   
Micronutrients Strengthen Elderly Immune SystemResearch and common knowledge have shown for a long time that a healthy diet is a balanced diet, because only a balanced one has the full array of vitamins, minerals and unidentified trace elements that help the body function well. Now research is focusing on the importance of a diet with complete micronutrients for the elderly to strengthen their immune function. What are micronutrient levels in the elderly and what is the relationship between micronutrients and natural killer cells in these participants? A new study reported in the American Journal Clinical Nutrition (2000; 71: pgs 590 to 598) conducted by a team of researchers led by Dr. Giovanni Ravaglia of the University Hospital Sant'Orsola-Malpighi in Bologna, Italy, shows that micronutrients influence the effect of natural killer cells in the elderly. Unfortunately, previous research has indicated that the elderly are often deficient in these nutrients, and that the NK cells of their immune system are often impaired in fighting cancer and infection. To gain more information about the level of specific micronutrients, the researchers studied 62 elderly men and women ranging in age from 90 to 106 years. All were healthy, apparently well nourished and able to live independently. None took nutritional supplements or medications that affect the immune system. In spite of their apparent health and nourishment, many of the participants had some micronutrient deficiencies. About 50% of both men and women were deficient in selenium. About the same percentage of men and 41% of women were deficient in zinc which plays a role in wound healing, proper growth, and immune system functioning. Deficiencies also existed in vitamins A, E, B6, folate, and ubiquinone-10. All of these are either antioxidant or associated with cell and immune system functioning. The level of natural killer cells was higher when zinc levels were higher in the men and women, and when the level of selenium was higher in women. The immune activity of these cells was also greater when blood levels of vitamin E and ubiquinone-10 (an antioxidant, often called Coenzyme Q10) were higher in women. No other important relationships of micronutrients with natural killer cells were observed. The study confirmed the importance of a balanced diet for health, which is often harder for the elderly who get out less often and do not drive. The study does not address whether vitamin/mineral supplements would improve immune system function.
Exercise Helps Blood Vessel LiningIts long been known that exercise is good for the heart and that its beneficial effect comes from increasing blood flow to the heart. Exactly why increased blood flow works to improve the heart in people with heart disease is not clear, but new research suggests it works in part because it improves the endothelium, which is the cell lining within blood vessels. A study reported in The New England Journal of Medicine (2000; 342: pgs. 454 to 460) by Dr. Rainer Hambrecht and colleagues at the University of Leipzig Heart Center in Germany says that exercise improves the endothelial function in arteries which enables them to dilate when needed, thus providing necessary blood flow to the heart. The researchers studied 19 people with heart disease but no other risk factors that could be improved by exercise, such as diabetes, high blood pressure or high cholesterol. The participants were given a drug called acetylcholine, which causes healthy arteries to dilate. At the start of the study this drug either caused the arteries of the 19 participants to constrict or there was no response. But after a 4-week exercise program for 10 of the participants chosen randomly, the responsive dilation of their endothelium when this drug was given improved dramatically. The remaining participants did not exercise regularly and their endothelium responsiveness did not change. After the 4-week exercise program, blood vessel function was still not normal in the group of 10 heart patients. The researchers note that an exercise program lasting longer than 4 weeks might be necessary.
Heart Attack And Unblocked ArteriesBetween 1% and 10% of people who have a heart attack have normal, unblocked coronary arteries as shown by angiography. Now research is offering clues as to how this happens. Researchers Dr. Peter Ammann and his colleagues from Triemli Hospital in Zurich, Switzerland report in the journal Chest (2000; 117: pgs. 333 to 338), on research to explain why people with healthy heart arteries suffer a heart attack in a condition referred to as myocardial infarction with normal coronary arteries, or MINC. They looked at 21 such people and contrasted them with 21 men and women who had heart attacks due to coronary artery disease. One piece of good news is that people with MINC suffer fewer problems after their heart attack. The researchers found that 10 participants with artery disease suffered chest pain in the 5 years after a heart attack, but only 2 participants with normal arteries did. Furthermore, 11 of the artery-disease participants were hospitalized during that time, but none of the MINC participants were. The heart attacks of people with MINC are not caused by a blockage of blood flow to the heart. So what causes these people's heart attacks? Some possible answers include impairment of the blood-clotting function and the blood-vessel spasms associated with migraine headaches and Raynaud's phenomenon. In Reynaud's phenomenon, small arteries in the fingers and toes constrict when exposed to cold or strong emotion. The researchers found that the MINC participants had fewer risk factors that are associated with artery disease such as high blood pressure, high cholesterol, and chest pain. On the other hand, MINC participants were more likely to suffer migraine headaches or Raynaud's phenomenon. Based on questionnaires, 10 MINC participants had migraine, compared with 2 artery-disease participants; 5 MINC participants were diagnosed with Raynaud's, only 1 with Raynaud's was in the other group. As another possible avenue for explaining heart attacks without artery disease, the research team also measured signs of infection in MINC participants. Certain infections can cause long-term inflammation which has been linked to the development of artery disease. The infections can also cause antibodies which the researchers found in the same amount in both the participants with artery disease and the ones with MINC. When both of these groups were compared with a third group of healthy participants, however, both groups of participants with heart attack showed a higher level of antibodies to all of the infections that are associated with heart attack. The other connection drawn was the possibility of a fever and infection occurring before the heart attack in MINC participants. Six MINC participants had suffered an illness with fever during the 2 weeks before their heart attacks, but no artery-disease participant had. This raises the possibility that inflammation or some component of infection triggers the heart attack in MINC participants. On the bright side, Swiss researchers report, these patients have an excellent prognosis, with fewer cardiac problems later than may occur in patients who have diseased arteries.
MiniMed's New Implantable Pump Approved In EuropeMiniMed Inc. has received approval to ``CE'' mark its improved implantable insulin pump, enabling the pump to be sold in Europe. This next generation implantable pump, manufactured for MiniMed by Medical Research Group, Inc., has several improved features, such as a lighter weight, improved memory and a longer battery life than the previous pump. The new battery is believed to extend the pump's life to about 10 years. European distributors are waiting for the approval of the Hoerst insulin which has been specially formulated for the pump before they sell the pump. Neither the implantable pump nor the insulin have been cleared for marketing in the U.S.
Illnesses From Inactivity Called A Silent EpidemicConvenience is a killer. What's the downside of your car, cordless cell phone and electric can opener? They require less and less exertion, which lowers your fitness. As technology increases, physical activity becomes less necessary. This sharply increases levels of some chronic diseases, such as heart disease, diabetes and cancer, a trend researched and reported by Frank Booth and colleagues at the University of Missouri-Columbia. In their report, published in the Journal of Applied Physiology, these researchers call this surge of illnesses a ''silent epidemic,'' because these illnesses are causing an annual 250,000 premature deaths and close to $1 trillion in healthcare costs. Over the last 40 years obesity has doubled and diabetes has increased 6 times. Deaths from heart attacks have increased 29 times from 1900. The researchers recommend that the National Institutes for Health launch research on the link between exercise and disease, specifically, an understanding of the mechanisms by which exercise helps prevent these diseases. This would enable the prescribing of the appropriate type of exercise for the type of disease, such as aerobic for heart disease or weight bearing for osteoporosis.
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