Nibble on Chocolate for Lower Heart Attack, Stroke Risks

A new study suggests eating a small piece of chocolate every day can reduce your risk of heart attack and stroke.

http://www.webmd.com/heart/news/20100330/nibble-on-chocolate-for-healthier-heart?src=RSS_PUBLIC

Sleep Apnea Increases Stroke Risk

Obstructive sleep apnea more than doubles the risk of stroke in men and also increases the danger in women, new research indicates.

http://www.webmd.com/sleep-disorders/news/20100408/sleep-apnea-increases-stroke-risk?src=RSS_PUBLIC

New Research Finds Milk Supplies Half Of All Vitamin D In The American Diet

Experts agree - America needs more vitamin D. It's one more reason to grab another glass of milk, according to new research presented at the Experimental Biology conference in Anaheim, California. Milk is the primary source of vitamin D in the American diet, supplying nearly half of all of the much-needed vitamin D...

http://mnt.to/f/3BRW

Chili Pepper Compound Speeded Up Fat Burning In Dieters

Chili peppers may do more than taste hot and bring us out in a sweat: they may also help people following a low calorie diet burn or oxidize fat more quickly, according to a new study by US researchers who tested the weight-reducing potential of a compound found in peppers belonging to the genus Capsicum...

http://mnt.to/f/3BWV

Science Fiction is only a few years away

The first paragraph and the rest of the ensuing article reads like a
medical science fiction novel but it is REAL. Its truly amazing what
these researchers are doing.

"Scientists and engineers have used uniform magnetic fields to drive iron-bearing nanoparticles to metal stents in injured blood vessels, where the particles deliver a drug payload that successfully prevents blockages in those vessels. In this animal study, the novel technique achieved better results at a lower dose than conventional non-magnetic stent therapy."

http://mnt.to/f/3Bsp

Raising Your HDL Levels

Here's a list of ways that you can help raise your HDL ("H"ealthy cholesterol)

1. Get more exercise
2. Lose weight
3. Stop smoking
4. Cut out the trans fatty acids
5. Alcohol:.one or two drinks per day can significantly increase HDL levels
6. Increase the monounsaturated fats in your diet
7. Add soluble fiber to your diet
8. Other dietary means to increasing HDL
- Cranberry juice has been shown to increase HDL levels
- Fish and other foods containing omega-3 fatty acids can also
increase HDL levels.

Source: http://heartdisease.about.com/b/2010/04/26/raising-your-hdl-levels.htm

The Truth About Vtiamin D: Why You Need Vitamin D

This is a great, easy to read primer on vitamin D. I hope it helps answer some questions you may have.


Get answers to commonly asked questions about vitamin D.

http://www.webmd.com/osteoporosis/features/the-truth-about-vitamin-d-why-you-need-vitamin-d?src=RSS_PUBLIC

Stanford Study Shows Stealthy Leads To Healthy In Effort To Improve Diet

How do you get college students to eat better? A new study from the Stanford University School of Medicine suggests that a "stealth" strategy of raising the students' awareness of environmental and social issues related to food can persuade them to eat more veggies and less ice cream. The study will be published in the May issue of the American Journal of Preventive Medicine...

http://mnt.to/f/3BNW

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Nearly Half Of Americans Have High Blood Pressure, High Cholesterol, Or Diabetes

This is really troubling. As I discussed in my blog last week, health care will continually be a problem if we do not prevent the disease from occurring in the first place. With almost 50% of Americans having high BP, high cholesterol or diabetes, it should come as no surprise that heart disease and stroke are the #1 and #3 killers of all Americans respectively. Although the cause of this phemomena is complex, we must become a healthier society. This must start with how we care for ourselves and are children. We all must eat better and get more exercise. It will take years to change this trend but if we do not start now, health care costs will bankrupt us.

 

From the ACC Newsletter:

ABC World News (4/26, story 7, 1:20, Sawyer) reported that "almost half of American adults, 45% of us, now have high blood pressure, high cholesterol, or diabetes," according to researchers from the national Centers for Disease Control and Prevention.

