Got fish? Increased fish consumption grants health gains for diabetic women

~Note: this research study is from 2003. Old news. Still relevant.~

Regular fish consumption reduced the risk of heart disease by as much as 64% in diabetic women, according to a 2003 study in “Circulation.”

The results confirm previous findings suggesting frequent fish intake is beneficial for heart health in the general population. What set this study apart was that it assessed the relationship between fish and heart health in diabetic women, who have high heart disease risk.

“12.6 million, or 10.8% of all women aged 20 years or older have diabetes,” according to the American Diabetes Association. This study looked at type 2 diabetes specifically, the most common form among Americans. After eating, the body breaks down sugar from food into fuel for the body’s cells. Type 2 diabetes prevents that fuel from being delivered to cells, leading to complications including: blindness, kidney disease, amputations, and heart problems, among others. “Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.”

The study team, led by Dr. Frank Hu of the Harvard School of Public Health, followed 5103 women who had or developed physician-diagnosed type 2 diabetes from 1980 to 1996. Diabetic women who had already experienced heart disease before the start of the study were excluded. Heart disease included heart attack, stroke, blocked arteries, chest pain, and irregular heart beat.

These women were a subset of the larger Nurses’ Health Study, which has sent health questionnaires to 121,700 female registered nurses biennially since 1976. These surveys collect information on medical history, lifestyle, eating habits, and newly diagnosed illnesses. From looking at these, Dr. Hu’s team was able to find out how much fish participants ate over 16 years and if heart disease or death happened.

The women were divided into five groups depending on how often they ate fish: less than once a month, one to three a month, once a week, two to four a week, and five or more times a week. Investigators reported 362 new cases of heart disease and 468 deaths. Compared to diabetic women who rarely ate fish (less than once a month), the risk of heart disease reduced by 30% for women who ate fish one to three times a month. 40% for women who ate fish once per week. 36% for women who ate fish two to four times a week. And finally, 64% for women who ate fish five times a week. Higher fish intake was also associated with significantly lower death rates; ranging from 25% reduced risk (1-3 fish/month) to 52% reduced risk (5 or more/week).

Hu concedes the self-report nature of the questionnaires to be a limitation of the study. He further allows that lifestyle could influence results. Participants with a culinary affinity for fish, also ate more fruits, vegetables, and lean meat. Participants taking aspirin could have improved blood flow thanks to the medication. He backs his results nevertheless. Whether or not investigators took these variables into account in their statistical analyses, it did not appreciably alter findings.

The American Heart Association recommends adults, barring pregnant women, consume at least two servings of fish weekly. Fish are rife with fish oil (aka omega-3 fatty acids), especially fatty fish like salmon, mackerel, tuna, and herring. Omega-3 fatty acids improve blood vessel function, reduce blood clot formation, decrease circulating fats in the blood, and stabilize irregular heartbeats. Consuming more fish could yield significant health gains for those with, or at high risk of heart disease or diabetes. While not assessed in this study, fish oil capsules, with your doctor’s blessing, could conceivably offer an alternative for those who dislike eating fish.

Hu F. Rish and Long-Chain ω-3 Fatty Acid Intake and Risk of Coronary Heart Disease and Total Mortality in Diabetic Women. Circulation. January 2003; 107:1852-1857.

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Common surgery for knee arthritis receives stiff competition from placebo effect

~Note: this research study is from 2002. Old news. Still relevant.~

HOUSTON – (July 11, 2002) – Patients with knee osteoarthritis who undergo placebo arthroscopic surgery report the same amount of pain relief and improved mobility as those who undergo the real procedure. The landmark study appears as the lead article in the July 2002 issue of the New England Journal of Medicine.

Researchers at the Baylor College of Medicine collaborated with Houston’s Department of Veteran Affairs to recruit 180 patients, aged 75 years and under, experiencing knee pain, stiffness, or swelling; all symptoms of osteoarthritis, a degenerative joint disease. Baseline characteristics across groups such as race, sex and severity of medical condition were roughly equivalent.

