The Benefits of High Cholesterol

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People with high cholesterol live the longest.

This statement seems so incredible that it takes a long time to clear one´s brainwashed mind to fully understand its importance.

Yet the fact that people with high cholesterol live the longest emerges clearly from many scientific papers.

Consider the finding of Dr. Harlan Krumholz of the Department of Cardiovascular Medicine at Yale University, who reported in 1994 that old people with low cholesterol died twice as often from a heart attack as did old people with a high cholesterol.

Supporters of the cholesterol campaign consistently ignore his observation, or consider it as a rare exception, produced by chance among a huge number of studies finding the opposite.

But it is not an exception; there are now a large number of findings that contradict the lipid hypothesis.

To be more specific, most studies of old people have shown that high cholesterol is not a risk factor for coronary heart disease.

This was the result of my search in the Medline database for studies addressing that question.

Eleven studies of old people came up with that result, and a further seven studies found that high cholesterol did not predict all-cause mortality either.

Now consider that more than 90 % of all cardiovascular disease is seen in people above age 60 and that almost all studies have found that high cholesterol is not a risk factor for women.

This means that high cholesterol is only a risk factor for less than 5 % of those who die from a heart attack.

But there is more comfort for those who have high cholesterol; six of the studies found that total mortality was inversely associated with either total or LDL-cholesterol, or both.

This means that it is actually much better to have high than to have low cholesterol if you want to live to be very old.

High Cholesterol Protects Against Infection

Many studies have found that low cholesterol is in certain respects worse than high cholesterol.

For instance, in 19 large studies of more than 68,000 deaths, reviewed by Professor David R. Jacobs and his co-workers from the Division of Epidemiology at the University of Minnesota, low cholesterol predicted an increased risk of dying from gastrointestinal and respiratory diseases.

Most gastrointestinal and respiratory diseases have an infectious origin.

Therefore, a relevant question is whether it is the infection that lowers cholesterol or the low cholesterol that predisposes to infection?

To answer this question Professor Jacobs and his group, together with Dr. Carlos Iribarren, followed more than 100,000 healthy individuals in the San Francisco area for fifteen years.

At the end of the study those who had low cholesterol at the start of the study had more often been admitted to the hospital because of an infectious disease.

This finding cannot be explained away with the argument that the infection had caused cholesterol to go down, because how could low cholesterol, recorded when these people were without any evidence of infection, be caused by a disease they had not yet encountered?

Isn´t it more likely that low cholesterol in some way made them more vulnerable to infection, or that high cholesterol protected those who did not become infected? Much evidence exists to support that interpretation.

Written By: Uffe Ravnskov, MD, PhD

Article Source: https://www.functionalmedicineuniversity.com/public/924.cfm

 

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The Myth of Drug Expiration Dates

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Hospitals and pharmacies are required to toss expired drugs, no matter how expensive or vital. Meanwhile the FDA has long known that many remain safe and potent for years longer.

The box of prescription drugs had been forgotten in a back closet of a retail pharmacy for so long that some of the pills predated the 1969 moon landing. Most were 30 to 40 years past their expiration dates — possibly toxic, probably worthless.

But to Lee Cantrell, who helps run the California Poison Control System, the cache was an opportunity to answer an enduring question about the actual shelf life of drugs: Could these drugs from the bell-bottom era still be potent?

Cantrell called Roy Gerona, a University of California, San Francisco, researcher who specializes in analyzing chemicals. Gerona had grown up in the Philippines and had seen people recover from sickness by taking expired drugs with no apparent ill effects.

“This was very cool,” Gerona says. “Who gets the chance of analyzing drugs that have been in storage for more than 30 years?”

The age of the drugs might have been bizarre, but the question the researchers wanted to answer wasn’t. Pharmacies across the country — in major medical centers and in neighborhood strip malls — routinely toss out tons of scarce and potentially valuable prescription drugs when they hit their expiration dates.

Gerona and Cantrell, a pharmacist and toxicologist, knew that the term “expiration date” was a misnomer. The dates on drug labels are simply the point up to which the Food and Drug Administration and pharmaceutical companies guarantee their effectiveness, typically at two or three years. But the dates don’t necessarily mean they’re ineffective immediately after they “expire” — just that there’s no incentive for drugmakers to study whether they could still be usable.

ProPublica has been researching why the U.S. health care system is the most expensive in the world. One answer, broadly, is waste — some of it buried in practices that the medical establishment and the rest of us take for granted.  We’ve documented how hospitals often discard pricey new supplies, how nursing homes trash valuable medications after patients pass away or move out, and how drug companies create expensive combinations of cheap drugs. Experts estimate such squandering eats up about $765 billion a year — as much as a quarter of all the country’s health care spending.

What if the system is destroying drugs that are technically “expired” but could still be safely used?

In his lab, Gerona ran tests on the decades-old drugs, including some now defunct brands such as the diet pills Obocell (once pitched to doctors with a portly figurine called “Mr. Obocell”) and Bamadex. Overall, the bottles contained 14 different compounds, including antihistamines, pain relievers and stimulants. All the drugs tested were in their original sealed containers.

The findings surprised both researchers: A dozen of the 14 compounds were still as potent as they were when they were manufactured, some at almost 100 percent of their labeled concentrations.

“Lo and behold,” Cantrell says, “The active ingredients are pretty darn stable.”

Cantrell and Gerona knew their findings had big implications. Perhaps no area of health care has provoked as much anger in recent years as prescription drugs. The news media is rife with stories of medications priced out of reach or of shortages of crucial drugs, sometimes because producing them is no longer profitable.

Tossing such drugs when they expire is doubly hard. One pharmacist at Newton-Wellesley Hospital outside Boston says the 240-bed facility is able to return some expired drugs for credit, but had to destroy about $200,000 worth last year. A commentary in the journal Mayo Clinic Proceedings cited similar losses at the nearby Tufts Medical Center. Play that out at hospitals across the country and the tab is significant: about $800 million per year. And that doesn’t include the costs of expired drugs at long-term care pharmacies, retail pharmacies and in consumer medicine cabinets.

After Cantrell and Gerona published their findings in Archives of Internal Medicine in 2012, some readers accused them of being irresponsible and advising patients that it was OK to take expired drugs. Cantrell says they weren’t recommending the use of expired medication, just reviewing the arbitrary way the dates are set.

“Refining our prescription drug dating process could save billions,” he says.

But after a brief burst of attention, the response to their study faded. That raises an even bigger question: If some drugs remain effective well beyond the date on their labels, why hasn’t there been a push to extend their expiration dates?

