JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives of Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENTS
ARCHIVES OF INTERNAL MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, October 22, 2007)
EATING WHOLE-GRAIN BREAKFAST CEREALS MAY BE ASSOCIATED WITH A LOWER RISK OF HEART FAILURE FOR MEN
WEIGHT GAIN RELATED TO POSTMENOPAUSAL BREAST CANCER RISK
HEALTHY DIET AND LIFESTYLE BEHAVIORS ASSOCIATED WITH DECREASED RISK OF HEART ATTACK IN WOMEN
FUNDING SOURCE MAY BE ASSOCIATED WITH FINDINGS REGARDING ADVERSE EFFECTS IN CORTICOSTEROID STUDIES
HIGH-RISK INDIVIDUALS LESS LIKELY TO FOLLOW THROUGH ON HIV TESTING PLANS
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, October 22, 2007
Media Advisory: To contact Luc Djoussé, M.D., M.P.H., D.Sc., call Jessica Podlaski at 617-534-1603.
EATING WHOLE-GRAIN BREAKFAST CEREALS MAY BE ASSOCIATED WITH A LOWER RISK OF HEART FAILURE FOR MEN
CHICAGO—Men who consume a higher amount of whole grain breakfast cereals may have a reduced risk of heart failure, according to a report in the October 22 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
“The lifetime risk of heart failure is estimated at 20 percent (one in five) for both men and women aged 40 years,” according to background information in the article. Studies have suggested that the risk of hypertension, coronary heart disease, hypercholesterolemia (high blood cholesterol) and mortality can be reduced with a diet rich in grain products.
Luc Djoussé, M.D., M.P.H., D.Sc. and Michael Gaziano, M.D., M.P.H. of the Brigham and Women’s Hospital and Harvard Medical School, Boston, analyzed the association between breakfast cereal intake and new cases of heart failure among 21,376 men (average age 53.7) participating in the Physician’s Health Study I. Cereal intake was estimated by using a food frequency questionnaire and incident heart failure was assessed by annual follow-up questionnaires for an average of 19.6 years.
During follow-up, 1,018 of the participants experienced heart failure. This included 362 of 6,995 participants who did not eat any cereal, 237 of 4,987 of those who ate one serving or less per week, 230 of 5,227 of those who ate two to six servings per week and 189 of 4,167 of those who ate seven or more servings per week.
“Our data demonstrate that a higher intake of whole grain breakfast cereals is associated with a lower risk of heart failure,” the authors conclude. This association may be due to the beneficial effects of whole grains on heart failure risk factors such as hypertension, myocardial infarction [heart attack], diabetes mellitus and obesity. “If confirmed in other studies, a higher intake of whole grains along with other preventive measures could help lower the risk of heart failure.”
(Arch Intern Med. 2007;167(19):2080-2085. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: The PHS is supported by grants from the National Cancer Institute and grants from the National Heart, Lung and Blood Institute (NHLBI), Bethesda, Maryland. Dr. Djoussé is supported by a grant from the NHLBI. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, October 22, 2007
Media Advisory: To contact Jiyoung Ahn, Ph.D., call NCI Press Officers at 301-496-6641.
WEIGHT GAIN RELATED TO POSTMENOPAUSAL BREAST CANCER RISK
CHICAGO—Women who do not take hormone therapy after menopause may have an increased risk for breast cancer if they have gained weight throughout adulthood rather than maintaining a stable weight, according to a report in the October 22 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Obesity is known to be a risk factor for developing breast cancer after menopause, according to background information in the article. Estrogens may accumulate in fat tissue, potentially initiating or promoting the growth of cancerous cells in the breast.
Jiyoung Ahn, Ph.D., of the National Cancer Institute, Bethesda, Md., and colleagues analyzed data from 99,039 postmenopausal women who were part of the National Institutes of Health–AARP Diet and Health Study. In 1996, the women reported their current body measurements and weight, plus their weight at ages 18, 35 and 50. Body mass index (BMI) was used to classify the women as underweight, normal weight, overweight or obese.
Through 2000, 2,111 of the women developed breast cancer. In women who did not take hormone therapy, gaining weight in the early reproductive years (age 18 to 35), late reproductive years (age 35 to 50), perimenopausal and postmenopausal years (age 50 to the current age) and throughout adulthood (age 18 to the current age) were each associated with an increased risk of developing breast cancer compared with maintaining a stable weight during those periods.