 

The Los Angeles Times (4/27, Maugh) reports that "one in eight Americans has at least two of the conditions and one in 33 has all three, sharply increasing their risk." These "data come from the ongoing National Health and Nutrition Examination Survey." While "researchers should be able to use the new data to plan interventions, 'the main thing here is for people to be aware that they have these conditions and know that lifestyle modifications and medications can control them and reduce their risk for cardiovascular disease,' said epidemiologist Cheryl D. Fryar of the CDC's National Center for Health Statistics, one of the study's authors."

 

WebMD (4/26, Woznicki) reported that "the study shows that about 8% of adults have undiagnosed high blood pressure, 8% have undiagnosed high cholesterol, and 3% of have undiagnosed diabetes." HealthDay (4/26, Edelson) also covered the story.

NYTimes: An Unforeseen Complication of Electronic Medical Records

As a lover of all things "tech" (except my love of fountaim pens), I'm
very excited about our transition to an EMR over the next year. Yet as
wonderfully descibed in the article below, I have some very
significant reservations too. How will it affect my interaction with
my patients? How will it affect my work flow? Will it help or hinder
my communication with patients and my referring MD's?

From The New York Times:

DOCTOR AND PATIENT: An Unforeseen Complication of Electronic Medical
Records

Learning to juggle computers in the exam room can have unexpected
consequences for doctor-patient relations.

http://nyti.ms/ac51jF

Get The New York Times on your iPhone for free by visiting http://itunes.com/apps/nytimes

My Take on Medicare and Health Care Reform

I've been holding off writing on health care reform. Clearly something needed to be done. Its impossible for a practising physician not to have noticed just how wrong the current system was. Many patients did not have health insurance at all. Some who did, did not have enough to cover expensive therapies. Some had ridiculously high dedectables. Some were dropped by their insurance when they got sick. Many times, I had to spend a great deal of time on the phone with health insurance medical directors to try and get pre-approval for a necessary medication/test/procedure. Something definitely needed to change.

 

Now as a young Cardiologist, with a mortgage and three young girls, these are nervous times. Cardiology has been hit specifically hard by Medicare in 2010. As a way to try and save money, Medicare has changed its fee scheduled which has resulted in an overall payment cut of 11% for cardiology. Echo Payments Cut by 42%, Caths by 24%, and ECGs by 21%. Stress testing has taken a big hit too.

 

This will be in addition to the proposed possible 21% cut in medicare re-imbursements across the board - unless Congress permantly votes to change the dependance of the Medicare fee schedule on the flawed Sustained Growth Rate (SGR).

 

Now, I'm all in favor of trying to cut costs. But Cardiology is one of the only areas in modern medicine where medical breakthroughs (risk assessment, medications, testing and procedures) have dramatically reduced mortality and morbidity.

 

I'm also worried that the new reforms will not change the biggest issues that drive up the costs of modern medicine - fear of medical malpractice and very poor preventitive care (a real lack of focus on healthy living). If we could just prevent disease in the first place (healthy eating, frequent exercise, significant societal weight loss and frequent primary preventitive care) and keep doctors from ordering unnecessary tests out of fear of lawsuits -- we could save the entire medical community a real significant amount of $$$$$$.

UB Researchers Find Vitamin D Status Not Predicted By Surrogate Markers

More data for the "Vitamin D Story"

"Vitamin supplements, diet, geographic location, demographic information or lifestyle, independently or in combination, cannot accurately predict vitamin D concentrations in blood, researchers at the University at Buffalo have found. This finding indicates that data such as vitamin D from foods and supplements or latitude of residence (northern vs..."

