Energy drinks increase heart strain

Healthy adults who consumed energy drinks high in caffeine and taurine had significantly increased heart contraction rates one hour later.

Healthy adults who consumed energy drinks high in caffeine and taurine had significantly increased heart contraction rates one hour later, according to a study presented at the annual meeting of the Radiological Society of North America (RSNA).

"Until now, we haven't known exactly what effect these energy drinks have on the function of the heart," said radiology resident Jonas D?rner, MD, of the cardiovascular imaging section at the University of Bonn, Germany, which is led by the study's principal investigator, Daniel K. Thomas, MD. "There are concerns about the products' potential adverse side effects on heart function, especially in adolescents and young adults, but there is little or no regulation of energy drink sales."

Energy drinks represent a multibillion dollar industry that is growing every day. While teenagers and young adults have traditionally been the largest consumers, in recent years more people of all demographics have begun consuming energy drinks.

More emergency department visits

A 2013 report from the Substance Abuse and Mental Health Services Administration stated that in the US from 2007 to 2011, the number of emergency department visits related to energy drink consumption nearly doubled, increasing from 10 068 to 20 783. Most of the cases were identified among patients aged 18 to 25, followed by those aged 26 to 39.

"Usually energy drinks contain taurine and caffeine as their main pharmacological ingredients," Dr D?rner said. "The amount of caffeine is up to three times higher than in other caffeinated beverages like coffee or cola. There are many side effects known to be associated with a high intake of caffeine, including rapid heart rate, palpitations, rise in blood pressure and, in the most severe cases, seizures or sudden death."

For the study, which is ongoing, Dr D?rner and colleagues used cardiac magnetic resonance imaging (MRI) to measure the effect of energy drink consumption on heart function in 18 healthy volunteers, including 15 men and three women with a mean age of 27.5 years. Each of the volunteers underwent cardiac MRI before and one hour after consuming an energy drink containing taurine (400 mg/100 ml) and caffeine (32 mg/100 ml).

Compared to the baseline images, results of cardiac MRI performed one hour after the study participants consumed the energy drink revealed significantly increased peak strain and peak systolic strain rates (measurements for contractility) in the left ventricle of the heart. The heart's left ventricle receives oxygenated blood from the lungs and pumps it to the aorta, which distributes it throughout the rest of the body.

Additional studies required

"We don't know exactly how or if this greater contractility of the heart impacts daily activities or athletic performance," Dr D?rner said. "We need additional studies to understand this mechanism and to determine how long the effect of the energy drink lasts."

The researchers found no significant differences in heart rate, blood pressure or the amount of blood ejected from the left ventricle of the heart between the volunteers' baseline and second MRI exams.

"We've shown that energy drink consumption has a short-term impact on cardiac contractility," Dr D?rner said. "Further studies are needed to evaluate the impact of long-term energy drink consumption and the effect of such drinks on individuals with heart disease."

Dr D?rner said that while long-term risks to the heart from drinking energy drinks remain unknown, he advises that children, as well as people with known cardiac arrhythmias, should avoid energy drinks, because changes in contractility could trigger arrhythmias. He also cautions that additional study is needed to address risks posed by the consumption of energy drinks in combination with alcohol.

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Dutch government warns about e-cigarettes

The Dutch Health Ministry sounded an early warning about the possible health risks of electronic cigarettes.

The Dutch Health Ministry sounded an early warning on Thursday about the possible health risks of electronic cigarettes, announcing plans to clamp down on labelling ahead of European regulations.

The move followed an analysis of existing scientific research by the National Institute for Public Health, the leading Dutch government health advisory body.

The institute said it was concerned about a lack of evidence on the possible health effects of e-cigarettes, and said that as a precaution, they should not be used by pregnant women or in the vicinity of children.

Some health experts say e-cigarettes – battery-powered metal tubes that turn nicotine-laced liquid into vapour – may be the answer to helping millions of smokers to quit cigarettes and thereby avoid the damaging health effects of smoke.

