'Guardian angel' protein packs punch in fight against cancer

WASHINGTON — It's a tiny molecule with a nondescript name — "p53" — but it has an awesome responsibility: preventing more than half of all human cancers.

Some scientists call it the "guardian angel," "guardian of the genome," or the "dictator of life and death."

P53 is a protein, a string of 393 chemical units stored in the DNA of most of the body's cells. Normally, p53 works to suppress malignant tumors. When it's missing or mutated, however, it can't carry out its lifesaving mission and lets cancerous cells run amok.

Scientists are developing drugs to repair or restore damaged p53 in mice, but so far none of those drugs are ready to treat human cancers.

Almost 50,000 papers about p53 have been published in scientific journals, but its workings are still not fully understood, and it's little known outside the worlds of biology and medicine.

P53 is "certainly the most studied protein in the whole history of cancer," Magali Olivier , an expert at the World Health Organization's International Agency for Research on Cancer in Lyons, France , wrote in the journal Cancer Gene Therapy this fall.

Arnold Levine , a cancer expert at the Institute for Advanced Study in Princeton, N.J. , who discovered p53 almost 30 years ago, said "We have uncovered and explored a process central to life — how a cell responds to stress or perturbation in its environment."

Here's how it works: A normal p53 protein detects a patch of DNA in the nucleus of a cell that has been damaged by accident, a virus, radiation, smoking or other environmental assaults, raising the chance that the cell will turn cancerous. P53 triggers a complex biochemical program that stops the pre-cancerous cell from dividing until it repairs its DNA or commits suicide.

When p53 itself is flawed, however, it allows other cancer-causing genes (known as oncogenes) to hijack the cell's control machinery and set it free to spread wildly — the hallmark of cancer.

"Loss of p53 function in cells leads to uncontrolled proliferation and promotes cancer development," Olivier wrote in a summary of recent p53 research.

The gene that carries the instructions to make p53 is called TP53. Mutations in the gene may be inherited, which is why some cancers run in families.

TP53 is "the most mutated gene in human cancer, and these mutations are correlated with more than 50 percent of all human cancer," said Ronen Marmorstein , an expert on gene regulation at the Wistar Institute in West Philadelphia, Pa.

According to Gerard Evan , a researcher at the University of California's Comprehensive Cancer Center in San Francisco , p53 mutations are also associated with more aggressive cancers, resistance to treatment by radiation and chemotherapy, and decreased patient survival.

Despite the vast amount of research, work is only beginning on cancer therapies based on fixing damaged p53.

Nevertheless, hopes are rising that the immense body of knowledge about p53 will lead to better ways to diagnose, prevent and treat cancer.

"The growing number of p53-targeting strategies raises hope for more efficient cancer therapies in the future," reported Swedish researcher Klas Wiman in the journal Cell Death and Differentiation.

In an experiment in his San Francisco lab, for example, Evan restored damaged p53 in mice suffering from lymphoma.

"The tumors were completely dead within hours." Evan said. "This result is very good news to the many of us who are thinking about trying to restore p53 function in established human cancers."

Unfortunately, restoring p53 may cause accelerated aging, at least in mouse experiments.

"Cancer and senescence may be seen as two alternative fates in aging organisms, the secret of longevity being to find the best possible trade-off between these two options," Olivier reported.

Many questions remain about the workings of p53.

"Complete understanding still remains elusive," Antony Braithwaite , a New Zealand researcher, wrote in Cell Death and Differentiation. "How p53 makes decisions to do one thing or another, or turn on one gene or another, is far from clear."

To accomplish its job, p53 has scan three billion letters in the human genetic code to decide which genes it's going to activate or repress. "This is a tall order," Braithwaite wrote.

ON THE WEB:

For more information on p53

To see Cancer Gene Therapy's summary of recent p53 research

Disco tune "Stayin' Alive" could save your life

WASHINGTON (Reuters) - U.S. doctors have found the Bee Gees 1977 disco anthem "Stayin' Alive" provides an ideal beat to follow while performing chest compressions as part of CPR on a heart attack victim.

The American Heart Association calls for chest compressions to be given at a rate of 100 per minute in cardiopulmonary resuscitation (CPR). "Stayin' Alive" almost perfectly matches that, with 103 beats per minute.

CPR is a lifesaving technique involving chest compressions alone or with mouth-to-mouth rescue breathing. It is used in emergencies such as cardiac arrest in which a person's breathing or heartbeat has stopped.

CPR can triple survival rates, but some people are reluctant to do it in part because they are unsure about the proper rhythm for chest compressions. But research has shown many people do chest compressions too slowly during CPR.

In a small study headed by Dr. David Matlock of the University of Illinois College of Medicine at Peoria, listening to "Stayin' Alive" helped 15 doctors and medical students to perform chest compressions on dummies at the proper speed.

Five weeks after practicing with the music playing, they were asked to perform CPR again on dummies by keeping the song in their minds, and again they kept up a good pace.

"The theme 'Stayin' Alive' is very appropriate for the situation," Matlock said in a telephone interview on Thursday. "Everybody's heard it at some point in their life. People know the song and can keep it in their head."

The findings will be presented this month at a meeting of the American College of Emergency Physicians in Chicago.

Gene discovery may help hunt for blindness cure

LONDON (Reuters) - Scientists have discovered a gene mutation linked to the most common cause of blindness in the developed world, holding out the prospect of better treatments and perhaps eventually a cure.

British scientists said on Tuesday they had found six variants within the gene called Serping1 that were associated with age-related macular degeneration (AMD).

"Our findings add to the growing understanding of the genetics of age-related macular degeneration, which should ultimately lead to novel treatments for this common and devastating disease," Sarah Ennis and Andrew Lotery of the University of Southampton reported in the Lancet journal.

AMD -- which involves damage to the delicate cells of the macula, a region at the center of the retina -- is increasingly common as people get older.

Around 90 percent of patients diagnosed with AMD have the so-called dry version, for which no treatment is currently available.

The rest have wet AMD, which occurs when tiny new blood vessels grow between the retina and the back of the eye. This form of the disease can be treated with modern drugs.

Some cereals more than half sugar: report

WASHINGTON (Reuters) - Some breakfast cereals marketed to U.S. children are more than half sugar by weight and many get only fair scores on nutritional value, Consumer Reports said on Wednesday.

A serving of 11 popular cereals, including Kellogg's Honey Smacks, carries as much sugar as a glazed doughnut, the consumer group found.

And some brands have more sugar and sodium when formulated for the U.S. market than the same brands have when sold in other countries.

Post Golden Crisp made by Kraft Foods Inc and Kellogg's Honey Smacks are more than 50 percent sugar by weight, the group said, while nine brands are at least 40 percent sugar.

The most healthful brands are Cheerios with three grams of fiber per serving and one gram of sugar, Kix and Honey Nut Cheerios, all made by General Mills, and Life, made by Pepsico Inc's Quaker Oats unit.

"Be sure to read the product labels, and choose cereals that are high in fiber and low in sugar and sodium," Gayle Williams, deputy editor of Consumer Reports Health, said in a statement.

Honey Smacks has 15 grams of sugar and just one gram of fiber per serving while Kellogg's Corn Pops has 12 grams of sugar and no fiber.

Consumer Reports studied how 91 children aged 6 to 16 poured their cereal and found they served themselves about 50 to 65 percent more on average than the suggested serving size for three of the four tested cereals.

Consumers International, which publishes Consumer Reports, said it would ask the World Health Organization to develop international guidelines restricting advertising and marketing of foods high in sugar, fat or sodium to children.

However, the group noted that breakfast cereal can be a healthful meal and said adults and children alike who eat breakfast have better overall nutrition, fewer weight problems, and better cognitive performance throughout the day.

Kellogg said it was working to make its food more nutritious.

"Kellogg recently reformulated a number of our cereals including Froot Loops, Corn Pops, Rice Krispies, Cocoa Krispies and Apple Jacks in the U.S. with improved nutritional profiles," a company spokeswoman said by e-mail.

"To put Consumer Reports' information in perspective, yogurt contains more sugar and sodium than a serving of Honey Smacks cereal (25 grams of sugar vs. 15 grams of sugar in Honey Smacks)."

Consumer Reports, like other groups, compares the sugar content of food with its fiber, mineral and vitamin content. Many cereals are fortified with vitamins and minerals.

Glucosamine and chondroitin don't slow arthritis

Two hugely popular supplements used to fight arthritis and joint pain, glucosamine and chondroitin sulfate, do not seem to work any better than placebo to slow the loss of knee cartilage in osteoarthritis, researchers reported on Monday.

But the researchers said some of their findings were confusing and said more study was needed.

"At two years, no treatment showed what we determined to be a clinically important reduction in joint space width loss," said Dr. Allen Sawitzke of the University of Utah School of Medicine, who helped lead the study.

The study, funded by the National Center for Complementary and Alternative Medicine at the National Institutes of Health, confirms other findings showing the supplements have few or no effects.

The trial is called glucosamine/chondroitin arthritis intervention trial or GAIT. Writing in the October issue of Arthritis & Rheumatism, Sawitzke and colleagues said they had trouble interpreting their results because patients who took placebos had a smaller loss of cartilage than they should have.

The original GAIT study results in 2006 found the supplements did not reduce the pain of knee arthritis, except among a small group of patients with moderate to severe pain.

The GAIT researchers continued to watch 572 volunteers for another 18 months and found the supplements did not appear to slow the loss of cartilage, taken either alone or together.

They said arthritis worsened in 24 percent of participants taking both, similar to those taking placebo.