http://mnt.to/f/3Bzc

Email Congressman Jim Himes - Earth Day's 40th Anniversary

Dear Friends,

In the four decades since the first Earth Day in 1970, we have made remarkable progress in the fight to protect our planet. Today, our air and water are cleaner, pollution has been greatly reduced, and Americans everywhere are living in a healthier environment. We've passed the Clean Air Act,
the Clean Water Act, and founded the Environmental Protection Agency.
The most critical moment for environmental protection is the one we face today. Our reliance on foreign fossil fuels has set us on a massively destabilizing path, threatening our national security, our environment, and our economy. Very simply, the country that harnesses the power of clean, renewable energy will be the nation that leads in the 21st century.
Congress has taken on the challenge of energy independence from many
angles. The Recovery Act, Clean Energy and Security Act, and other legislation are all working together
to improve our national security, create jobs, and protect the environment.
The Recovery Act included
more than $80 billion in clean energy investments, such as building a bigger, smarter electricity grid
and providing incentives for expanding manufacturing capacity for clean energy technology, and advancing
vehicle and fuel technologies. In fact, the wind industry grew its capacity nearly 40 percent in 2009,
blowing past expectations that existed prior to the passage of the Recovery Act. The American Clean Energy and Security Act took a powerful and historic step toward a wholly new approach to energy in our country. Once signed into law, its reforms will help create 1.7 million clean energy jobs, finally
end our nation's dangerous addiction to foreign oil, and begin to curb the harmful effects of climate
change.

On this 40th anniversary of Earth Day, I take great pride in the steps we have taken to help protect our natural resources, especially those right here in Connecticut. For example, this past
year, we increased funding for the Long Island Sound Stewardship Act to $15 million, up from $3 million
previously. Additionally, the sweeping and significant Public Land Management Act signed into law by
the president in March will strengthen our National Parks, improve the health of our forests, ensure
better management of our public lands, and increase the quantity and quality of water provided to numerous
local communities. These are significant victories for the cause of environmental protection.
But much work remains. As we take this day to consider how best we can protect the planet we call home,
be assured that I will continue to work diligently on these measures and on any other which will help
ensure the beauty and stability of our environment.

Sincerely,

Jim Himes

Do you have Sleep Apnea?

Do you have any of these symptoms:

- excessive daytime sleepiness

- waking up feeling unrefreshed after sleep

- memory and concentration problems

- heart burn at night

- swelling in the legs

- LOUD SNORING

- night time gasping or choking spells

If you have any of these, you may have SLEEP APNEA.

Sleep Apnea can reek havoc on your body and your heart.

It can:

- make it very hard to lose weight

- give you high blood pressure

- make you legs swell

- increase your risk of developing atrial fibrillation

- make you feel very short of breath

- increase your chances of heart failure

- increase your chances of heart attack

- increase your chances of stroke

If you think you have any of these -- please consult your physician

New Explanation For Cardiac Arrest

Its amazing how one patient and an inquisitive physician can lead to the discovery of an entirely new disorder. The physicians involved in this discovery should be commended for their work.

"Researchers have discovered a new disorder linked to heart problems that stems from a genetic defect in the protein glycogenin..."

http://mnt.to/f/3BsB

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Statement From American Heart Association CEO Nancy Brown On Institute Of Medicine Report On Strategies To Reduce Sodium Intake In The U.S.

The Institute of Medicine (IOM) sodium reduction recommendations will have a tremendous impact on public health and significantly drive our efforts to improve the cardiovascular health of all Americans. These recommendations should not be taken lightly...

http://mnt.to/f/3ByY

WARNING: Do not wait to get Rx filled

A new study published in the Circulation: Cardiovascular Quality and Outcomes revealed that waiting even a day to fill a prescription for blood thinners after heart stent surgery may double the risk of heart attack or death.

Over 22 months of follow-up, patients who waited a day or more to fill their blood thinner medication prescription had a 14.2% risk of heart attack or death, which was nearly double the 7.9% risk among those who filled their prescription on the day they were discharged from the hospital.

Factors positively associated with delaying included older age, prior MI or revascularization, diabetes, renal failure, cardiogenic shock, inhospital bleeding, and clopidogrel use at hospital admission.