Smoking tobacco causes lung cancer and other chronic respiratory diseases and is a major contributor to cardiovascular disease, the world's number one killer.

May outsell conventional cigarettes

Tobacco has an annual death toll of 6 million people, and the World Health Organisation says that could exceed 8 million by 2030 unless something urgent is done to stop people smoking.

All the top tobacco companies are investing in e-cigarettes, which some analysts have predicted may outsell conventional cigarettes in 10 years.

But they are far from universally accepted as a public health tool - with some critics worried they will not break nicotine addiction and may be a "gateway" to regular cigarettes - and the fast-growing market is largely unregulated.

The Dutch institute also recommended banning flavour and scent enhancers in e-cigarettes that contain nicotine because of concerns they may attract children to smoking.

Citing the institute's findings, Dutch deputy health minister Martin Van Rijn argued that e-cigarettes are as addictive as tobacco cigarettes because they contain nicotine, and he said there was no proof of claims by manufacturers that they help smokers quit.

"There is insufficient scientific evidence to be able to say whether the quantities of toxins in the exhaled air are dangerous for bystanders," Van Rijn wrote in a letter to parliament on Thursday.

Flashing lights

"In advance of European regulations, I will take measures in national legislation in regard to advertising, safety, quality and labelling of e-cigarettes," the letter said.

Additional research will be conducted by the institute to learn more about e-cigarettes, the ministry said.

The warning came as Britain signalled it would force tobacco companies to scrap branded cigarette packaging on Thursday in an attempt to reduce the number of children who may be drawn to smoking by striking and brightly coloured packs.

The Dutch institute raised concerns on its website last week that e-cigarettes are attractive to young people because of bright colours, flashing lights and jewellery-like appearance.

Roughly 11 to 18 percent of Dutch smokers have tried the e-cigarette, while about 5 percent said they use it regularly, the ministry said.

More than $2 billion

Market consultant Euromonitor estimates the world market for electronic cigarettes was more than $2 billion last year, with the United States accounting for a quarter of that.

A few countries have banned them outright – such as Brazil, Norway and Singapore – while others are opting for varying degrees of regulation, in some cases including limits on advertising and curbs on their use in public places.

Big tobacco companies are grappling with declining sales of tobacco in a number of markets due to increasing government regulation and more health-aware consumers, as well as smuggling and an economic downturn.

Philip Morris International Inc, the maker of Marlboro cigarettes, said this month it plans to enter the e-cigarette market next year, saying it is the "greatest growth opportunity".

Imperial Tobacco Group plans to launch two electronic cigarettes in its new fiscal year.

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Acupuncture could help in dentist's chair

For people who fear going to the dentist, a natural remedy may help them overcome thier gag reflex.

Acupuncture may provide relief for dental patients who reflexively gag during procedures like teeth impressions, according to Italian researchers.

Up to 20% of the US population has severe anxiety at the dentist's office. People who cannot help their gag reflex may unintentionally deprive themselves of the best dental care, write Giuseppa Bilello and Antonella Fregapane, both from the University of Palermo in Sicily.

Acupuncture may be one strategy to solve that problem, the pair suggests."It is a small study, and that is one weakness," Dr Palle Rosted told Reuters Health.

"But it is a good start."Rosted is a consultant acupuncturist with Weston Park Hospital in Sheffield, England. He was not involved with the current study.

The researchers recruited 20 people with a history of gag reflex in the dental chair to have upper and lower teeth impressions taken under normal circumstances and then immediately after acupuncture. Participants ranged in age from 19 to 80.

No comparison group

For the first round of upper teeth impressions, they reported an average gag reflex score of 7 on a 0-10 scale, with 10 representing the maximum nausea sensation. During the second round, the researchers applied acupuncture needles about 30 seconds before taking impressions and left the needles in until the procedure ended.

On average, gag reflex scores dropped to just 1.The pattern was similar for gag reflex scores during lower teeth impressions done with and without acupuncture, according to findings published in the journal Acupuncture in Medicine. The researchers point out that they can't be sure the improvements were due to the acupuncture needles themselves – in part because there was no comparison group that didn't get acupuncture.

