By Todd Zwillich
WebMD Medical News Reviewed by Louise Chang, MD

March 9, 2010 — Most companies lack meaningful policies to curb the marketing of high-fat and high-sugar junk food to children, according to a report by a consumer watchdog group.

The Center for Science in the Public Interest (CSPI) gives failing grades to nearly three-quarters of the 128 food, restaurant, and media companies it investigated. The group is concerned that food marketers continue to aggressively promote unhealthy foods to children despite high obesity rates and regulators’ pleas to rein in ads.

Packaged food companies performed much better than media firms or restaurants, the group says. But the report finds that overall 68% of the companies have no policy governing marketing to kids.

Many companies signed onto a voluntary self-regulation system after the regulators fielded complaints about aggressive junk food advertising and the licensing of characters and movies to make junk food more attractive to children.

In 2008, the Federal Trade Commission found that companies spent $870 million marketing food to children under 12. An additional $1 billion went to marketing aimed at adolescents. Two years earlier, “cross-promotions tied foods and beverages to about 80 movies, television shows, and animated characters that appeal primarily to children,” the commission said in a report published in July 2008.

The agency urged food, restaurant, and media companies to come up with comprehensive policies controlling junk food marketing to kids.

“If companies were marketing bananas and broccoli, we wouldn’t be concerned. But instead, most of the marketing is for sugary cereals, fast food, snack foods, and candy. And this junk food marketing is a major contributor to childhood obesity ,” says Margo G. Wootan, CSPI’s nutrition policy director.

Curbing Food Ads to Kids

The group gave its highest grade of B+ to Mars Inc. The companies with grades of B were Procter & Gamble Company and Qubo Venture, a media company that places Saturday morning programming on NBC, Telemundo, and other networks. Several food companies, including Mars, Procter & Gamble, and Cadbury Adams, have policies calling for no advertising to children under 12.

Six companies got a B-, 17 got a C+, C, or C-, seven companies got a D+ or D, none received a D-, and 95 received an F. The complete report card is published on CSPI’s web site.

“In 2007 shortly after the launch of the Qubo kids channel, we established very stringent nutritional guidelines for advertising only healthy foods to children,” Brandon Burgess, chairman and CEO of ION Media Networks, the Qubo Channel’s parent company, says in a statement.

But many companies advertise not directly through television, but more indirectly through product tie-ins, online games, and event sponsorships, the report said.

It found that while two-thirds of food companies had child-targeted marketing polices, only one-quarter of restaurants and one-fifth of entertainment companies had the policies. And while many of those policies lay out nutritional standards for licensing characters for food ads, fewer impose strict rules for what kind of foods can be advertised, the CSPI report found.

WebMD made calls to several trade associations to get their reaction to the CSPI report. None responded in time for publication.

SOURCES:Center for Science in the Public Interest: “Report Card on Food Marketing Policies,” March 9, 2010.Margo G. Wootan, director, nutrition policy, Center for Science in the Public Interest.Federal Trade Commission: “Marketing Food to Children and Adolescents: A Review of Industry Expenditures, Activities, and Self-Regulation,” July 2008.Brandon Burgess, chairman and CEO, ION Media Networks.

A: Energy drinks are all the rage among not just athletes but also young adults. And hundreds of varieties are currently available, including Rage, Pimp Juice, Red Bull, and Monster. These drinks claim to make you more alert or boost your sports performance — or both.

But here’s the danger: Most energy drinks get their kick from stimulants, such as caffeine, guarana, ginseng, taurine, and ginkgo biloba. Some energy drinks have as much caffeine as five cups of coffee — or 10 times as much as a can of cola. Many also contain large amounts of sugar.

Granted, stimulants may make you feel great while working out (or just plain working). But consuming too much of these substances can cause sleep problems, nausea, vomiting, high blood pressure, anxiety, heart palpitations, and seizures. They also can alter your perception of fatigue and pain, which means you might push yourself past your natural limits.

The best energy drink may very well be water, since staying hydrated can help you think more clearly, exercise harder, and stay healthier in the long run.

Kathleen Zelman, MPH, RD/LD, WebMD Nutrition Expert

Reviewed by Michael W. Smith, MD on 6/1/2009

For example, clear soups can help thin mucus and clear nasal passages. Some studies suggest that the probiotic Lactobacillus acidophilus strain L-92, often added to yogurt or milk, may help ease Japanese cedar-pollen allergy. Vitamin C may help minimize many spring allergy symptoms.