It turns out that the FDA, the agency that helps set the dates, has long known the shelf life of some drugs can be extended, sometimes by years.

In fact, the federal government has saved a fortune by doing this.


For decades, the federal government has stockpiled massive stashes of medication, antidotes and vaccines in secure locations throughout the country. The drugs are worth tens of billions of dollars and would provide a first line of defense in case of a large-scale emergency.

Maintaining these stockpiles is expensive. The drugs have to be kept secure and at the proper humidity and temperature so they don’t degrade. Luckily, the country has rarely needed to tap into many of the drugs, but this means they often reach their expiration dates. Though the government requires pharmacies to throw away expired drugs, it doesn’t always follow these instructions itself. Instead, for more than 30 years, it has pulled some medicines and tested their quality.

The idea that drugs expire on specified dates goes back at least a half-century, when the FDA began requiring manufacturers to add this information to the label. The time limits allow the agency to ensure medications work safely and effectively for patients. To determine a new drug’s shelf life, its maker zaps it with intense heat and soaks it with moisture to see how it degrades under stress. It also checks how it breaks down over time. The drug company then proposes an expiration date to the FDA, which reviews the data to ensure it supports the date and approves it. Despite the difference in drugs’ makeup, most “expire” after two or three years.

Once a drug is launched, the makers run tests to ensure it continues to be effective up to its labeled expiration date. Since they are not required to check beyond it, most don’t, largely because regulations make it expensive and time-consuming for manufacturers to extend expiration dates, says Yan Wu, an analytical chemist who is part of a focus group at the American Association of Pharmaceutical Scientists that looks at the long-term stability of drugs. Most companies, she says, would rather sell new drugs and develop additional products.

Pharmacists and researchers say there is no economic “win” for drug companies to investigate further. They ring up more sales when medications are tossed as “expired” by hospitals, retail pharmacies and consumers despite retaining their safety and effectiveness.

Industry officials say patient safety is their highest priority. Olivia Shopshear, director of science and regulatory advocacy for the drug industry trade group Pharmaceutical Research and Manufacturers of America, or PhRMA, says expiration dates are chosen “based on the period of time when any given lot will maintain its identity, potency and purity, which translates into safety for the patient.”

That being said, it’s an open secret among medical professionals that many drugs maintain their ability to combat ailments well after their labels say they don’t. One pharmacist says he sometimes takes home expired over-the-counter medicine from his pharmacy so he and his family can use it.

The federal agencies that stockpile drugs — including the military, the Centers for Disease Control and Prevention and the Department of Veterans Affairs — have long realized the savings in revisiting expiration dates.

In 1986, the Air Force, hoping to save on replacement costs, asked the FDA if certain drugs’ expiration dates could be extended. In response, the FDA and Defense Department created the Shelf Life Extension Program.

Each year, drugs from the stockpiles are selected based on their value and pending expiration and analyzed in batches to determine whether their end dates could be safely extended. For several decades, the program has found that the actual shelf life of many drugs is well beyond the original expiration dates.

A 2006 study of 122 drugs tested by the program showed that two-thirds of the expired medications were stable every time a lot was tested. Each of them had their expiration dates extended, on average, by more than four years, according to research published in the Journal of Pharmaceutical Sciences.

Some that failed to hold their potency include the common asthma inhalant albuterol, the topical rash spray diphenhydramine, and a local anesthetic made from lidocaine and epinephrine, the study said. But neither Cantrell nor Dr. Cathleen Clancy, associate medical director of National Capital Poison Center, a nonprofit organization affiliated with the George Washington University Medical Center, had heard of anyone being harmed by any expired drugs. Cantrell says there has been no recorded instance of such harm in medical literature.

Marc Young, a pharmacist who helped run the extension program from 2006 to 2009, says it has had a “ridiculous” return on investment. Each year the federal government saved $600 million to $800 million because it did not have to replace expired medication, he says.

An official with the Department of Defense, which maintains about $13.6 billion worth of drugs in its stockpile, says that in 2016 it cost $3.1 million to run the extension program, but it saved the department from replacing $2.1 billion in expired drugs. To put the magnitude of that return on investment into everyday terms: It’s like spending a dollar to save $677.

“We didn’t have any idea that some of the products would be so damn stable — so robustly stable beyond the shelf life,” says Ajaz Hussain, one of the scientists who formerly helped oversee the extension program.

Hussain is now president of the National Institute for Pharmaceutical Technology and Education, an organization of 17 universities that’s working to reduce the cost of pharmaceutical development. He says the high price of drugs and shortages make it time to reexamine drug expiration dates in the commercial market.

“It’s a shame to throw away good drugs,” Hussain says.

Some medical providers have pushed for a changed approach to drug expiration dates — with no success. In 2000, the American Medical Association, foretelling the current prescription drug crisis, adopted a resolution urging action. The shelf life of many drugs, it wrote, seems to be “considerably longer” than their expiration dates, leading to “unnecessary waste, higher pharmaceutical costs, and possibly reduced access to necessary drugs for some patients.”

Citing the federal government’s extension program, the AMA sent letters to the FDA, the U.S. Pharmacopeial Convention, which sets standards for drugs, and PhRMA asking for a re-examination of expiration dates.

No one remembers the details — just that the effort fell flat.

“Nothing happened, but we tried,” says rheumatologist Roy Altman, now 80, who helped write the AMA report. “I’m glad the subject is being brought up again. I think there’s considerable waste.”

At Newton-Wellesley Hospital, outside Boston, pharmacist David Berkowitz yearns for something to change.

On a recent weekday, Berkowitz sorted through bins and boxes of medication in a back hallway of the hospital’s pharmacy, peering at expiration dates. As the pharmacy’s assistant director, he carefully manages how the facility orders and dispenses drugs to patients. Running a pharmacy is like working in a restaurant because everything is perishable, he says, “but without the free food.”

Federal and state laws prohibit pharmacists from dispensing expired drugs and The Joint Commission, which accredits thousands of health care organizations, requires facilities to remove expired medication from their supply. So at Newton-Wellesley, outdated drugs are shunted to shelves in the back of the pharmacy and marked with a sign that says: “Do Not Dispense.” The piles grow for weeks until they are hauled away by a third-party company that has them destroyed. And then the bins fill again.

“I question the expiration dates on most of these drugs,” Berkowitz says.

One of the plastic boxes is piled with EpiPens — devices that automatically inject epinephrine to treat severe allergic reactions. They run almost $300 each. These are from emergency kits that are rarely used, which means they often expire. Berkowitz counts them, tossing each one with a clatter into a separate container, “… that’s 45, 46, 47 …” He finishes at 50. That’s almost $15,000 in wasted EpiPens alone.

