Tag Archives: british medical journal

Doubts on suicide-anti-smoking drug Chantix link

Doubts on suicide-anti-smoking drug Chantix link

Despite earlier health agency warnings, there is no strong evidence that the anti-smoking drug Chantix raises the risk of suicidal thoughts or depression compared to other stop-smoking products, researchers reported Thursday in the British Medical Journal.

Back in July of this year, U.S. health officials ordered strong “black box” warnings be added to Chantix (also called varenicline) as well as anti-smoking drug Zyban, following more than five thousand reports of depression, hostility and other behavioral changes possibly associated with use of these drugs.

“There have been recent concerns that varenicline, a relatively new smoking cessation product, may increase the risk of suicidal behavior and suicide,” study co-author Dr. David Gunnell of the University of Bristol, UK, explained in an email to Reuters Health.

“We found no clear evidence of an increased risk of self-harm or depression associated with varenicline,” he said.

The findings stem from data on more than 80,660 would-be quitters in the UK who used different smoking cessation products between September 2006 and May 2008.

A total of 63,265 of these individuals used nicotine replacement products, 10,973 used Chantix, and 6,422 used Zyban, an antidepressant also called bupropion, which has been found to help smokers quit.

When researchers looked at medical records, they didn’t find any evidence of an increased risk of serious mental health problems (i.e., self-harm, suicidal thoughts or depression) while they were using these products and during the three months after the last prescription was filled.

Gunnell cautioned, however, that based on the size of the study, it’s still possible that Chantix does increase the risk of suicide – or even decrease it.

“Other studies should be undertaken to provide further evidence on this issue,” he concluded.

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Thin thighs – maybe not your heart’s desire

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Thin thighs – maybe not your heart’s desire

People who have agonized over their fat thighs might be able to relax a bit — Danish doctors said on Thursday they found patients with the thinnest thighs died sooner than the more endowed.

Obesity, age, smoking and other factors did not reduce the effect, the researchers reported in the British Medical Journal.

“Our results suggest that there might be an increased risk of premature death related to thigh size,” Berit Heitmann of Copenhagen University Hospital and Peder Frederiksen of Glostrup University Hospital wrote.

The explanation may lie in many different studies that suggest where you gain your weight is a strong factor in how it affects health. People with lots of abdominal fat — wrapped in and around the internal organs — appear to be at higher risk of heart disease, diabetes, and other ills.

So-called pear-shaped people may have lower risks, even if they have more body fat overall.

Heitmann and Frederiksen studied 1,436 men and 1,380 women taking part in a larger medical research study who were examined in 1987 and 1988, then watched them for more than 12 years.

Men and women whose thighs were less than 24 inches in circumference were more likely to die during those 12 years, they found.

Those with the thinnest thighs — less than 18 inches — were more than twice likely to have died within 12 years, they reported in the study, published here

Dozens of studies have shown waist size can also be a good predictor of heart disease and death.

Women with a waist circumference of greater than 35 inches and men whose waists are more than 40 inches have a much higher risk of heart disease, diabetes and early death than people with smaller waists — regardless of how much body fat they have overall.

This is again linked to abdominal fat. Fat laid down under the skin, as when it is found on the legs, may be healthier for the body, although the mechanism is unclear.

The Danish team said they hoped thigh measurements might be an equally good indicator. But Dr. Ian Scott of Princess Alexandra Hospital in Brisbane, Australia, disagreed, saying the statistics in the Danish study were too limited.

He said larger studies would need to be done before doctors could decide that thigh measurement was any kind of good predictor of health.

“It seems unlikely that thigh circumference will be clinically useful,” Scott wrote in a commentary.

Tim Olds, a professor of Health Sciences at the University of South Australia, saw some value in the study, however.

“This is a very interesting line of research, because it would suggest that interventions which protect or increase muscle mass (such as weight training) may be effective in reducing cardiovascular disease even if no loss of body fat occurs,” Olds said in a statement.

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Over 65? Take lots of vitamin D to prevent a fall

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Over 65? Take lots of vitamin D to prevent a fall

Important news for seniors: A daily dose of vitamin D cuts your risk of falling substantially, researchers reported today.

But not just any dose will do. “It takes 700 to 1000 international units (IU) of vitamin D per day and nothing less will work,” Dr. Heike A. Bischoff-Ferrari, who directs the Center on Aging and Mobility at the University of Zurich, Switzerland, noted in an email to Reuters Health.

Those recommendations – which are higher than those by the U.S. Institute of Medicine — are based on the results of eight studies that looked at vitamin D supplements for fall prevention among more than 2,400 adults aged 65 and older. Falls were not notably reduced with daily doses of vitamin D lower than 700 IU.

An analysis of all eight studies, posted online today in the British Medical Journal, add weight to several others which have shown that vitamin D improves strength and balance, and bone health in the elderly, the researchers note.

Each year, 1 in 3 people aged 65 and older, and 1 in 2 aged 50 and older, fall at least once. Nine percent of these mishaps require a trip to the emergency room and around 6 percent result in a fracture. Many elderly people who fall end up in nursing homes.

“Falls are important events to prevent,” Bischoff-Ferrari said, “and 700 to 1000 IU of vitamin D per day is safe and inexpensive,” but it’s higher than the currently recommended by the Institute of Medicine for older adults. (The Institute recommends 400 IU per day for adults between age 51 and 70, and 600 IU per day for those aged 70 years and over.)

The current findings, Bischoff-Ferrari said, provide an argument to revise the recommendations. They looked at two forms of the vitamin: Vitamin D3, or cholecalciferol, which is more readily absorbed by the body and more potent than vitamin D2, or ergocalciferol, the form often found in multivitamins.

“At the higher dose of 700 to 1000 IU vitamin D, the benefit on fall prevention is significant — at least 19 percent, 26 percent with vitamin D3,” Bischoff-Ferrari said.

While vitamin D3 seemed more potent than D2, forms of vitamin D marketed as “active,” such as calcitriol, did not seem to be more effective than standard vitamin D supplements, the researchers found. Such active forms are more expensive and carry a higher risk of elevated calcium levels, which have been linked to hormone problems and cancer.

Moreover, the effect of 700 to 1000 IU vitamin D daily is kicks in “in a few months and is sustained over years, and the benefit is independent of age and present in those living at home and those living in nursing homes,” Bischoff-Ferrari noted.

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