Gum Disease Bacteria Tied To Diabetes

Bacteria from gum infections have been shown to play a role in heart disease, lung disorders and diabetes. Avoiding gum disease has become very important to health. Recent research reported at the annual meeting of the International Association for Dental Research in Vancouver gives new directions to follow to protect your gums. Here are the highlights.

Drink too much alcohol and you can increase your risk of gum disease, say University at Buffalo researchers. "As alcohol consumption increased from five drinks per week to 10, 15 and 20, the risk of periodontal disease rose from 10 percent to 20, 30 and then 40 percent," according to Sara G. Grossi, a senior research scientist who presented the results. The connection isn't clear yet as to how this occurs, but alcohol may increase the risk of periodontal disease by decreasing the body's ability to fight infection, interfering with the blood-clotting mechanism, decreasing the formation of new bone, and depleting vitamin B complex and proteins needed for healing.

In another study by Dr. Grossi, diets that are low in antioxidants, such as vitamins A and E that help protect cells against damage, were associated with more gum disease.

Earlier studies on hydrogen peroxide as a possible cancer initiator and promoter have produced mixed results. Other UB researchers studied the effects of hydrogen peroxide on laboratory animals and showed that use of hydrogen peroxide in certain strengths can promote precancerous lesions that have already begun to develop in the mouth. The effect on humans has not been studied.

Partnership For Health After Menopause

What do women over 50 in the United States have in common with each other? Many things most likely, but definitely the same health issues. Between 1995 and 2010, the number of women over 50 in the United States will increase by 15 million to a total of 52 million. These women face an increasing risk for the diseases of aging, such as heart disease, breast and gynecologic cancer, diabetes, and osteoporosis. To help inform women of these risks, the National Women's Health Resource Center, Inc., (NWHRC) has formed a national coalition with other women's groups called the Partnership for Postmenopausal Women's Health. The Partnership brings together women's health education, minority, aging and advocacy groups to educate women about their health after menopause.

As an educational resource, the NWHRC is sponsoring the Partnership's national information telephone line, 1-877-PM-Healt(h), beginning in early April of 1999. Here, a caller will learn that the risks for developing disease can be minimized by making healthy lifestyle choices, including quitting smoking, exercising, and eating a well-balanced diet. She can also become aware of unusual symptoms that can lead to detecting and treating diseases in their earliest stages, which improves her chances of survival. Callers can receive free educational materials like the NWHRC's February 1999 issue of the National Women's Health Report, entitled "Women's Health After Menopause." A unique feature of the report is the "Postmenopausal Health & Wellness Guide," which details various risks and symptoms and recommended questions women should ask their health care providers.

The NWHRC is the national clearinghouse for women's health information. The Partnership is supported by the Lilly Center for Women's Health. For information about NWHRC services call toll-free at 877-986-9472, at 732-828- 8575, or visit their web site.

What To Eat When You're Allergic To Wheat

Nearly one million Americans are allergic to gluten, a protein found in wheat. This allergy may not be easy to diagnose, because a person's symptoms may range from mild to severe. Contributing to the difficulty in making a diagnosis is the number of foods that contain unexpected wheat or other grains. Most people with this disease can't eat bread made with wheat, rye or barley flour, nor pasta and most cereals. They also can't eat a lot of things you might not expect, such as licorice, Milky Way candy bars, most ketchup, mustard, mayonnaise and ice cream. They may not be able to use toothpaste, mouthwash and some medicines. They even have to be careful about licking stamps and envelopes and using most hand lotions.

Shopping at the supermarket often seems like a nightmare. Every label must be scrutinized to decipher whether a food contains yeast, distilled vinegar made from grain, or stabilizers that contain wheat. But shopping got easier this year when Albertson's, one of the nation's top supermarket chains, volunteered to survey vendors to find out which products with the Albertson's, Jenny Lee and Good Day labels were gluten-free. "It was quite an extensive process, we polled about 120 vendors. And it was a big surprise to us. We found out this disease is more common than one would believe," said Laura Kidwai, secretary of product quality for Albertson's. Albertson's now has a five-page memo identifying gluten-free, gluten-safe and gluten-containing foods. It also is posting the information on its Web site and plans to make it available for a national guide for celiac sufferers. This service may lead the way for the store to do similar surveys for other types of allergens, such as corn, soy, eggs and rice.

Gluten intolerance, also known as celiac disease, is a genetic disorder believed to affect about one in 250 Americans to varying degrees of severity. People with this disease may have painful stomach cramps after they eat, as if they'd been food-poisoned, but never realized it is due to gluten intolerance. One way to determine whether you have celiac disease is to go on a chicken, rice, and banana diet for a week. Or seek another diet to restrict your choice of food, adding one food back at a time, until you can determine what is making you sick.