In May, Cantrell and Gerona published a study that examined 40 EpiPens and EpiPen Jrs., a smaller version, that had been expired for between one and 50 months. The devices had been donated by consumers, which meant they could have been stored in conditions that would cause them to break down, like a car’s glove box or a steamy bathroom. The EpiPens also contain liquid medicine, which tends to be less stable than solid medications.

Testing showed 24 of the 40 expired devices contained at least 90 percent of their stated amount of epinephrine, enough to be considered as potent as when they were made. All of them contained at least 80 percent of their labeled concentration of medication. The takeaway? Even EpiPens stored in less than ideal conditions may last longer than their labels say they do, and if there’s no other option, an expired EpiPen may be better than nothing, Cantrell says.

At Newton-Wellesley, Berkowitz keeps a spreadsheet of every outdated drug he throws away. The pharmacy sends what it can back for credit, but it doesn’t come close to replacing what the hospital paid.

Then there’s the added angst of tossing drugs that are in short supply. Berkowitz picks up a box of sodium bicarbonate, which is crucial for heart surgery and to treat certain overdoses. It’s being rationed because there’s so little available. He holds up a purple box of atropine, which gives patients a boost when they have low heart rates. It’s also in short supply. In the federal government’s stockpile, the expiration dates of both drugs have been extended, but they have to be thrown away by Berkowitz and other hospital pharmacists.

The 2006 FDA study of the extension program also said it pushed back the expiration date on lots of mannitol, a diuretic, for an average of five years. Berkowitz has to toss his out. Expired naloxone? The drug reverses narcotic overdoses in an emergency and is currently in wide use in the opioid epidemic. The FDA extended its use-by date for the stockpiled drugs, but Berkowitz has to trash it.

On rare occasions, a pharmaceutical company will extend the expiration dates of its own products because of shortages. That’s what happened in June, when the FDA posted extended expiration dates from Pfizer for batches of its injectable atropine, dextrose, epinephrine and sodium bicarbonate. The agency notice included the lot numbers of the batches being extended and added six months to a year to their expiration dates.

The news sent Berkowitz running to his expired drugs to see if any could be put back into his supply. His team rescued four boxes of the syringes from destruction, including 75 atropine, 15 dextrose, 164 epinephrine and 22 sodium bicarbonate. Total value: $7,500. In a blink, “expired” drugs that were in the trash heap were put back into the pharmacy supply.

Berkowitz says he appreciated Pfizer’s action, but feels it should be standard to make sure drugs that are still effective aren’t thrown away.

“The question is: Should the FDA be doing more stability testing?” Berkowitz says. “Could they come up with a safe and systematic way to cut down on the drugs being wasted in hospitals?”

Four scientists who worked on the FDA extension program told ProPublica something like that could work for drugs stored in hospital pharmacies, where conditions are carefully controlled.

Greg Burel, director of the CDC’s stockpile, says he worries that if drugmakers were forced to extend their expiration dates it could backfire, making it unprofitable to produce certain drugs and thereby reducing access or increasing prices.

The 2015 commentary in Mayo Clinic Proceedings, called “Extending Shelf Life Just Makes Sense,” also suggested that drugmakers could be required to set a preliminary expiration date and then update it after long-term testing. An independent organization could also do testing similar to that done by the FDA extension program, or data from the extension program could be applied to properly stored medications.

ProPublica asked the FDA whether it could expand its extension program, or something like it, to hospital pharmacies, where drugs are stored in stable conditions similar to the national stockpile.

“The Agency does not have a position on the concept you have proposed,” an official wrote back in an email.

Whatever the solution, the drug industry will need to be spurred in order to change, says Hussain, the former FDA scientist. “The FDA will have to take the lead for a solution to emerge,” he says. “We are throwing away products that are certainly stable, and we need to do something about it.”

This story was co-published with NPR’s Shots blog. Written BY: Marshall Allen

Article Source: https://www.propublica.org/article/the-myth-of-drug-expiration-dates

 

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Dangerous Combinations

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Five things you need to know about food and drug interactions

You are diligent about taking your medication each day. But did you ever think that the bologna sandwich, grapefruit or glass of milk you have with it could be making your medicine less effective, or even dangerous? Read on for five facts you need to know about food and drug interactions.

1. Beware of grapefruit.

This popular breakfast fruit interacts with a variety of medications, including blood pressure medications, statins, HIV medications and organ transplant medications, says Charlie Twilley, Pharm.D., a pharmacist at Johns Hopkins Bayview Medical Center. The culprits are furanocoumarins, compounds found in grapefruit that block the enzymes in the intestines responsible for breaking down these drugs. This can make the drugs more potent, and raise the level of drug in your bloodstream. If you are a big grapefruit fan, talk to your doctor or pharmacist to find out whether it is safe to eat with the medications you are taking.

2. Dairy diminishes antibiotics’ infection-fighting powers.

Twilley warns that the calcium in milk, yogurt, cheese, ice cream and antacids can interact with tetracycline and the tetracycline group of antibiotics used to treat a number of bacterial infections. To make sure you are getting the full benefit of your antibiotic, take it one hour before, or two hours after you eat anything containing calcium.

3. Leafy greens cancel the effects of warfarin.

The vitamin K in spinach, collards, kale and broccoli can lessen the effectiveness of warfarin, a blood thinner used to prevent blood clots and stroke. The darker green the vegetable is, the more vitamin K it has. “You don’t want to eliminate leafy greens from your diet, because they do have many health benefits,” says Twilley. The key is to be consistent with the amount you eat. If you plan to drastically change the amount of these veggies in your diet, talk to your doctor or pharmacist first.

4. Beer, red wine and chocolate are dangerous to mix with some antidepressants.

These popular indulgences may be a nice way to relax in the evening, but they contain tyramine, a naturally occurring amino acid that can cause an unsafe spike in blood pressure when mixed with MAO inhibitors. Tyramine also is found in processed meat, avocados and some cheeses. “This is a significant, dangerous interaction,” says Twilley. If you take MAO inhibitors for depression, talk to your doctor or pharmacist before eating anything with tyramine. Alternative therapy may be considered.

5. Think before you crush medication in applesauce.

Many people who have trouble swallowing pills like to crush them up and mix them with applesauce or pudding. Always ask your doctor or pharmacist before you crush or take apart medication. “This method can dump too much of the drug into your system at once, or change the way the drug works,” says Twilley.