"Research continues to reveal that osteoarthritis, the most common form of arthritis, appears to be the result of an array of factors including age, gender, genetics, obesity, and joint injuries," said Dr. Stephen Katz, director of the NIH's National Institute of Arthritis and Musculoskeletal and Skin Diseases.

"Because osteoarthritis affects nearly 21 million Americans, we are seeking ways to not only treat pain, but also address the structural effects of the condition," he said.

Doctors say leg pain can signal deadly blood clot

WASHINGTON - Far too many Americans are dying of dangerous blood clots that can masquerade as simple leg pain, says a major new government effort to get both patients and their doctors to recognize the emergency in time.

"It's a silent killer. It's hard to diagnose," said acting Surgeon General Dr. Steven Galson, who announced the new campaign Monday. "I don't think most people understand that this is a serious medical problem or what can be done to prevent it."

At issue are clots with cumbersome names: A deep vein thrombosis, or DVT, forms in large veins, usually a leg or the groin. It can quickly kill if it moves up to the lungs, where it goes by the name pulmonary embolism, or PE.

These clots make headlines every few years when seemingly healthy people collapse after long airplane flights or being in similarly cramped quarters. Vice President Cheney suffered one after a long trip last year. NBC correspondent David Bloom died of one in 2003 after spending days inside a tank while covering the invasion of Iraq.

But that provides a skewed vision of the problem. While there aren't good statistics, the new surgeon general's campaign estimates that every year, between 350,000 and 600,000 Americans get one of these clots — and at least 100,000 of them die.

There are a host of risk factors and triggers: Recent surgery or a broken bone; a fall or car crash; pregnancy or taking birth control pills or menopause hormones; being immobile for long periods. The risk rises with age, especially over 65, and among people who smoke or are obese.

And some people have genetic conditions that cause no other symptoms but increase their risk, making it vital to tell your doctor if a relative has ever suffered a blood clot.

People with those factors should have "a very low threshold" for calling a doctor or even going to the emergency room if they have symptoms of a clot, said Galson, who issued a "call to action" for better education of both consumers and doctors, plus more research.

Symptoms include swelling; pain, especially in the calf; or a warm spot or red or discolored skin on the leg; shortness of breath or pain when breathing deeply.

But here's the rub: Doctors are ill-informed, too. For example, studies suggest a third of patients who need protective blood thinners when they enter the hospital for major surgery don't get them. And patients can even be turned away despite telltale symptoms, like happened to Le Keisha Ruffin just weeks after the birth of her daughter, Caitlyn.

Ruffin made repeated visits to doctors and emergency rooms for growing pain in her leg and groin in December 2003 and January 2004, but was told it must be her healing Caesarean section scar.

Finally one night, Ruffin's husband ran her a really hot bath for pain relief — only to have her climb out minutes later with her leg swollen three to four times its normal size, and then pass out.

"I like to call that my miracle bath," Ruffin said, because the sudden swelling proved the tip-off for doctors.

Pieces of a giant clot in her right leg had broken off and floated to her lung. The ER doctor "said if I hadn't made it in when I did, I may not have lived through the rest of the night," recalled Ruffin, now 32, who spent a month in the hospital and required extensive physical therapy to walk normally again.

These clots "tend to fall through the cracks" because they cross so many areas of medicine, said Dr. Samuel Goldhaber, chairman of the Venous Disease Coalition and a cardiologist at Boston's Brigham & Women's Hospital.

With the surgeon general's campaign, "DVT after all these years will finally get the national spotlight like cigarette smoking did in the mid-60s," he said.

In addition to Galson's report:

_The Agency for Healthcare Research and Quality is issuing a 12-page booklet to help consumers tell if they're at risk for DVTs and what to do — and a 60-page DVT treatment-and-prevention guide for doctors and hospitals.

_As a prevention incentive, starting Oct. 1 Medicare will withhold payment from hospitals when patients develop the clots after knee- or hip-replacement surgery.

___

On the Net:

Surgeon General: http://www.surgeongeneral.gov

Venous Disease Coalition: http://www.venousdiseasecoalition.org

Coalition to Prevent DVT: http://www.preventdvt.org

Want to live a long life? Run

WASHINGTON (Reuters) - People who want to live a long and healthy life might want to take up running.

A study published on Monday shows middle-aged members of a runner's club were half as likely to die over a 20-year period as people who did not run.

Running reduced the risk not only of heart disease, but of cancer and neurological diseases such as Alzheimer's, researchers at Stanford University in California found.

"At 19 years, 15 percent of runners had died compared with 34 percent of controls," Dr. Eliza Chakravarty and colleagues wrote in the Archives of Internal Medicine.

Any type of vigorous exercise will likely do the trick, said Stanford's Dr. James Fries, who worked on the study.

"Both common sense and background science support the idea that there is nothing magical about running per se," Fries said in a telephone interview. "It is the regular physical vigorous activity that is important."

The team surveyed 284 members of a nationwide running club and 156 similar, healthy people as controls. They all came from the university's faculty and staff and had similar social and economic backgrounds, and all were 50 or older.

Starting in 1984, each volunteer filled out an annual survey on exercise frequency, weight and disability for eight activities -- rising, dressing and grooming, hygiene, eating, walking, reach, hand grip and routine physical activities.

Most of the volunteers did some exercise, but runners exercised as much as 200 minutes a week, compared to 20 minutes for the non-runners.

At the beginning, the runners were leaner and less likely to smoke compared with the controls. And they exercised more over the whole study period in general.

"Over time, all groups decreased running activity, but the runners groups continued to accumulate more minutes per week of vigorous activity of all kinds," the researchers wrote.

"Members of the running groups had significantly lower mean disability levels at all time points," they added.

The team also set out to answer whether taking up running late in life would benefit, and whether people who stopped exercising began to pay a price as they aged.

Most of the runners have stopped running as they reached their 70s, Fries said. But it was difficult to find people who totally stopped exercising. "Almost all of them did something else. They continued their vigorous exercise," he said.

People who took up exercise when they were older also improved their health, he said.

The study also showed that people cannot use the risk of injury as an excuse not to run -- the runners had fewer injuries of all kinds, including to their knees.

Eating fish high in fatty acids may help prevent memory loss

LONDON (Reuters) - Eating tuna and other fatty fish may help prevent memory loss in addition to reducing the risk of stroke, Finnish researchers said on Monday.

People who ate baked or broiled -- but not fried -- fish high in omega-3 fatty acids have been found to be less likely to have "silent" brain lesions that can cause memory loss and dementia and are linked to a higher risk of stroke, said Jyrki Virtanen of the University of Kuopio in Finland.

"Previous findings have shown that fish and fish oil can help prevent stroke, but this is one of the only studies that looks at fish's effect on silent brain (lesions) in healthy, older people,," Virtanen, who led the study, said in a statement.

Omega-3 fatty acids are also found in salmon, mackerel, herring, sardines, and in other foods such as walnuts. They have been shown to provide an anti-inflammatory effect and have been linked to a lower risk of heart disease.

The Finnish team studied 3,660 people aged 65 and older who underwent brains scans five years apart to detect the silent brain lesions, or infarcts, found in about 20 percent of otherwise healthy elderly people

The researchers found that men and women who ate omega-3-rich fish three times or more per week had a nearly 26 percent lower risk of having silent brain lesions.

Eating just one serving per week led to a 13 percent reduced risk, compared to people whose diets did not include this type of fish, the researchers reported in the journal Neurology.

Fried fish for some reason did not appear to have the same benefits, the researchers added.

"While eating tuna and other types of fish seems to help protect against memory loss and stroke, these results were not found in people who regularly ate fried fish," Virtanen said.

Experimental Alzheimer's drug shows early promise

CHICAGO - For the first time, an experimental drug shows promise for halting the progression of Alzheimer's disease by taking a new approach: breaking up the protein tangles that clog victims' brains.

The encouraging results from the drug called Rember, reported Tuesday at a medical conference in Chicago, electrified a field battered by recent setbacks. The drug was developed by Singapore-based TauRx Therapeutics.

Even if bigger, more rigorous studies show it works, Rember is still several years away from being available, and experts warned against overexuberance. But they were excited.

"These are the first very positive results I've seen" for stopping mental decline, said Marcelle Morrison-Bogorad, director of Alzheimer's research at the National Institute on Aging. "It's just fantastic."

The federal agency funded early research into the tangles, which are made of a protein called tau and develop inside nerve cells.

For decades, scientists have focused on a different protein — beta-amyloid, which forms sticky clumps outside of the cells — but have yet to get a workable treatment.

The drug is in the second of three stages of development, and scientists are paying special attention to potential treatments because of the enormity of the illness, which afflicts more than 26 million people worldwide and is mushrooming as the population ages.

The four Alzheimer's drugs currently available just ease symptoms of the mind-robbing disease.

TauRx's chief is Claude Wischik, a biologist at the University of Aberdeen in Scotland who long has done key research on tau tangles and studies suggesting that Rember can dissolve them.

He is an "esteemed biologist," and the research "comes with his credibility attached to it," said Dr. Sam Gandy of Mount Sinai School of Medicine in New York. He heads the scientific advisory panel of the Alzheimer's Association.

In the study, 321 patients were given one of three doses of Rember or dummy capsules three times a day. The capsules containing the highest dose had a flaw in formulation that kept them from working, and the lowest dose was too weak to keep the disease from worsening, Wischik said.

However, the middle dose helped, as measured by a widely used score of mental performance.

"The people on placebo lost an average of 7 percent of their brain function over six months whereas those on treatment didn't decline at all," he said.

