The data are in: Eat right, avoid diabetes

Follow me on Twitter @RobShmerling

Here’s a new medical study with a conclusion that might just change your life: eat healthy.

Sure, you’ve heard it before, but this time the benefit is the prevention of diabetes. That’s a big deal, especially if, like so many other people. you are at risk for the disease. More on that in a moment.

First, let’s review the study. Researchers publishing in PLoS Medicine describe a study of more than 200,000 people in the U.S. who participated in health surveys over a 20-year period. They found that:

• People who chose diets that were predominately of plant-based foods developed type 2 diabetes 20% less often than the rest of the study subjects.
• For those with the very healthiest plant-based diets (including fruits, vegetables, nuts, beans, and whole grains), the reduction in type 2 diabetes was 34%.
• On the other hand, those who made less healthy choices (such as sugar-sweetened beverages and refined grains) developed type 2 diabetes 16% more often than the rest.

It’s worth emphasizing that this was not a study of the effect of being a vegan or of following an expensive, pre-packaged diet plan that might be hard to maintain over time. This was a study of “normal” dietary choices across a spectrum, from largely animal-based to largely plant-based with all variations in between. That makes it more applicable to the average person.

While this type of study cannot prove that the reduction in diabetes was strictly due to the difference in diet, the “dose response” (the higher degree of protection with the very healthiest diets) is strongly suggestive of real effect due to diet.

Current recommendations

The USDA’s current dietary guidelines (called “MyPlate”) urge everyone to choose healthy foods. For example:

• Half of each meal should consist of whole fruits and vegetables.
• About a quarter of each meal should be made up of protein, and another quarter grains (especially whole grains).
• Low-fat dairy products such as low-fat milk and yogurt are preferred over higher fat options.
• Moderate total calorie intake (depending on your age, gender, size, and physical activity).
• Reduce the intake of saturated fat, sodium, and added sugar. Read nutrition labels so you know what you’re eating.

According to the USDA’s website, the MyPlate diet “can help you avoid overweight and obesity and reduce your risk of diseases such as heart disease, diabetes, and cancer.”

Even more recently, the 2015 Dietary Guidelines Advisory Committee reported that a diet “that is higher in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds, and lower in animal-based foods, is more health promoting.” And just this week, US News and World Report ranked plant-based diets (the DASH diet and the Mediterranean diet) as the healthiest.

These recommendations have been endorsed by nutritionists, doctors, and public health officials. But, the data on which they are based are not perfect. This new study is among the strongest to date supporting the notion that a healthy diet can lower your risk of a chronic disease such as diabetes.

Of course, there are caveats

Is this the last word on the connection between diet and prevention of diabetes? Not by a long shot.

For one thing, this study examined trends among thousands of people over time. While that allows some observations (and even predictions) about large groups of people in aggregate, it does not allow accurate predictions for an individual. You could follow a healthy diet all your life and still develop diabetes. And not everyone who chooses an animal-based diet that is high in refined sugars will develop diabetes.

The information about diet was self-reported, so some inaccuracy is inevitable. And for some foods, the designation of “healthful” is somewhat subjective.

In addition, such studies are unable to say that diet is the key reason for the findings. Some other factor — exercise, genetics, or a host of other possibilities in combination — might matter more than diet alone. However, the dose response (as defined above) does suggest that diet is playing a significant role.

And in conclusion….

Given the dramatic increase in the incidence of diabetes in this country, studies that identify preventive approaches are worthy of attention. Besides providing some of the strongest support to date for recommendations for healthier diets, perhaps the biggest impact of a study like this should be for people at increased risk of disease. For example, a person who is overweight, has “pre-diabetes” (a high blood sugar that’s not quite high enough to be diagnostic of diabetes), or a strong family history of diabetes might take this data to heart and commit to changing their diet.

Studying the impact of dietary (or any other) recommendations is an important way to validate the guidelines’ usefulness. This new study is a good example.