Women who were not obese or overweight at age 18 but were at ages 35 and 50 had 1.4 times the risk of developing breast cancer compared with women who maintained a normal weight, while those who were overweight or obese at ages 18, 35 and 50 had no increased risk. Women who lost weight had the same breast cancer risk as those whose weight remained stable.
“Because weight gain during adulthood mainly reflects the deposition of fat mass rather than lean body mass, weight gain potentially represents age-related metabolic change that may be important in breast cancer development,” the authors write. “These findings may reinforce public health recommendations for the maintenance of a healthy weight throughout adulthood as a means of breast cancer prevention.”
(Arch Intern Med. 2007;167(19)2091-2102. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This research was supported by the Intramural Research Program of the National Institutes of Health, National Cancer Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, October 22, 2007
Media Advisory: To contact Agneta Akesson, Ph.D., M.P.H., e-mail Agneta.Akesson{at}ki.se.
HEALTHY DIET AND LIFESTYLE BEHAVIORS ASSOCIATED WITH DECREASED RISK OF HEART ATTACK IN WOMEN
CHICAGO—Women who eat a healthy diet, drink moderate amounts of alcohol, are physically active, maintain a healthy weight and do not smoke have a significantly reduced risk of heart attack, according to a report in the October 22 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
“Coronary heart disease is the most important cause of death and disability in women,” the authors write as background information in the article. “Despite a lower incidence in women, coronary heart disease–related mortality and the percentage of sudden deaths from coronary heart disease without previous symptoms is higher and the trend of decline in incidence is slower than in men.”
Agneta Akesson, Ph.D., M.P.H., of the Karolinska Institutet, Stockholm, and colleagues identified dietary patterns in 24,444 postmenopausal women by analyzing food frequency questionnaires, on which the women supplied information about how often they ate 96 common foods. “We derived four major dietary patterns: ‘healthy’ (vegetables, fruits and legumes), ‘Western/Swedish’ (red meat, processed meat, poultry, rice, pasta, eggs, fried potatoes and fish), ‘alcohol’ (wine, liquor, beer and some snacks) and ‘sweets’ (sweet baked goods, candy, chocolate, jam and ice cream),” the authors write. Participants also answered questions about education, family history, health status, use of medications, body measurements and physical activity. When they enrolled in the study in 1997, none of the women had heart disease, diabetes or cancer.
Over an average of 6.2 years of follow-up, 308 women had a new myocardial infarction (heart attack); 51 of these cases were fatal. Two diet types—“healthy” and “alcohol”—were associated with a reduced risk for heart attack.
“The low-risk diet (high scores for the healthy dietary pattern) characterized by a high intake of vegetables, fruit, whole grains, fish and legumes, in combination with moderate alcohol consumption (5 grams of alcohol per day or less), along with the three low-risk lifestyle behaviors [not smoking, having a waist-hip ratio of less than the 75th percentile and being physically active], was associated with 92 percent decreased risk compared with findings in women without any low-risk diet and lifestyle factors,” the authors write. “This combination of healthy behaviors, present in 5 percent, may prevent 77 percent of myocardial infarctions in the study population.”
Several components of fruits, vegetables and whole grains—including fiber, antioxidant vitamins and minerals—have been associated with a reduced risk for coronary heart disease, the researchers note. In addition, previous studies have found beneficial effects of small amounts of alcohol in preventing the buildup of plaque in the arteries, which could help prevent heart attacks.
“Our study findings indicate that healthy dietary behaviors are present in the population,” the authors conclude. “These dietary behaviors together with a healthy lifestyle and body weight may prevent most myocardial infarction events.”
(Arch Intern Med. 2007;167(19):2122-2127. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by research grants from the Center for Health Care Sciences, Karolinska Institutet; the Swedish Research Council/Medicine and Longitudinal Studies; and the Swedish Council for Working Life and Social Research. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, October 22, 2007
Media Advisory: To contact corresponding author Angel Mazon, M.D., Ph.D., e-mail amazon{at}comv.es.
FUNDING SOURCE MAY BE ASSOCIATED WITH FINDINGS REGARDING ADVERSE EFFECTS IN CORTICOSTEROID STUDIES
CHICAGO—Studies of inhaled corticosteroids, medications frequently prescribed for asthma and other respiratory problems, appear less likely to find adverse effects if they are funded by pharmaceutical companies than if they are funded by other sources, according to a report in the October 22 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
“Inhaled corticosteroids are considered the cornerstone treatment for inflammatory respiratory diseases, especially asthma, even in mild or moderate cases,” the authors write as background information in the article. “However, they are not free of adverse effects, and concerns have been raised about long-term treatment courses in milder cases of disease or in young children.” Their use has been associated with potentially harmful decreases in the stress hormone cortisol, decreases in bone mineral density and growth suppression.