Also keep in mind that some medications are affected by whether or not you eat with them. Before you start any new drug, talk to your doctor or pharmacist about whether it is affected by food. “They can help you come up with a schedule that’s good for the drug and convenient for you,” says Twilley. Even over-the-counter medications and supplements can have food interactions.

Article Source: http://www.hopkinsmedicine.org/news/publications/jh_bayview_news/fall_2014/dangerous_combinations

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New Study: Standard American Diet Causes Nearly Half of All Deaths from Heart Disease, Stroke and Type 2 Diabetes

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It should come as no surprise that our diet plays a critical role in our health and longevity, but the sheer level of influence may come as a shock to you.

A new study published in the March 7 issue of JAMA found that poor diet is responsible for an astonishing 45 percent of all deaths from heart disease, stroke and type 2 diabetes in the US. The researchers attributed this high mortality rate to the Standard American Diet (SAD), which is high in sodium, processed meats, sugar-sweetened beverages and unprocessed red meats.

The good news is, just as diet can be our downfall, it’s also just as powerful in promoting exceptional health and longevity — as seen in “Blue Zone” cultures, who are known for their extraordinary lifespan and phenomenal vitality.

A Deadly Trinity of Disease, Directly Linked to Poor Food Choices

According to the newly released JAMA study, which was funded by the National Heart, Lung and Blood Institute (NHLBI), nearly half of all US deaths in 2012 caused by cardiometabolic diseases — like heart disease, stroke and type 2 diabetes — are due to poor diet. Out of the 702,308 adult deaths from cardiometabolic diseases, 318,656 — about 45 percent — were linked with over-consumption of certain unhealthy foods, as well as low consumption of specific nutrient dense edibles.

“Nationally, estimated cardiometabolic deaths related to insufficient healthier foods/nutrients remained at least as substantial as those related to excess unhealthful foods/nutrients,” said lead researcher Renata Micha, RD, PhD, of the Tufts Friedman School of Nutrition Science and Policy, Boston.

Excess consumption of sodium was associated with the highest percentage of death. Consuming high amounts of processed meats, sugar-sweetened beverages and unprocessed red meat were also linked with high mortality. Americans also don’t eat enough of certain health-promoting foods — like fruit, vegetables, nuts and seeds, whole grains, polyunsaturated fats and seafood omega-3 fats.

“Among unhealthful foods/nutrients, the present findings suggest that sodium is a key target,” noted the researchers. “Population-wide salt reduction policies that include a strong government role to educate the public and engage industry to gradually reduce salt content in processed foods (for example, as implemented in the United Kingdom and Turkey) appear to be effective, equitable, and highly cost-effective or even cost-saving.”

According to a press release from the NHLBI:

“The study also shows that the proportion of deaths associated with diet varied across population groups. For instance, death rates were higher among men when compared to women; among blacks and Hispanics compared to whites; and among those with lower education levels, compared with their higher-educated counterparts.”

The findings of the study were based on death certificate data from the National Center of Health Statistics.

With annual US healthcare spending hitting $3.8 trillion in 2014 and $3.2 trillion in 2016 — heart disease and stroke costing nearly $1 billion a day in medical costs along with lost productivity, and diabetes totaling $245 billion annually — the results of this study come as a stark reality check. However, they can also help encourage positive outcomes, such as new public health strategies, public education programs, and revamped industry standards.

For inspiration, we can also look to cultures and communities that have outstanding health and longevity for guidance — and a perfect place to start is with the Blue Zones.

The Island Where People Forgot to Die

Just off the coast of Turkey, very close to Samos, where Pythagoras and Epicurus lived, is a Greek island named Ikaria that is renown as “the island where people forgot to die” because of the exceptional lifespan of its inhabitants. Included in what is referred to as the Blue Zones — five regions in Europe, Latin America, Asia and the US with the highest concentrations of centenarians in the world — the people of Ikaria live about eight years longer than average and have exceedingly good health. These communities are also largely free of health complaints like obesity, cancer, diabetes and heart disease. Moreover, they’re sharp to the very end, whereas in the US, almost half the population over 85 suffers from dementia.

Diet is a key ingredient to their robust health and longevity. In Ikaria, they’re eating a variety of a Mediterranean diet, but with lots of potatoes. They also consume high amounts of beans. One unique foodstuff is called horta, a weed-like green that’s eaten as a salad, lightly steamed or baked into pies. Goat’s milk, wine, honey, some fruit and small amounts of fish are also enjoyed. Other foods include feta cheese, lemons and herbs such as sage and marjoram, which are made into tea.

Lifestyle also comes into play. Plenty of sex (even in old age) and napping are integral aspects of the culture, as is physical activity. There are no treadmills or aerobic classes here. Instead, exercise involves planting and maintaining a garden, manual labor (houses in Ikaria only have hand tools) and walking to run errands.

Another Blue Zone region is Sardinia, Italy where goat’s milk and sheep’s cheese are staples, along with moderate amounts of flat bread, sourdough bread and barley. They also eat plenty of fennel, fava beans, tomatoes, chickpeas, almonds, milk thistle tea and wine from Grenache grapes.

Seventh-day Adventists in Loma Linda, California made the list as well. The community shuns smoking, drinking and dancing, while also avoiding movies, television and other media distractions. Their diet focuses on grains, fruits, nuts, vegetables — and they only drink water. Sugar, except for natural sources found in whole fruit, is taboo. Adventists who follow the religion’s lifestyle live about 10 years longer than those who don’t. Interestingly, pesco-vegetarians in the community, who include up to one serving of fish per day with their plant-based diet, live longer than vegan Adventists. Avocados, salmon, beans, oatmeal, avocados, whole wheat bread and soy milk make up the bulk of their diet.

Nicoya Peninsula in Costa Rica also has a high number of centenarians. Theirs is a traditional Mesoamerican diet of beans, corn and squash — plus papayas, yams, bananas and peach palms (an oval fruit dense in vitamins A and C).

The final Blue Zone is Okinawa, Japan. Their “top longevity foods” are bitter melons, seaweed, turmeric, sweet potato, tofu, garlic, brown rice, green tea and shitake mushrooms.

All Blue Zones share the following characteristics:

  • Only eat until you’re 80 percent full.
  • The smallest meal of the day is always in the late afternoon or evening.
  • Diet consists mostly plants, especially beans. Meat is eaten rarely — on average of just five times a month — and in small portions of about 3 to 4 ounces.
  • Moderate amounts of wine is consumed with 1-2 glasses per day (doesn’t apply to Seventh-day Adventists).
  • A sense of community and close social bonds, often with religious underpinnings.