The post The data are in: Eat right, avoid diabetes appeared first on Harvard Health Blog.

From: Robert H. Shmerling, MD http://www.health.harvard.edu/blog/the-data-are-in-eat-right-avoid-diabetes-2017010510936

The "spanking" debate: Views depend on what you call it

Using the word "spank" for corporal punishment normalizes violence toward children, new research suggests

From: http://www.cbsnews.com/news/spanking-children-corporal-punishment-study/

Paul Ryan indicates GOP will strip federal funding from Planned Parenthood

Republicans have tried to defund Planned Parenthood in the past, but have been unsuccessful under Obama

From: http://www.cbsnews.com/news/paul-ryan-indicates-republicans-will-strip-federal-funding-from-planned-parenthood/

Brain-injury deaths in high school football players rising

Although rare, two dozen high school football players​ died in recent years from traumatic brain and spinal cord injuries, according to a new study

From: http://www.cbsnews.com/news/brain-injury-deaths-high-school-football-players-rising/

Heartburn drugs may raise risk of stomach infections: study

A new study suggests long-term use of acid suppressors might open door to C. difficile and Campylobacter bacteria

From: http://www.cbsnews.com/news/heartburn-drugs-including-prilosec-prevacid-nexium-may-raise-risk-of-stomach-infections/

U.S. cancer death rates continue to fall

A new report reveals cancer death rates have plummeted since the early 1990s

From: http://www.cbsnews.com/news/us-cancer-death-rates-continue-to-fall/

Vision Check Needed for Kids With Concussion

Lingering eye problems linked to poorer academic performance

From: http://www.webmd.com/brain/news/20170105/kids-with-concussion-need-vision-check-before-return-to-school?src=RSS_PUBLIC

U.S. Cancer Death Rates Continue to Fall: Report

Researchers credit declines in smoking, better detection and treatment

From: http://www.webmd.com/cancer/news/20170105/us-cancer-death-rates-continue-to-fall-report?src=RSS_PUBLIC

ADA adopts multitiered policy on opioids

In October, the ADA House of Delegates passed Resolution 64H-2016, an ADA Statement on the Use of Opioids in the Treatment of Dental Pain, which includes recommendations for dentists.

From: http://www.ada.org/en/publications/ada-news/2017-archive/january/ada-adopts-multitiered-policy-on-opioids

HHS to continue enforcing Section 1557

The U.S. Department of Health and Human Services Office for Civil Rights said Jan. 3 that it will continue to enforce the final rule promulgated under Section 1557 of the Affordable Care Act consistent with a federal court's preliminary injunction of the provision that prohibits discrimination based on gender identity or termination of pregnancy.

From: http://www.ada.org/en/publications/ada-news/2017-archive/january/hhs-to-continue-enforcing-section-1557

Just the Facts — January 9, 2017

In 2015, 40 percent of dental care expenditures were financed out of pocket. This is compared to 11 percent of overall health expenditures financed out of pocket.

From: http://www.ada.org/en/publications/ada-news/2017-archive/january/just-the-facts-january-9-2017

Anthony Anderson talks about his health and his part on black-ish

Anthony Anderson tells how he tapped his own experiences to prepare for his part on black-ish.

From: http://www.webmd.com/diabetes/features/anthony-anderson-shares-laughs-and-life-lessons?src=RSS_PUBLIC

The data are in: Eat right, avoid diabetes

Follow me on Twitter @RobShmerling

Here’s a new medical study with a conclusion that might just change your life: eat healthy.

Sure, you’ve heard it before, but this time the benefit is the prevention of diabetes. That’s a big deal, especially if, like so many other people. you are at risk for the disease. More on that in a moment.

