Posts tagged with "Cleveland Clinic"

Paleo Diet linked to heart disease biomarker

July 23, 2019

If you are not living the life of a hunter-gatherer, you probably shouldn’t be eating that way, results of a study have found.

Indeed, more than twice the amount of a key biomarker linked closely to heart disease has been found in the blood of people who adhere to the Paleo Diet.

Researchers from Edith Cowan University in Perth, Australia have just completed the world’s first major study examining the impact of the Paleo Diet on gut bacteria.

The controversial Paleo (or “caveman”) Diet advocates eating meat, vegetables, nuts and limited fruit, therefore excluding grains, legumes, dairy, salt, refined sugar and processed oils.

ECU researchers compared 44 people who adhered to the diet with 47 who were following a traditional Australian diet.

They measured the amount of trimethylamine-n-oxide (TMAO) in the participants’ blood. High levels of TMAO, an organic compound produced in the gut, are associated with an increased risk of cardiovascular disease—including heart attack, stroke, and death in patients who otherwise appear to be healthy, according to pioneering research conducted at the Cleveland Clinic in 2015. 

About 610,000 people die of heart disease in the United States every year, according to the Centers for Disease Control and Prevention. That equates to one in every four deaths.

Lead researcher Dr. Angela Genoni from ECU’s School of Medical and Health Sciences said: “Those who promote the Paleo Diet often cite it as beneficial for your gut health, but this research suggests there were adverse differences in those who followed the dietary pattern.”

She said the reason TMAO was so elevated in people on the Paleo Diet appeared to be due to the higher intake of red meats, but also because of the lack of whole grain intake.

“The Paleo Diet excludes all grains and we know that whole grains are a fantastic source of resistant starch, and many other fermentable fibers [that] are vital to the health of your gut microbiome,” Dr Genoni said.

“Because TMAO is produced in the gut, a lack of whole grains might change the populations of bacteria enough to enable higher production of this compound.

“Additionally, the Paleo Diet includes greater servings per day of red meat, which provides the precursor compounds to produce TMAO.”

Dr. Genoni presented the findings of her research at the 2018 Nutrition Society of Australia Conference in Canberra last November.

Research contact: a.genoni@ecu.edu.au

Take a chill pill: You actually may not be allergic to penicillin

February 1, 2019

Penicillin was the original “wonder drug”—but, today, people are wondering why, for more than half a century, doctors have warned them it’s contraindicated for their care.

Discovered in 1928 and found to “miraculously” cure infections by 1942, penicillin was the first antibiotic that many Baby Boomers were prescribed as children. However, that first dose of penicillin also turned out to be the last for many youngsters—who broke out in bumps or rashes that were diagnosed as allergic reactions.

Now there is a different school of thought. In fact, according to a study posted by the Journal of the American Medical Association in January, fully 19 out of 20 people who have been told they are allergic to penicillin actually can tolerate it well.

Indeed, The New York Times reported on January 22, millions of Americans whose medical histories document their penicillin sensitivities are not actually allergic. But they are steered away from using some of the safest, most effective antibiotics—relying instead on substitutes that are often pricier, less effective, and more likely to cause complications such as antibiotic-resistant infections.

Experts in allergy and infectious disease, including the paper’s authors, are now urging patients to ask doctors to review their medical history and re-evaluate whether they truly have a penicillin allergy.

The evaluation—which may require allergy skin testing and ideally should be done while people are healthy— is especially important, The Times reports, for pregnant women, people with cancer and those in long-term care, and anyone anticipating surgery or being treated for a sexually transmitted infection.

“When you have a true infection that needs to be treated, the physician will see you have the allergy and not question it,” said  Dr. Erica S. Shenoy, an author of  the study, and an infectious diseases specialist who is s on the staff of Harvard Medical School of Massachusetts General Hospital.

The review was carried out with input from the boards of three professional medical organizations: the American Academy of Allergy, Asthma and Immunology; the Infectious Diseases Society of America; and the Society for Healthcare Epidemiology of America. All three groups endorsed the findings.

There is no question that some patients have potentially life-threatening allergic reactions to penicillin, but the label appears to have been applied far too broadly, experts say. About 10% of Americans report having a penicillin allergy, and the rate is even higher among older people and hospital patients—15% of whom have a documented penicillin allergy.

But studies that have gone back and conducted allergy skin testing on patients whose medical records list a penicillin allergy have found that the overwhelming majority test negative. A 2017 review of two dozen studies of hospitalized patients found that over all, 95 percent tested negative for penicillin-specific immunoglobulin E, or IgE, antibodies, a sign of true allergy.

 “We used to say nine out of 10 people who report a penicillin allergy are skin-test negative. Now it looks more like 19 out of 20,” Dr. David Lang, president-elect of the American Academy of Allergy, Asthma and Immunology and chairman of allergy and immunology in the respiratory institute at the Cleveland Clinic, told the Times.

What’s more, the researchers say, many people who have avoided penicillin for a decade or more after a true, severe allergic reaction will not experience that reaction again.

“Even for those with true allergy, it can wane,” said Dr. Kimberly Blumenthal, the review’s senior author, who is an allergist and an assistant professor at Harvard Medical School. “We don’t really understand this, but once you’ve proven you’re tolerant, you go back to having the same risk as someone who never had an allergy” to penicillin.

Finally, the researchers warn, don’t challenge yourself to penicillin on your own. Patients who have been told they’re allergic to penicillin should talk to their doctors, who should take a careful history and review the symptoms of the reaction.

If the past reaction to penicillin included symptoms like headache, nausea, vomiting and itching, or the diagnosis was made based on a family history of the allergy, the patient is considered low-risk and may be able to take a first dose of penicillin or a related antibiotic, such as amoxicillin, under medical observation.

If the past reaction included hives, a rash, swelling, or shortness of breath, patients should have penicillin skin test, followed by a second test that places the reagent under the skin if the first test is negative. If both tests are negative, the patient is unlikely to be allergic to penicillin, and an oral dose may be given under observation to confirm

Research contact:  @nytimes