After about a year, the placebo group had continued to decline but those on the mid-level dose of Rember had not. At 19 months, the treated group still had not declined as Alzheimer's patients have been known to do.

Two types of brain scans were available on about a third of participants, and they show the drug was active in brain areas most affected by tau tangles, Wischik said.

"This is suggestive data," not proof, Wischik warned. The company is raising money now for another test of the drug to start next year.

The main chemical in Rember is available now in a different formulation in a prescription drug sometimes used since the 1930s for chronic bladder infections — methylene blue. However, it predates the federal Food and Drug Administration and was never fully studied for safety and effectiveness, and not in the form used in the Alzheimer's study, Wischik and other doctors cautioned.

On Monday at the International Conference on Alzheimer's Disease, other researchers reported encouraging results from a test of a different experimental drug that also targets tau tangles. That drug, by British Columbia-based Allon Therapeutics Inc., was tested in people with an Alzheimer's precursor, mild cognitive impairment.

The tau-drug results are in stark contrast to the flop of Flurizan, which was aimed at blocking enzymes that form the beta-amyloid clumps. Myriad Genetics announced in June that it would abandon development of Flurizan after the failure. Full results were presented at the conference Tuesday.

Also, fuller results were given from a closely watched test of bapineuzumab, an experimental drug that aims to enlist the immune system to clear out the sticky brain clumps.

Its developers — New Jersey-based Wyeth and the Irish company Elan Corp. PLC — previously announced that the 240-patient study missed its main goal of improving patients' mental performance at 18 months.

But the company found a silver lining — the drug appeared to help the roughly 60 percent of people in the study who did not have a gene that scientists think makes Alzheimer's disease more severe.

The results back up the company's claims of potential effectiveness in some patients, but now there are concerns about possible side effects. Twelve cases of a type of brain swelling occurred in those on bapineuzumab and none in the placebo group. The swelling caused few if any symptoms, company scientists said, but outside experts said it may have contributed to other side effects.

Those were two or more times more common in patients on bapineuzumab than people given the dummy drug. For example, cases of anxiety occurred in 11 percent versus 4 percent on placebo; paranoia, 7 versus 1 percent. Other complaints were vomiting, high blood pressure, weight loss, and back pain.

Three deaths occurred among the 124 patients given bapineuzumab, but they were not related to the drug, said Dr. Sid Gilman of the University of Michigan, who headed the study's data safety monitoring board. One death was due to pneumonia and two others to worsening Alzheimer's disease.

Investors reacted to the news by driving down Wyeth's shares $5.01, or 11.1 percent, in after-hours trading.

Wyeth and Elan have already said they will move on to late-stage testing of bapineuzumab in more than 4,000 patients.

___

On the Net:

National Institute on Aging: http://www.nia.nih.gov

Alzheimer's Association: http://www.alz.org

Study: Exercise slows Alzheimer's brain atrophy

NEW YORK - Patients with early Alzheimer's disease who exercised regularly saw less deterioration in the areas of the brain which control memory, according to a study released Sunday at the 2008 International Conference on Alzheimer's Disease in Chicago.

Magnetic resonance imaging (MRI) studies showed that exercise positively affected the hippocampus region of patients' brains, an area which is important for both memory and balance. In Alzheimer's, the hippocampus is one of the first parts of the brain to suffer damage.

Exercise and physical fitness have been shown to slow down age-related brain cell death in healthy older adults, and earlier this month a preliminary study was published showing that exercise may help slow brain shrinkage in people with early Alzheimer's disease.

Now, researchers at the University of Kansas Medical Center in Kansas City, Kan., have used MRI and other neuroimaging tools to analyze how exercise affects the brains of those with early Alzheimer's.

The researchers found that patients with early Alzheimer's had a "significant relationship" between the size of key brain areas associated with memory and fitness, unlike healthy older adults. Those patients with better fitness ratings had less brain tissue atrophy and those with worse fitness had more brain damage.

"This is the first study to get an inside look into specifically where these changes occur in the brain — we're able to locate the changes associated with fitness to the actual memory region, the hippocampus, which is a key area for Alzheimer's-related atrophy," said Robyn A. Honea, PhD, a lead investigator on the study. "This suggests that maintaining cardiorespiratory fitness may positively modify Alzheimer's-related brain atrophy."

The study was funded by the National Institute on Aging and National Institute on Neurological Disorders and Stroke.

Another report from ICAD 2008 showed that a 12-month home-based exercise program reduced falls and improved balance in patients with dementia. According to researchers from Western Medicine, a consultant physician service provider for Hollywood Hospital in Nedlands, Western Australia, people suffering from dementia fall up to three times more than those who have no cognitive impairment.

"Falls have a negative impact on a person's quality of life, often resulting in nursing home placement, increased mortality and significant costs to the community," said Megan J. Wraith, a speech pathologist at Western Medicine and a researcher on the study. "Targeting this high risk group may be a relatively cost effective way of having a significant impact on the overall rate of falling in the elderly."

The study was funded by the Sir Charles Gairdner Research Foundation and Hollywood Private Hospital Research Foundation.

Currently, the prognosis for patients with Alzheimer's is bleak. The Alzheimer's treatment market is small, led by Pfizer Inc.'s Aricept, Forest Laboratories Inc.'s Namenda, Razadyne from Johnson & Johnson and Shire Ltd., Novartis AG's Exelon and Sciele Pharma Inc.'s Cognex. But while those drugs fight Alzheimer's symptoms, they can't stop its ultimate progress.

Wyeth and Elan Corp. are currently developing a new kind of Alzheimer's treatment, bapineuzumab, which is designed to actually slow progress of the disease. In June, study data showed that drug was shown to benefit Alzheimer's patients who lacked a certain gene.

Vytorin fails to meet main goal of heart study

NEW YORK (Reuters) - The cholesterol fighter Vytorin sold by Merck & Co Inc and Schering-Plough Corp failed to meet the main goal of improving outcomes in a closely-watched heart study, according to data presented on Monday.

Slightly higher incidents of cancer deaths were also seen in those taking the drug -- 39 versus 23 on placebo -- although the lead researcher said those could have occurred as a result of chance.

The shares of both companies fell after the data were released, with Schering off more than 15 percent and Merck down by 7 percent.

No significant difference in the study's composite heart goals was seen between the patients who received Vytorin and those who received a placebo, according to data presented in London by its primary researcher, Dr. Terje Pedersen of Ulleval University Hospital in Oslo, Norway.

Researchers played down the cancer data, saying much larger studies of Vytorin have not showed increased cancer risk.

"There is no overall credible evidence of an increase in cancer," said Sir Richard Peto, professor of medical statistics and epidemiology at the University of Oxford, who reviewed the data. "We should not be diverted (from using Vytorin) by fears of cancer."

Merck and Schering-Plough delayed reporting quarterly financial results, which were expected on Monday morning, so investors could first learn about the outcome of the study.

The primary composite goals of the study of patients with irregular thickening of the main valve to the aorta were broken into two sets of secondary goals and Vytorin was superior on one of those sets, researchers said.

Vytorin was significantly better than placebo in reducing atherosclerotic events, defined as nonfatal heart attacks, need for coronary artery bypass surgery or artery-clearing procedures, hospitalization due to chest pain and strokes.

"The study has given a clear-cut answer whether lipid lowering will influence the cause of aortic stenosis and we can conclude it does not," Pedersen said.

But he noted that Vytorin did offer some benefits in reducing risk of coronary artery disease in the study.

The drug was no better than placebo on the other secondary measure of reducing aortic valve disease events -- the need for surgical valve replacement, hospitalization because of heart failure and cardiovascular death.

"Overall it looks positive. They did decrease atherosclerotic events, which is sort of what everyone expected," said Jon LeCroy, an analyst for Natixis Bleichroeder.

He said cancer fears should be allayed by results of larger, previous studies.

"But we've seen with drugs in the past any time cancer gets tagged on them sometimes the prescriptions can come off a little bit," he added.

Vytorin did lower bad LDL cholesterol by 61 percent throughout the study.

"The bottom line is there was a trade-off in this trial -- in a reduction in some cardiovascular events and an excess of cancer deaths. It's obviously not a favorable result," said Dr Steven Nissen, chairman of cardiovascular medicine at Cleveland Clinic, who has been critical of Vytorin use in the past.

The trial was designed to determine whether aggressive cholesterol lowering can lessen the need for surgical replacement of aortic valves, reduce cardiac death and reduce cardiovascular events, including heart attacks.

The 1,873-patient study, meant to follow subjects for a minimum of four years, is the largest formal trial ever conducted in patients with the condition, known as aortic stenosis. An estimated 2 percent of people over age 65 have the condition, which can lead to heart failure.

Sales of the pill have suffered this year and Merck and Schering-Plough stock has fallen sharply, following Vytorin's failure to cut plaque in neck arteries in a separate trial called Enhance.

Widespread unfavorable publicity followed release of the Enhance results in mid-January and subsequent recommendations by researchers that patients first try other cholesterol fighters before opting for Vytorin.

Linda Bannister, an analyst for Edward Jones, said it would have been a positive surprise had Vytorin met the main goal of the latest study, called SEAS.

"The concern is how this is going to be portrayed and perceived and is it just going to be another issue where there is a lot of negative publicity surrounding the drug," Bannister said.

Merck shares were down $2.80, or 7.4 percent, at $34.28, while Schering-Plough shares were down $3.36, or 15.6 percent, at $18.08 in afternoon trading.

Green tea can protect the heart's arteries, new study shows

The next time you're offered a choice between Earl Grey and green tea, you might want to go green.