First, let’s review the study. Researchers publishing in PLoS Medicine describe a study of more than 200,000 people in the U.S. who participated in health surveys over a 20-year period. They found that:

• People who chose diets that were predominately of plant-based foods developed type 2 diabetes 20% less often than the rest of the study subjects.
• For those with the very healthiest plant-based diets (including fruits, vegetables, nuts, beans, and whole grains), the reduction in type 2 diabetes was 34%.
• On the other hand, those who made less healthy choices (such as sugar-sweetened beverages and refined grains) developed type 2 diabetes 16% more often than the rest.

It’s worth emphasizing that this was not a study of the effect of being a vegan or of following an expensive, pre-packaged diet plan that might be hard to maintain over time. This was a study of “normal” dietary choices across a spectrum, from largely animal-based to largely plant-based with all variations in between. That makes it more applicable to the average person.

While this type of study cannot prove that the reduction in diabetes was strictly due to the difference in diet, the “dose response” (the higher degree of protection with the very healthiest diets) is strongly suggestive of real effect due to diet.

Current recommendations

The USDA’s current dietary guidelines (called “MyPlate”) urge everyone to choose healthy foods. For example:

• Half of each meal should consist of whole fruits and vegetables.
• About a quarter of each meal should be made up of protein, and another quarter grains (especially whole grains).
• Low-fat dairy products such as low-fat milk and yogurt are preferred over higher fat options.
• Moderate total calorie intake (depending on your age, gender, size, and physical activity).
• Reduce the intake of saturated fat, sodium, and added sugar. Read nutrition labels so you know what you’re eating.

According to the USDA’s website, the MyPlate diet “can help you avoid overweight and obesity and reduce your risk of diseases such as heart disease, diabetes, and cancer.”

Even more recently, the 2015 Dietary Guidelines Advisory Committee reported that a diet “that is higher in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds, and lower in animal-based foods, is more health promoting.” And just this week, US News and World Report ranked plant-based diets (the DASH diet and the Mediterranean diet) as the healthiest.

These recommendations have been endorsed by nutritionists, doctors, and public health officials. But, the data on which they are based are not perfect. This new study is among the strongest to date supporting the notion that a healthy diet can lower your risk of a chronic disease such as diabetes.

Of course, there are caveats

Is this the last word on the connection between diet and prevention of diabetes? Not by a long shot.

For one thing, this study examined trends among thousands of people over time. While that allows some observations (and even predictions) about large groups of people in aggregate, it does not allow accurate predictions for an individual. You could follow a healthy diet all your life and still develop diabetes. And not everyone who chooses an animal-based diet that is high in refined sugars will develop diabetes.

The information about diet was self-reported, so some inaccuracy is inevitable. And for some foods, the designation of “healthful” is somewhat subjective.

In addition, such studies are unable to say that diet is the key reason for the findings. Some other factor — exercise, genetics, or a host of other possibilities in combination — might matter more than diet alone. However, the dose response (as defined above) does suggest that diet is playing a significant role.

And in conclusion….

Given the dramatic increase in the incidence of diabetes in this country, studies that identify preventive approaches are worthy of attention. Besides providing some of the strongest support to date for recommendations for healthier diets, perhaps the biggest impact of a study like this should be for people at increased risk of disease. For example, a person who is overweight, has “pre-diabetes” (a high blood sugar that’s not quite high enough to be diagnostic of diabetes), or a strong family history of diabetes might take this data to heart and commit to changing their diet.

Studying the impact of dietary (or any other) recommendations is an important way to validate the guidelines’ usefulness. This new study is a good example.

The post The data are in: Eat right, avoid diabetes appeared first on Harvard Health Blog.

From: Robert H. Shmerling, MD http://www.health.harvard.edu/blog/the-data-are-in-eat-right-avoid-diabetes-2017010510936

Does Living Near Major Roads Boost Dementia Risk?

Study couldn't prove cause-and-effect, but risk rose as proximity to traffic increased, researchers report

From: http://www.webmd.com/alzheimers/news/20170104/does-living-near-major-roads-boost-dementia-risk?src=RSS_PUBLIC

Weight Loss May Ease Psoriasis Symptoms

Quality-of-life boost seen in obese patients who lost significant amounts

From: http://www.webmd.com/skin-problems-and-treatments/psoriasis/news/20170104/weight-loss-may-ease-psoriasis-symptoms-study-finds?src=RSS_PUBLIC

Office exercise: Add more activity to your workday

Are you too sedentary? See how to sneak more activity into your day.