Although the secret to Blue Zone longevity doesn’t rely exclusively on diet, it’s certainly a core foundation for their exceptional health and vitality. We can take a cue from these regions and integrate their wisdom into our own lives for improved well-being. Have a look at these quick and easy Blue Zone recipes for inspiration.

Written By: Carolanne Wright

Article Source: https://wakeup-world.com/2017/04/24/new-study-standard-american-diet-causes-nearly-half-all-deaths-heart-disease-stroke-type-2-diabetes/

 

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Shoulder blade (scapula) pain causes, symptoms, treatments, and exercises

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Shoulder blade pain can occur for numerous reasons, and we are going to look into those causes along with the symptoms, treatments, and exercises that can help improve shoulder blade pain.

The shoulder blades – known as the scapula – are two triangle-shaped bones located at the top of your back. The scapula is connected to the humerus (upper arm bone) and clavicle (collar bone) along with the muscles of the upper back, neck, and arms.

Shoulder blade pain can be experienced above, within, over, or under the shoulder blades, as well as in-between and below the shoulder blades. As mentioned, there are numerous reasons for shoulder blade pain ranging from mild causes like muscle strain to more severe like lung conditions or tumors.

Causes of shoulder blade pain

Below are 27 different causes of shoulder blade pain to help you narrow in on what may be causing your pain.

Muscle strains, muscle contusion (bruise): Overuse of the muscles surrounding the shoulder can result in shoulder blade pain. Other causes of muscle strain are changing workout routine, overusing the muscles, lifting heavier weight than what you are used to, or sleeping in one position for too long.

Disc disease: Compression of nerves in the neck due to a collapsed or displaced disc can result in shoulder blade pain. You may also experience pain in your neck, or tingling or numbness down your arms to your fingers.

Heart conditions: More commonly seen in women, shoulder pain can be sometimes a result of a heart condition. Heart attacks, pericarditis, or aortic dissection can cause pain in the left shoulder.

Fractures: It is quite difficult to fracture the scapula, but it is possible. Fractures of the scapula commonly occur as a result of a car accident or fall and can lead to shoulder blade pain.

Shingles: Shingles is an infection from the chickenpox virus. This type of shoulder blade pain is often a burning sensation followed by a rash.

Bone metastases: Bone metastases occur with the spread of a cancerous tumor. The shoulder pain is often a result of the spread of breast, lung, esophageal, and colon cancer.

Lung conditions and tumor: Lung conditions like pulmonary emboli or a collapsed lung along with lung tumors can contribute to shoulder blade pain.

Arthritis, osteoarthritis: Arthritis or osteoarthritis can affect the scapula causing shoulder blade pain.

Snapping scapula syndrome, broken scapula, scapular cancer: There are conditions that solely affect the scapula, such as snapping scapula syndrome, broken scapula, and scapular cancer, leading to pain.

Osteoporosis: Osteoporosis is a bone disease, which causes the bones to become thin and fragile. The scapula can be affected by osteoporosis resulting in pain.

Abdominal conditions (GERD, stomach disorders): Sometimes, a shoulder blade pain can result from stomach and digestive issues. This type of pain can occur in the right shoulder and is a result of gallstones, peptic ulcers, and liver disease. Ailments that lead to pain in the left shoulder blade include pancreatitis.

Gallbladder disease: A gallbladder attack can cause pain under the right scapula and the pain can radiate from the upper abdomen to the shoulder.

Liver disease: Liver disease can lead to pain under the right shoulder because the liver is located under the right rib so the pain radiates to the shoulder.

Overuse of shoulder muscles: As mentioned, the overuse of shoulder muscles, whether through exercise or work, can cause pain.

Sleeping the “wrong way”: Sleeping for prolonged periods of time on one side or simply sleeping at an odd angle can cause shoulder blade pain.

Nerve impingement: If your shoulder blade pain radiates down your arm it could be a result of nerve impingement. You may also experience a burning sensation in your hand.

Rotator cuff injury: This injury is most common among athletes and affects one of the four muscles of the rotator cuff.

Scoliosis: Scoliosis is a curvature of the spine, which can cause pain between the two shoulders.

Paget’s disease: Paget’s disease is a chronic viral infection of the bones which can cause shoulder blade pain.

Brachial neuritis: Brachial neuritis is a rare neurological condition without a precise cause. Symptoms of brachial neuritis include sudden, severe burning pain above the shoulder.

Whiplash: Whiplash is a strain or sprain of the upper neck muscles, tendons, or ligaments. Pain can begin at the neck and radiate downward.

Fibromyalgia: Fibromyalgia is characterized by allover pain with unknown cause. Fibromyalgia patients are known to have tender points and shoulder blades are among those tender points.

Pleurisy: Pleurisy is inflammation of the lung membrane caused by a viral infection.

Enlarged spleen: An enlarged spleen can cause left shoulder blade pain, which can worsen when breathing in and out.

Frozen shoulder: Frozen shoulder (adhesive capsulitis) is inflammation and thickening of the shoulder capsule, which wraps the shoulder joint. The condition can take years to heal, but can be aided in physiotherapy exercises.

Avascular necrosis: Avascular necrosis is bone death as a result of limited blood supply. Symptoms include deep, throbbing, and poorly localized pain around the shoulder that can radiate down to the elbow.

Symptoms of shoulder blade pain

The symptoms you experience depend on the cause of your shoulder pain. Pain can be sudden, chronic, temporary, burning, radiating from one area to another, and appearing in different parts of the shoulder. Shoulder blade pain can also cause numbness or tingling, and pain can become worsened when lying on the shoulder or breathing.

Another symptom of shoulder blade pain is crepitus, which is a grating sound when the shoulder moves or when it is pressed.

Pain under right shoulder blade

Pain under the right shoulder can have minor or severe causes. Causes which typically result in pain under the right shoulder include using a computer mouse, carrying a child on the right side, incorrect posture, sleep positions, heart attack, gallbladder attack, liver disease, breast cancer, and arthritis.

Pain under left shoulder blade

Common causes of pain under the left shoulder blade include injury, aging, wrong sleeping position, cold or flu, dislocation, frozen shoulder, fracture, bursitis, torn rotator cuff, compressed nerve, trigger points, inflammation, heart attack, gallbladder attacks, and pneumonia.

Pain between the shoulder blades

Common causes of shoulder blade pain experienced in-between the shoulders are poor posture, herniated discs, gallbladder disease, heart attack, inflammation under the diaphragm, spinal stenosis, cervical spondylosis, osteoarthritis, and facet joint syndrome.

