A study that compared heart attack victims to healthy volunteers found the heart patients had higher numbers of bacteria in their mouths, the researchers said.

Their findings add to a growing body of evidence linking oral hygiene with overall health.

Oelisoa Andriankaja and colleagues at the University at Buffalo in New York were trying to find if any particular species of bacteria might be causing heart attacks.

Their tests on 386 men and women who had suffered heart attacks and 840 people free of heart trouble showed two types — Tannerella forsynthesis and Prevotella intermedia — were more common among the heart attack patients.

But more striking, the people who had the most bacteria of all types in their mouths were the most likely to have had heart attacks, they told a meeting of the International Association of Dental Research in Miami.

“The message here is that even though some specific periodontal pathogens have been found to be associated with an increased risk of coronary heart disease, the total bacterial pathogenic burden is more important than the type of bacteria,” Andriankaja, now at the University of Puerto Rico, said in a statement.

“In other words, the total number of ‘bugs’ is more important than one single organism.”

Doctors are not sure how bacteria may be linked with heart attacks but several studies have shown associations between gum disease and heart disease. Bacteria may set off general inflammation that in turn causes blood to clot.

Unlike numerous studies that have evaluated diets to see which might be better at achieving weight loss, this study, funded by the U.S. National Institutes of Health, looked at what happens to cholesterol levels and other cardiac risk factors when dieters reach their goal weight and remain on the diet.

The study involved 18 healthy people, with an average body-mass index (BMI) of 22.6 (18.5 to 24.9 is considered normal weight). Participants completed four weeks each on the Atkins (50 percent fat), South Beach (30 percent fat) and Ornish (10 percent fat) diets, in random order and with a four-week “washout” period between each diet. The study was done from January to December 2006.

The switch between diets meant that “each person served as his own control,” explained principal investigator Dr. Michael Miller, director of the Center for Preventive Cardiology at the University of Maryland Medical Center in Baltimore.

At the start and after each four-week diet, the researchers evaluated cholesterol levels and other cardiac risk factors. They also looked at three-day food records at the end of each diet phase. And they checked blood vessel functioning by measuring blood vessel dilation in the arm.

They found that “as you increase the amount of saturated fat [in the diet], blood vessel dilation is reduced,” Miller said. Healthy vessel dilation is important to proper blood flow.

“The diet that performed the worst [on the blood vessel test] was the Atkins diet,” Miller said. “It contains more saturated fat.”

Participants ate about 30 grams of saturated fat a day while on the Atkins diet, compared to about 14 grams on South Beach and about 3 grams while on Ornish.

“We like to say saturated fat should be below 7 percent of total calories,” Miller said. “So, if your caloric intake is 2,000, saturated fat should be about 14 grams [or less] daily.”

The researchers also measured cholesterol levels, including total cholesterol, “good” cholesterol (HDL) and “bad” cholesterol (LDL). “On Atkins, cholesterol levels tended to go up,” Miller said. “LDL increased by 8 percent [which was not enough to be statistically significant].”

On the South Beach diet, LDL decreased by about 12 percent, and on Ornish it declined by about 17 percent, the study showed.

The findings are published in the April issue of the Journal of the American Dietetic Association. An early look at the study was first discussed at the American Heart Association’s 2007 annual meeting.

Connie Diekman, a registered dietitian and director of university nutrition at Washington University in St. Louis, said that although the study was small, the findings are notable.

Representatives from Atkins Nutritionals took exception with the study, however. In a statement, Colette Heimowitz, vice president of nutrition and education at Atkins Nutritionals, noted that, “given the short duration of his study, the very small sample size and the weak correlations, drawing conclusions about possible long-term health risks tied to fat consumption in the maintenance phase of any weight control program is not good science.” She also questioned whether the participants were actually following a true Atkins diet.

But Diekman saw the results as reason to worry.

“The outcome does show an indication for concern about the impact of a diet like the Atkins diet that relies on a large amount of saturated fat and the effect on heart health,” she said.

“More studies are needed in both healthy and overweight individuals, but the early indication of this study is that high-saturated-fat diets are connected to heart disease risk, a fact that has been long known but not always seen when diets high in saturated fat are used for weight loss,” Diekman noted.

“We need to start our preventive methods when children are much younger,” said study author Dr. Elsie M. Taveras. “Even in the first couple of weeks of life, we can start guiding parents about how to prevent rapid weight gain in their infants.”

While past research has established a link between birth weight and obesity, the impact of factors such as length of gestation, height and lifestyle of the mother were often not considered.

The researchers tracked 559 children who were part of Project Viva, an ongoing study of pregnant women and their children. The babies were measured for weight and height at birth, at 6 months and again at the age of 3.

