In this issue:

Dear Readers,

Welcome to the April 2007 True North Tune-Up. We continue to emphasize “up stream” strategies for health in the areas of nutrition, mind-body, and lifestyle. Some of this month’s results are mixed. The studies are from peer-reviewed scientific journals; though this month’s last “bullet” reminds us that they too are subject to bias. (Also shown in the October 2006 Tune-Up.)

To your health,

B. Joseph Semmes, MD
Director of Research, True North
Diplomate, American Board of Internal Medicine

Folate supplements may not lower risk of heart attacks in patients with vascular (blood vessel) disease. Stroke risk is lowered.
Folate supplementation has long been shown to reduce high homocysteine, which can damage blood vessels. Surprisingly, and controversially, this meta-analysis of 12 studies which “made the grade” looking at more than 16,000 patients with pre-existent vascular disease, showed no significant benefit for heart disease and mortality, though there was a 17% reduction in stroke. Folate supplementation may protect the brain from dementia, though this data is from food survey questionnaires and not as strong a form of evidence as an interventional trial going forward in time. (See the second link.)

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Saw palmetto did not improve symptoms or objective measures of benign prostatic hypertrophy.
Saw palmetto is used by 2 million men in the U.S. This double blind trial of 225 men over age 49 years, who were given 160 mg twice daily over a year, failed to show improvement in urine flow, prostate size, PSA, quality of life or residual volume after voiding.

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Policosanol fails to lower “bad” (LDL) cholesterol in a small study of 40 patients.
Policosanol is a popular supplement for lowering cholesterol. This well-designed, though small, study showed that 20 mg a day did not lower LDL over 8 weeks compared to placebo.

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Soybean protein supplement lowers blood pressure.
302 participants were studied. Patients with hypertension had more marked effects than those who had normal blood pressure. Those with high blood pressure who received 40 gms of a soybean supplement daily experienced a drop of systolic blood pressure (the “upper” number in blood pressure readings) of almost 8 (mm Hg). The diastolic (“lower” number) was lowered more than 5 (mm Hg). The effect is significant. (Forty grams is a hefty slug of soybean supplement, one suspects.)

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Study finds bias in peer review
The survey, in the April 12 Journal of the AMA, focused on 67,000 research abstracts submitted to the American Heart Association, which in 2002 started stripping the names and institution affiliations when deciding which studies to accept for publication.  Before “blinding”, 80% of accepted authors were from the U.S. compared to only 41% U.S.–based authors when reviewers could not tell where the studies were conducted. Further, the share of abstracts accepted from faculty from highly regarded U.S. research universities dropped by 20% after blinding.  Interested readers should pick up a copy of John Abramson M.D.’s Overdo$ed America which shows how some of our most respected journals may include interpretations and recommendations that stretch or spin the data.

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Information provided in the True North Tune-Up is neither intended nor implied to be a substitute for professional medical advice. The information and links in this e-publication are intended to provide general education on the topics listed, but you should not use the information or links to diagnose or treat a health problem or disease without consulting with a qualified healthcare practitioner. True North advises you to always seek the advice of your physician or other qualified health practitioner prior to starting any new treatment or with any questions you may have regarding a medical condition.


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