Another possibility is that gag reflex scores improved because participants were more used to the impressions the second time around. Still, "It has certainly given us some more evidence that acupuncture may be effective," Rosted said.

The study's positive result "is something that we doctors definitely need exposure to and to keep in mind as a possible option," Dr. Preeti Nair said.

"We rarely think of acupuncture, and usually use local anaesthetics."Nair was not part of the current research. She has studied gag reflex at the People's College of Dental Sciences & Research Centre in Bhopal, India. One difference between a drug like local anaesthesia and acupuncture could be side effects.

"We haven't gotten all of the details in our hand, but with acupuncture, the side effects could be less," Nair said. Much more research is needed on the subject, she added. In order for a large, randomised controlled trial - the gold standard in medical research – to be done on this subject, dental offices and academic institutions may have to work together, said Chris Dickinson of King's College London Dental Institute at Guy's Hospital in England. In England, the British Dental Acupuncture Society offers training for dentists in certain dental applications of acupuncture, said Dickinson, who was not involved in the new study.

Simple technique

"There are very few contraindications associated with acupuncture and dental operations that we've experienced," Dickinson said. "But we don't use the technique in patients with metal allergies, pregnant women and those with needle phobias."

Dickinson noted that other acupuncture points could have been used for gag control such as ear points and LI4, also known as the Hegu point. Researchers in the current study placed needles in the PC6, EX 1 and CV24 acupuncture points on the face and wrist."The message to dentists is that it's a simple technique and easily learned," Dickinson said.

"It's also cost-effective. Even though it does not work in every case there's very little lost by trying it."In the US, acupuncture typically costs about $100 per session. One of the positive aspects of acupuncture is that after an operation, a patient may choose to drive home, which is not possible with other treatments, such as general anesthesia, Rosted said. "The risk of causing harm with this treatment is nearly non-existent," he said.

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Blood vessels reorganise after face transplants

Blood vessels in face transplant recipients re-organise themselves, leading to an understanding of the biologic changes that happen after full face transplantation.

Blood vessels in face transplant recipients re-organise themselves, researchers have found, leading to an understanding of the biologic changes that happen after full face transplantation.

The results of the study have been presented at the annual meeting of the Radiological Society of North America .

Face transplantation is a recent development in reconstructive surgery for patients who have lost some or all of their face from injury or disease. The first full face transplantation in the US was carried out at Brigham and Women's Hospital in Boston in 2011.

As part of the procedure, surgeons connect the patient's major arteries and veins to those from a donor face to ensure healthy circulation in the transplanted tissue. Because the technology is new, not much is known about the vascular changes that help blood penetrate into the transplanted tissue.

Arteries and veins

 The development of new blood vessel networks in transplanted tissue is critical to the success of face transplant surgery.

 "We assumed that the arterial blood supply and venous blood return was simply from the connections of the arteries and the veins at the time of the surgery."
                
 Co-author Dr Frank J Rybicki,  director of the hospital's Applied Imaging Science Laboratory and his fellow researchers used 320-detector row dynamic computed tomography angiography (CTA) to study the facial allografts of patients one year after successful transplantation.

 The CTA technology offers imaging over 16cm of coverage, enabling the researchers to view collateralisation, a process in which the body stimulates existing blood vessels to elongate, widen and form new connections.

Larger vessels

"The key finding of this study is that, after full face transplantation, there is a consistent, extensive vascular reorganisation that works in concert with the larger vessels that are connected at the time of surgery," said another researcher, Dr Kanako K Kumamaru.

"We have found that since the vessels more commonly associated with the back of the head are critical to maintain the vascular reorganisation.”                    
The authors note that the findings could help improve surgical planning and assessment of potential complications in face transplant patients.

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Blacks happier at work than whites

Research shows that although black people report being happier at work, they tend to have fewer friends in the workplace.

Despite working in more routine and less autonomous jobs, having fewer close friends at work, and feeling less supported by their co-workers, blacks report significantly more positive emotions in the workplace than whites, according to a new study in Social Psychology Quarterly.