PLEASE TAKE YOUR PLAVIX OR EFFIENT AFTER YOUR STENTING PROCEDURE

Added Sugar Linked To Higher Heart Disease Risk Factors

US researchers found that people who consume higher amounts of added sugar, such as in processed foods and beverages, are also likely to have higher heart disease risk factors...

If these results are replicated in other studies, it will be important for the FDA to require food manufactures to document on labeling the total sugar content as well as the amount of natural AND ADDED SUGAR separately.
http://mnt.to/f/3Bxx

Your never to young

Last week I took care of two patients with very significant heart disease.

1. 34 year-old male with a strong history of premature coronary heart disease presented with a large acute heart attack. I took him emergently to the cath lab and an angiogram revealed that he had a totally blocked proximal LAD (the most important artery feeding the heart muscle). He required an angioplasty and stent to open the artery.

2. A 29 year old (just one day shy of his 30th birthday) presented with chest pain, shortness of breath and swelling in his ankles. He was clearly in heart failure on exam. He also had evidence of a leaky aortic valve. With the aid of a STAT echocardiogram in the ER, I diagnosed him with an acute proximal thoracic aortic dissection (a tear in his aorta), a huge thoracic aortic aneurysm, severe aortic insufficiency and a large, boggy, poorly functioning heart. He was taken emergently to the operating room where Dr Coady replaced his aorta and his aortic valve.

Both patients did remarkably well and walked out of the hospital.

Nevertheless, it gives me pause when time and again I am reminded that you are never to young to escape the rath of heart disease.

Tumblr

I've now made the leap to the newest social media format. Besides here and on twitter (@drportnay), I will also be posting on tumblr.com. Its a very easy way to share thoughts, links, qoutes, pictures and videos.

Check me out: drportnay.tumblr.com

B Vitamins Reduce Stroke, Heart Disease Deaths

I always find these reports dangerous. Observation studies are helpful for hypothesis generating, not hypothesis testing. In fact, All vitamin randomized controlled trials to date (vit E, vit C, folate) have been negative, despite the fact that obeservational studies seemed to suggest a correlation. For now, I would continue to try and eat a well balanced "mediterranian style" diet.

Foods rich in B vitamins such as folate and B6 may reduce the risk of death from stroke and heart problems, Japanese researchers say.

http://www.webmd.com/heart-disease/news/20100415/b-vitamins-reduce-strokes-and-heart-disease-deaths?src=RSS_PUBLIC

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Tort Reform, Tort Reform, Tort Reform. Where are thou?

Regional variation in cardiac cath rates linked to malpractice concern

Some surveyed cardiologists reported they order cardiac catheterization "frequently" or "sometimes" because of peer pressure or to avoid possible malpractice charges. Such concerns may partly explain...

For complete story visit theheart.org.

http://feedproxy.google.com/~r/Theheartorg/~3/DTjB2rM9vm8/1067277.do

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Study Compares Bypass Surgery To Angioplasty

We've been doing amazing things with stenting lately. One of the absolute indications for cardiac surgery has always been "left main disease". Since the emergence of drug eluting stenting in 2003, we have been working on stenting the left main coronary artery in patients deemed "to sick for surgery." These patient have done remarkably well. Now, we are starting to perform left main stenting on lower risk patients. The below mentioned review reveals that indeed, for the right patient, the results of left main stenting may be equivalent to cardiac surgery. I anticipate that sooner rather than later, both left main stenting and cardiac surgery will be officially indicated for treatment of "left main disease."

From Medical News Today:

At 56, Tim Obrenski found himself getting so exhausted that he couldn't even pull weeds from his garden. A visit to the cardiologist uncovered a major blockage in his heart's left main artery, and he was told he needed bypass surgery. Obrenski's search for alternatives to surgery brought him to UCLA interventional cardiologist Dr. Michael Lee...

http://mnt.to/f/3Bc9

Docs Still Say Malpractice Fears Often Add to Health-Care Costs

I still cannot believe that "tort reform" was not a integral part of the healthcare reform act.

