the source ar­ti­cle was pub­lished on pages 18-25 in vol­ume num­ber 35 of the pub­li­ca­tion, in 2007. A doi num­ber or web­site ad­dress is used for re­search pub­lished on a jour­nal’s web­site.

Lift­ing: Train­ing pro­grams are not work­ing

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