From: http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/office-exercise/art-20047394

Video: Modified pushup

The modified push-up is less challenging than a classic push-up. See how it's done.

From: http://www.mayoclinic.org/healthy-lifestyle/fitness/multimedia/modified-pushup/vid-20084674

Symptoms of pregnancy: What happens first

Even before you miss a period, you might suspect — or hope — that you're pregnant. Know the earliest clues.

From: http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/symptoms-of-pregnancy/art-20043853

Cardiopulmonary resuscitation (CPR): First aid

From: http://www.mayoclinic.org/first-aid/first-aid-cpr/basics/art-20056600

More Signs Mediterranean Diet May Boost Your Brain

Older adults who favored this eating style lost less brain volume, study finds

From: http://www.webmd.com/brain/news/20170104/more-signs-mediterranean-diet-may-boost-your-brain?src=RSS_PUBLIC

Antibiotics don’t speed recovery from asthma attacks

Does winter in the Northeast make you think of snowmen, warm fires, and hot chocolate? Or, does it instead inspire visions of runny noses, congestion, and cough? Although it is less rosy, I know readers with asthma may be picturing the latter.

People with asthma get respiratory infections more often

In general, people with asthma tend to get sick more easily, and illnesses can trigger asthma attacks. In my practice, we generally start seeing an increase in the number of asthma attacks, or asthma flares, once the ground frosts. If you are fortunate enough not to have asthma, chances are that you know somebody who does. The Centers for Disease Control and Prevention  reports that rates of asthma in the United States are soaring, such that today, 1 in 12 people has it. Because people with asthma get sick more often, it is logical to suspect that they will often be prescribed antibiotics. But do antibiotics really help? New research is helping to answer this very question.

Do antibiotics help people with asthma get back to normal faster?

A study recently published in the Journal of American Medicine Association looked at the effectiveness of an antibiotic called azithromycin for treating asthma attacks. The trial, nicknamed AZALEA, aimed to look at whether adding azithromycin to the usual treatment helped people recover from asthma attacks more quickly.  This was of interest to the researchers for several reasons: For starters, azithromycin is a very commonly prescribed antibiotic, so it is important to know if it works. Also, studies showed that an older drug called telithromycin actually did help people heal from asthma attacks more quickly. Doctors rarely prescribe telithromycin today because it can cause serious side effects. But azithromycin is similar in many ways, so it might be a good alternative.

Azithromycin did not help the asthma attacks  improve

Participants in the study were separated into two groups. One group was given usual treatment for an asthma attack (a high potency anti-inflammatory pill and breathing treatments), plus azithromycin. The other group was given standard treatment for an asthma attack plus a placebo, or sugar pill. To help reduce confusion, the researchers excluded asthma sufferers who had taken antibiotics — for any reason — during the four weeks prior to the study.. At the end of the study, the researchers concluded that both groups recovered from their asthma attacks at the same speed.

This means  azithromycin did not make people recover any better or any faster, and those that did not receive  azithromycin still got better.

So, should you take antibiotics for asthma? No, but there are rare exceptions

There are several take-aways  from this study. First, azithromycin did not make any difference in making people with asthma attacks feel better. As a clinician, this makes a lot of sense to me. Azithromycin was the most commonly prescribed antibiotic in the U.S. in 2010, and remains heavily prescribed today. But it’s popularity comes at a cost. Many of the bacteria that typically cause respiratory infections in adults have become resistant to it. Furthermore, most adults with asthma attacks will have viral respiratory infections, and antibiotics don’t  kill viruses. That’s why I rarely prescribe an antibiotic for an asthma attack. When I do, I rarely prescribe azithromycin, because it will only work on a small fraction of bacteria. There are certainly some exceptions; smokers, in particular, can be different. But overall, the results of this study make intuitive sense.

