According to a study reported at the EPA 2011: 19th European Congress of Psychiatry, nearly three-quarters of healthy individuals report that they would consent to being prescribed a placebo medication if they experienced depression. The study analyzed questionnaires completed by 344 healthy students 18 years of age or older. Participants were provided with a detailed written explanation about the placebo effect and its efficacy and limitations in the treatment of depression. The investigators also confirmed that patients understood the ethical complexity associated with placebo use, including informed consent issues. Overall, 243 survey participants (70%) said they would agree to the use of a placebo as a first-line treatment if they developed depression. Also, 248 (73%) said they would consent to receive placebo treatment for other medical conditions. Also, 275 (88%) said that they did not consider a physician who administered a placebo deceitful, and 256 (75%) did not feel that taking a placebo medication would negatively affect their sense of autonomy or the patient-physician relationship. The lifetime prevalence of the disorder is reportedly as high as 20% and antidepressants are among the most widely prescribed medications. However, placebo pills in depressed patients have produced response rates of 30% to 50% with sustained efficacy, minimal side effects, and nominal cost. (EPA 2011: 19th European Congress of Psychiatry: Abstracts P02-160 and FC31-02. Presented March 14 and 15, 2011.).

Reactive hypoglycemia (RH), which is a postprandial hypoglycemic state, occurs within 2-5 h after food intake. It is classified as idiopathic, alimentary, or diabetic reactive hypoglycemia. This cross sectional study examined reactive hypoglycemia incidence and correlations with insulin sensitivity and/or beta cell function in 64 young patients with lean phenotype polycystic ovary syndrome (PCOS) (BMI < or = 25 kg/m2). Notably, the rate of RH was found to be 50% in lean young women with PCOS. DHEA-S was lower in subjects with RH (P < 0.05). The 4h glucose level, but not the 3h glucose level, was significantly correlated with insulin resistance indices, including fasting insulin and other measures in the RH group. These results indicate that more definite insulin resistance occurs in subjects with RH later on in the fourth hour of the OGTT than those with RH only at the third hour. In addition, RH in the fourth hour together with a low DHEA-S level may be predictive of future diabetes in young women with PCOS even when they are not obese. (Eur J Obstet Gynecol Reprod Biol. 2005 Apr 1;119(2):198-205.) PMID: 15808380

This study examined the association between timing of introduction of solid foods during infancy and obesity at 3 years of age (defined as BMI for age and gender ≥95th percentile) in 847 children. The primary exposure was the timing of introduction of solid foods, categorized as less than 4 months after birth, 4 to 5 months, or ≥6 months after birth. Separate analysis was conducted for infants who were breastfed for at least 4 months (“breastfed”) and infants who were never breastfed or stopped breastfeeding before the age of four months (“formula-fed”). In the first 4 months of life, 568 infants (67%) were breastfed and 279 (32%) were formula-fed. At age 3 years, 75 children, an alarming 9%, were obese. Among breastfed infants, the timing of solid food introduction was not associated with odds of obesity (OR 1.1, 95%CI 0.3-4.4). However, among formula-fed infants, introduction of solid foods before 4 months of age was associated with a sixfold increase in odds of obesity at age 3 years, and this association was not explained by rapid early growth (OR after adjustment 6.3, 95%CI 2.3-6.9). Pediatrics. 2011 Feb 7. PMID: 21300681.

A total of 50 healthy women were enrolled during lactation received either oral treatment with micronized Silymarin (420 mg/day) or an identical placebo and equally distributed into two groups based on age and other demographic factors. Women had borderline low production of breastmilk at the time of enrollment. All women were assigned to a 2600 kcal diet. Breastmilk was measured to include both the milk sucked by the newborn (double weighing, before and after sucking) and the milk expressed with the breast-pump after each sucking to empty the breast. A portion of the milk sample was used to carry out the quantitative analysis of water, fat, protein and carbohydrate content. After 63 days, women treated with Silymarin showed a clear galactagogue effect with an increase of 85.94% in their daily milk production, compared to a 32.09% increase in the placebo group. There was no change in the macronutrient content of the breastmilk. No drop outs or side effects were reported in either group. Authors concluded that silymarin is a safe and effective herbal product that can be orally administered in order to improve the daily milk production in healthy women after delivery, without affecting milk quality. Acta Biomed. 2008 Dec;79(3):205-10. PMID: 19260380.

This randomized controlled trial evaluated the effect of omega-3 fatty acid supplementation on the rate of muscle protein synthesis in older adults. Sixteen healthy, older adults were randomly assigned to receive either omega-3 fatty acids (3.36g combined EPA+DHA per day) or corn oil for 8 wk. The rate of muscle protein synthesis and the phosphorylation of key elements of the anabolic signaling pathway were evaluated before and after supplementation during basal, postabsorptive conditions and during a hyperaminoacidemic-hyperinsulinemic clamp. Omega-3 fatty acid supplementation had no effect on the basal rate of muscle protein synthesis (P = 0.80) but augmented the hyperaminoacidemia-hyperinsulinemia-induced increase in the rate of muscle protein synthesis (from 0.009 ± 0.005% per hour above basal values to 0.031 ± 0.003%/h above basal values; P <0.01), which was accompanied by greater increases in muscle mTOR(Ser2448) (P = 0.08) and p70s6k(Thr389) (P < 0.01) phosphorylation. Corn oil supplementation had no effect on any measure of muscle protein synthesis. Omega-3 fatty acids stimulate muscle protein synthesis in older adults and may be useful for the prevention and treatment of sarcopenia. Am J Clin Nutr. 2011 Feb;93(2):402-12. PMID: 21159787.