WebMD turned to two nutritional experts for their advice on foods to help you fight allergy symptoms:

Christine Gerbstadt, MD, RD, mother of a child with bad seasonal allergies and spokeswoman for the American Dietetic Association
David Leopold, MD, director of integrative medical education at the Scripps Center for Integrative Medicine in San Diego
The meals in this 7-day menu plan feature foods high in antioxidants, omega-3 fatty acids, and other nutrients that our experts say may help ease inflammation and minimize complications of hay fever.

Even better, these healthy foods benefit your body in many other ways: boosting heart health and strengthening your immune system, too.

Day 1: Meals for the Spring Allergy Season

Breakfast: Homemade or low-sugar instant oatmeal made with skim or 1% acidophilus milk fortified with vitamin D, kiwi halves or orange wedges, and a cup of freshly brewed coffee or tea.

Lunch: Roasted turkey sandwich with light cream cheese and cranberry sauce on whole wheat bread, 3-Bean salad with light vinaigrette (made with canola or olive oil), plain or light yogurt (with active cultures) with frozen strawberries or raspberries stirred in.

Dinner: Teriyaki Salmon with a side of steamed brown rice and broccoli served with a cup of hot miso soup (or other broth-based soup).

Acidophilus milk is regular cow’s milk, but it has the probiotic bacteria, Lactobacillus acidophilus, added to it. The miso soup, along with other warm broths and teas, can help loosen mucus and ease congestion.

Salmon is one of the best food sources of the potent omega-3 fatty acids, DHA and EPA. Gerbstadt recommends fitting in fish three times a week for these anti-inflammatory omega-3s. Studies have suggested the consumption of fatty acids reduce inflammatory markers and may improve lung function. More research, however, is needed.

Day 2: Meals for the Spring Allergy Season

Breakfast: Peach smoothie made with frozen or canned unsweetened peaches, banana, and yogurt with active cultures, hot green or black tea.

Lunch: Vegetarian pizza (with garlic, onions, mozzarella cheese), fruit salad (red grapes, apples, cherries, or pears).

Dinner: Chicken (or lean beef) and vegetable stew served with a whole grain roll or crackers and a glass of skim or low-fat milk with active cultures.

All of the fruits (except bananas) and some of the vegetables in today’s menu (garlic, onions) are rich in quercetin, a flavonoid phytochemical that has reported antihistamine properties — good for nasal congestion.

Drinking warm fluids from tea or broth or tomato-based soups can help soothe throats and relieve sinus congestion.

Day 3: Meals for the Spring Allergy Season

Breakfast: Honey-wheat raspberry pancakes (stir frozen raspberries into pancake batter), freshly brewed coffee or tea or hot chocolate.

Lunch: Salad Nicoise made with albacore or solid white tuna canned in water, potatoes and tomatoes tossed with a light vinaigrette featuring olive or canola oil, red grapes.

Dinner: Spicy lean beef (or chicken) enchiladas made from steamed corn tortillas or tortillas lightly coated with canola oil and shredded Jack cheese, steamed summer squash.

This menu gives a second fish serving for the week and several produce items that contribute antioxidants including, vitamin C (berries, potatoes, tomatoes, kale). Using vegetable oils that are higher in monounsaturated fat and/or omega-3s and lower in omega-6 fatty acids (like canola and olive oil) may benefit people with asthma.

Spicy ingredients in the enchiladas (cayenne pepper, onions, or garlic) may help thin mucus and clear nasal passages. Use Jack cheese instead of cheddar. Aged cheeses may contribute dietary histamine and possibly provoke allergic symptoms. Other foods thought to contain high concentrations of histamine include sauerkraut, wine, and processed meat, although Leopold says sulfite-free wine is probably fine.

Day 4: Meals for the Spring Allergy Season

Breakfast: Scrambled eggs made with one higher omega-3 egg and 1/4 cup egg substitute topped with shredded Jack or mozzarella cheese and served on a toasted whole wheat English muffin, strawberries, freshly brewed coffee or tea.

Lunch: Vegetarian quesadilla (made with grilled onions and bell peppers, Jack cheese, and a whole grain tortilla) served with fat-free refried beans and hot sauce or taco sauce, yogurt parfait (made with layers of light or plain yogurt with active cultures and vitamin D, frozen blueberries, and fortified whole-grain cereal).