Shoulder blade pain diagnosis and treatment options

If shoulder pain does not go away within a few days, you should see your doctor as it could be an indication of a more serious injury or ailment. Your doctor will perform MRI scans in order to see what is going on with your shoulder to determine if medical intervention is required or home remedies will suffice.

Some treatment options for shoulder blade pain include stopping the pain-causing activity and resting, keeping proper posture, practicing scapular retraction exercises, applying cold and hot compresses, reducing stress, maintaining a healthy weight, practicing acupuncture, wearing a sling, getting massages, taking medications like painkillers or anti-inflammatory medications, getting treatment for underlying illnesses like heart or lung conditions, arthritis, and other infections, which could contribute to shoulder blade pain.

Stretches for shoulder blade pain

Here are some tips, stretches, and exercises you can perform in order to help shoulder blade pain.

Improve your work station: Ensure feet are flat on the ground and knees are bent at a 90-degree angle, back is straight, arms are bent at the elbow at 90 degrees, monitor is at eye level, and your mouse is close to your keyboard.

Correct your posture: Ear, shoulder, and hip joint should be aligned when sitting with good posture. Shoulders should not be slouched and your head should not be tilted.

Massage the area: Lay your shoulder on the massage ball and roll on it with the weight of your body.

Stretch the shoulders: Intertwine your fingers together, lean back, and hunch your upper body as far back as possible, push your hands as far away from you as possible, while looking down. In this position, you can move around to feel other areas of the upper back become stretched.

Stretch the thoracic spine: Have a foam roller underneath your shoulders and lay on it. Keep your ribs downward, but don’t arch your back too much. Keep your hands behind your head in order to support it. Roll gently on the roller.

Do a chest stretch: Stand in the middle of a doorway with each hand forward flat on the side of the door frame. Gently lean into the door frame and feel your chest opening up.

Strengthen postural muscles: Stand up against a wall with your back touching. Have your arms bent at the elbow, hands facing up, palms outward (you should look like a W). Lift your hands above the head to make yourself into the letter I, hold, and return back to the W.

After completing any type of exercise, apply heat packs to the area to further relax the muscle.

Written By:  Emily Lunardo

Article Source: http://www.belmarrahealth.com/shoulder-blade-scapula-pain-causes-symptoms-treatments-and-exercises/

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Benefits Of Swearing: Saying Curse Words Makes You Stronger, Numb To Pain, And More Trustworthy

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We may have been taught to keep swearing to a minimum, as it’s seen as rude and vulgar, new research suggests that in certain situations, swearing may be advantageous. The research found that swearing out loud can actually make you stronger, adding to the many surprising benefits of this offensive behavior.

The study, presented at this year’s annual conference of The British Psychological Society, found that volunteers were able to produce more power and had a stronger handgrip when they swore out loud. However, closer examination revealed that swearing did not have an effect on heart rate, suggesting another reason for this sudden increase in strength.

“So quite why it is that swearing has these effects on strength and pain tolerance remains to be discovered,” explained study author Dr. Richard Stephens in a statement. “We have yet to understand the power of swearing fully.”

For their study, Stephens and his team from Keele University and Long Island University Brooklyn had 29 volunteers complete a test of anaerobic power, a measurement of physical effort during a short period of time where an individual will go “all out.” For the study, the anaerobic exercise consisted of a short intense period on an exercise bike. Volunteers did this bike exercise both after swearing and after not swearing to measure differences in strength. In a second experiment, 52 volunteers were asked to complete an  isometric handgrip test, a physiological test done to increase arterial pressure. Results revealed that swearing resulted in more strength in both experiments.

Surprisingly, increased strength is not the only benefit of swearing, as past research has also shown that swearing helps to reduce pain. According to a 2009 study, swearing triggered higher aggression and a “fight-or-flight” response. In turn, this led to increased heart rate and higher adrenaline, both of which help to numb pain. Although it’s not clear why some words have more physical power than others, researchers suggest it has to do with the high level of emotion tied to swear words. These emotional ties have a stronger physical reaction than other words in your vernacular.

Honesty is also another positive side effect of swearing, as research suggests that people are more trusting of speakers that use more swear words in their speech. According to The Independent, this may be tied to speech patterns. Liars are more likely to use third-person pronouns and negative words in their speech, where honest individuals prefer profanity. This may be because swearing is used to express yourself, and those who swear more regularly are thought to portray their true selves to others.

Source: Stephens R, Spierer D, Katehis E.Effect of swearing on strength and power performance. British Psychological Society annual conference. 2017

 

Written By: Dana Dovey

Article Source: http://www.medicaldaily.com/benefits-swearing-saying-curse-words-makes-you-stronger-numb-pain-and-more-416927

 

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Surprising Dangers of Elevated Uric Acid

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Elevated levels of uric acid are associated with gout, an excruciating form of arthritis.

More recent evidence demonstrates powerful correlations between high uric acid levels and some of the most deadly conditions of our time, including metabolic syndrome, diabetes, kidney failure, and cardiovascular disorders.1-5

In 2016-2017, a group of studies appeared linking uric acid elevations to bipolar disorder.6-9

Many people don’t realize that it is possible to have high uric acid without having gout. About 21% of Americans have elevated levels of uric acid (hyperuricemia), but only 4% suffer from gout.10

A 2016 study highlighted a natural plant extract, called Terminalia bellerica, that can effectively lower uric acid blood levels without the side effects associated with prescription drugs.11

Let’s look at how lowering uric acid blood levels is an important step not only in addressing gout, but also in helping prevent life-shortening diseases.11

Terminalia Bellerica Lowers Uric Acid

Terminalia bellerica is a tree native to lower elevations in Southeast Asia, whose fruit has been used for centuries in Indian traditional medicine to treat a variety of diseases, particularly diabetes.12

In 2011, a component of the T. bellerica fruit rind, gallic acid, was shown to promote antidiabetic activity in a study of diabetic rats.12 In that study, the extract lowered blood sugar levels, and, in a surprising finding, the animals’ pancreases showed regeneration of their insulin-producing islet cells.

