News in brief - May 10, 2004

Smoking cessation success reported - Serious dieting helps avoid diabetes, heart problems - Young adult blood pressure readings could mislead - Statin use does not increase breast cancer risk

Smoking cessation success reported

Training nurses and medical assistants who register patients at primary care facilities to use specific, guideline-based methods to encourage smoking cessation increases the likelihood that patients will successfully quit, according to a study published in the April 21 Journal of the National Cancer Institute.

Researchers tested the effectiveness of guidelines developed by the Agency for Healthcare Research and Quality in a randomized, controlled trial among 2,163 adult smokers at eight primary care clinics in southern Wisconsin. At the test sites, patients' smoking status was assessed and free nicotine patches and telephone counseling were offered. Patients at the control sites received only general information about the AHRQ guideline.

Follow-up interviews found that test site patients were more successful in quitting than control site patients.

Serious dieting helps avoid diabetes, heart problems

People who severely restrict their caloric intake can dramatically reduce their risk of developing diabetes or clogged arteries, according to researchers at Washington University School of Medicine in St. Louis.

They found that some risk factors among these avid dieters were so low they were comparable to those of people decades younger. Their findings are in the April 27 Proceedings of the National Academy of Sciences.

The researchers recruited participants through a national organization called the Caloric Restriction Optimal Nutrition Society. By eating small amounts of nutrient-dense foods, members of this group try to consume between 10% and 25% fewer calories than the average American, while still attempting to maintain proper nutrition.

The 18 individuals, ages 35 to 82, who participated in the study had voluntarily been following this very-low-calorie diet for three to 15 years. The group was compared with 18 age- and gender-matched individuals who ate a typical Western diet.

The calorie-restricted group ate between 1,100 and 1,950 calories per day depending on height, weight and gender, and these calories consisted of about 26% protein, 28% fat and 46% complex carbohydrates. The comparison group consumed between 1,975 and 3,550 calories per day with 18% from protein, 32% from fat and 50% from carbohydrates.

While the researchers couldn't say how long the individuals on the restricted calorie diets will live, they have a much longer life expectancy than average, said John O. Holloszy, MD, professor of medicine and the study's lead author. They're most likely not going to die from a heart attack, stroke or diabetes, he predicted.

Young adult blood pressure readings could mislead

Taking blood pressure readings of those younger than 35 might lead to patients being prescribed anti-hypertensives for much of their life unnecessarily, according to a study published last month in the British Medical Journal.

Dr. Tom Marshall, the author and a lecturer in the department of public health and epidemiology at Birmingham University in Great Britain, analyzed data from a health survey taken in England in 1998, 1999 and 2000 that included more than 13,000 people. He found that of 55 people who had high blood pressure, only 16 had other cardiac risk factors that would actually make them eligible for treatment.

Dr. Marshall recommended that doctors be cautious about diagnosing hypertension in young adults and have a higher threshold before writing a prescription.

"Young adults are at low risk of heart disease and therefore benefit little from treatment," he wrote. "But misdiagnosis could mean a lifetime on medication."

Statin use does not increase breast cancer risk

Caucasian race, a history of smoking, hypertension, hormone therapy, excess weight and a family history were associated with the development of breast cancer, but statin use was not, according to a paper published in Cancer last month.

Researchers in Seattle interviewed nearly a thousand local residents with breast cancer who were older than 65 and part of the state's cancer surveillance system. Another thousand controls without cancer who were on the Medicare rolls also were questioned.

Previous studies have suggested that statins may be carcinogenic. Researchers found no such link for short-term use and found a slight decrease for those who took it more than five years.

"Our results both provide reassurance on the safety of statin use among older women and support the emerging evidence that statins may have a chemoprotective action on breast cancer risk," concluded the authors.