A water-soluble extract from a cultured medium of Ganoderma lucidum mycelia (MAK) has been reported to exhibit cancerpreventive effects in animal studies. This study examined the effect of MAK on prevention of colorectal cancer in patients with colorectal adenomas as determined by colonoscopy. A total of 123 patients in the MAK group took MAK (1.5 g/day) for 12 months, and were compared to 102 control subjects receiving no treatment. Follow-up colonoscopy was performed after 12 months, and the colonoscopists recorded the size, site and macroscopic type of all adenomas. The changes in the number of adenomas at 12 months increased to 0.66 +/- 0.10 (mean +/- SE) in the control group, and decreased in the MAK group: -0.42 +/- 0.10 (p < 0.01). Similarly, the total size of adenomas increased to 1.73 +/- 0.28 mm in the control group and decreased to -1.40 +/- 0.64 mm in the MAK group (p < 0.01). The results suggest that MAK suppresses the development of colorectal adenomas. Hiroshima J Med Sci. 2010 Mar;59(1):1-6. PMID: 20518254.

Because traditional nonsteroidal antiinflammatory drugs have been associated with increased risk for acute cardiovascular events, current guidelines recommend acetaminophen as the first-line analgesic of choice on the assumption of its greater cardiovascular safety. This study evaluated the safety of acetaminophen in patients with coronary artery disease. A total of 33 patients with coronary artery disease participated in a randomized, doubleblind, placebo-controlled, crossover study of acetaminophen or placebo (1g 3x/d) on top of standard cardiovascular therapy for 2 weeks. Treatment with acetaminophen resulted in a significant increase in mean systolic (from 122.4±11.9 to 125.3±12.0 mmHg, p=0.02 versus placebo) and diastolic (from 73.2±6.9 to 75.4±7.9 mmHg, p=0.02 versus placebo) ambulatory blood pressures. Heart rate, endothelial function, early endothelial progenitor cells, and platelet function did not change. This is the first study to demonstrate that acetaminophen induces a significant increase in ambulatory blood pressure in patients with coronary artery disease. Use of acetaminophen should be critically evaluated for use in patients at increased cardiovascular risk. Circulation. 2010 Nov 2;122(18):1789-96. PMID: 20956208.

Pesticide-monitoring results suggest that a shift in residential pesticide exposure from organophosphorus insecticides to pyrethroid insecticides has occurred. However, pyrethroid insecticides are also potential neurodevelopmental toxicants and have not been evaluated for developmental toxicity. This study investigated the association between prenatal exposure to permethrin (a common pyrethroid) and piperonyl butoxide (a pyrethroid synergist) and neurodevelopment at 36-months. Participants (n=348) were part of a prospective cohort of black and Dominican mothers and newborns living in low-income neighborhoods in New York City. We examined 36-month cognitive and motor development using the Bayley Scales of Infant Development as a function of 1) permethrin levels measured in maternal and umbilical cord plasma collected on delivery and 2) permethrin and piperonyl butoxide levels measured in personal air collected during pregnancy. Prenatal exposure to permethrin in personal air and/or plasma was not associated with performance scores for the Bayley Mental Developmental Index or the Psychomotor Developmental Index. Pediatrics. 2011 Feb 14. PMID: 21300677.

A total of 58 type 2 diabetic patients treated only with oral hypoglycemic agents but with an HbA1c >7% were randomly assigned to receive either 2g of cinnamon or placebo daily for 12 weeks. After 12 weeks, mean HbA1c decreased significantly in the cinnamon group (8.22% to 7.86%) compared with placebo group (8.55% to 8.68%, P<0.005). Mean systolic and diastolic blood pressures (SBP and DBP) were also significantly reduced (P<0.001) after 12 weeks in the cinnamon group (SBP: 132.6 to 129.2 mmHg and DBP: 85.2 to 80.2 mmHg) compared with the placebo group (SBP: 134.5 to 134.9 mmHg and DBP: 86.8 to 86.1 mmHg). A significant reduction in fasting plasma glucose (FPG), waist circumference and body mass index (BMI) was observed at week 12 compared to baseline in the cinnamon group, however, the changes were not significant when compared to placebo group. There were no significant differences in serum lipid profiles between nor within the groups. Intake of 2g of cinnamon for 12 weeks significantly reduces the HbA1c, SBP and DBP among poorly controlled type 2 diabetes patients. Diabet Med. 2010.

This study determined the occurrence of gluten sensitivity (GS) in a group of allergic patients and assessed the efficacy of a gluten-free diet (GFD) as treatment for presenting symptomatology in those diagnosed with GS but not celiac disease. A total of 262 unrelated allergic patients with gastrointestinal symptoms of obscure origin were tested for gluten sensitivity through biopsy. All patients were also genotyped for the typical celiac DQ2 and DQ8 molecules and investigated for hematological markers such as antigliadin and antiendomysial antibodies. Patients displaying mucosal lesions were invited to follow a GFD. Seventy-seven of the 262 allergic patients were positive for mucosal lesions, but negative to the antiAGA, antiEMA and to DQ2 and DQ8 molecules. The positive patients, who after the GS diagnosis followed a GFD, exhibited control of symptoms as well as stabilization of the hematological parameters even if allergic manifestations were not abated. Authors concluded that a nonceliac gluten-sensitive enteropathy (NCGSE) commonly exists in allergic patients. Based on the high prevalence of NCGSE in allergy, these authors recommended that biopsy should be part of the routine investigation of allergic disease. Int Arch Allergy Immunol. 2011 Feb 22;155(4):389-394. PMID: 21346369.