Additional beneficial effects noted in that study included reductions in serum total cholesterol, triglycerides, LDL, urea, creatinine (a measure of kidney dysfunction when elevated)—and also uric acid.12

Other studies have shown that T. bellerica has protective properties against oxidative stress, which in turn are thought to directly inhibit the action of an enzyme involved in the synthesis of uric acid.11,13

Human Studies

These findings in diabetic rats led a group of Indian researchers to perform a randomized, controlled clinical trial to determine the efficacy and tolerability of a standardized extract of T. bellerica at lowering uric acid levels in humans.11

For the study, 110 people with elevated uric acid received one of the following: a placebo, 40 mg daily of the uric-acid lowering drug febuxostat, 500 mg of T. chebula extract twice daily, or either 250 mg or 500 mg of T. bellerica standardized extracts twice daily.

After 24 weeks, the uric acid levels in the placebo recipients had risen significantly compared to baseline levels. In contrast, all non-placebo groups showed a reduction in uric acid levels compared to baseline and to placebo subjects.11

The most effective dose of T. bellerica was at 500 mg twice daily, which reduced uric acid levels by nearly twice as much as the lower dose.

And while the T. bellerica treatment was only about 60% as effective as the prescription drug febuxostat at reducing uric acid levels, it achieved these results without the side effects associated with this drug,11 which include liver function abnormalities, rash, nausea, and joint pain.14

Because the other common uric acid-lowering drug, allopurinol, also carries a wide range of side effects—including a potentially life-threatening hypersensitivity syndrome15T. bellerica supplementation offers a leap forward in safely lowering high uric acid levels while reducing risks of the conditions associated with them.

WHAT YOU NEED TO KNOW

The Dangers of High Uric Acid

  • Uric acid, a byproduct of normal cell growth and turnover, builds up in our bloodstreams as we age, and is exacerbated by the modern American diet.

  • While initially associated with gout, rising uric acid levels are now associated with many dangerous, lifespan-shortening conditions including cardiovascular and kidney disease, diabetes, and metabolic syndrome.

  • While all of these conditions are proving challenging to treat using modern mainstream medicine, most are proving amenable to prevention with natural compounds.

  • Terminalia bellerica is an Asian tree whose fruit contains valuable bioactive compounds long used in Indian traditional medicine.

  • Extracts of T. bellerica have now been shown to safely and effectively reduce uric acid in humans.

  • Given the anticipated benefits of across-the-board uric acid reduction, these findings make T. bellerica extracts an essential part of any disease-preventing strategy.

Why is it Important to Lower Uric Acid Levels?

Our bodies naturally produce uric acid when we break down and recycle the molecules that constitute DNA and RNA. An enzyme called xanthine oxidase is responsible for conversion of those compounds into uric acid, which is then normally excreted in the urine.

But age-related declines in kidney function lead to impaired excretion and gradual buildup of uric acid in the blood, accounting for the elevated serum uric acid levels in up to 25% of adults.16

Making matters worse, a diet rich in red meats and sugars, especially fructose—in other words, the typical American diet—can sharply increase uric acid production, further exacerbating the problem.17,18 In fact, gout has historically been called “the disease of kings” because of its association with rich diets.19

While gout was the original disorder associated with high uric acid, more recent evidence reveals that it is associated with conditions that are far worse.

Uric acid blood levels above 8.6 mg/dL in men or 7.1 mg/dL in women are classified as hyperuricemia (although some laboratories and research groups use different limits).20,21 High uric acid levels have now been found to be significantly associated with risks for:

  • Decreasing kidney function22
  • Chronic low-level inflammation, itself a major risk factor for many chronic disorders23
  • Metabolic syndrome18,24,25
  • Type II diabetes26-28
  • A wide array of cardiovascular risks, including elevated blood pressure, heart arrhythmias, and risk of death from heart attacks and strokes.1,29-35

TABLE: Risk Elevations Associated with High Uric Acid Levels

Condition Risk Increase With Elevated Uric Acid
Kidney failure 7% per 1 mg/dL increase22
Chronic inflammation as measured by hs-CRP 52%23
Metabolic syndrome 410%25
Diabetes 18% per 1 mg/dL increase26
Unstable lipid-rich arterial plaques 143%36
Prehypertension 44%34
Atrial fibrillation (cardiac arrhythmia) 67%35
Heart muscle enlargement 96% in highest vs. lowest uric acid levels;
26% increase per 1 mg/dL elevation of uric acid31
In-Hospital death from heart attack 432%32
Major adverse cardiac event (death,
congestive heart failure, repeat heart attack, stroke)
184%33

 

The Table above shows elevations in risks associated with high uric acid levels in blood.

If recent findings are any indication, these conditions may represent only the tip of the uric acid iceberg.

For example, in 2016 and 2017, a group of Italian researchers published several papers demonstrating that elevated uric acid levels play a role in bipolar disorder,6-8 while a 2015 study related high uric acid with depression in adolescents.37

Several drugs can be effective for many cases of major depression. Yet very few drugs are helpful with bipolar disorder, a condition that’s possibly even more heartbreaking than depression.

Together, the evidence that uric acid plays a major role in so many human disorders presents an opportunity for intervention with a safe, effective, plant extract, T. bellerica.

Summary

Levels of uric acid rise with age, exacerbated by declining kidney function and our meat- and sugar-rich diets.

Formerly associated mostly with painful gout, we now know that uric acid elevations threaten millions more people with elevated risks for kidney disease, diabetes, metabolic syndrome, and a wide range of cardiovascular disorders.

Exciting research has revealed the potent uric acid-lowering effect of extracts from the fruits of the Terminalia bellerica tree, a South Asian shade tree long used in traditional medicine.

These findings suggest one more natural way to combat the risks of so many age-related disorders—and they make T. bellerica an important weapon in our arsenal against premature aging and death.

 