A new study shows that the beverage, which is more popular in Eastern cultures, can protect heart arteries by keeping them flexible and relaxed, and therefore better able to withstand the ups and downs of constant changes in blood pressure. Led by Dr. Nikolaos Alexopoulos of Athens Medical School in Greece, the researchers found that among 14 subjects, those who drank green tea showed greater dilation of their heart arteries on ultrasound 30 min. later than those drinking either diluted caffeine or hot water. That's because, the scientists speculate, green tea works on the lining of blood vessels, helping cells there to secrete the substances needed to relax the vessels and allow blood to flow more freely. It's the flavonoids in the tea, which work as antioxidants and help prevent inflammation in body tissue, that keep the vessels pliable. These substances may also protect against the formation of clots, which are the primary cause of heart attacks. "We found very promptly [that] after drinking green tea, there was a protective effect on the endothelium," says Dr. Charalambos Vlachopoulos, a cardiologist and one of the authors of the study.


All it took, says Vlachopoulos, was 6 g of green tea, which amounts to 3 to 4 cups. To make sure the dilation effect was not due to the small amounts of caffeine found in green tea, the group compared the arterial sizes in the green-tea drinkers with those consuming a diluted caffeine beverage and found no change in arterial size in the caffeine drinkers. Even more intriguing, the beneficial effect seems to be long-lasting and cumulative. When the doctors measured the green-tea drinkers' arteries two weeks after daily consumption of the beverage, they found that their vessels were more dilated than they had been at the beginning of the study. "It's something that needs to be investigated, but we think that if someone takes green tea for one or two months, the beneficial effect will be even greater," says Vlachopoulos.


But experts caution that one study isn't enough to catapult green tea to wonder-drink status. Dr. Robert Eckel, a professor at the University of Colorado, Denver, and past president of the American Heart Association, notes that endothelial function is affected by a number of factors, including large doses of vitamins E and C. "Green-tea consumption may have beneficial effects on the arteries, but we should stop short of translating that into a recommendation that everybody should be drinking green tea because it's been proven to reduce heart attacks and strokes," he says. He acknowledges, however, that early studies hint that green tea may be a good addition to a heart-healthy diet. The American Heart Association does not yet include the beverage in its dietary recommendations, but more studies like this one may change that. In the meantime, if you're drinking tea, it might not be such a bad idea to go green.

Study shows how broccoli fights cancer

LONDON (Reuters) - Just a few more portions of broccoli each week may protect men from prostate cancer, British researchers reported on Wednesday.

The researchers believe a chemical in the food sparks hundreds of genetic changes, activating some genes that fight cancer and switching off others that fuel tumors, said Richard Mithen, a biologist at Britain's Institute of Food Research.

There is plenty of evidence linking a healthy diet rich in fruits and vegetables to reduced cancer risk. But the study published in the Public Library of Science journal PLoS One is the first human trial investigating the potential biological mechanism at work, Mithen added in a telephone interview.

"Everybody says eat your vegetables but nobody can tell us why," said Mithen, who led the study. "Our study shows why vegetables are good."

Prostate is the second-leading cancer killer of men after lung cancer. Each year, some 680,000 men worldwide are diagnosed with the disease and about 220,000 will die from it.

Mithen and colleagues split into two groups 24 men with pre-cancerous lesions that increase prostate cancer risk and had them eat four extra servings of either broccoli or peas each week for a year.

The researchers also took tissue samples over the course of the study and found that men who ate broccoli showed hundreds of changes in genes known to play a role in fighting cancer.

The benefit would likely be the same in other cruciferous vegetables that contain a compound called isothiocyanate, including brussel sprouts, cauliflower, cabbage, rocket or arugula, watercress and horse radish, they added.

Broccoli, however, has a particularly powerful type of the compound called sulforaphane, which the researchers think gives the green vegetable an extra cancer-fighting kick, Mithen said.

"When people get cancer some genes are switched off and some are switched on," he said. "What broccoli seems to be doing is switching on genes which prevent cancer developing and switching off other ones that help it spread."

The broccoli eaters showed about 400 to 500 of the positive genetic changes with men carrying a gene called GSTM1 enjoying the most benefit. About half the population have the gene, Mithen said.

The researchers did not track the men long enough to see who got cancer but said the findings bolster the idea that just a few more vegetable portions each week can make a big difference.

It is also likely that these vegetables work the same way in other parts of the body and probably protect people against a whole range of cancers, Mithen added.

"You don't need a huge change in your diet," he said. "Just a few more portions makes a big difference."

20 cancer-fighting foods to eat all summer

A healthy, balanced diet is key, experts say, but these foods may have an extra punch.

Leafy greens: Deep green leafy vegetables are packed with lutein, vitamin A and folate, nutrients that may help prevent colon and ovarian cancer.


Spinach
Kale
Collard greens
Arugula
Dandelion greens

Curry: Yellow curry contains cur-cumin, a pungent spice that may help prevent melanoma and other types of cancer cells from proliferating.

Cruciferous veggies: These contain phytochemicals that may cut the risk of stomach, breast and skin cancers.

Broccoli
Broccoli sprouts
Cabbage
Bok choy
Cauliflower
Watercress
Swiss chard

Berries: These fruits contain antioxidants such as polyphenols, which counteract and repair cell damage.

Blueberries
Blackberries
Raspberries
Strawberries
Cranberries
Red grapes

Tomatoes: Studies suggest that having a tomato-rich diet may help lower the risk of developing both lung and stomach cancer.

Get in Step With Summer Foot Care

SATURDAY, June 21 (HealthDay News) -- Summer is here, and many of you will be kicking off your shoes at home, at the beach or in the park. But is that a good thing?

To sort the myths from the facts about your feet, Dr. Tracey Vlahovic, associate professor of podiatric medicine and orthopedics at Temple University's School of Podiatric Medicine, offers this information about your tootsies with a caveat -- always check with your doctor before starting any treatment:

Myth: Flats, flip-flops and going barefoot are good for your feet.

Fact: "This is a common misconception, because we always hear about the problems with high heels," Vlahovic said in a prepared statement. "But these three present their own types of problems." Flip-flops provide no support, which can cause plantar fasciitis, ankle sprains and tendonitis. Wearing flats can lead to severe heel pain and blisters, crowding toes and conditions such as hammertoes and bunions. Walking barefoot leaves feet open to cuts, scrapes, bruises, and puncture wounds along with skin issues or nail injuries.

Diagnosis: Flip-flops or flats are fine for a few hours, but you should stretch your Achilles tendon for a bit if you wear them for longer than that, Vlahovic said. Save walking barefoot for around your own home, unless you are at risk for diabetes or have peripheral vascular disease. In those cases, always wear shoes in and out of the house.

Myth: Over-the-counter scrubs and soaks for corns are safe and effective.

Fact: "At-home soaks or scrubs would just exfoliate, not remove corns," Vlahovic said.

Diagnosis: A corn is a buildup of skin with a hard center. This often is caused by a hammertoe in which the toe knuckle rubs against the shoe. To permanently remove a corn, the hammertoe must be corrected so that it stops rubbing against the shoe. Or, just wear shoes with a wider toe box.

Myth: Feet don't need sunscreen.

Fact: "Skin cancer on the legs and feet actually has a high mortality rate due to people forgetting to do skin checks on that area. It's often caught too late," Vlahovic said. "This is due in large part to the fact that many people simply forget to apply or reapply sunscreen to the lower extremities."

Diagnosis: Apply sunscreen with an SPF of at least 15 and with both UVB and UVA protection every two to three hours to the feet. Apply more often if you're going to be at the beach, in and out of the water, or sweating.

Myth: All pedicure salons use sterile instruments, so it's fine to use theirs.

Fact: "Unfortunately, this is not the case with all nail salons," Vlahovic said. "As a result, the instruments can spread germs that can cause nail fungus and bacterial infections."

Diagnosis: Invest in your own nail files, clippers and cuticle sticks, unless you can be sure your nail salon sterilizes its instruments after each use. Also ask the technician if they have a clean bowl or basin or one with individual liners before sticking your feet in the motorized tub.

Myth: It's best to trim your toenails straight across.

Fact: Doing this, and cutting them too short, can lead to ingrown toenails, a true danger for diabetics. Untreated ingrown toenails can lead to infection and possibly an abscess requiring corrective surgery.

Diagnosis: Leave the nail slightly longer, trimming along the natural curve of your toe.

Myth: Soaking your feet in vinegar clears up toenail fungus.

Fact: "Vinegar can't penetrate the layers of the nail to get to the infection site. And without proper treatment, the infection can spread to other nails," Vlahovic said.

Diagnosis: See your dermatologist or podiatrist so they can perform a culture to see if it is definitely a fungal infection. Follow their instructions to the letter to avoid a recurrence.

Myth: Athlete's foot and warts aren't contagious.

Fact: Both are highly contagious, and easily spread in environments such as locker rooms or showers. They are often picked up through small breaks in the skin of the foot bottom.

Diagnosis: Keep your feet clean and dry, don't wear dirty socks and thoroughly clean your bath or shower area. "If one person in the household has it, everyone should be cautious and take proper precautions," Vlahovic said. If you must use a public shower, wear flip-flops.

Myth: Duct tape removes plantar warts.

Fact: Studies have shown duct tape to be one of the many ways to treat warts, but Vlahovic noted that several studies have shown duct tape in no better than a placebo.

Diagnosis: "If you have a plantar wart, don't pick or perform bathroom surgery on it," Vlahovic said "Don't put duct tape on it and expect it to go away, since there is a specific protocol for using it. See your dermatologist or podiatrist for this and other treatment options."

More information

The U.S. National Library of Medicine has more about foot health.