A second, and very interesting, conclusion was that 90% of the asthmatics initially considered for  entry into this study had received antibiotics in the preceding month! We don’t know why these antibiotics were prescribed, but the rate of antibiotics prescribed for people with asthma is concerning. Common sense makes me suspect that this is too high a rate of antibiotic prescription. I’ve never yet had the need to give 9 out of 10 patients I see antibiotics. This makes me worry that antibiotics may be over-prescribed in asthmatics, and I would like to know why.

I hope that everyone out there has as healthy a winter as possible, filled only with snowmen, warm fires, and hot chocolate. For the asthma sufferers out there, I hope you know that research like this helps us providers learn how to take care of you better. And that is a very warm thought.

The post Antibiotics don’t speed recovery from asthma attacks appeared first on Harvard Health Blog.

From: Nandini Mani, MD http://www.health.harvard.edu/blog/antibiotics-dont-speed-recovery-asthma-attacks-2017010410941

Breathalyzer lock laws cut drunk-driving deaths, study shows

Cars equipped with an ignition interlock won't start if the driver's blood alcohol level exceeds a preset limit

From: http://www.cbsnews.com/news/breathalyzer-lock-laws-prevent-drunk-driving-deaths-study-shows/

Dementia risk linked to living near busy roads

The closer people lived to heavy traffic, the stronger the association with Alzheimer's and other types of dementia

From: http://www.cbsnews.com/news/dementia-risk-alzheimers-linked-to-living-near-busy-roads/

Mayo Clinic Minute: What should be in your sports drink?

From: Mayo Clinic http://www.youtube.com/watch?v=fvz_qTFan68

Comments sought on digital oral health assessment report

Dental professionals are invited to review and comment on a recently developed technical report that addresses digital risk assessment resources.

From: http://www.ada.org/en/publications/ada-news/2017-archive/january/comments-sought-on-digital-oral-health

Find meaning in the small things

From: http://www.mayoclinic.com/healthy-lifestyle/adult-health/in-depth/find-meaning-in-the-small-things/art-20269949

How to break the busy cycle

From: http://www.mayoclinic.com/healthy-lifestyle/adult-health/in-depth/how-to-break-the-busy-cycle/art-20269953

New guidelines to prevent peanut allergies

New guidelines recommend parents introduce peanut products into infants' diets to reduce the risk of developing peanut allergies. The new approach is a major departure from the practice of avoiding peanut products all together. This comes after a five-fold increase in peanut allergies between 1999 and 2010. Dr. Tara Narula joins "CBS This Morning" to discuss the findings.

From: http://www.cbsnews.com/videos/new-guidelines-to-prevent-peanut-allergies/

The data are in: Eat right, avoid diabetes

Follow me on Twitter @RobShmerling

Here’s a new medical study with a conclusion that might just change your life: eat healthy.

Sure, you’ve heard it before, but this time the benefit is the prevention of diabetes. That’s a big deal, especially if, like so many other people. you are at risk for the disease. More on that in a moment.

First, let’s review the study. Researchers publishing in PLoS Medicine describe a study of more than 200,000 people in the U.S. who participated in health surveys over a 20-year period. They found that:

• People who chose diets that were predominately of plant-based foods developed type 2 diabetes 20% less often than the rest of the study subjects.
• For those with the very healthiest plant-based diets (including fruits, vegetables, nuts, beans, and whole grains), the reduction in type 2 diabetes was 34%.
• On the other hand, those who made less healthy choices (such as sugar-sweetened beverages and refined grains) developed type 2 diabetes 16% more often than the rest.

It’s worth emphasizing that this was not a study of the effect of being a vegan or of following an expensive, pre-packaged diet plan that might be hard to maintain over time. This was a study of “normal” dietary choices across a spectrum, from largely animal-based to largely plant-based with all variations in between. That makes it more applicable to the average person.