References

  1. Jin M, Yang F, Yang I, et al. Uric acid, hyperuricemia and vascular diseases. Front Biosci (Landmark Ed). 2012;17:656-69.
  2. Ford ES, Li C, Cook S, et al. Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents. Circulation. 2007;115(19):2526-32.
  3. Lehto S, Niskanen L, Ronnemaa T, et al. Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus. Stroke. 1998;29(3):635-9.
  4. Schretlen DJ, Inscore AB, Vannorsdall TD, et al. Serum uric acid and brain ischemia in normal elderly adults. Neurology. 2007;69(14):1418-23.
  5. Siu YP, Leung KT, Tong MK, et al. Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis. 2006;47(1):51-9.
  6. Bartoli F, Crocamo C, Dakanalis A, et al. Purinergic system dysfunctions in subjects with bipolar disorder: A comparative cross-sectional study. Compr Psychiatry. 2017;73:1-6.
  7. Bartoli F, Crocamo C, Gennaro GM, et al. Exploring the association between bipolar disorder and uric acid: A mediation analysis. J Psychosom Res. 2016;84:56-9.
  8. Bartoli F, Crocamo C, Mazza MG, et al. Uric acid levels in subjects with bipolar disorder: A comparative meta-analysis. J Psychiatr Res. 2016;81:133-9.
  9. Machado-Vieira R, Salem H, Frey BN, et al. Convergent lines of evidence support the role of uric acid levels as a potential biomarker in bipolar disorder. Expert Rev Mol Diagn. 2017;17(2): 107-8.
  10. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011;63(10):3136-41.
  11. Usharani P, Nutalapati C, Pokuri VK, et al. A randomized, double-blind, placebo-, and positive-controlled clinical pilot study to evaluate the efficacy and tolerability of standardized aqueous extracts of Terminalia chebula and Terminalia bellerica in subjects with hyperuricemia. Clin Pharmacol. 2016;8:51-9.
  12. Latha RC, Daisy P. Insulin-secretagogue, antihyperlipidemic and other protective effects of gallic acid isolated from Terminalia bellerica Roxb. in streptozotocin-induced diabetic rats. Chem Biol Interact. 2011;189(1-2):112-8.
  13. Hazra B, Sarkar R, Biswas S, et al. Comparative study of the antioxidant and reactive oxygen species scavenging properties in the extracts of the fruits of Terminalia chebula, Terminalia belerica and Emblica officinalis. BMC Complement Altern Med. 2010;10:20.
  14. Love BL, Barrons R, Veverka A, et al. Urate-lowering therapy for gout: focus on febuxostat. Pharmacotherapy. 2010;30(6):594-608.
  15. Lupton GP, Odom RB. The allopurinol hypersensitivity syndrome. J Am Acad Dermatol. 1979;1(4):365-74.
  16. Vitart V, Rudan I, Hayward C, et al. SLC2A9 is a newly identified urate transporter influencing serum urate concentration, urate excretion and gout. Nat Genet. 2008;40(4):437-42.
  17. Angelopoulos TJ, Lowndes J, Zukley L, et al. The effect of high-fructose corn syrup consumption on triglycerides and uric acid. J Nutr. 2009;139(6):1242S-5S.
  18. Cirillo P, Sato W, Reungjui S, et al. Uric acid, the metabolic syndrome, and renal disease. J Am Soc Nephrol. 2006;17(12 Suppl 3):S165-8.
  19. Giuffra V, Minozzi S, Vitiello A, et al. On the history of gout: paleopathological evidence from the Medici family of Florence. Clin Exp Rheumatol. 2017;35(2):321-6.
  20. Schlesinger N, Norquist JM, Watson DJ. Serum urate during acute gout. J Rheumatol. 2009;36(6):1287-9.
  21. Sun SZ, Flickinger BD, Williamson-Hughes PS, et al. Lack of association between dietary fructose and hyperuricemia risk in adults. Nutr Metab (Lond). 2010;7:16.
  22. Tsai CW, Lin SY, Kuo CC, et al. Serum Uric Acid and Progression of Kidney Disease: A Longitudinal Analysis and Mini-Review. PLoS One. 2017;12(1):e0170393.
  23. Raeisi A, Ostovar A, Vahdat K, et al. Association of serum uric acid with high-sensitivity C-reactive protein in postmenopausal women. Climacteric. 2017;20(1):44-8.
  24. Choi H, Kim HC, Song BM, et al. Serum uric acid concentration and metabolic syndrome among elderly Koreans: The Korean Urban Rural Elderly (KURE) study. Arch Gerontol Geriatr. 2016;64:51-8.
  25. Rubio-Guerra AF, Morales-Lopez H, Garro-Almendaro AK, et al. Circulating Levels of Uric Acid and Risk for Metabolic Syndrome. Curr Diabetes Rev. 2017;13(1):87-90.
  26. Juraschek SP, McAdams-Demarco M, Miller ER, et al. Temporal relationship between uric acid concentration and risk of diabetes in a community-based study population. Am J Epidemiol. 2014;179(6):684-91.
  27. Moleda P, Fronczyk A, Safranow K, et al. Is Uric Acid a Missing Link between Previous Gestational Diabetes Mellitus and the Development of Type 2 Diabetes at a Later Time of Life? PLoS One. 2016;11(5):e0154921.
  28. Sun HL, Pei D, Lue KH, et al. Uric Acid Levels Can Predict Metabolic Syndrome and Hypertension in Adolescents: A 10-Year Longitudinal Study. PLoS One. 2015;10(11):e0143786.
  29. Clarson LE, Hider SL, Belcher J, et al. Increased risk of vascular disease associated with gout: a retrospective, matched cohort study in the UK clinical practice research datalink. Ann Rheum Dis. 2015;74(4):642-7.
  30. Singh JA. When gout goes to the heart: does gout equal a cardiovascular disease risk factor? Ann Rheum Dis. 2015;74(4):631-4.
  31. Cuspidi C, Facchetti R, Bombelli M, et al. Uric Acid and New Onset Left Ventricular Hypertrophy: Findings From the PAMELA Population. Am J Hypertens. 2017.
  32. Gazi E, Temiz A, Altun B, et al. The association between serum uric acid level and heart failure and mortality in the early period of ST-elevation acute myocardial infarction. Turk Kardiyol Dern Ars. 2014;42(6):501-8.
  33. Kawabe M, Sato A, Hoshi T, et al. Gender differences in the association between serum uric acid and prognosis in patients with acute coronary syndrome. J Cardiol. 2016;67(2):170-6.
  34. Lotufo PA, Baena CP, Santos IS, et al. Serum Uric Acid and Prehypertension Among Adults Free of Cardiovascular Diseases and Diabetes: Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Angiology. 2016;67(2):180-6.
  35. Tamariz L, Hernandez F, Bush A, et al. Association between serum uric acid and atrial fibrillation: a systematic review and meta-analysis. Heart Rhythm. 2014;11(7):1102-8.
  36. Ando K, Takahashi H, Watanabe T, et al. Impact of Serum Uric Acid Levels on Coronary Plaque Stability Evaluated Using Integrated Backscatter Intravascular Ultrasound in Patients with Coronary Artery Disease. J Atheroscler Thromb. 2016;23(8):932-9.
  37. Tao R, Li H. High serum uric acid level in adolescent depressive patients. J Affect Disord. 2015;174:464-6.

 

Article By:By Stephen Curtis

Article Source: http://www.lifeextension.com/Magazine/2017/7/Surprising-Facts-About-Uric-Acid/Page-01?utm_source=facebook&utm_medium=social&utm_campaign=normal

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