Dinner: Ground sirloin or turkey meatloaf served over horseradish mashed potatoes (hot cooked potatoes blended with low-fat milk and horseradish to taste), steamed carrots.

The scrambled eggs along with the fortified yogurt and whole grain cereal will add a hefty dose of vitamin D. Studies suggest an association between vitamin D deficiency and increased risk of asthma and wheezing. It has even been proposed that vitamin D deficiency may explain a portion of the current asthma epidemic.

Caffeine from tea or coffee can act like antihistamine in the body, according to Leopold, but the tea and coffee need to be of high quality and freshly brewed. Hot liquid in general will have soothing effects on the throat and sinus congestion.

Horseradish not only offers the mucus-thinning benefits of other “hot” spices, but studies have indicated that some horseradish constituents may have antibiotic activity. The hot sauce will also help clear the sinuses.

Day 5: Meals for the Spring Allergy Season

Breakfast: Toasted whole wheat bagel and light cream cheese, melon wedges, freshly brewed hot coffee or tea.

Lunch: Italian chicken wrap made with grilled chicken, pesto, fresh mozzarella cheese, tomatoes and romaine lettuce, fresh fruit cup.

Dinner: Ginger shrimp stir fry made with shrimp, kale or broccoli, fresh ginger, and a little canola oil served over steamed rice or cooked noodles with a side of mandarin oranges.

All of the vegetables in today’s menu are rich in quercetin, a flavonoid phytochemical that might help suppress the allergic response by controlling the release of histamine.

Fresh ginger is featured in the shrimp stir fry (the third serving of fish this week). Anecdotally, according to Leopold, using spices like ginger, cayenne, and turmeric seem to help patients who suffer from seasonal allergies.

Day 6: Meals for the Spring Allergy Season

Breakfast: Blueberry wheat muffin or scone with a latte made with skim or low-fat vitamin D fortified milk.

Lunch: Spicy sirloin burger topped with Jack cheese and Ortega or pasilla peppers served on a whole grain bun with apple slices and freshly brewed green tea.

Dinner: Spinach lasagna made with whole wheat noodles, marinara sauce with garlic and onions, part-skim ricotta and mozzarella cheese, served with orange segments.

From tea to tomatoes, today’s menu is brimming with high-antioxidant plant foods. Low intakes of dietary antioxidants may contribute to increases in asthma and allergy, so featuring plant foods rich in an assortment of antioxidants in as many meals as possible may be helpful.

The apple slices and the garlic and onions in the marinara sauce contribute quercetin and the lasagna features two non-aged cheeses. The spicy peppers may help allergy symptoms temporarily by encouraging the sinuses to run.

Day 7: Meals for the Spring Allergy Season

Breakfast: Whole grain waffles topped with fresh or frozen strawberries and a glass of skim or 1% acidophilus milk fortified with vitamin D.

Lunch: Chicken salad made with cashews or walnuts, Dijon or spicy mustard and plain or vanilla yogurt (with active cultures and vitamin D) served on Romaine lettuce with a cup of mango cubes, freshly brewed coffee or tea.

Dinner: Thai curry tofu with cauliflower and broccoli florets served over steamed brown rice or cooked noodles, with a cup of broth-based soup such as won ton or hot and sour soup.

This menu includes two servings of probiotic-containing dairy foods, several foods with quercetin (tea, strawberries, lettuce, and broccoli) plus several top vitamin C-rich foods (strawberries, romaine lettuce, mango, cauliflower, and broccoli). A high antioxidant intake may be helpful for people with seasonal allergies.

Getting enough vitamin D each day benefits our health in a myriad of ways, including possibly decreasing the risk of asthma. One of the easiest ways to get vitamin D is through fortified dairy products such as the milk and yogurt in this menu. The hot soup, curry spice, and spicy mustard will help get the sinuses running. Curry and mustard typically contain turmeric which seem seems to offer additional relief with allergy symptoms.