While this type of study cannot prove that the reduction in diabetes was strictly due to the difference in diet, the “dose response” (the higher degree of protection with the very healthiest diets) is strongly suggestive of real effect due to diet.

Current recommendations

The USDA’s current dietary guidelines (called “MyPlate”) urge everyone to choose healthy foods. For example:

• Half of each meal should consist of whole fruits and vegetables.
• About a quarter of each meal should be made up of protein, and another quarter grains (especially whole grains).
• Low-fat dairy products such as low-fat milk and yogurt are preferred over higher fat options.
• Moderate total calorie intake (depending on your age, gender, size, and physical activity).
• Reduce the intake of saturated fat, sodium, and added sugar. Read nutrition labels so you know what you’re eating.

According to the USDA’s website, the MyPlate diet “can help you avoid overweight and obesity and reduce your risk of diseases such as heart disease, diabetes, and cancer.”

Even more recently, the 2015 Dietary Guidelines Advisory Committee reported that a diet “that is higher in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds, and lower in animal-based foods, is more health promoting.” And just this week, US News and World Report ranked plant-based diets (the DASH diet and the Mediterranean diet) as the healthiest.

These recommendations have been endorsed by nutritionists, doctors, and public health officials. But, the data on which they are based are not perfect. This new study is among the strongest to date supporting the notion that a healthy diet can lower your risk of a chronic disease such as diabetes.

Of course, there are caveats

Is this the last word on the connection between diet and prevention of diabetes? Not by a long shot.

For one thing, this study examined trends among thousands of people over time. While that allows some observations (and even predictions) about large groups of people in aggregate, it does not allow accurate predictions for an individual. You could follow a healthy diet all your life and still develop diabetes. And not everyone who chooses an animal-based diet that is high in refined sugars will develop diabetes.

The information about diet was self-reported, so some inaccuracy is inevitable. And for some foods, the designation of “healthful” is somewhat subjective.

In addition, such studies are unable to say that diet is the key reason for the findings. Some other factor — exercise, genetics, or a host of other possibilities in combination — might matter more than diet alone. However, the dose response (as defined above) does suggest that diet is playing a significant role.

And in conclusion….

Given the dramatic increase in the incidence of diabetes in this country, studies that identify preventive approaches are worthy of attention. Besides providing some of the strongest support to date for recommendations for healthier diets, perhaps the biggest impact of a study like this should be for people at increased risk of disease. For example, a person who is overweight, has “pre-diabetes” (a high blood sugar that’s not quite high enough to be diagnostic of diabetes), or a strong family history of diabetes might take this data to heart and commit to changing their diet.

Studying the impact of dietary (or any other) recommendations is an important way to validate the guidelines’ usefulness. This new study is a good example.

The post The data are in: Eat right, avoid diabetes appeared first on Harvard Health Blog.

From: Robert H. Shmerling, MD http://www.health.harvard.edu/blog/the-data-are-in-eat-right-avoid-diabetes-2017010510936

PARALYZED BOY MAKES A COMEBACK

From: Mayo Clinic http://www.youtube.com/watch?v=MqanXaQ7Ugo

Making Mayo's Recipes Apple Cinnamon Muffins

From: Mayo Clinic http://www.youtube.com/watch?v=g4RI_RKlb8Q

Antibiotics don’t speed recovery from asthma attacks

Does winter in the Northeast make you think of snowmen, warm fires, and hot chocolate? Or, does it instead inspire visions of runny noses, congestion, and cough? Although it is less rosy, I know readers with asthma may be picturing the latter.

People with asthma get respiratory infections more often

In general, people with asthma tend to get sick more easily, and illnesses can trigger asthma attacks. In my practice, we generally start seeing an increase in the number of asthma attacks, or asthma flares, once the ground frosts. If you are fortunate enough not to have asthma, chances are that you know somebody who does. The Centers for Disease Control and Prevention  reports that rates of asthma in the United States are soaring, such that today, 1 in 12 people has it. Because people with asthma get sick more often, it is logical to suspect that they will often be prescribed antibiotics. But do antibiotics really help? New research is helping to answer this very question.