After adjusting for factors such as the babies’ length, researchers found that those who increased their body-mass index (BMI) during their first six months were more likely to be classified as obese at age 3.

“At present, most guidelines around obesity management recommend that we start assessment and treatment of children after the age of 2,” Taveras said.

According to the National Institutes of Health, nearly a third of adults in the United States are obese. Obese people are 10 percent to 50 percent more likely to die of all causes. In 2000, the obesity epidemic cost the U.S. health system $117 billion.

“The key indication for this study is the importance of better education about feeding infants,” said Connie Diekman, director of university nutrition at Washington University in St. Louis. “Since the study did not look at what children were fed after weaning, it is hard to know if overfeeding then is a contributor.”

Addressing this issue may involve simply making minor changes. In Germany, water fountains were installed in 32 schools located in poor areas of two German cities. Teachers then presented four lesson plans to second- and third-grade students about the benefits of water consumption.

The study found that the students who attended these schools were 31 percent less likely to become overweight than those who attended other schools not involved in the study.

Both studies are to be published in the April issue of Pediatrics.

“The researchers themselves identified that we need to study caregiver and infant relationships, since other studies have shown when there is a lack of a bonding during feeding, infants will change what they eat,” says Diekman. “In addition, other potential confounders need to be removed, and then the study repeated, to see if weight gain during pregnancy is a factor.”

“Our study raises a lot of questions about the reason rapid infant weight gain results in obesity later on,” Taveras said. “We need more research to identify the factors that explain this relationship.”

The research, conducted by scientists from the United States and Italy and presented here Sunday at an annual conference of the American College of Cardiology, said the hormone helped patients to breathe more easily.

Given in addition to standard treatment, the hormone relaxin also reduced hospital time for patients and prevented heart failure from worsening during hospitalization, the study said.

The hormone substantially relieved shortness of breath, or dyspnea, within just a few hours, an improvement that persisted over several days, the authors pointed out.

“Over 90 percent of patients with acute heart failure have dyspnea, and for the majority of these patients, it is the dyspnea that causes them to seek medical care,” John Teerlink, a professor of clinical medicine at the University of California San Francisco, who authored the study.

“Consequently, improvement of dyspnea is an important and clinically relevant target of heart failure therapy.”

Relaxin causes blood vessels to dilate, taking pressure off the heart and increasing blood flow to the kidneys.

Marco Metra, a professor of medicine at the University of Brescia, Italy, and a co-author of the report, said relaxin was “a promising new therapy for acute heart failure that requires further testing in additional, larger clinical trials.”

Prior research has linked tonsillectomy to accelerated weight gain, but whether it is a risk factor for becoming overweight was unclear, note Dr. Alet H. Wijga, from the National Institute for Public Health and the Environment, Bilthoven, the Netherlands, and colleagues.

To investigate this relationship, the research team analyzed data from 3963 children enrolled in the Dutch Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study.

Annual parental questionnaires were used to assess weight, tonsillectomy status, and other factors. In addition, the height and weight of all subjects at 8 years of age was assessed by the researchers.

Tonsillectomy with or without adenoidectomy significantly increased the odds of being overweight and obese at 8 years by 61 percent and 136 percent, respectively. Adenoidectomy alone did not increase the risk of becoming overweight, but it did increase the risk of obesity by 94 percent.

Overweight status at 2 years of age was not linked to subsequent tonsillectomy, suggesting that the operation led to overweight and obesity and not vice-versa.

“Longitudinal data on weight and height in the years before and after surgery,” the authors note, “suggest that (adeno) tonsillectomy forms a turning point between a period of growth faltering and a period of catch-up growth,” which may explain the increased risk of becoming overweight and explain the increased risk of becoming overweight after the operation.

Based on these findings, the authors recommend that dietary and lifestyle advice be given to parents whose children are undergoing tonsillectomy. Growth monitoring after surgery is key to ensure that catch-up growth occurs within healthy limits, they add.

SOURCE: Pediatrics April, 2009.

This finding contrasts with another recent study that found that these same two tests did find early cancer. Taken together, experts say these studies highlight the need to find an effective screening method for this deadly cancer, which is often called the “silent killer.”

“The jury is still out on the efficacy of screening with CA125 and transvaginal ultrasound in terms of reducing the mortality rate of ovarian cancer,” said lead researcher Dr. Edward Partridge, director of the University of Alabama Birmingham Comprehensive Cancer Center.

“In this study, we do not have mortality data on the screening versus the non-screening group, so no conclusions can be made of the impact of screening with CA125 and transvaginal ultrasound,” he added.

This study only reports data on women who were screened, Partridge noted. “We learned that the positive predictive value for the combination of tests is pretty low — in the 1 to 1.3 percent range,” he said. “A substantial number of the tests are false positives.”