SOURCES:Christine Gerbstadt, MD, RD, spokeswoman for the American Dietetic Association, Certified Diabetes Educator and Specialist in Sports Dietetics.David Leopold MD, director of Integrative Medical Education at the Scripps Center for Integrative Medicine in San Diego.Natural Standard Research Collaboration, Integrative Therapies for Allergies.American Dietetic Association Nutrition Care Manual, 2009.Thorax, August 2001; vol 56, pp 589-595.Journal of the American Dietetic Association, January 2005; vol 105, no 1, pp 98-105.The American Journal of Clinical Nutrition, June 2006 vol 83, no 6, pp S1536-1538S.American Journal of Clinical Nutrition, May 2007 vol 85; no 5, pages 1185-1196.The American Journal of Clinical Nutrition, March 2007; vol 85, no 3, pp 853-859.The American Journal of Clinical Nutrition, March 2007; vol 85, no 3, pp 788-795.Journal of the American Dietetic Association, August 2005; vol 105, no 8, p 26.The American Journal of Clinical Nutrition October 2006; vol 84, no 4, pp 903-911.

Reviewed by Brunilda Nazario, MD on 3/9/2010

Acne is a skin condition characterized by whiteheads, blackheads, and inflamed red pimples or “zits.”
Symptoms

* Blackheads
* Crusting of skin eruptions
* Cysts
* Inflammation around the skin eruptions
* Pustules
* Redness around the skin eruptions
* Scarring of the skin
* Whiteheads

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Take the following self-care steps to lessen the effects of acne:

* Clean your skin gently with a mild, non-drying soap (such as Dove, Neutrogena, or Basics). Remove all dirt or make-up. Wash once or twice a day, including after exercising. However, avoid excessive or repeated skin washing.
* Shampoo your hair daily, especially if it’s oily. Comb or pull your hair back to keep the hair out of your face. Avoid tight headbands.
* Try not to squeeze, scratch, pick, or rub the pimples. Although it might be tempting to do this, it can lead to scarring and skin infections.
* Avoid touching your face with your hands or fingers.
* Avoid greasy cosmetics or creams. Look for water-based or “non-comedogenic” formulas. Take make-up off at night.

If these steps do not clear up the blemishes to an acceptable level, try over-the-counter acne medications. These creams and lotions are applied directly to the skin. They may contain benzoyl peroxide, sulfur, resorcinol, or salicylic acid. They work by killing bacteria, drying up the oil, and causing your skin to peel.

If the pimples are still a problem, a dermatologist can prescribe stronger medications and discuss other options with you.

Prescription medicines include:

* Oral antibiotics (taken by mouth) such as minocycline, doxycycline, and tetracycline
* Topical antibiotics (applied to the skin) such as clindamycin or erythromycin
* Retinoic acid cream or gel (Retin-A) and isotretinoin pills (Accutane) — pregnant women and sexually active adolescent females should NOT take Accutane, as it causes severe birth defects; Women taking Accutane should use two forms of birth control before starting the drug
* Prescription formulas of benzoyl peroxide, sulfur, resorcinol, salicylic acid

Birth control pills can sometimes help clear up acne. (In some cases, though, they may make it worse.)

Your doctor may also suggest chemical skin peeling, removal of scars by dermabrasion, or removal or drainage of cysts.

A small amount of sun exposure may improve acne. However, excessive exposure to sunlight or ultraviolet rays is not recommended because it increases the risk of skin cancer.
Causes

Acne occurs when tiny holes on the surface of the skin, called pores, become clogged. Each pore is an opening to a canal called a follicle, which contains a hair and an oil gland. Normally, the oil glands help keep the skin lubricated and help remove old skin cells. When glands produce too much oil, the pores can become blocked, accumulating dirt, debris, and bacteria. The blockage is called a plug or comedone.

The top of the plug may be white (whitehead) or dark (blackhead). If it ruptures, the material inside, including oil and bacteria, can spread to the surrounding area and cause an inflammatory reaction. If the inflammation is deep in your skin, the pimples may enlarge to form firm, painful cysts.

Acne commonly appears on the face and shoulders, but may also occur on the trunk, arms, legs, and buttocks.

Acne is most common in teenagers, but it can happen at any age, even as an infant. Three out of four teenagers have acne to some extent, probably caused by hormonal changes that stimulate oil production. However, people in their 30s and 40s may also have acne.