Participants agreed to be randomized into one of three groups: Lavage involving washing out the knee joint; Lavage followed by debridement, involving removing damaged cartilage or bone; and placebo surgery involving making skin incisions only. For consistency of surgical technique, one surgeon with 10 years of experience performed all procedures. Both the patients and the study staff responsible for follow-up care and assessments were unaware of group assignments. The director of Baylor College’s Center for Medical Ethics and Health Policy oversaw the stringent consent process of the study and assured ethical standards were upheld throughout the study.

Pain relief and functional improvement of the joint were assessed at seven follow up visits over the course of two years. At the first and second year follow up visits, moderate pain improvements were similar across all groups, as was functional improvements in walking and climbing stairs.

Researchers concede limitations. Since the participants were predominantly men, the study sample might not accurately represent all candidates for arthroscopic treatment of knee osteoarthritis. Furthermore, 44 percent of the 324 people eligible for study inclusion chose not to participate. The patients who agreed to participate might have had higher hopes of a positive outcome and consequently have been more influenced by the placebo effect. Furthermore, patients with severe osteoarthritis were excluded, so it remains uncertain whether the surgery would have been useful for them.

The study’s strength lies in the fact that it was the first in arthroscopic surgery research to compare the actual procedure to a placebo surgery. Its findings, showing that the placebo surgery delivers equally therapeutic benefits as the actual surgery, were certainly surprising.

The results leave the public questioning whether the billions of dollars spent on more than 650,000 procedures annually might be put to better use. It may be best to consider alternative therapies and remedies if you have moderate osteoarthritis for the knee. While the study did not recommend any specific alternative treatments, some typical ones involve exercise, anti-inflammatory drugs, pain killers, or heat-therapy. Doctors should use extra precaution in recommending candidates who could benefit from surgery.

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The Center for Quality Care and Utilization Studies at the VA Houston Medical Center facilitated this research. Funds were obtained primarily from the VA itself, while the Department of Medicine at Baylor College served as co-funder.

Moseley, Bruce. "A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee."New England Journal of Medicine 347.2 (2002): 81-88.

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Restaurant Review: Lolita Cocina & Tequila Bar

Lolita Cocina & Tequila Bar
271 Dartmouth Street
Boston, MA 02116

Price: $10-30
Selection: Mexican and seafood
Vegetarian options: Limited, but do-able.
Overall grade: A

Written by Xtine Gary for the Tufts Friedman Sprout.

“It’s like a vampire’s lounge!” my friend exclaimed as we walked into Lolita Cocina & Tequila Bar. Well, that’s one way to describe the entrancing décor of this upscale Mexican dining destination. With red lights accenting brick columns, and glowing gothic chandeliers pendant from the ceilings, Lolita Cocina & Tequila Bar achieves an ambiance that is both mysterious and alluring. Lavish damask wallpaper adorns the crimson walls of the dining area, offset by weathered wooden floors. And flickering candles beckon guests towards tables set with rose petal centerpieces. Antique wrought-iron gates bookend the bar, whose rustic cabinets house their renowned selection of 250 tequilas. The music tops off the ambiance with a customized blend of classic rock with Latin influences.

While Lolita boasts an extensive tequila list that is constantly updated, you can also choose to indulge in one of their inventive margaritas (available by the glass or pitcher). A house favorite among patrons is the “Lolita” ($12) made withsauza ‘100 years’, patron citronge, fresh lime, cane syrup, and a squeeze of grapefruit. Also popular is the “Spicy Cucumber” ($13) which has Don Julio Blanco, habanero infused vodka, patron citronge, fresh cucumber, and lime.Beyond that, beer, cocktails, mojitos, and non alcoholic iced beverages round out the drink menu.