During the health-care debate, the impact of medical malpractice suits was controversial, with the Republicans saying it was a key part of the escalating cost issue and the Democrats saying, not so much. For its part, the CBO estimated tort-law changes would cut only about 0.5% from U.S. health-care spending.

A study now reinforces the long-held belief of many doctors that malpractice -– or fear of same — is really pretty important on the cost front after all. Researchers wanted to know if physicians' behavior and attitudes explain some of the regional variations in the number of intensive procedures. (Citing the Dartmouth Atlas of Health Care, they said the rate of a given cardiac procedure might be three to eight times higher in one area of the country than another, depending on the procedure.) The researchers surveyed 598 cardiologists across the U.S. about what non-clinical reasons might lead them to recommend cardiac catheterization. They also calculated a doctor's "cardiac intensity score" — a quantitative measure of his or her propensity to test and treat, based on his or her response to hypothetical patient scenarios.

The study, published online in Circulation: Cardiovascular Quality and Outcomes, found that nearly 24% of those surveyed reported that fear of malpractice was a non-clinical factor in their decision to recommend catheterization; docs with high intensity scores were more likely to say that legal fears influenced their recommendation. And 27% said if they thought their colleagues were likely to order the procedure, they would too. Researchers also asked doctors if they'd recommend the test because "the patient expects it," "to satisfy the expectations of the referring physician," or to enhance "the financial stability" of a medical practice. (Surprisingly, five doctors actually admitted they frequently or sometimes recommended catheterization for that last reason.)

Only the fear of malpractice, however, was significantly associated with regional differences in the level of health-care services used. "I think this study provides enough evidence to think it's maybe a target for intervention," says F. Lee Lucas, lead author of the study and associate director of the Center for Outcomes Research and Evaluation at Maine Medical Center, who found the malpractice findings surprising. "It seemed to be, for a fair number of physicians, to be a clear motivation for doing something potentially unnecessary."

Even for doctors who aren't directly affected by malpractice suits, the fear of being sued may lead them to order more tests than they otherwise might have – that's so-called defensive medicine.

Image: iStockphoto

http://feedproxy.google.com/~r/wsj/health/feed/~3/5jEnZYTtpxk/

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Cost Concerns Delay Heart Attack Care

This is not good. More evidence that our healthcare system is broken. I'm not sure that our new plan will help this though.

Patients without health insurance and even insured patients worried about paying for medical care are more likely to delay seeking treatment during a heart attack, new research confirms.

http://www.webmd.com/heart-disease/news/20100413/cost-concerns-delay-heart-attack-care?src=RSS_PUBLIC

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Eggs: Good or Bad

I agree with the below article. Its probably ok to eat one egg a day. To be safe, I usually tell my patients that its ok to eat 2-3 servings of eggs over the course of a week.

http://mobile.latimes.com/inf/infomo;JSESSIONID=334C3CB9BC074BA3F3B4.385?view=webarticle&feed:a=latimes_1min&feed:c=health&feed:i=53209819&part=0

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Walking Protects Women Against Stroke: WHS Long-Term Follow-Up (mobile format)

April 8, 2010 — Women who walk 2 or more hours a week, especially at a brisk pace, are significantly less likely to experience any type of stroke than women who do not walk, according to long-term follow-up findings from the Women's Health Study (WHS).

Findings were published online April 6 and will appear in the June issue of Stroke.

http://www.medscape.com/viewarticle/719982?sssdmh=dm1.610983&src=nldne&uac=142673DZ

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Sleep Apnea May Increase Risk Of Stroke In Men

From ACC Newsletter:

WebMD (4/8, Hendrick) reported that "obstructive sleep apnea" may increase "the risk of stroke in men," according to a study published in the American Journal of Respiratory and Critical Care Medicine.

        HealthDay (4/8, Preidt) reported that investigators "looked at more than 5,400 people, age 40 and older and with no history of stroke, who were participating in the Sleep Heart Health Study." All "participants underwent a standard at-home sleep test at the start of the study to determine if they had sleep apnea and, if so, the severity of the condition."