Acne tends to run in families and can be triggered by:

* Hormonal changes related to menstrual periods, pregnancy, birth control pills, or stress
* Greasy or oily cosmetic and hair products
* Certain drugs (such as steroids, testosterone, estrogen, and phenytoin)
* High levels of humidity and sweating

Despite the popular belief that chocolate, nuts, and other foods cause acne, this does not seem to be true.
Tests & diagnosis

Your doctor can diagnose acne based on the appearance of the skin. Testing is usually not required.
Prognosis

Acne usually subsides after adolescence, but may last into middle age. The condition generally responds well to treatment after a few weeks, but may flare up from time to time. Scarring may occur if severe acne is not treated. Some people, especially teenagers, can become significantly depressed if acne is not treated.
Complications

Possible complications include:

* Changes in skin color
* Cysts
* Damage to self-esteem, confidence, personality, and social life
* Permanent facial scars
* Side effects of Accutane (including very dry skin and mucous membranes, high triglyceride levels, liver damage, and birth defects in an unborn baby; call your doctor right away if you become pregnant while taking this drug)
* Side effects of other medications

When to contact a doctor
Call your doctor or a dermatologist if:

* Self-care measures and over-the-counter medicine have not helped after several months
* Your acne is severe (for example, you have lots of redness around the pimples or you have cysts) or getting worse
* You develop scars as your acne clears up

Call your pediatrician if your baby has acne that does not clear up on its own within 3 months.

Oct. 6, 2009 — Here’s a surprise: Some of the healthiest foods may also be the most likely to cause food-borne illness.

That’s the conclusion in a report by the Center for Science in the Public Interest (CSPI). The report shows leafy greens, sprouts, and berries are among the most prone to carry infections or toxins.

“We don’t recommend that consumers change their eating habits,” says Caroline Smith DeWaal, the CSPI’s head of food safety programs. Instead, the group is trying to point out vulnerabilities in the nation’s food safety system as it lobbies Congress to beef up enforcement.

The group analyzed CDC data on food illness outbreaks dating back to 1990. They found that leafy greens were involved in 363 outbreaks and about 13,600 illnesses, mostly caused by norovirus, E. coli, and salmonella bacteria.

The rest of the top 10 list included:

* Eggs, involved in 352 outbreaks and 11,163 reported cases of illness.
* Tuna, involved in 268 outbreaks and 2,341 reported cases of illness.
* Oysters, involved in 132 outbreaks and 3,409 reported cases of illness.
* Potatoes, involved in 108 outbreaks and 3,659 reported cases of illness.
* Cheese, involved in 83 outbreaks and 2,761 reported cases of illness.
* Ice cream, involved in 74 outbreaks and 2,594 reported cases of illness.
* Tomatoes, involved in 31 outbreaks and 3,292 reported cases of illness.
* Sprouts, involved in 31 outbreaks and 2,022 reported cases of illness.
* Berries, involved in 25 outbreaks and 3,397 reported cases of illness.

It is unclear how many of the outbreaks can be blamed on the foods themselves. The CDC’s database can’t discriminate between outbreaks caused by tomatoes, for example, vs. those caused by other ingredients in a salad. Foods like potatoes are almost always consumed cooked, so it is unlikely that potatoes themselves caused 108 outbreaks.

Still, Smith DeWaal called the list “the tip of the iceberg” when it comes to food-borne illnesses in the U.S. Not all outbreaks are reported to public health authorities. In addition, the analysis focused only on foods regulated by the FDA; that leaves out beef, pork, poultry, and some egg products, which are policed by the U.S. Department of Agriculture.

“Consumers always want to know what they should do to avoid getting sick,” says Sarah Klein, lead author of the report. She recommends “defensive eating,” including keeping food cold and cooking it thoroughly, chilling oysters and avoiding them when raw, and avoiding raw eggs or using them in homemade ice cream.

Several bills that are circulating in Congress aim to crack down on food safety by requiring all food producers to keep written safety plans and giving the FDA more power to inspect plans and enforce rules.

“In a relative scale our food supply remains quite safe,” says Craig Hedberg, a professor of environmental and occupational health at the University of Minnesota School of Public Health. The CDC says 76 million Americans get sick from food-borne illnesses each year.

“Because most people don’t experience a bad outcome from a lapse in good behavior it’s difficult to enforce,” he says.

SOURCES:Center for Science in the Public Interest: “The Ten Riskiest Foods Regulated by the U.S. Food and Drug Administration,” Oct. 6, 2009.Caroline Smith DeWaal, director, food safety programs, Center for Science in the Public Interest.Sarah Klein, author, CSPI report.Craig Hedberg, professor of environmental and occupational health, University of Minnesota School of Public Health.CDC web site: “Food-Related Diseases.”

Oct. 13, 2009 — Cancer patients undergoing chemotherapy feel less exhausted if they enroll in an intense program that exercises the mind as well as the body, a Danish study finds.