If you decide you do have this disease, use a cookbook, such as the "Gluten Free Gourmet Book" by Bette Hagman, for recipes, such as a bread made with rice flour, tapioca and potato starch. It's also important to see your doctor if you think you might be intolerant to gluten. Even a mild disorder should be checked out, because it can damage the small intestine. This can cause malnutrition, tooth decay, bone problems and profuse bleeding, because calcium, Vitamin K and other vitamins and minerals aren't being absorbed properly. Researchers also believe there may be a connection between gluten intolerance and adult-onset diabetes and rheumatoid arthritis. You can get information at the Celiac web site.

Medicare Medical Nutrition Therapy Act May Be Passed

Passage of the Medicare Medical Nutrition Act could save dollars and lives and improve the quality of health care says the American Dietetic Association. The passage of this act, which would extend Medicare to cover medical nutrition therapy, is strongly supported by the American Dietetic Association. The Chicago-based ADA is the world's largest organization of food and nutrition professionals. With nearly 70,000 members, ADA serves the public by promoting nutrition, health and well-being.

"Medical nutrition therapy" refers to the services normally provided by a registered dietitian or other nutrition professional as part of a patient's health-care team. It assists in treating and controlling heart disease, stroke, some forms of cancer, diabetes, high cholesterol and other life-threatening conditions. It is cost effective also, since studies show patients receiving medical nutrition therapy require fewer hospitalizations and medications and have fewer complications. However, there is no consistency in reimbursement for nutrition services, either under Medicare or privately.

Two recent studies, both conducted by the Lewin Group, a Fairfax, Va., independent health policy research firm, support the health benefits and cost savings of medical nutrition therapy. One study, to be published in the April issue of The Journal of The American Dietetic Association, reports that the costs of extending Medicare to cover all beneficiaries -- inpatient and outpatient -- would exceed savings for the first three years, but savings would outweigh costs beginning the fourth year and afterward. The other study, conducted by Lewin for the Department of Defense, estimates that costs of medical nutrition therapy would be more than offset by reductions in money spent, for inpatient and outpatient services, treating people with diabetes, cardiovascular disease and kidney disease.

A Toast To Health--Nuts To You!

True, nuts are high in fat, but new research shows they may protect against heart disease. How? Nuts contain mono and polyunsaturated fats as opposed to saturated fats. These fats seem to actually be good for you. They exert a lowering, or at least stabilizing, effect on LDL cholesterol. Scientists are also studying the magnesium, vitamin E and fiber content of nuts as possible factors. Magnesium, for example, is an important mineral in heart muscle function.

Old studies have suggested these results before. But two new, large studies are very persuasive. The Nurses' Health Study, an investigation of more than 86,000 women over a 14-year period was reported in The British Medical Journal in late 1998. Women who ate more than half a cup of nuts per week were 35 percent less likely to develop heart disease or suffer a heart attack than women who rarely or never ate nuts. These results held up even after controlling for differences in exercise, smoking, body weight, and fiber and vitamin intake.

Also last fall, the Physicians Health Study, which followed 22,000 men for 11 years showed similar results. Those whose diets included the most nuts had the lowest risk of dying from heart disease during the study. Again, researchers controlled for other factors like exercise, high blood pressure, smoking and diabetes.

So, does this mean you can go nuts with nuts? Just remember that nuts, because of their high fat content, are a rich source of calories. Most nuts provide around 100 calories per ounce (approximately two tablespoons). If you want to eat nuts, but don't want your weight to creep up, eat them in place of other high-fat foods like chips, doughnuts or cookies. And get them in the shell as this also helps you build up your biceps.

Rezulin Deaths--Declining Or Increasing?

Warner-Lambert Co., whose sales of Rezulin have topped $1 billion, assured the FDA in a letter dated Dec. 31 that liver-related deaths associated with the drug had declined 65 percent over the previous year. But had they? Deaths linked to the diabetes drug increased dramatically last year, according to a recent article in the Los Angeles Times. Rezulin was listed as a contributing factor in the deaths of 65 people last year, more than four times as many as in 1997, the newspaper reported, citing federal records. According to these federal records, some of the patients had other health conditions, including stroke, cancer and heart attacks, that could have contributed to or caused their deaths.

In all, 155 Rezulin patients have died since the drug went on the market in 1997. About 60 percent of the patients showed signs of liver damage. In the first six weeks of 1999, 12 liver-related deaths were reported.

The same FDA advisory panel that approved Rezulin in 1996 is expected to vote March 26 on whether to restrict or ban the drug. Rezulin is a blood sugar control drug used in adult-onset diabetes. Company officials declined to comment specifically on the deaths, saying only that the drug's risks should be weighed against its benefits in treating diabetes.