        MedPage Today (4/8, Bankhead) reported that, "among men with mild or moderate apnea, each one-unit increase in the obstructive apnea hypopnea index (OAHI) raised stroke risk by 6%."

http://mailview.custombriefings.com/mailview.aspx?m=2010040901acc&r=4181702-4762

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Small Amounts of Chocolate Lower BP, Cut Strokes and MIs

From Medscape:

The largest observational study so far to examine the association between chocolate consumption and risk of cardiovascular disease has found that those who ate the most chocolate--around 7.5 g per day--had a 39% lower risk of MI and stroke than individuals who ate almost no chocolate (1.7 g per day).

http://www.medscape.com/viewarticle/719622?sssdmh=dm1.609807&src=nldne&uac=142673DZ

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Heart Attack Rates May Be Declining Among Older Americans

The Wall Street Journal (4 /6 , Winslow, subscription required) reports that an analysis of Medicare data indicates that heart attack rates may be declining among older Americans. A number of factors may be behind the decline. Sidney Smith, a cardiologist at University of North Carolina, said, "It looks like our effort with preventive medicine, with guidelines and a systematic approach to caring for patients, is paying off." Meanwhile, the Journal adds that the American College of Cardiology and the American Heart Association have created programs designed to better the in-hospital care that heart-attack patients receive.
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Are We Overselling The Sunshine Vitamin?

More on vitamin D

I found the following story on the NPR iPhone App:
http://www.npr.org/templates/story/story.php?storyId=125226703&sc=17&f=1128

Are We Overselling The Sunshine Vitamin?
by Richard Knox

- March 29, 2010

Dr. Cliff Rosen of Portland, Maine, knows a lot about vitamin D. It's necessary for strong bones, and Rosen is a leading bone specialist. So he was surprised recently when his wife's new physician thought she might be deficient in vitamin D.

"She's a runner. She's in great shape," Rosen says. "She drinks dairy. She gets a lot of sun exposure." Sun exposure is key for vitamin D, known as the sunshine vitamin. When skin is exposed to sun, it makes vitamin D.

Still, the doctor wanted to run a blood test to see if Rebecca Rosen had adequate vitamin D.

"So my wife said, 'Well, why do I need to have a vitamin D [test]?' And the physician said, 'Well, that's part of our measurement for wellness.' "

It's not just Rebecca's doctor, and it's not just in Portland, Maine. Increasingly, doctors all over the country are convinced that checking patients' vitamin D levels is as important as monitoring their cholesterol.

A Surge In Attention

Medicare payments for vitamin D testing, at $40 a pop, nearly quadrupled between 2006 and 2008, to $129 million. A decade ago, Medicare payments were only about $1 million. The figures for 2009 and this year are bound to be higher.

"There's overwhelming evidence ... that increasing your vitamin D intake can make substantial improvement in your overall health and welfare," says Dr. Michael Holick of Boston University. "And there is no downside to increasing your vitamin D intake. As a result I think that most people are now getting on the bandwagon."

Holick is leading the band. Forty years ago, he discovered the active form of the vitamin, 1,25-dihydroxyvitamin D. He has written several popular books on the subject and has another one, The Vitamin D Solution, coming out next month. Its cover calls vitamin D deficiency "our most common health problem."

"In my opinion, everybody should be taking either a vitamin D supplement, take a prescription that the doctor recommends," Holick says. "All adults should be taking at least 1,000 to 1,500 international units a day." Dietary intake, mainly through sources such as vitamin D-fortified dairy products and juice, may add up to 200 to 400 units a day.

Holick is convinced that if people boost their vitamin D levels, they'll be substantially less likely to develop not only osteoporosis but also many types of cancer, heart attack, diabetes (both types), autoimmune diseases such as multiple sclerosis and rheumatoid arthritis, Alzheimer's, autism, even tuberculosis and the flu.

Not so fast, other experts say.