Do antibiotics help people with asthma get back to normal faster?

A study recently published in the Journal of American Medicine Association looked at the effectiveness of an antibiotic called azithromycin for treating asthma attacks. The trial, nicknamed AZALEA, aimed to look at whether adding azithromycin to the usual treatment helped people recover from asthma attacks more quickly.  This was of interest to the researchers for several reasons: For starters, azithromycin is a very commonly prescribed antibiotic, so it is important to know if it works. Also, studies showed that an older drug called telithromycin actually did help people heal from asthma attacks more quickly. Doctors rarely prescribe telithromycin today because it can cause serious side effects. But azithromycin is similar in many ways, so it might be a good alternative.

Azithromycin did not help the asthma attacks  improve

Participants in the study were separated into two groups. One group was given usual treatment for an asthma attack (a high potency anti-inflammatory pill and breathing treatments), plus azithromycin. The other group was given standard treatment for an asthma attack plus a placebo, or sugar pill. To help reduce confusion, the researchers excluded asthma sufferers who had taken antibiotics — for any reason — during the four weeks prior to the study.. At the end of the study, the researchers concluded that both groups recovered from their asthma attacks at the same speed.

This means  azithromycin did not make people recover any better or any faster, and those that did not receive  azithromycin still got better.

So, should you take antibiotics for asthma? No, but there are rare exceptions

There are several take-aways  from this study. First, azithromycin did not make any difference in making people with asthma attacks feel better. As a clinician, this makes a lot of sense to me. Azithromycin was the most commonly prescribed antibiotic in the U.S. in 2010, and remains heavily prescribed today. But it’s popularity comes at a cost. Many of the bacteria that typically cause respiratory infections in adults have become resistant to it. Furthermore, most adults with asthma attacks will have viral respiratory infections, and antibiotics don’t  kill viruses. That’s why I rarely prescribe an antibiotic for an asthma attack. When I do, I rarely prescribe azithromycin, because it will only work on a small fraction of bacteria. There are certainly some exceptions; smokers, in particular, can be different. But overall, the results of this study make intuitive sense.

A second, and very interesting, conclusion was that 90% of the asthmatics initially considered for  entry into this study had received antibiotics in the preceding month! We don’t know why these antibiotics were prescribed, but the rate of antibiotics prescribed for people with asthma is concerning. Common sense makes me suspect that this is too high a rate of antibiotic prescription. I’ve never yet had the need to give 9 out of 10 patients I see antibiotics. This makes me worry that antibiotics may be over-prescribed in asthmatics, and I would like to know why.

I hope that everyone out there has as healthy a winter as possible, filled only with snowmen, warm fires, and hot chocolate. For the asthma sufferers out there, I hope you know that research like this helps us providers learn how to take care of you better. And that is a very warm thought.

The post Antibiotics don’t speed recovery from asthma attacks appeared first on Harvard Health Blog.

From: Nandini Mani, MD http://www.health.harvard.edu/blog/antibiotics-dont-speed-recovery-asthma-attacks-2017010410941

Find meaning in the small things

From: http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/find-meaning-in-the-small-things/art-20269949

How to break the busy cycle

From: http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/how-to-break-the-busy-cycle/art-20269953

New guidelines to prevent peanut allergies in kids

The new approach turns conventional wisdom on its head, but experts say this can greatly reduce the risk

From: http://www.cbsnews.com/news/peanut-allergies-new-guidelines-for-parents-children/

Find meaning in the small things

From: http://www.mayoclinic.com/healthy-lifestyle/adult-health/in-depth/find-meaning-in-the-small-things/art-20269949

How to break the busy cycle

From: http://www.mayoclinic.com/healthy-lifestyle/adult-health/in-depth/how-to-break-the-busy-cycle/art-20269953

Antibiotics don’t speed recovery from asthma attacks

Does winter in the Northeast make you think of snowmen, warm fires, and hot chocolate? Or, does it instead inspire visions of runny noses, congestion, and cough? Although it is less rosy, I know readers with asthma may be picturing the latter.