Miss America's Search For The Missing Millions

Miss America 1999 Nicole Johnson is making appearances around the country in her national diabetes campaign. Called the Search for the Missing Millions, the campaign is to identify and reach the more than six million Americans who are at risk for serious complications from diabetes either because they are undiagnosed or because their current therapy is not adequately controlling their blood sugar.

"I was diagnosed with diabetes when I was 19 years old," said Johnson, who will spend the next year traveling an average of 20,000 miles a month as a national advocate for diabetes awareness. "Effective treatment and careful monitoring keep my blood sugar levels as close to normal as possible and allow me to lead a healthy and active life. I want to encourage people to test early and get appropriate treatment for diabetes so they, too, can enjoy healthy, active lives."

The Journal of the American Medical Association recently reported that diabetes testing should begin as early as age 25 to help save patients from such serious complications as blindness, kidney failure and amputation. Johnson, who has lived with diabetes for more than five years, is assisting with the program's blood-sugar screenings and symposium for people with diabetes and their families.

The Search for the Missing Millions aims to reach people whose blood-sugar levels are considered "out of control" (with a fasting blood-sugar consistently above 140 mg/dl) to encourage them to be screened for diabetes and to adopt therapies that fully control their disease. In an effort to reach this goal, Johnson will be bringing The Search to 16 cities in the U.S.

New Obesity Drug May Result From Gene Cloning

Scientists from various teams report in the British journal Nature that the cloning of a mouse gene that suppresses obesity could lead to drugs to control obesity. The gene, called mahogany, produces protein MG that primarily acts on the hypothalmus, a specific brain region that regulates body weight. ``The cloning of the mouse mahogany gene and the identification of its protein product are major first steps in achieving a better understanding of their roles in controlling weight based on the amount of fat in a diet,'' said Karen Moore, director of genetic systems at Millennium Pharmaceuticals, Inc. in Cambridge, Mass.

Because of the great metabolic similarity between mouse and man, scientists expect the gene to play a parallel role in humans. ``We are currently optimistic that our preliminary findings in the mouse will lead to the development of therapeutic agents to help treat obesity in humans'' Moore says. ``One might imagine that a subclass of obese patients will be found to have alterations in (the gene) and that drugs might be developed that affect how mahogany protein functions,'' says Dr. Gregory Barsh, leader of the second study at the Howard Hughes Medical Institute and associate professor of pediatrics and genetics at the Stanford University School of Medicine in Palo Alto, Calif., .

Scientists hope that this new era of body weight research will eventually result in using MG protein as a screening target for testing various compounds for their effectiveness as human obesity therapies. A small molecule could be developed that could attach to a receptor in the protein and affect its function. Dr. Robert Tepper, chief scientific officer of Millennium's pharmaceutical division, says ``If successful, the small molecule could become the basis of a drug for obesity.''

``Because the desired affect is obtained when the mahogany gene is defective, we are optimistic about using the protein for obesity drug development,'' Moore concluded. ``In developing a drug, it is always easier to decrease gene function rather than to try to increase it.''

New Drug To Delay Or Prevent Type 1 Diabetes?

Neurocrine Biosciences, Inc. announced that it has commenced a Phase I clinical study with a compound from Neurocrine's proprietary altered peptide ligand (APL) technology. The clinical study will evaluate the APL compound NBI-6024 in diabetic patients with Type 1 or insulin dependent diabetes mellitus (IDDM) and is designed to assess immune response following the administration of NBI-6024. Neurocrine filed and received approval of a Clinical Trials Certificate (CTX) with the Medicines Control Agency in the United Kingdom for NBI-6024. Upon successful completion of these trials, trials are planned to begin in pre-diabetic patients to evaluate the drug's ability to delay or prevent diabetes.

IDDM is an autoimmune disease in which the immune system incorrectly identifies healthy tissue as foreign and mounts an immune response against itself. The B-islet pancreatic cells, which are responsible for the production of insulin, are the targets for destruction. APL has been shown to draw a protective immune response by down regulating the immune-mediated destructive process, thereby preserving the B-islet cell and their insulin producing capability. This preclinical data suggests that this therapeutic intervention may have the potential to prevent the onset of diabetes in those patients who are at high risk, such as first degree relatives of patients with IDDM. In addition, the potential exists to intervene in newly diagnosed patients or patients who still have residual intact B-islet cells function to stop disease progression.

Type 1 diabetes is characterized by this immune-mediated destruction of the insulin producing beta cells of the pancreatic islet, and represents 10% of all diagnosed cases of diabetes. It is estimated that more than one million people in North America and comparable numbers in Europe have this type.

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