Bone drug Zometa helps fight breast cancer spread

CHICAGO - A drug to prevent bone loss during breast cancer treatment also substantially cut the risk that the cancer would return, results that left doctors excited about a possible new way to fight the disease.

It is the first large study to affirm wider anti-cancer hopes for Zometa and other bone-building drugs called bisphosphonates. Zometa, made by Novartis AG, is used now for cancers that have already spread to the bone.

The new study involved 1,800 premenopausal women taking hormone treatments for early-stage breast cancer. Zometa cut by one-third the chances that cancer would recur — in their bones or anywhere else.

"This is an important finding. It may well change practice," said Dr. Claudine Isaacs, director of the clinical breast cancer program at Georgetown University's Lombardi Cancer Center.

About three-fourths of breast cancers occur in women after menopause. Zometa may help them, too, but it hasn't been tested yet in that age group.

The study was led by Dr. Michael Gnant of the Medical University of Vienna and reported Saturday at an American Society of Clinical Oncology conference in Chicago.

If a second, ongoing study also finds a benefit, doctors predict that Zometa will quickly be tested against other cancers that tend to spread, or metastasize, to bones, such as prostate and kidney cancer.

"Hugely important is whether this has to do with the fact that it just makes the bone hostile, somehow, to metastasis or if there is a more global anti-metastasis effect," said the oncology group's president, Dr. Nancy Davidson of Johns Hopkins University.

"Either of those would be good and would teach us a lot about what to do next."

Breast cancer is the most common cancer in women. About 184,450 cases and 40,930 deaths from the disease are expected in the United States this year.

Standard treatments are surgery, chemotherapy, radiation and hormone-blocking drugs if the tumors are like those in the study — helped to grow by estrogen or progesterone.

The hormone-blockers often weaken bones, so bisphosphonates like the osteoporosis pill Fosamax have become increasingly popular to treat this side effect. However, using them to treat the cancer itself is a very different approach.

Lab studies hinted it would work, and Gnant's is the first to test it in a large group of breast cancer patients.

All had surgery to remove their tumors and were taking hormone-blocking drugs — goserelin plus either tamoxifen or anastrozole — treatments that made them menopausal. Half also were given infusions of Zometa once every six months.

The women were treated for three years and studied for two more. By then, only 6 percent of those given Zometa had suffered a relapse or died, compared to 9 percent of the others. That translated to a 36 percent decline in risk.

Sixteen women given Zometa died versus 26 of the others — a difference that could have occurred by chance alone but an encouraging trend that doctors hope will mean better survival as the groups are followed for a longer time.

There were no big differences in serious side effects, though minor ones like fever and bone and joint pain were more common among women given Zometa. Two percent of all study participants developed a rapid heartbeat, but only three were hospitalized — two on Zometa and one of the others.

The study was sponsored by Zometa's maker, Swiss-based Novartis, and British-based AstraZeneca PLC, which makes Arimidex, the brand name of anastrozole. Gnant consults for the companies and several other breast cancer drugmakers.

With doctor fees for the infusion, a Zometa treatment can run more than $1,200. The other large study is testing it in 3,360 pre- and postmenopausal women with cancer that has spread but not extensively.

Experts stressed that the results so far are only in women who were made menopausal by hormone-blocking treatments — not women who develop breast cancer after natural menopause.

For now, using Zometa to prevent breast cancer recurrence should be confined to those who develop breast cancer before menopause, said Dr. Eric Winer of Dana-Farber Cancer Center in Boston.

"This is a treatment that doctors should talk to a patient about" because of these encouraging new results, Winer said.

In other news at the conference, women with advanced breast cancers who were given Avastin plus Taxotere were a little less likely to have their cancers progress than women given Taxotere alone. However, side effects including high blood pressure were more common for those taking both drugs. Taxotere treatment is more common in Europe and Asia; in the United States, doctors are more likely to use Taxol.

In the study of 736 women, 44 percent of those given just Taxotere had their tumors shrink versus 55 percent of those also given a lower dose of Avastin and 63 percent of those given a higher dose.

Avastin, marketed by California-based Genentech and Swiss-based Roche Holding AG, recently won federal approval for breast cancer — against the recommendations of outside advisers. The approval was based on measurements like those in this study — cancer progression, rather than overall survival. The new study was too short to show any differences in survival.

___

On the Net:

Cancer conference: http://www.asco.org

Patient information: http://www.cancer.net

American Cancer Society: http://www.cancer.org

National Cancer Institute: http://www.cancer.gov/cancertopics/types/lung

THURSDAY, May 22 (HealthDay News) -- Diet and exercise programs for people at high risk for developing diabetes, when followed for six years, can actually delay the development of diabetes for 14 years after the programs end, a new report finds.

The report is published in the May 24 special diabetes issue of The Lancet.

In another study in the same journal issue, Chinese researchers found that intensive therapy with insulin in patients with newly diagnosed type 2 diabetes can help restore the cells in the body that produce insulin, and thereby restore blood sugar balance.

"Early intensive insulin therapy in patients with newly diagnosed type 2 diabetes has favorable outcomes on recovery and maintenance of B-cell function and prolonged glycemic remission compared with treatment with oral hypoglycemic agents," the researchers concluded.

In terms of the lifestyle study, a series of trials around the world have shown lifestyle changes in diet and exercise can reduce cases of diabetes in people with high blood sugar levels. However, whether these gains remain over an extended period isn't clear, researchers said.

"When you do lifestyle interventions in communities, it seems to have a durability beyond the life of the intervention itself, which is very encouraging," said co-author Edward Gregg, branch chief of the Epidemiology and Statistical Branch in the Division of Diabetes Translation at the U.S. Centers for Disease Control and Prevention.

In the trial, called the China Da Qing Diabetes Prevention Outcome Study, 577 adults with high blood sugar levels, at risk for developing diabetes, from 33 clinics in China, were randomly assigned to one of three lifestyle intervention groups. One group relied on diet, a second group on exercise and a third on a combination of diet and exercise. In addition, there was a group that did not participate in any diet or exercise program.

People were counseled to reduce the amount of food they ate and to cut down on sugar and alcohol, Gregg said. "People were encouraged to eat more vegetables and increase their levels of physical activity," he added.

The study began in 1986, and these groups continued their diet and/or exercise programs until 1992. In 2006, the people in the study were seen again to determine the long-term effect of diet and exercise.

Gregg's team found lifestyle interventions reduced the incidence of diabetes by 51 percent over the six years of the program.

Moreover, over the whole 20-year period, the incidence of diabetes was reduced by 43 percent in those people who had been in diet and exercise programs.

On average, the incidence of newly diagnosed diabetes was 7 percent for people who had participated in diet and exercise programs, compared with 11 percent for people who hadn't, the researchers reported.

By the 20th year, 80 percent of those who had participated in a diet and exercise program had developed diabetes, compared with 93 percent of the people who did not participate in such a program. People who had been in a diet and exercise program, spent 3.6 fewer years with diabetes than people who hadn't, Gregg's team found.

Gregg believes that similar programs could be effective in the United States. "Interventions used in this study are similar to interventions that have been used in the United States and do work," he said.

One expert says that despite these impressive results, the study does have a couple of important limitations.

"The majority of study participants in both intervention and control groups went on to develop diabetes eventually," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine. "Moreover, the study is unable to prove that the intervention conferred a survival benefit."

Another limitation is how these results from lifestyle changes can be translated into the real world, Katz said.

"Despite these limitations and the challenges that lie ahead, the finding that we can teach people to eat well and be active, and thereby provide them meaningful defense against diabetes that lasts for decades, is of extraordinary significance," Katz said.

In a third study, Finnish researchers found that incidence of type 1 diabetes has more than doubled among Finnish children in the past 25 years. The incidence of type 1 diabetes rose from 31.4 percent per 100,000 in 1980 to 64.2 percent per 100,000 in 2005.

The increase is expected to continue. This dramatic increase in type 1 diabetes appears to be a combination of genetic and lifestyle factors, the researchers say. For example, obesity among Finnish children has risen from 9.5 percent in the mid-1980s to 20 percent currently.

More information

For more about diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases.

Vitamin D may help curb breast cancer, study finds

Breast cancer patients with low levels of vitamin D were much more likely to die of the disease or have it spread than patients getting enough of the nutrient, a study found — adding to evidence the "sunshine vitamin" has anti-cancer benefits. The results are sure to renew arguments about whether a little more sunshine is a good thing.

The skin makes vitamin D from ultraviolet light. Too much sunlight can raise the risk of skin cancer, but small amounts — 15 minutes or so a few times a week without sunscreen — may be beneficial, many doctors believe.

While the vitamin is found in certain foods and supplements, most don't contain the best form, D-3, and have only a modest effect on blood levels of the nutrient. That's what matters, the Canadian study found.

Only 24 percent of women in the study had sufficient blood levels of D at the time they were first diagnosed with breast cancer. Those who were deficient were nearly twice as likely to have their cancer recur or spread over the next 10 years, and 73 percent more likely to die of the disease.

"These are pretty big differences," said study leader Dr. Pamela Goodwin of Mount Sinai Hospital in Toronto. "It's the first time that vitamin D has been linked to breast cancer progression."

But people shouldn't start downing supplements, she warned. Experts don't agree on how much vitamin D people need or the best way to get it, and too much can be harmful. They also don't know whether getting more vitamin D can help when someone already has cancer.

"We have no idea whether correcting a vitamin D deficiency will in any way alter these outcomes," said Dr. Julie Gralow, a cancer specialist at the University of Washington in Seattle.