In addition, screening with transvaginal ultrasound lead to a higher rate of surgery for positive findings than positive CA125, Partridge said. “Transvaginal ultrasound leads to more ‘unnecessary’ surgeries,” he said.

And a high percentage of the cancers detected through screening were late-stage malignancies, Partridge said. “If you detect them at a late stage, it is unlikely that you are going to impact mortality,” he said. “In order to affect mortality, one has to detect them at an earlier stage.”

The report is published in the April issue of Obstetrics & Gynecology.

For the study, Partridge’s team collected data on 34,261 women who underwent annual screening for CA125 and also had transvaginal ultrasound.

The researchers found that over the four years of screening, transvaginal ultrasound produced more positive findings for cancer than CA125 screening. In fact, CA125 positive tests decreased from 60 percent in the first year to 34 percent in the third year.

Of the 89 invasive ovarian cancers diagnosed, 60 were detected through screening. In addition, 72 percent of the screen-detected cancer were late-stage cancers, the researchers reported.

Partridge noted that even detecting cancer early may not have an impact on mortality. “In any screening trial, the ultimate test of its usefulness is does it impact mortality,” he said.

Based on the findings of this study and the study published in the March 10 online edition of The Lancet Oncology, this screening method will not have any effect on mortality, Partridge said. “What we need is a more sensitive and specific screening test,” he said.

In that study, a British research team found that screening was able to identify most women with cancer. The combination of the blood test and ultrasound found 90 percent of the cancers, while ultrasound alone found 75 percent of the cancers.

Almost 50 percent of all the cancers found were in an early stage (stage I or II), the researchers noted. And 48 percent of the more invasive ovarian cancers detected were designated as being stage I tumors. Usually, only 28 percent of ovarian cancers are identified in this early stage, the researchers pointed out.

Dr. David G. Mutch, the Ira C. and Judith Gall Professor of Obstetrics and Gynecology at Washington University, St. Louis, and author of an accompanying journal editorial, agreed there is no worthwhile screening test for ovarian cancer as yet.

“Patients who were screened presented at the same stage as they would have if they were unscreened,” Mutch said. “There is no good screening test at this point.”

Mutch added that there is no reason to screen for ovarian cancer in the general population at this point. “The prevalence of the diseases is so low, one in 2,500, and the specificity of the tests are so low, that we are going to operate on a lot of patients unnecessarily,” he said.

The 5-foot-8 (1.7-meter) 23-year-old recently lost more than 50 pounds (23 kg) and looks healthy. But 15 weeks into her third pregnancy, she was gaining the weight back — too fast.

“I found out I was pregnant in December. I didn’t go to the doctor until mid-January and I had already gained 15 pounds (7 kg),” said Nieves. Having struggled with excess weight in her last pregnancy, she decided to take action.

Nieves became the newest member of an experimental program at Northwestern Memorial Hospital in Chicago designed to help pregnant mothers keep their weight in check.

It is based on new research suggesting that excessive weight gain in pregnancy hurts both the mother and her fetus, raising the risk of complications during pregnancy and putting the child at risk for obesity and diabetes later in life.

“We’ve known for a long time that children of overweight mothers are more likely to be overweight themselves,” said Dr. Robert Kushner, who directs the Northwestern Comprehensive Center on Obesity.

But he said researchers had assumed that was simply because the mother passed along her bad eating and lifestyle habits to her child after birth. Now, animal studies suggest the environment the fetus is growing in influences the genes.

“The whole idea is, as that child comes out of the birth canal, you’ve already imprinted that child’s vulnerability to be overweight,” Kushner said.

“It’s like being born with handcuffs on. In this environment, how do they have a fighting chance?” said Kushner, referring to the growing obesity epidemic that affects a third of adults and nearly 17 percent of children in the United States.

U.S. Centers for Disease Control and Prevention estimates nearly one quarter of the 4 million births each year in the United States involve obese women.

Obesity raises the risk for diabetes, hypertension, heart disease, osteoarthritis, stroke, gallbladder disease, sleep apnea, respiratory problems and even some cancers.

A 2000 report by the U.S. Surgeon General estimated the direct and indirect cost of obesity at $117 billion each year.

Kushner said the program at Northwestern is among the first in the country to tackle obesity in pregnancy. He said pregnant women have often been considered hands off because of fear of harming the developing baby.

But it now seems doing nothing may be doing more harm.

NO MORE HANDS OFF

Doctors have referred about 20 women since the program started in November, and new ones come in each week.

Women meet for classes every other week on nutrition, stress and exercise and keep daily logs of their diet and activity levels. That is proving difficult for some women, who are already juggling work, child care and weekly appointments with their obstetrician.