People with asthma get respiratory infections more often

In general, people with asthma tend to get sick more easily, and illnesses can trigger asthma attacks. In my practice, we generally start seeing an increase in the number of asthma attacks, or asthma flares, once the ground frosts. If you are fortunate enough not to have asthma, chances are that you know somebody who does. The Centers for Disease Control and Prevention  reports that rates of asthma in the United States are soaring, such that today, 1 in 12 people has it. Because people with asthma get sick more often, it is logical to suspect that they will often be prescribed antibiotics. But do antibiotics really help? New research is helping to answer this very question.

Do antibiotics help people with asthma get back to normal faster?

A study recently published in the Journal of American Medicine Association looked at the effectiveness of an antibiotic called azithromycin for treating asthma attacks. The trial, nicknamed AZALEA, aimed to look at whether adding azithromycin to the usual treatment helped people recover from asthma attacks more quickly.  This was of interest to the researchers for several reasons: For starters, azithromycin is a very commonly prescribed antibiotic, so it is important to know if it works. Also, studies showed that an older drug called telithromycin actually did help people heal from asthma attacks more quickly. Doctors rarely prescribe telithromycin today because it can cause serious side effects. But azithromycin is similar in many ways, so it might be a good alternative.

Azithromycin did not help the asthma attacks  improve

Participants in the study were separated into two groups. One group was given usual treatment for an asthma attack (a high potency anti-inflammatory pill and breathing treatments), plus azithromycin. The other group was given standard treatment for an asthma attack plus a placebo, or sugar pill. To help reduce confusion, the researchers excluded asthma sufferers who had taken antibiotics — for any reason — during the four weeks prior to the study.. At the end of the study, the researchers concluded that both groups recovered from their asthma attacks at the same speed.

This means  azithromycin did not make people recover any better or any faster, and those that did not receive  azithromycin still got better.

So, should you take antibiotics for asthma? No, but there are rare exceptions

There are several take-aways  from this study. First, azithromycin did not make any difference in making people with asthma attacks feel better. As a clinician, this makes a lot of sense to me. Azithromycin was the most commonly prescribed antibiotic in the U.S. in 2010, and remains heavily prescribed today. But it’s popularity comes at a cost. Many of the bacteria that typically cause respiratory infections in adults have become resistant to it. Furthermore, most adults with asthma attacks will have viral respiratory infections, and antibiotics don’t  kill viruses. That’s why I rarely prescribe an antibiotic for an asthma attack. When I do, I rarely prescribe azithromycin, because it will only work on a small fraction of bacteria. There are certainly some exceptions; smokers, in particular, can be different. But overall, the results of this study make intuitive sense.

A second, and very interesting, conclusion was that 90% of the asthmatics initially considered for  entry into this study had received antibiotics in the preceding month! We don’t know why these antibiotics were prescribed, but the rate of antibiotics prescribed for people with asthma is concerning. Common sense makes me suspect that this is too high a rate of antibiotic prescription. I’ve never yet had the need to give 9 out of 10 patients I see antibiotics. This makes me worry that antibiotics may be over-prescribed in asthmatics, and I would like to know why.

I hope that everyone out there has as healthy a winter as possible, filled only with snowmen, warm fires, and hot chocolate. For the asthma sufferers out there, I hope you know that research like this helps us providers learn how to take care of you better. And that is a very warm thought.

The post Antibiotics don’t speed recovery from asthma attacks appeared first on Harvard Health Blog.

From: Nandini Mani, MD http://www.health.harvard.edu/blog/antibiotics-dont-speed-recovery-asthma-attacks-2017010410941