"We were surprised by this," said lead author Melissa M. Sloan, an assistant professor of interdisciplinary social sciences and sociology at the University of South Florida Sarasota-Manatee. "Based on the history of discrimination against African Americans in the workplace, we thought blacks would experience more negative emotions at work than whites. As it turned out, the opposite was true."

Titled, "Counting on Coworkers: Race, Social Support, and Emotional Experiences on the Job," the study considered more than 1 300 state government employees in Tennessee.

Sloan and her co-authors Ranae J. Evenson Newhouse, an assistant professor of sociology at Tennessee State University, and Ashley B. Thompson, an assistant professor of sociology at Lynchburg College, also found that the higher the percentage of minorities in a workplace, the more close friends blacks had and the fewer whites had.

Negative emotions and race

In workplaces with a low percentage of minority employees — 13% or less — black workers said they considered 39% of their co-workers to be close friends versus 61% for white workers. However, in workplaces with a high percentage of minority employees — 35% or more — black workers said they considered about 42% of their co-workers to be close friends versus 46% for white workers.

"What was surprising to us about these findings was that the percentage of minority workers in a workplace more strongly influenced the friendships of whites than blacks," Sloan said.

In addition, the study found that the more minorities in a workplace, the more negative emotions whites experienced at work. "This is a concern because the increased negative emotions of white workers in racially diverse workplaces can negatively impact the workplace atmosphere," Sloan said.

Sloan and her co-authors also discovered that while providing social support to co-workers negatively affected the emotional experiences of white workers, it was associated with increased levels of positive emotion among black workers. "By providing support to colleagues, black workers may feel valued and more integrated into the work environment," Sloan said. "In contrast, white workers who do not experience social isolation in the same way as black workers do, may find providing support to be a burden."

In terms of policy implications, Sloan said the study suggests that more research is needed to determine how to encourage people from different racial and ethnic backgrounds to develop supportive relationships with each other. "Simply increasing racial and ethnic diversity in the workplace might not be enough to foster social connections between workers with different backgrounds and, in fact, may elicit negative emotions among members of the majority group," Sloan said.

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600 teens start smoking every day

The number of teenage smokers is increasing, with research showing that in London the daily tally is 67 new smokers a day.

UK national figures on smoking prevalence are available, but the researchers* wanted to estimate smoking uptake among children, to provide some baseline data to inform efforts for preventive measures, and focus attention and resources on what is "essentially a child protection issue."

This is because taking up smoking at a young age is an even greater risk to health than starting later in life, they say. Smoking at a young age affects lung development and boosts the risk of progressive lung disease (COPD).

And people who start smoking before the age of 15 run a higher risk of developing lung cancer than those who take up the habit later on, even if the cumulative number of cigarettes smoked is smaller, they add.

How the study was done

The researchers based their analysis on data taken from the 2011 'Smoking, drinking and drug use among young people in England' survey, which targets schoolchildren in England between the ages of 11 and 15 every year.

Questionnaires were completed by 6519 children in 219 schools. And by comparing the numbers of current smokers - regular and occasional - with smoking rates among the same age band surveyed the previous year, the researchers were able to estimate the numbers of new 11 to 15 year olds starting to smoke in 2010-11 in the UK.

To calculate the number of new child smokers for each locality, this estimate of 207 000 was then split across geographical areas according to population size and smoking prevalence among adults, on the assumption that there would be more child smokers where the proportion of adult smokers was high. Parental smoking is one of the strongest predictors of smoking among children.

The researchers then used population and adult smoking prevalence data for each of the four UK countries to calculate the number of new child smokers for each locality.

The analysis indicated that among the 3.7 million children aged between 11 and 15 in the UK, an estimated 463 start smoking every day in England, with the equivalent figures for Scotland, Wales and Northern Ireland, 55, 30, and 19, respectively.

Of 74 000 children in this age group in Birmingham, nine take up smoking every day, while the daily tally in London is 67 out of 458 000 children in this age group.