Fatigue is one of the most troubling side effects of cancer chemotherapy. Patients don’t feel like doing anything, either physically or mentally. And the less they do, the weaker and more depression -prone they become.

Earlier studies showed that moderate exercise can help. So can psychosocial programs. Could both kinds of programs be combined — and intensified — for greater impact?

To find out, Lis Adamsen, PhD, and colleagues at Copenhagen University Hospital, Denmark, asked 269 adult cancer patients to enroll in a nine-hours-a-week exercise program for six weeks. Half the volunteers were randomly assigned to a control group and were asked to wait six weeks to join the program.

Although the program was designed to appeal to men and women, women were much more likely to volunteer. In the end, 196 women and 73 men volunteered for the study; 235 of them completed the program.

The program included:

* Monday, Wednesday, and Friday: High-intensity physical training (30 minutes of warmup, 45 minutes resistance training, and 15 minutes of cardiovascular training).
* Tuesdays: 90 minutes of body-awareness training (stretching on week 1, yoga breathing on weeks 2-3, and Pilates movement on weeks 4-6).
* Monday, Tuesday, Wednesday, and Friday: 30 minutes of relaxation training to follow physical training or body-awareness training.
* Monday and Friday: 30 minutes of massage

Patients weren’t allowed to pick and choose — they had to show up for the entire program, regardless of how they felt after their chemo treatments.

One patient with a brain tumor had a seizure after cardio training, so Adamsen and colleagues warn brain cancer patients not to try this kind of exercise. Ill effects were not seen in other patients.

Instead, those completing the program felt better. Although improvements were small to medium in size, the exercise program significantly reduced fatigue and increased patients’ sense of vitality. They felt fewer limits in their daily activities than did patients who did not exercise.

“The range of exercise components used … has been shown to be feasible, safe, and beneficial to various patients with cancer during chemotherapy — even patients with advanced disease,” Adamsen and colleagues conclude.

They note, however, that a program with more appeal to men needs to be developed.

The findings appear in the Online First edition of BMJ.

SOURCE:Adamsen, L. BMJ, Online First edition, Oct. 14, 2009.

Oct. 15, 2009 (Baltimore) — A diet rich in cruciferous and green leafy vegetables, nuts, fish, and tomatoes and low in red meat and high-fat dairy products may protect against Alzheimer’s disease, a study suggests.

Researcher Nikolaos Scarmeas, MD, associate professor of neurology at Columbia University in New York, tells WebMD that recommendations can’t be made on this study alone. “But in general, these foods are part of what we consider a healthy diet for other reasons, such as protection against heart disease . And they could help [your brain].”

The study was presented at the annual meeting of the American Neurological Association (ANA).

The research involved 1,691 people aged 65 and older with no signs of dementia when they entered the study. All filled out detailed questionnaires that asked about what foods they ate over the past year.

The researchers then studied various foods in the lab to determine which were rich in nutrients such as omega-3 fatty acids and vitamin E that have been linked to a lower risk of Alzheimer’s disease and which were low in nutrients such as saturated fatty acids that have been linked to a greater risk.

Based on the amounts of each nutrient in each food, “we discovered an Alzheimer’s-disease-protective dietary pattern that was characterized by a high consumption of nuts, fish, salad dressing, poultry, tomatoes, cruciferous, dark, and green leafy vegetables and fruits, and low in high-fat dairy, red meat, organ meat, and butter,” Scarmeas says. “Foods are not consumed in isolation, so studying the dietary pattern may offer substantial advantage.”

The 1,691 study participants were then divided into three groups according to how well they adhered to such a diet over the past year. Over the next four years, 211 of them were diagnosed with Alzheimer’s disease. Results showed that those in the top third were 38% less likely to develop Alzheimer’s four years later than those in the lowest third.

The analysis was adjusted for a variety of factors that could potentially explain the association, including age, smoking status, physical activity , body mass index, and caloric intake.

The fact that the researchers followed healthy people over time and that the analysis was adjusted to take into account factors such as physical activity that may also lower the risk of Alzheimer’s disease gives it strength, says Craig Blackstone, MD, PhD, of the National Institute of Neurological Disorders and Stroke.

“This is certainly a healthy diet to follow,” he says.

SOURCES:134th Annual Meeting of the American Neurological Association, Baltimore, Oct. 11-14, 2009.Nikolaos Scarmeas, MD, associate professor of neurology, Columbia University, New York.Craig Blackstone, MD, PhD, National Institute of Neurological Disorders and Stroke, Bethesda, Md.