A Tricky Thing To Measure

Dr. JoAnn Manson, chief of preventive medicine at Harvard-affiliated Brigham and Women's Hospital, points out that nearly all of the proliferating studies involving vitamin D are what scientists call "observational." That is, they compare people with high and low levels of vitamin D and correlate those levels with whether or not the person has a disease.

But these studies, she points out, are fraught with possible error. People with higher vitamin D levels may be healthier because they exercise more, have better diets, are out in the sun more. Those who are sick may have low levels because they don't have those healthy habits.

"We don't yet have the large-scale, randomized clinical trials showing benefits in terms of prevention of cardiovascular disease, cancer, diabetes, hypertension, cognitive decline, depression, autoimmune disease," Manson says.

Manson and her colleagues are launching such a trial. The National Institutes of Health is devoting $22 million for a five-year study. Twenty-thousand people across the country will be randomly assigned to take daily doses of vitamin D, omega-3 fatty acid — also linked in many studies to lower levels of heart disease — together or alone. Others will be assigned to take inert placebo pills. Neither study subjects nor investigators will know until the end which regimen they are on.

'Promising But Not Yet Proven'

Manson says she thinks there is promising evidence that vitamin D supplements may protect against heart disease and perhaps some cancers. The evidence is strongest for colorectal cancer, she says. The fact that the government is funding the study is an indicator that the idea has traction.

Until those results are in, Manson advises patients and doctors to view vitamin D claims as "promising but not yet proven."

"We need to keep in mind the lessons of history," she says. "It was believed that megadoses of vitamin E, beta-carotene, selenium, folic acid and the B vitamins would confer a large array of health benefits. And in fact, the trials were very disappointing for all those nutrients."

In the case of beta-carotene, scientists were surprised to find that when the results of randomized trials were in, those taking the supplement actually had a higher risk of lung cancer.

Holick and others say there is little or no downside to ingesting even high levels of vitamin D.

"I've been treating patients with 50,000 units of vitamin D once a week for eight weeks followed by 50,00 every other week for over a decade, and I've not seen any untoward toxicity," Holick says.

He says he has seen dramatic results in patients he has treated with vitamin D supplements for disorders such as fibromyalgia, involving generalized muscular aches and pains, and multiple sclerosis. He is convinced that the vitamin D supplements lower patients' risk of cancer and heart disease, although he acknowledges that's harder to show.

How Much Is Enough?

Holick himself takes 3,000 international units of vitamin D every day.

Set by the National Institute of Medicine in 1997, the current recommended intake is 400 units a day for adults ages 50 to 70, and 200 units a day for younger adults. The American Academy of Pediatrics currently recommends 400 units a day for infants.

The recommendations may change soon. An Institute of Medicine panel is working on a vitamin D update, which may come out this summer. The panel may raise the Dietary Reference Intake, which has replaced the old Recommended Dietary Allowance. But the group is not expected to embrace the newer claims being made for vitamin D supplementation.

The Institute of Medicine panel has a difficult task. "We don't know exactly where to draw the line in terms of calling someone deficient in vitamin D," says Manson, who is a member of the committee, as is Rosen, the Maine bone specialist.

Meanwhile, an increasing number of patients are getting their vitamin D levels tested, and more are being told they need to take supplements.

"I've been surprised at the number of patients who are significantly vitamin D deficient," says Dr. Elizabeth Ross, a cardiologist in Washington, D.C., who has been testing patients routinely for the past year. "Whether or not we'll affect the incidence of cardiovascular disease or other diseases remains to be seen. But it appears to be a relatively benign intervention, and we may be benefiting people." Copyright 2010 National Public Radio

To learn more about the NPR iPhone app, go to http://iphone.npr.org/recommendnprnews

NYTimes: How Much Exercise Will Prevent Weight Gain?

From The New York Times:

How Much Exercise Will Prevent Weight Gain?
By RONI CARYN RABIN

In one study, Harvard researchers found that an hour of moderate physical activity a day kept women from gaining weight in midlife. ...

http://www.nytimes.com/2010/04/06/health/06regi.html
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