The study was released Thursday by the American Society of Clinical Oncology and will be presented at the group's annual meeting later this month.

Lots of earlier research suggests vitamin D may help prevent prostate, breast and especially colon cancer. In lab and animal tests, vitamin D stifles abnormal cell growth, curbs formation of blood vessels that feed tumors and has many other anti-cancer effects.

Other evidence: People who live in northern regions of the world have higher cancer rates than those living closer to the equator, possibly because of less sunshine and vitamin D.

The Canadian researchers wanted to see whether it made a difference in survival. They took blood from 512 women at three University of Toronto hospitals between 1989 and 1995, when the women were first diagnosed with early-stage breast cancer.

A decade later, 83 percent of those who had had adequate vitamin D blood levels were alive without extensive spread of their cancer, versus 79 percent of those whose vitamin D levels were insufficient and 69 percent of those who were deficient, as defined by widely used medical standards for measuring intake.

One red flag: The few women with the very highest levels of vitamin D seemed to have worse survival.

Though the study was too small and those results were not conclusive, "there may be an optimal level of vitamin D in women with breast cancer and it may be possible to take too much," Goodwin said.

The federal government says up to 2,000 international units of vitamin D a day seems OK. Taking 800 units per day will, on average, raise blood levels to the middle of the range that seems best for bone and general health, Goodwin said.

Vitamin D is in salmon and other oily fish, and milk is routinely fortified with it, but dietary sources account for little of the amount of D circulating in the blood, experts say.

"It's very hard to make a recommendation" because how much difference a supplement makes depends on someone's baseline level, which also can be affected by sunlight, skin type and time of year, she explained.

Doctors do suggest breast cancer patients get their vitamin D levels checked to see whether they are deficient. The simple blood test is available in many hospitals and labs for about $25, Goodwin said.

Dr. Nancy Davidson, a Johns Hopkins University cancer specialist who is president of the oncology society, said those tests are growing in popularity, even in ordinary medical care.

"Rightly or wrongly, I'm increasingly seeing physicians who are measuring this," she said.

The Canadian study was paid for by the Breast Cancer Research Foundation in New York, established by cosmetics magnate Evelyn Lauder.

"It's a very provocative paper. It's confirmatory of a tremendous amount of evidence that vitamin D is an important component of health," said Dr. Larry Norton, chief of breast cancer programs at Memorial Sloan-Kettering Cancer Center in New York and a medical adviser to the foundation.

Breast cancer is the most common cancer in women. About 184,450 cases and 40,930 deaths from the disease are expected in the United States this year.

___

On the Net:

Government vitamin information:

http://ods.od.nih.gov/factsheets/vitamind.asp

Cancer conference: http://www.asco.org

Food Facts That Restaurants Hide From You

What does the restaurant industry have to hide? One of the true issues behind obesity is the fact that many chain restaurants — which provide one-third of all restaurant meals, according to the New York Department of Health — obfuscate the fat and calorie counts of their menu items, and fight any attempt to shed light on what, exactly, is going on between their buns and inside their taco shells.

Through scientific testing, consultations with nutrition experts, and good old-fashioned snooping, we uncovered some of the secrets these mega-restaurateurs have been keeping.

It's no wonder . . .

1) T.G.I. Friday’s

. . . doesn’t want you to know the nutritional impact of any of its dishes, which they have made a policy of not revealing to customers for years, despite the fact that major competitors such as Chili’s and Ruby Tuesday’s do just that. Thankfully, new legislation in New York City forces restaurants with 15 or more branches nationwide to provide calorie counts for all dishes and drinks on their menus.

We popped by T.G.I. Friday’s the day the law went into effect and saw some real shockers: 2,270 calories for Potato Skins, 1,670 calories for Double-Stack Quesadillas, and, most appalling of all, a Pecan Crusted Chicken Salad with 1,360 calories! Now we see why they worked so hard to keep these numbers hidden.

2) Burger King

. . . doesn't want you to know that its French Toast Sticks (which deliver more than 4 grams of fat per stick) share a deep fryer with the pork sausage, pork fritters, Chicken Tenders, Chicken Fries, Big Fish patties, hash browns, onion rings, and Cheesy Tots — and that all of those items contain harmful trans fats.

But there is hope: After the company was sued by the Center for Science in the Public Interest for moving too slowly to remove trans fats from its menu, Burger King promised to phase them out by the end of this year.

3) Red Robin

. . . doesn't want you to know the nutritional impact of its gourmet burgers. "A gourmet burger starts by being an honest burger," Red Robin's Web site declares — but not, apparently, a burger that will come clean about its nutrition facts.

When contacted, Red Robin's senior vice president responded that nutritional information for the menu would be available in October 2007. As of May 2008, however, nutrition facts were still not posted on the site.

4 ) Maggiano's Little Italy

. . . doesn't want you to know just how many calories and carbs you're consuming in those massive pasta portions. (As the menu puts it, "Family-style service or individual entrees are available . . . Whichever you choose, you'll have plenty to share or take home.")

In Italy, a standard pasta serving means 4 ounces of noodles with a few tablespoons of sauce. At Maggiano's, a large order of pasta translates into 2 pounds of noodles piled high on a hubcap-size dinner plate (15 1/2 inches in diameter). A Maggiano's PR rep responded to our request for nutritional information a week later: "Sorry for the delay. I had to wait for corporate's approval. Unfortunately, they have declined to participate."

5) Sit-down chains

. . . don't want you to know that their food is actually considerably worse for you than the often-maligned fast-food fare. In fact, our menu analysis of 24 national chains revealed that the average entree at a sit-down restaurant contains 867 calories, compared with 522 calories in the average fast-food entree. And that's before appetizers, sides, or desserts — selections that can easily double your total calorie intake.

For more reasons to insist on nutritional transparency from the food industry, check out these shocking secrets they don’t want you to know.

Egg Consumption Poses Risks for Diabetic Men: Study

THURSDAY, April 10 (HealthDay News) -- A new study suggests that consuming more than six eggs a week seems to raise the risk of dying from all causes.

And diabetics seem to face an even higher mortality risk, according to the study that was limited to men.

On average, the physicians were found to have consumed one egg a week -- a rate the study authors termed "relatively low."

Overall, egg consumption wasn't found to be associated with heart attack or stroke risk. And consumption of up to six eggs a week also wasn't found to be associated with a higher risk of death from all causes. But eating seven or more eggs a week among healthy study participants was linked to a 23 percent higher risk of death.

Even more striking was the finding that mortality risk was much higher among those doctors with diabetes. Consuming seven or more eggs a week doubled their risk of death from all causes, compared with diabetic doctors who ate just one egg each week.

The findings were published in the April issue of The American Journal of Clinical Nutrition.

Heart disease is the leading cause of death in the United States, and elevated LDL ("bad") cholesterol is a prime risk factor for cardiovascular trouble. And while eggs are rich in cholesterol -- and circulating cholesterol is related to the risk of cardiovascular disease -- the relationship between dietary cholesterol and blood cholesterol is complex. Some studies have suggested that dietary cholesterol doesn't affect blood cholesterol levels in many people, but it may in other individuals, such as those with diabetes, the researchers noted.

A single egg contains about 200 milligrams of cholesterol -- just 100 milligrams shy of the daily limit advocated for those at risk for heart disease, the researchers added.

On the other hand, eggs are a source of minerals, folate, B vitamins, protein and monounsaturated fats -- all of which have the potential to lower overall risk.

To explain the finding on diabetic men, the researchers theorized that diabetics might somehow convert dietary cholesterol more readily into blood cholesterol than people without diabetes.

"We need additional data to confirm these findings, so it's kind of premature to advise against egg consumption until we have more information," Djousse said.

Donald McNamara, executive director of the Washington, D.C.-based Egg Nutrition Center, said that while diabetics need to carefully assess all aspects of their diet, "no one food exists in isolation."

"And when we look at all the other studies that have been published, they show that easily an egg a day can fit into a healthy diet with no change in heart-disease risk for the average person and those with diabetes," McNamara added. "Eggs also provide some very important nutrients in terms of high quality protein and choline, which we know is insufficient in the diet today. So, you have to balance out the nutritional contribution of eggs in the diet relative to this kind of a study, which presents a very unique finding which has not been presented anywhere else, and has a lot of variables included that we don't know enough about."

In an accompanying editorial published in the journal, Dr. Robert H. Eckel, a professor of physiology and biophysics at the University of Colorado and co-chair of both the Cardiometabolic Health Congress and the Committee on Cardiovascular and Metabolic Diseases, echoed some of McNamara's comments and called for more research to validate the study findings.

"Eggs are like all other foods -- they are neither 'good' nor 'bad', and they can be part of an overall heart-healthy diet," Eckel said. But he suggested that those wary of the high cholesterol content in whole eggs might want to skip yolks in favor of egg whites, which are ripe with protein, riboflavin and selenium.

And Lona Sandon, a registered dietician and assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas, said that "the white part of the egg is the gold standard for protein."

"It contains all the essential immunoacids that your muscle needs for building," she said. "It's better than beef even. And it's one of the cheapest sources of protein as well. There are some good things in the yolk as well. But for someone who has had their cholesterol measured and found to have high LDL, the American Heart Association and the American Dietetic Association say watch your egg consumption, and try not to consume more than two yolks per week."

More information

For additional information on nutrition and diabetes, visit the American Diabetes Association

Genetic link tied to smoking addiction

WASHINGTON - Scientists have pinpointed genetic variations that make people more likely to get hooked on cigarettes and more prone to develop lung cancer — a finding that could someday lead to screening tests and customized treatments for smokers trying to kick the habit.

