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Health & Wellbeing
 

Update November 22, 2015

Study: Good gut bacteria may affect babies’ risk of asthma

Lauran Neergaard
Washington (AP)
- Gut checks suggest that not having enough of certain “good” intestinal germs early in life may increase babies’ risk of developing asthma, according to a new Canadian study of more than 300 children.
Wait: What could gut bacteria have to do with a lung disease? People share their bodies with trillions of microbes that play key roles in keeping us healthy - and different combinations of bacteria in the gut are thought to shape the immune system in ways that can affect the risk of a variety of diseases.
Wednesday’s study raises the provocative possibility of one day altering tots’ buildup of protective bugs, maybe through probiotics.
“I want to emphasize that we’re not ready for that yet,” cautioned study co-author Dr. Stuart Turvey, a pediatric immunologist at the University of British Columbia and BC Children’s Hospital. But a “vision for the future would be to prevent this disease.”
Asthma has been on the rise in recent decades, and is estimated to affect 300 million people worldwide and nearly 10 percent of U.S. children. While medications can help control the wheezing and airway inflammation, asthma is a common reason for childhood hospitalizations and severe attacks can be life-threatening at any age.
Babies begin accumulating their own custom bacterial community, or microbiome, at birth. Which bugs they acquire is a haphazard process, starting with whether they were born vaginally or by C-section. But previous studies have shown that babies treated with antibiotics before their first birthday were more likely to be diagnosed later with asthma; the drugs can kill good germs as well as harmful ones.
In the new study, the University of British Columbia tracked health records of 319 children from birth to age 3, and analyzed stool samples taken during infancy to check their gut bacteria.
The first clue: There were 22 youngsters deemed very high risk because of early asthma warning signs - and at 3 months of age, all of them harbored much lower levels of four specific gut bacteria than the other babies.
That doesn’t prove the missing bugs are protective. In a first step to tell, the researchers infected germ-free mice with an at-risk tot’s stool sample alone, or with a supplement of the four supposedly “good” bacteria. Restoring the missing bugs markedly reduced airway inflammation in the mice’s offspring, they reported in the journal Science Translational Medicine.
“This is a really important study” because of that mouse evidence that altering bacteria affects symptoms, said Dr. Rachel Rosen, a gastroenterology specialist at Boston Children’s Hospital who wasn’t involved with the research. “Just knowing that’s possible opens up a whole field of using bacteria as a therapy for lung disease.”
Researchers don’t know much about how people naturally acquire these four bacteria groups with tongue-twisting names - Faecalibacterium, Lachnospira, Veillonella and Rothia - that the Canadian team abbreviated the FLVR combination.
But stool samples from 1-year-olds didn’t show much difference between the at-risk group and the rest, suggesting the first three months of life may be a critical time period, the researchers concluded.
“There’s this really early dance in the gut” that influences the immune system, said University of British Columbia microbiology professor B. Brett Finlay, a study coauthor.
For now, the consumer message is to stay tuned: Much larger studies are needed to prove the bacterial role, and that timing theory, Rosen cautioned. Plus, gut bacterial checks are part of research, not routine care.
Already, the British Columbia team has begun testing samples from 500 more babies who are enrolled in a larger Canadian study exploring factors in the development of allergy and asthma.
Still, the study “provides new pieces of the puzzle,” New York University microbiome specialists Martin Blaser and Maria Gloria Dominguez-Bello wrote in an accompanying commentary.


Txt msgs may lead to broad heart-linked benefits, study says

Lindsey Tanner
Chicago (AP) - Txt msgs may b gud 4U.
That’s the message in a study that suggests just four monthly text messages might spur health improvements for heart patients.
The simple, heart-related advice led to substantial changes in blood pressure, cholesterol and physical activity levels, according to the results published in Tuesdays’ Journal of the American Medical Association.
About 700 Australian adults took part. The strategy cost just $10 a person, and if lasting benefits can be shown in a broader group of patients, it could be a cheap and simple way to help tackle heart disease, the leading cause of death worldwide.
Smaller studies have linked health-oriented text messages with improvement in a single measure, but this is the largest to find multiple benefits, the researchers said, led by Dr. Clara Chow of the University of Sydney’s George Institute for Global Health.
The basics
The researchers randomly assigned heart patients to receive usual care alone, or usual care plus automated healthy text messages for six months. Almost one-third of the text message group reached target levels for four or more heart disease risk factors, versus only 10 percent of the usual care group. These included blood pressure below 140 over 90, exercising at least five times weekly for 30 minutes, and not smoking.
The texts
A sampling of the messages:
- Try avoiding adding salt to your foods by using other spices or herbs.
- Walking is cheap. It can be done almost anywhere. All you need is comfortable shoes & clothing.
- Try identifying the triggers that make you want a cigarette & plan to avoid them.
- Studies show that stress, worry & loneliness can increase the risk of heart disease. Please talk to a health professional if you need help.
The limitations
The study didn’t last long enough to see if improvement in heart disease risk factors led to fewer heart attacks. A journal editorial notes other weaknesses included relying on patients self-reporting physical activity levels, and no attempt to measure whether adding more text messages would lead to bigger improvements.
The quote
The benefits could potentially “reduce risk of recurrent heart attacks by at least a quarter if they were maintained long-term,” said Chow. “We think it is really important to see if they can be repeated elsewhere in Australia and internationally, and maintained long-term.”
Future research
Chow said she’s involved in a broader study at about 20 centers in Australia in urban, rural and indigenous settings, and will be following patients to see it the text message program results in lasting benefits.
Online:
Journal: http://jama.jamanetwork.com