By Daniel J. DeNoon
WebMD Medical News Reviewed by Louise Chang, MD

June 12, 2009 – There’s no shortcut to three years of difficult “chemical castration” hormone therapy for men receiving radiation treatment for locally advanced prostate cancer .

But there are silver linings to the finding, from European clinical trials led by Michel Bolla, MD, of the University of Grenoble, France.

Most men with newly diagnosed prostate cancer in the U.S. have an earlier stage of prostate cancer than the men in the Bolla study. If they need hormone therapy at all, they are likely to get by with a six-month treatment course.

Bolla explored whether this might work for men treated with radiation for what doctors call locally advanced prostate cancer — that is, prostate cancer that has spread beyond the inside of the prostate but not throughout the body.

In a study of 970 men, the researchers compared six months of hormone treatment — with additional treatment if men relapsed — to immediate assignment to three years of hormone treatment.

“The increase of overall survival in men given three years of treatment is superior,” Bolla tells WebMD.

Because hormone therapy blocks male hormones, it causes loss of sexual function and severe hot flashes. The good news, Bolla says, is that after three years, these side effects go away.

“We can see a modification of quality of life with respect to decrease of sexual activity during the three years of treatment,” he says. “But once the treatment is completed, the quality of life is like the quality of life prior to treatment.”

For most men in the U.S. — who, because of prostate-cancer screening have their cancers detected at an earlier stage than the men in the Bolla study — three years of hormone therapy would be “overkill,” says prostate cancer researcher Peter Albertsen, MD, of the University of Connecticut, Farmington.

“In many parts of the country, these men are automatically getting hormonal therapy just because doctors figure if it works for the more aggressive cancers it can work for the more localized cancers,” Albertsen tells WebMD. “The radiation therapy itself may be overkill — so then when you add three years of hormonal therapy, you are really overtreating these men.”

Unfortunately, it’s still not known for sure whether men with more limited disease than those in the Bolla study get a benefit from hormone therapy.

It’s not really an issue for many men whose prostate cancer is diagnosed before age 70. That’s because most such men in the U.S. opt for surgery to remove the prostate. At least for now, there’s no convincing evidence that men treated with prostatectomy benefit from hormone therapy.

“We are learning step by step when hormonal therapy seems to be effective and when it is not,” Albertsen says. “For men with relatively localized disease, we have no evidence that the additional hormonal therapy adds any value whether it is six months or three years or any permutation in between. That is because the radiation therapy may itself be sufficient.”

Bolla’s study — and editorial comments by Albertsen — appear in the June 11 issue of the New England Journal of Medicine.

SOURCES:Bolla, M. New England Journal of Medicine, June 11, 2009; vol 360: pp 2516-2527.Albertsen, P. New England Journal of Medicine, June 11, 2009; vol 360: pp 2572-2574.Peter C. Albertsen, MD, chairman, department of urology, University of Connecticut, Farmington.Michel Bolla, MD, head of radiotherapy, University of Grenoble, France; president, European Organization for Research and Treatment of Cancer (EORTC).

By Todd Zwillich
WebMD Medical News Reviewed by Louise Chang, MD

June 18, 2009 — A consumers group complained to regulators and threatened a lawsuit Thursday over what it calls a drug company’s misleading claims that two of its multivitamins reduce the risk of prostate cancer .

The Center for Science in the Public Interest is taking aim at One A Day Men’s 50+ Advantage and Men’s One A Day Men’s Health Formula multivitamins, both of which contain selenium . The group says widespread ads for the products claiming selenium helps reduce the risk of prostate cancer are false and not supported by major scientific studies.

Early studies suggested selenium, an antioxidant, could have some protective effect against cancer. But a major government-sponsored trial published in January, called SELECT (The Selenium and Vitamin E Cancer Prevention Trial), concluded that selenium “did not prevent prostate cancer” in a population of healthy men.

But the group complained that Bayer Healthcare LLC, which makes both products, continues to claim on packaging and in ads that they help reduce the risk of prostate cancer.

“A complete multivitamin plus selenium, which emerging research suggests may reduce the risk of prostate cancer,” Bayer’s ads state, according to the CSPI’s complaint to the Federal Trade Commission.

“We urge the Federal Trade Commission to take swift and strong action to get these deceptive Bayer ads off television, radio, and Internet and out of newspapers and magazines or wherever else they may be displayed,” states the CSPI’s complaint to the FTC.