The discovery by three separate teams of scientists makes the strongest case so far for the biological underpinnings of nicotine addiction and sheds more light on how genetics and lifestyle habits join forces to cause cancer.

"This is kind of a double whammy gene," said Christopher Amos, a professor of epidemiology at the M.D. Anderson Cancer Center in Houston and author of one of the studies. "It also makes you more likely to be dependent on smoking and less likely to quit smoking."

A smoker who inherits these genetic variations from both parents has an 80 percent greater chance of lung cancer than a smoker without the variants, the researchers reported. And that same smoker on average lights up two extra cigarettes a day and has a much harder time quitting than smokers who don't have these genetic differences.

The researchers disagreed on whether the variants directly increased the risk of lung cancer or did so indirectly, by causing more smoking.

The three studies, funded by governments in the U.S. and Europe, are being published Thursday in the journals Nature and Nature Genetics.

The scientists studied the genes of more than 35,000 white people of European descent in Europe, Canada and the United States. Blacks and Asians will be studied soon and may yield different results, scientists said.

They aren't quite sure if what they found is a set of variations in one gene or in three closely connected genes.

The gene variations, which govern nicotine receptors on cells, could eventually help explain some of the mysteries of chain smoking, nicotine addiction and lung cancer. These oddities include why there are 90-year-old smokers who don't get cancer and people who light up an occasional cigarette and don't get hooked.

"This is really telling us that the vulnerability to smoking and how much you smoke is clearly biologically based," said psychiatry professor Dr. Laura Bierut of Washington University in St. Louis, a genetics and smoking expert who did not take part in the studies. She praised the research as "very intriguing."

The smoking rate among U.S. adults has dropped from 42 percent in 1965 to less than 21 percent now.

The new studies are surprising in that they point to areas of the genetic code that are not associated with pleasure and the rewards of addiction.

That may help explain why some people can quit and others fail, said Dr. Nora Volkow, director of the National Institute of Drug Abuse in Bethesda, Md., which funded one of the studies.

"It opens our eyes," Volkow said Wednesday. "Not everyone takes drugs for the same reason. Not everyone smokes cigarettes for the same reasons."

One clue is in the location of the just-discovered variants, on the long arm of chromosome 15, Volkow said. It is in an area that, when damaged during tests on animals, makes them depressed and anxious. While some people smoke because it helps them focus or gives them a physiological reward, others do it to stave off depression.

That suggests that adding antidepressants to some smokers' treatment could help them kick the habit.

Bierut said a simple, inexpensive test could be developed to screen people for the variants. Kari Stefansson, lead author of the largest of the three studies, agreed. He is chief executive of deCode Genetics of Iceland, which already does prostate cancer genetic tests.

Such testing could carry risks all its own, bioethicist Arthur Caplan of the University of Pennsylvania warned. People who have been found to have a genetic predisposition to addiction and lung cancer could find it harder to get health or life insurance, or their employer might drop their coverage, he said.

"The good news is that getting these risk estimates will help focus anti-smoking campaigns, and some people will want to voluntarily get into anti-addiction programs early, where they will probably work better," Caplan said in an e-mail. But if such testing is done, it should be voluntary, and the results should be kept private, he said.

Smoking-related diseases worldwide kill about one in 10 adults, according to the World Health Organization.

Among the findings:

• Smokers who get the set of variants from only one parent see a risk of lung cancer that is about one-third higher than that of people without the variants. They also smoke about one more cigarette a day on average than other smokers. This group makes up about 45 percent of the population studied.

• Smokers who inherit the variants from both parents have nearly a 1-in-4 chance of developing lung cancer. Their cancer risk is 70 to 80 percent higher than that of smokers without the genetic variants. They smoke on average two extra cigarettes a day. This group accounts for about one in nine people of European descent.

• Smokers who don't have the variants are still more than 10 times more likely to get lung cancer than nonsmokers. Smokers without the variant have about a 14 percent risk of getting lung cancer. The risk of lung cancer for people who have never smoked is less than 1 percent, said another study author, Paul Brennan of the International Agency for Research on Cancer in Lyon, France.

Brennan and Amos, working on different teams, linked the genetic variation itself — when triggered by smoking — directly to lung cancer. Brennan said the nicotine receptors that the variants act on also can stimulate tumor growth.

But Stefansson said the increased lung cancer risk was indirect — the variants led to more smoking, which led to more cancer.

For Stefansson, the research hits home. His father, a smoker, died of lung cancer. And Stefansson, who doesn't smoke, frequently lectures his 23-year-old daughter "who smokes like a chimney." She acts as if she is immortal and smoking can't kill her, Stefansson said. But his own research shows that her genes are probably stacked against her.

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On the Net:

Nature: http://www.nature.com/nature

Big belly boosts risk of later dementia

NEW YORK - Having a big belly in your 40s can boost your risk of getting Alzheimer's disease or other dementia decades later, a new study suggests.

It's not just about your weight. While previous research has found evidence that obesity in middle age raises the chances of developing dementia later, the new work found a separate risk from storing a lot of fat in the abdomen. Even people who weren't overweight were susceptible.

That abdominal fat, sometimes described as making people apple-shaped rather than pear-shaped, has already been linked to higher risk of developing diabetes, stroke and heart disease.

"Now we can add dementia to that," said study author Rachel Whitmer of the Kaiser Permanente Division of Research in Oakland, Calif.

She and others report the findings in Wednesday's online issue of the journal Neurology.

The study involved 6,583 men and women who were ages 40 to 45 when they had checkups between 1964 and 1973. As part of the exam, their belly size was measured by using a caliper to find the distance between their backs and the surface of their upper abdomens. For the study, a distance of about 10 inches or more was considered high.

The researchers checked medical records to see who had developed Alzheimer's or another form of dementia by an average of 36 years later. At that point the participants were ages 73 to 87. There were 1,049 cases.

Analysis found that compared to people in the study with normal body weight and a low belly measurement:

• Participants with normal body weight and high belly measurements were 89 percent more likely to have dementia.

• Overweight people were 82 percent more likely if they had a low belly measurement, but more than twice as likely if they had a high belly measurement.

• Obese people were 81 percent more likely if they had a low belly measurement, but more than three times as likely if they had a high measurement.

Whitmer said there's no precise way to translate belly measurements into waist circumference. But most people have a sense of whether they have a big belly, she said. And if they do, the new study suggests they should get rid of it, she said.

It's not clear why abdominal fat would promote dementia, but it may pump out substances that harm the brain, she said.

Dr. Jose Luchsinger of the Columbia University Medical Center in New York, who studies the connection between obesity and Alzheimer's disease but didn't participate in the new work, cautioned that such a study cannot prove abdominal fat promotes dementia.

But the study results are "highly plausible" and "I'm not surprised at all," he said. High insulin levels might help explain them, he said.

Dr. Samuel Gandy, who chairs the medical and scientific advisory council of the Alzheimer's Association, said the results fit in with previous work that indicates a person's characteristics in middle age can affect the risk of dementia in later life.

And it's another example of how traits associated with the risk of developing heart disease are also linked to later dementia, he said.

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On the Net:

Neurology: http://www.neurology.org

Alzheimer's Association: http://www.alz.org

Whitmer Web site: http://www.dor.kaiser.org/staff/investigators/whitmer.shtml

10 Million Baby Boomers Face Alzheimer's, Report Predicts

TUESDAY, March 18 (HealthDay News) -- An estimated 10 million American baby boomers will develop Alzheimer's disease in their lifetime, placing enormous strains on the U.S. health-care system and the already overburdened network of caregivers, a new report predicts.

Currently, at least 5.2 million Americans suffer from Alzheimer's, including 200,000 to 250,000 people under age 65. By 2010, projections say there will be 500,000 new cases of the mind-wasting disease each year, and nearly one million new cases annually by 2050, the report estimates.


In addition, the report, released Tuesday by the Alzheimer's Association, showed that the disease is now the seventh deadliest in the nation and that women are at greater risk than men.


The overall prediction for 10 million, which translates to 1 out of every 8 boomers, is a number that is "particularly significant because it's people who are now just approaching what we refer to as the age of highest risk," said Stephen McConnell, the association's vice president for advocacy and public policy.


The age of highest risk for Alzheimer's starts at 65, McConnell said. "Some of these people are already developing the disease, and those numbers are just going to increase dramatically over the next several decades," he added.


This is going to have a huge impact on baby boomers' lives, their families, and the nation's health-care system, McConnell said.


Right now, there are 10 million caregivers providing care, many of them family members, at enormous personal cost, McConnell noted. "These caregivers tend to be spouses, but there's evidence that 250,000 of these caregivers are children 8 to 18," he said. "So you get the sense of an expanded circle of people who are affected by this disease. It's not just the person with the disease. It's not just their immediate caregiver -- it's the children and grandchildren."


Most people with Alzheimer's are eligible for Medicare, so a burgeoning number of Alzheimer's patients will put a major strain on the federal health insurance program, McConnell pointed out.


Medicare currently spends more than three times as much money on people with Alzheimer's and other dementias than it does for the average Medicare recipient. In 2005, Medicare spent $91 billion on people with Alzheimer's and other dementias. By 2010, that number is expected to climb to $160 billion, and by 2015, to $189 billion annually, according to the report.


These high Medicare costs occur because Alzheimer's tends to complicate the treatment of other medical conditions such as diabetes and heart disease, McConnell said. Also, while people with Alzheimer's live an average of eight years, they can live more than 20 years, placing an additional strain on the health-care system.