Update November 7, 2015

Low-nicotine cigarettes cut use, dependence, study finds

Researchers found that smokers who switched to special low-nicotine ones wound up smoking less and were more likely to try to quit, according to a new study published in the New England Journal of Medicine on Wednesday, Sept. 30. (AP Photo/Sue Ogrocki)

Marilynn Marchione
A new study might help the push for regulations to limit nicotine in cigarettes. Smokers who switched to special low-nicotine ones wound up smoking less and were more likely to try to quit, researchers found.
The study only lasted six weeks, and researchers call the evidence preliminary. But they say it’s the first large study to show that slashing nicotine, perhaps below an addiction threshold, is safe and leads to less smoking.
The Food and Drug Administration was given the power in 2009 to mandate lower nicotine levels if it would help public health, but has not yet done so.
“This, I think, provides support” for lowering nicotine, said one study leader, Dr. Neal Benowitz of the University of California, San Francisco.
“What our study shows is that it’s feasible,” and that people won’t smoke more regular cigarettes to compensate, he said.
Results are in the New England Journal of Medicine. The FDA and the National Institute on Drug Abuse paid for the study. Two study leaders have advised companies that make smoking cessation aids, and two testified in tobacco lawsuits.
Smoking is a leading cause of heart disease and cancer. Tar and other substances inhaled through smoking make cigarettes deadly, but the nicotine in tobacco is what makes them addictive.
Some earlier work suggests they might not be if nicotine was limited to roughly 0.7 milligrams per gram of tobacco. Most cigarettes contain around 15.8 milligrams per gram of tobacco. There are no low-nicotine cigarettes on the market; the government made special ones with several lower nicotine levels to test.
“We wanted to see how much lower it would need to be to see that effect,” where dependence did not happen or was diminished, said another study leader, Dr. Eric Donny, a University of Pittsburgh psychologist.
For the study, about 800 people who smoked five or more cigarettes a day and had no interest in quitting were assigned to smoke either their usual brand or an experimental type with nicotine ranging from a low of 0.4 milligram to 15.8 milligrams, the level in most cigarettes.
The cigarettes were provided for free, and no one except people assigned to keep smoking their regular brand knew how much nicotine any of their smokes contained.
Smokers had to report daily how much they smoked and to make 10 office visits, some of which included tests to measure nicotine exposure and dependence. They were paid $20 an hour or so for the visits and extra for completing tests and daily calls, up to $835 in all.
The low-nicotine users were a little more likely to smoke some regular cigarettes in addition to the ones provided in the study, yet the overall number of cigarettes and nicotine levels were lower in those groups. During the last week of the study, those given cigarettes with low amounts of nicotine - 2.4, 1.3 or 0.4 milligrams per gram of tobacco - were averaging 15 or 16 smokes a day. That compares to 21 or 22 cigarettes for those given the 15.8-milligram cigarettes or their usual brand.
One low-nicotine level - 5.2 milligrams - did not cause any change in number of cigarettes smoked from smokers’ usual brand.
All low-nicotine cigarette users reported fewer symptoms of nicotine dependence on various standardized tests.
The study was not intended or designed to get smokers to quit. But twice as many in the low-nicotine group than those smoking standard-strength cigarettes - 35 percent versus 17 percent - said they had tried in the month after the study ended.
A longer study is under way to see whether a gradual or abrupt shift to low-nicotine cigarettes is best.
Dr. Michael Fiore and Timothy Baker, tobacco researchers from the University of Wisconsin, Madison, wrote in a commentary in the journal that the study shows the potential for a policy to cut nicotine that “could help to end the devastating health consequences” of smoking.
The FDA declined to comment on the study, but the director of its Center for Tobacco Products, Mitch Zeller, said in a statement that “though all tobacco products are potentially harmful and potentially addictive, different categories of tobacco products may have the potential for varying effects on public health.”
Two large cigarette makers - R.J. Reynolds Tobacco Co., which sells Camel and other brands, and Altria Group Inc., which owns Philip Morris USA - declined to comment. (AP)
Online:
Study: http://www.nejm. org/doi/full/10.1056/NEJMsa1502403
Commentary: http://www. nejm.org/doi/full/10.1056/NEJMp1509510

 


UN: More studies needed on new malaria shots before using it

Geneva (AP) - Vaccine experts advising the World Health Organization have recommended that further studies be done on a new malaria vaccine to figure out if officials can actually administer the four doses needed.
The new vaccine, Mosquirix, received an approval recommendation from the European regulator in July even though it only protects about 30 percent of children. After a meeting in Geneva this week of WHO’s vaccine advisory group, chair Jon Abramson said if health workers can’t give children four shots of the vaccine within 18 months “we’re not going to be using it.”
The experts also made recommendations for a new Ebola vaccine, but those are contingent on regulatory approval. Abramson said they provisionally advise vaccinating health workers in an outbreak but noted any regulatory decision is probably several months away.


HEADLINES [click on headline to view story]

Study: Good gut bacteria may affect babies’ risk of asthma

Txt msgs may lead to broad heart-linked benefits, study says

Low-nicotine cigarettes cut use, dependence, study finds

UN: More studies needed on new malaria shots before using it