The FTC in 2007 ordered Bayer to stop making unproven health claims for a One A Day weight loss product and told the company not to make any unsubstantiated claims for any vitamins in the One A Day product line.

In a statement, Bayer says “We are aware of CSPI’s complaint and are in the process of reviewing their allegations.”

“In the meantime, we stand behind all claims made in support of our products, including One A Day multivitamins. The claims made in support of selenium are based on an FDA-approved qualified health claim,” reads the statement, provided to WebMD.

The CSPI also threatened to sue Bayer if the company does not change its advertising for the One A Day multivitamins.

“Bayer is thumbing its nose at the Food and Drug Administration, the FTC, and any number of state consumer protection laws,” CSPI Litigation Director Steve Gardner says.

“FTC can sometimes take years. Because these ads are so bad we’ve threatened to sue Bayer within 30 days if they don’t stop running them,” David Schardt, CSPI senior nutritionist, tells WebMD.

The CSPI also notes that prostate cancer experts from across the U.S. have written to the FTC in support of the CSPI complaint against Bayer.

SOURCES:Journal of the american Medical Association, 2009; v 301: pp 39-51. Center for the Science in the Public Interest, letter to Federal Trade Commission, June 18, 2009.Statement, Bayer Healthcare LLC. Steve Gardner, CSPI litigation director.David Schardt, senior nutritionist, CSPI.

By Salynn Boyles
WebMD Medical News Reviewed by Louise Chang, MD

June 19, 2009 — Mayo Clinic researchers say an experimental treatment may have cured two patients whose prostate cancers were so advanced they had been considered inoperable.

Both patients were reportedly free of cancer after treatment with a combination of hormone therapy, an experimental immunotherapy, and surgery.

No one was more surprised than their doctors. “This is certainly not the way we thought it would go,” Mayo urologist and immunologist Eugene Kwon, MD, tells WebMD.

He adds that the point of the treatment had been to buy some time for patients whose cancers appeared to be incurable.

The two men were originally enrolled in a study designed to determine if treatment to suppress testosterone (known as androgen ablation), followed by treatment with an experimental immunotherapy called ipilimumab, could slow the progression of advanced prostate cancer .

“The goal was to see if we could modestly improve upon current treatments,” Kwon says.

The 85 patients in the study were not considered candidates for surgery, but several showed such dramatic regressions in their cancers that they left the trial in order to have it.

Kwon admits that this was done in the first patient not because the study investigators thought it was a good idea, but because the patient’s wife insisted.

“Even though this patient had remarkable reduction in disease, we still did not think surgery would be beneficial,” he says. “But in a two-hour, late-night phone conversation that became quite acrimonious, she demanded that we take her husband off the study and do surgery.”

More than a year and a half later, that patient shows no signs of prostate cancer, Kwon says.

One other patient who also left the study to have surgery also appears free of the cancer, and a third patient was operated on last week.

“This occurred not because we as physicians and scientists were so brilliant, but because a patient’s wife re-crafted our thinking about what was achievable,” he says.

Second Opinion

But just how promising is the treatment that Kwon and colleagues ended up with?

A prostate cancer specialist who spoke to WebMD says that remains to be seen.

“I think this is interesting information, but it is way too early to get excited,” says Derek Raghavan, MD, PhD, who directs the Cleveland Clinic’s Taussig Cancer Institute.

The study is ongoing and has yet to be published, but the researchers did present details on the patients who had the combination treatment and surgery in a poster presentation at a recent meeting of the American Society of Clinical Oncology.

Raghavan says prolonged androgen ablation is known to improve survival in locally advanced prostate cancer patients.

He adds that until more details of the trial are published, there is no way to independently assess the impact of ipilimumab on outcomes.

Ipilimumab is an experimental monoclonal antibody that targets a molecule on T-cells (a type of immune cell) that inhibits the immune system’s ability to fight cancer cells. It has mostly been studied in melanoma patients.

“We and others have shown remarkable responses after initial androgen ablation in this group of patients,” he says. “In this small, phase II study it is impossible to dissect out the impact of this … antibody.”

SOURCES:American Society of Clinical Oncology annual meeting, Orlando, Fla., May 29-June 2, 2009.Eugene Kwon, MD, urologist and immunologist, Mayo Clinic, Rochester, Minn.Derek Raghavan, MD, PhD, FACP, director, Cleveland Clinic Taussig Cancer Institute.