Antonio Nieto, M.D., Ph.D., of the Children’s Hospital La Fe, Valencia, Spain, and colleagues assessed the safety reporting of inhaled corticosteroids in 504 studies of the drugs published between 1993 and 2002. Of those, 275 were funded by pharmaceutical companies and 229 were funded by other sources, including non-profit organizations and government agencies.
Overall, 34.5 percent of pharmaceutical-funded studies and 65.1 percent of studies with other funding sources found a significant difference in adverse effects between individuals assigned to inhaled corticosteroid groups and those who were not. This difference was no longer statistically significant when the researchers factored in components of the study design, such as dosage amounts or a focus limited to certain adverse effects, suggesting that the association between funding source and more positive outcomes may result from variations in study design.
“Remarkably, type of funding was a major determinant of the authors’ interpretation of the adverse effects,” the authors write. In studies that did find a significant association between corticosteroids and adverse effects, authors of manufacturer-funded studies were more likely to conclude the drugs were safe than authors of studies with no pharmaceutical funding.
Because the interpretations are subjective, it is difficult to determine if studies funded by the manufacturer are too positive or studies with no pharmaceutical funding are too cautious, the authors note. “However, we postulate that having information on source of funding will help readers of these studies have a better informed and balanced judgment on the authors’ interpretations,” they conclude. “Disclosure of conflicts of interest should be strengthened for a more balanced opinion on the safety of drugs.”
(Arch Intern Med. 2007;167(19):2047-2053. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, October 22, 2007
Media Advisory: To contact corresponding author Brian Wells Pence, Ph.D., M.P.H., call Richard Merritt at 919-660-1309.
HIGH-RISK INDIVIDUALS LESS LIKELY TO FOLLOW THROUGH ON HIV TESTING PLANS
CHICAGO—One-fourth of individuals at high risk for contracting HIV report planning to be tested for the virus in the next year, but fewer appear to follow through on that intention than individuals who are at lower risk, according to a report in the October 22 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
About 1.1 million U.S. individuals are affected with the HIV virus, and 24 percent to 27 percent do not know they are infected, according to background information in the article. The HIV epidemic is increasingly affecting groups not perceived as being high-risk, including women, the poor and individuals living in rural areas. “Initiatives to increase the rates of HIV testing, particularly among groups not traditionally perceived as being at high risk, have been advanced as a primary strategy in the effort to combat the HIV epidemic,” the authors write.
Jan Ostermann, Ph.D., M.S., of Duke University, Durham, N.C., and colleagues analyzed data from 146,868 adults age 18 to 64 who were interviewed between 2000 and 2005 as part of the National Health Interview Surveys. Participants were asked whether any of a list of HIV risk factors, such as receiving blood clotting factors for hemophilia or using injection drugs, applied to them. They also reported their HIV testing history and whether they planned on being tested in the next year, in addition to how often they drank alcohol, whether they had symptoms of depression and their sociodemographic information, such as age, education and marital status.
Overall, rates of HIV testing remained approximately the same between 2000 and 2005, with 37 percent of participants reporting being tested in their lifetimes and 10 percent within the past year. Females, minorities and individuals who reported greater risks for HIV were more likely to be tested. However, even among those reporting a medium or high risk for HIV, fewer than 25 percent were tested in the previous year.
In addition, “the difference between planned and actual testing was greater for those with greater HIV risk factors,” the authors write. “Indeed, those with a lifetime HIV risk factor, with medium or high self-perceived HIV risk, and with heavier alcohol consumption were all less likely to actually get tested than to report an intention to get tested.” For example, among those who reported a lifetime risk factor for HIV, 16 percent fewer individuals received a voluntary HIV test than reported planning to get tested, compared with a 5.6 percent deficit between planned and actual testing for those with no risk factors.
“These findings suggest that considerable potential exists to increase testing in higher-risk groups if individual and structural barriers can be identified and addressed,” the authors conclude. “Alcohol and mental health treatment sites, for example, may represent a valuable opportunity to increase testing rates for higher-risk populations who exhibit a marked demand for testing. Although compelling arguments have motivated the current focus on general population testing, such efforts should not come at the expense of ensuring access to and utilization of testing by higher-risk groups.”
(Arch Intern Med. 2007;167(19):2128-2135. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This work was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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