I found the dining experience to be unrivaled when it came to presentation. Our waitress immediately brought out a grapefruit and mint granita (similar to Italian ice) with a splash of tequila served atop smoking dry ice. It was a refreshing palate cleanser before the meal. The next complimentary goodie was a bucket of warm, crisp, tortilla chips served alongside three distinct salsas – roasted red pepper, chipotle crema, and tomatillo, aka salsa verde. Customers willing to test their taste buds can venture to try some spicy mango habanero sauce. ­Since the chips are bottomless, it’s almost a shame not to explore at least one of the four guacamole flavors offered. The “Especial” ($15) comes with jumbo lump crab meat and lobster. I’ve never heard of those ingredients in guacamole.

Similarly, the rest of the menu flaunts a penchant for the unexpected, reinventing Mexican-inspired cuisine by mixing it with New England seafood staples. Health-conscious eaters can opt for grilled fish. The salmon coco ($23) is cooked in a coconut lime broth and served with black bean plantain mash. Vegetarians have limited options, but they could request Chef’s Choice Tacos, which comprises a rotating selection of fresh veggies among other ingredients created daily. They could also order the creamy poblano pepper soup ($8) or put a meal together by mixing any of the eight side dishes (rice, beans, vegetables). While I didn’t try any personally, I’ve heard that the zocola corn and sweet potato fries are both delicious sides.

What I ordered is also vegetarian: The “Spinach and Cheese” quesadilla ($9) with chihuahua cheese, queso fresco, and pickled jalapenos. It was delicious and one of several creative quesadilla options. The “Mariscos” quesadilla ($14) had shrimp and scallops, onion poblano chile rajas and fresh salsa. While the “Ancho Chile Chicken” ($10) had black beans, fire roasted corn and smoked bacon. These were all refreshing twists on the tired and typical Mexican quesadilla you’ll find elsewhere – y’know the one, scant chicken strips stuck in plastic-looking monterey jack cheese. My friends and I found the meals filling, but still had room to share a delectable dessert.

Just when you think your senses have experienced it all, out comes a billowy tower of green apple cotton candy speckled with cherry pop rocks to accompany the bill. Another extra perk, on the house. At Lolita, you feel like you’re getting the VIP treatment at an affordable price.

We went on a Monday night, so there was no need to make a reservation. I’d wager the place fills up on weekends though. This dining destination has a night club vibe, so it’s not a place you bring children. Fortunately, this means the aisles aren’t booby trapped with high chairs for you to trip over. You won’t lose an eye thanks to projectile crayons, nor have to compete with a crying child to carry on a conversation. As for the attire, you can get by dressed casually, but given the trendy setting, you wouldn’t feel out of place if you wore a cocktail dress or fancy top.

It was perfect for our girl’s night out. But I could also see it being a memorable date spot. Or a great place to unwind after work. Happy hour happens weekdays from 5-7 pm and offers $1 mini tacos and $2 coronitas (7 fl oz). A stone’s throw from the green line’s Copley stop, Lolita is easily accessible and affords an escape from Boston’s bustling Back Bay. It’s a must-visit stop for city-dwellers and tourists alike!

*Image credits: Lolita Cocina & Tequila Bar website.

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When Lies Masquerade as Science

An oversized replica of this pic hangs in The Hirsh Health Sciences Library (aka where I abscond on Friday nights). The text quotes philosopher Maimonides, "Teach thy tongue to say I do not know, and thou shalt progress." It's ostensibly a mantra of the scientific community, but Dr. John Ioannidis holds that it's long since been disowned. The current scientific community believes, "Teach thy tongue to say I do not know, and you'll lose your funding."

What if the 100 billion US dollars annually spent on research, were pumping out 90% lies; that your doctors then rely on to justify medical advice, prescription, and even surgery?

Dr. Ioannidis has set out to reveal just that. And has been pretty damn successful. The article, Lies, Damned Lies, and Medical Science, chronicles his career. Take a look. Sobering stuff.

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