The authors acknowledge that as their figures are calculated from survey data, they can only be approximate, but the fact that they are regional might be more helpful to healthcare professionals and regulators, they say.

Smoking rates among both adults and children are falling in the UK, but the figures are still high, so the pressure needs to be kept up to reduce smoking further, say the authors.

This means increasing taxation, curbing smuggling, and running well-funded anti-smoking media campaigns, as a well as banning smoking in cars and introducing plain packaging to reduce children's exposure to branding, they say.

"Smoking is among the largest causes of preventable deaths worldwide," they write. "The present data should help to raise awareness of childhood smoking and to focus attention on the need to address this important child protection issue," they conclude.

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Party-season survival plan

If you've been watching your diet over the past months and getting ready to show off your new figure this summer, you may be approaching the party season with some trepidation.

Hooray! The end of the year is in sight and the party season has officially started. Though we're still slaving away at the office to get all the last things done before year-end, we're partying equally hard to reward ourselves for all the hard work.

If you've been watching your diet over the past few months and getting ready to show off your new figure this summer, you may be approaching the party season with some trepidation. Parties = foods and drink galore = kilojoule bombs = bikini crisis.

Before you sink into a deep pit of depression and deprivation, take heart: food fests and trim waistlines do not have to be mutually exclusive.

Follow these tips and you can have the best of both worlds:

• Never go to a party hungry. Have a healthy balanced snack beforehand and you'll be far better able to resist temptations.
  
• Once you're at the party, don't torture yourself by lingering near the buffet table. The persistent call of your favourite party snack will become totally irresistible if you hover there long enough.
  
• When you do feel like having a snack, avoid the fried, fatty foods, chips, nuts and cheese platters which are very high in kilojoules.
  
• Rather opt for the vegetable crudités and fresh slices of summer fruit. Watch out for the fatty mayonnaise and creamy dips.
  
• When it comes to drinks, choose carefully. Alcoholic drinks, especially cocktails, can be loaded with kilojoules and they also tend to make you feel like eating unhealthy snacks.
  
• Add soda water or ice to your wine, use sugar-free mixers with spirits and drink lots of water in between.
  
• And finally, shake that booty. If dancing on the tables or jumping into the pool is not part of your party repertoire, make some time for at least 30 minutes of exercise every day - this will act as the perfect antidote to that forbidden snack that somehow snuck past your willpower right into your mouth.

Here's to a healthy, fun-filled summer.

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Obese people do have more heart attacks

An analysis supports the idea that obese people who are otherwise healthy are still at risk of heart problems down the road.

A new analysis supports the idea that obese people who are otherwise healthy are still at risk of heart problems down the road.

Contrary to previous results

Researchers who reviewed past studies found that even heavy people who didn't have high blood pressure or diabetes, for instance, had more heart attacks and strokes over time than healthy normal-weight people. That runs contrary to the results of some recent shorter-term reports, which suggested people could be obese but heart-healthy.

"It made perfect sense to say there might be a group that have extra body fat but aren't necessarily at risk," James O. Hill said. "I think what this study says is, they are. It's just that the risk may be lower (than among obese people who also have other problems) and it might take a little longer to see it."

Studies over 10 years or more

Hill, executive director of the Anschutz Health and Wellness Center at the University of Colorado in Aurora, co-wrote a commentary published with the new analysis. Canadian researchers pooled the results of eight studies that followed normal-weight, overweight and obese people over time. Some of those participants were metabolically healthy. Others had a mix of heart-related risk factors like a large waist circumference, high blood pressure, high triglycerides, low "good" cholesterol and diabetes.

The studies included just over 61,000 people. Over a period of three to 30 years, depending on the study, about 4,000 of them died or developed heart problems. At first, obese people without metabolic problems didn't seem to be any more at-risk than slimmer participants who were also metabolically healthy. Then, however, the researchers looked only at studies that followed people for 10 years or more. They found that over time, heavy but healthy people in those studies were 24 percent more likely to die, have a heart attack or stroke or develop heart failure.

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