The projected rise in Alzheimer's cases will also burden the long-term care system, McConnell said. "Right now, it's mostly families providing care at home, but most people with Alzheimer's disease end up in a nursing home or an assisted living facility," he said. "In fact, three-quarters of people with Alzheimer's will die in such a facility."


Complicating matters, long-term care isn't covered by most regular health insurance, and most people don't have long-term care insurance, McConnell said. "That's going to have a devastating impact on society," he said.


Still, McConnell said there's hope for new treatments for Alzheimer's, but it's going to take a lot more money for research and testing to make those hopes a reality.


There seems to be a connection between Alzheimer's and cardiovascular disease, McConnell said. Diet, exercise and blood-pressure control may help stave off cognitive decline and Alzheimer's, he said.


Also, new drugs being tested "show promise in altering the course of the disease," McConnell said.


"Eventually, this disease could be preventable. It's certainly a disease we hope will be manageable if we catch it early," McConnell said. "If we are just able to slow the progression of the disease and delay its onset, it could save many millions of people from having to deal with the consequences of the disease. And it could save billions of dollars in the health-care system."


But, the U.S. government has cut spending on Alzheimer's research, McConnell added. "Right now the government is spending about $640 million a year on Alzheimer's research," he said. "It seems like a lot, but we are spending over $5 billion a year on cancer, and more than $3 billion on heart disease each year. If we can just get that $640 million up to $1 billion a year, that would make a big difference."


Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City, worries that there won't be enough trained medical professionals to deal with the projected rise in Alzheimer's patients.

"We are not training enough generalists or specialists in geriatrics, whether it's medicine, psychiatry, family medicine, nursing or social work in the numbers we need to deal with people with dementia," he said.

However, Kennedy also thinks the projected number of Alzheimer's patients contained in the new report may be too high. Baby boomers are healthier, more active, better educated and wealthier than their parents, he noted, and this may help delay the development of the disease until the end of their natural lifespan.

Also, new medications may make Alzheimer's manageable by slowing its progression, Kennedy said.

"Probably within the next five years we're going to have medications that alter the course of the illness," he said. "When that happens, you're going to see pushing back of the disability of the illness even further. So we don't have to cure Alzheimer's disease, we just have to find interventions that are going to delay the disability."

More information

For more on Alzheimer's, visit the Alzheimer's Association.

Hospital 'code blue' deadlier at night

CHICAGO - Many hospitals call it "code blue," a signal given over the intercom when a patient's heart has stopped. When code blue works well, a team speeds to the bedside and revives the patient. The graveyard shift is the worst time to call code blue, a new study finds. Patients who go into cardiac arrest while in the hospital are more likely to die if it happens after 11 p.m., when staffing may be lower or patients watched less closely.

"Our findings should be a pretty big wakeup call to urge hospitals to critically evaluate how they are performing resuscitation," said the study's lead author, Dr. Mary Ann Peberdy of the Virginia Commonwealth University Health System in Richmond. "It may well be possible that there is a less effective and less efficient response at night."

The study, appearing in Wednesday's Journal of the American Medical Association, didn't examine why days and overnights differed. But researchers found among the late night cases a higher portion of instances where patients were discovered with no heart electrical activity, that is, too late to deliver a lifesaving shock.

Staff who are fatigued, less experienced or too few in number could be to blame, researchers speculated. Weekends had lower survival rates than weekdays, but the difference wasn't as pronounced as between late night and daytime hours.

Only in the emergency room was there no night-or-day difference in survival.

The study was based on an analysis of more than 86,000 cardiac arrests in more than 500 hospitals over seven years.

There were 58,593 cardiac arrests during the day or evening. Of those, 11,604, almost 20 percent, survived to leave the hospital. There were 28,155 cardiac arrests during the shift that began at 11 p.m. Of those, 4,139, fewer than 15 percent, survived for discharge.

After taking into account other factors associated with survival, the researchers still found the chances of surviving until discharge 18 percent lower if the cardiac arrest was during the period from 11 p.m. to 6:59 a.m.

(Past studies have found that, overall, 80 to 85 percent of patients who suffer a cardiac arrest in the hospital die in the hospital.)

"Everyone who works in a hospital is going to look at this and say, 'Are we doing everything we should be?'" said Dr. Charles Porter, a cardiologist at the University of Kansas Hospital in Kansas City, Kansas. There, automated external defibrillators, or AEDs, are readily available and any staff member, even a custodian, can summon a rapid response team if a patient doesn't look good.

A study last month found that being in the hospital was no guarantee of getting prompt treatment for cardiac arrest. In that study, published in the New England Journal of Medicine, researchers found that one-third of patients don't get a potentially live-saving shock within the recommended two minutes.

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On the Net:

JAMA: http://jama.ama-assn.org

Fast-food binge harms liver, but boosts good cholesterol: study

PARIS (AFP) - A month-long diet of fast food and no exercise led to dangerously high levels of enzymes linked to liver damage, in an unusual experiment inspired by the docu-movie "Supersize Me."

But investigators, reporting their findings on Thursday, were also stunned to find that a relentless regimen of burgers, fries and soda also boosted so-called good cholesterol, seen as a key measure of cardiovascular health.

Researchers in Sweden asked 12 men and six women in their twenties, all slim and in good health, to eat two meals per day at McDonalds, Burger King or other fast-food restaurants over four weeks.

The volunteers were also told to refrain from exercising. The goal was to increase body weight by 10 to 15 percent to measure the impact of an abrupt surge in calorie intake.

Blood samples were taken before, during and after the experiment to monitor levels of an enzyme called alanine aminotransferase, or ALT, a potential marker for liver damage often seen among heavy drinkers and patients with hepatitis C.

Levels of ALT increased sharply after only one week, and quadrupled on average over the entire period, said lead researcher Frederik Nystrom, a doctor at the University Hospital of Linkoping.

"The results scared me," he told AFP. "One of the subjects had to be withdrawn from the study because he had 10 times the normal ALT levels."

For 11 of the 18 subjects, ALT rose to levels that would normally reflect liver damage, even among individuals who did not drink any alcohol, although no such damage occurred, he said.

Two of the individuals had liver steatosis, or fatty liver, in which fat cells build up dangerously in the liver, he said. Steatosis is associated with the risk of developing Type 2 diabetes, which has taken on epidemic proportions, especially in industrialised countries.

Published in the British Medical Association's journal Gut, the study "proves that high ALT levels can be caused by food alone," said Nystrom.

That signs of liver damage were linked to carbohydrates was another key finding, he said.

"It was not the fat in the hamburgers, it was rather the sugar in the coke," he said.

But the most startling result implies that an intensive fast food diet might have some health benefits too, apparently from fat.

"We found that healthy HDL cholesterol actually increased over the four-week period -- this was very counter-intuitive," Nystrom said.

HDL, sometimes called "good cholesterol," seems to clean the walls of blood vessels, removing excess "bad cholesterol" that can cause coronary artery disease and transporting it to the liver for processing.

Nystrom has yet to publish the cholesterol findings, but said they were consistent with the so-called "French Paradox."

For nearly two decades, scientists have wrestled to explain how the French can consume a diet rich in fats -- from abundant butter, cream, cheese and meat -- yet have generally low levels of heart disease and hypertension.

"The study showed that the increase in saturated fat correlated with the increase in healthy cholesterol," he said.

The young Swedish guinea pigs ate at least two fast-food meals a day, and terminated the study once they had gained a maximum of 15 percent in weight.

On average, they tipped the scales 6.5 kilos (14.3 pounds) more, but one ballooned by 12 kilos (26.4 pounds).

Nystrom got the idea for his study from the 2004 Oscar-nominated documentary "Supersize Me," in which filmmaker Morgan Spurlock asked doctors to monitor him over a 30-day period in which he ate at McDonalds morning, noon and night.

Doctors were so alarmed by changes in his blood chemistry -- including skyrocketing levels of ALT -- that they begged him to halt his experiment.

"I wasn't just inspired by the movie, I copied it to the best of my ability," said Nystrom.

The movie helped spur a change of tack by fast-food corporations to include healthier options on their menus.

On their websites, McDonald's and Burger King highlight salads and low-fat products -- alongside the classic burgers and colas -- and offer guidance on balanced diets and a healthy lifestyle.

Key vitamin deficiency linked to tripled risk of dementia: study

PARIS (AFP) - Lack of folate, also called vitamin B-9, may triple the risk of developing dementia in old age, according to a study published Tuesday.

Researchers in South Korea measured naturally occurring folate levels in 518 elderly persons, none of whom showed any signs of dementia, and then tracked their development over 2.4 years.

At the end of the period, 45 of the patients had developed dementia, including 34 diagnosed with Alzheimer's disease, said the study, published by the British Medical Association's Journal of Neurology, Neurosurgery and Psychiatry.

When the researchers, led by Jin-Sang Yoon of Chonnam National University in Kwangju, South Korea, remeasured folate levels, they uncovered a strong link with the dementia.

Even after other factors were taken into account -- including age, disability, alcohol consumption, weight change -- "the onset of dementia was significantly associated with an exaggerated decline in folate," the researchers concluded.

Folate and folic acid, another form of the compound, are essential for the creation of new cells in the body.

The compound occurs naturally in leafy vegetables such as spinach, turnip greens, lettuces, dried beans and peas and in certain fruits.

An study published last year in The Lancet showed an improvement in short-term memory, mental agility and verbal fluency among persons over 50 who took a daily dose of 800 micrograms (mcg) of folic acid. The US recommended daily dose is 400 mcg.

Taking folic acid before conception and throughout the first trimester helps a mother ensure that her child will not develop certain brain and spinal cord defects, including spina bifida, according to previous research.