Charlotte Niznik, an advanced practice nurse who coordinates the program, said the team may start offering some of the services online. “Everything is flexible. If we’re rigid, we’ll never get participation.”

A three-year grant allows the team to offer the program for free. They hope to attract more black and Hispanic women, who are at highest risk for obesity and its complications.

Niznik said several women in the program have had gastric bypass surgery and fear gaining too much weight.

“They are motivated to maintain a normal weight gain in pregnancy, which is no more than 15 pounds (7 kg), because these women are obese,” Niznik said. “They are 300 (136 kg) to 400 pounds (180 kg).”

At 195 pounds (90 kg), Nieves weighs considerably less than that, but her previous weight battles and rapid weight gain — 20 pounds (9 kg) so far — make her a candidate.

During her last pregnancy, Nieves felt pressured by her obstetrician to gain weight. “I was about 220 pounds (100 kg). I would tell him, ‘I’m already overweight. I don’t want to gain the weight,’” she said.

“He would just tell me, ‘You have to gain a pound a week.’ That’s 40 pounds at the end of the pregnancy!”

She hopes the program will give her ammunition to resist some of the pressure she is getting to gain weight.

“My background is Hispanic,” she said. “My mother-in-law is like, ‘Oh my God, you are pregnant. Eat, eat, eat. The baby has to be nice and fat.’”

Dr. Alan Peaceman, an obstetrician who co-directs the pregnancy and obesity program, said the near-term goal is to help women like Nieves have healthy pregnancies.

Down the road, they hope to gather data to see if it helped reduce complications for mothers and gave babies a better shot at having a healthy weight.

“If we can show that weight control during pregnancy reverses these trends, this is going to be one of the first successful approaches toward reducing childhood obesity, and that will be a major accomplishment,” he said.

The studies, expected to be presented in Washington, D.C., at the annual meeting of the American Academy of Allergy, Asthma & Immunology, demonstrate how these common conditions can have a wide impact on a family’s quality of life.

In looking at the lives of thousands of caregivers to children, researchers at the University of Arkansas for Medical Sciences and Arkansas Children’s Hospital Research Institute in Little Rock found that caregivers with a food-allergic child were more likely to stop working, reduce work hours or incur financial problems.

This appeared most often at a critical juncture, often when the child was not receiving necessary medical care, such as prescriptions or help from a specialist. As a result, food-allergic children had twice the chance of not getting proper specialist care, the study found.

The study’s authors suggested that the financial burden caused by food allergies might be diminished if children with food allergies and their families received needed support and care.

A second study found that most families that have members with food allergies limit their vacation destinations because of the condition, with 90 percent saying it causes them to vacation only in the United States.

In studying questionnaires filled out by 410 people with a food-allergic family member, researchers found that 68 percent of participants limited where they went and more than a third avoided certain types of transportation, such as ships and planes.

Concern about having adequate medical care at a vacation spot was the most common parameter on vacation location, the researchers found, suggesting that tourist spots may want to have better access to medical care and arrange for special accommodation for those with food allergies.

Nearly all participants said they would not vacation in a remote location. Japan, India, China, Africa and beach resorts in foreign countries topped the list of places those surveyed said they doubted they would visit.

When they did travel, about half said they would eat most meals in their room, and more than 80 percent would ask for special meals if their vacation spot could accommodate them. When preparing to go, most also packed extra emergency medicines and allergen-free food, and almost half researched the location of the closest hospital to their destination.

The drugs — gamma-secretase inhibitors — are designed to target amyloid plaque that accumulates in the brains of people with Alzheimer’s disease, according to background information in the study.

“No one knows why it occurs, but abnormal amounts of amyloid plaque have been found during an autopsy in about a third of brain injury victims, some of whom were children who would ordinarily never have had these deposits,” Mark Burns, a neuroscientist and assistant professor at Georgetown and the study’s lead author, said in a university news release. “Remarkably, these deposits occur in less than one day after injury.”

It’s also known that people who’ve suffered a brain injury have a 400 percent increased risk of developing Alzheimer’s disease, according to the researchers.

“In this study, we show that the same pathways activated chronically in Alzheimer’s disease are activated acutely in traumatic brain injury and that they appear to play a very important role in secondary injury,” Burns said.

He and his colleagues first conducted tests that showed that brain injury in mice resulted in substantially more amyloid peptide than normal. They then found that amyloid peptide production after brain injury was reduced in mice that received an experimental agent called DAPT, one of the first gamma secretase inhibitors developed and the basis for some Alzheimer’s disease drugs now in clinical trials.

The researchers said that their findings, which are published online in Nature Medicine, suggest that this class of drugs could do something no other drug has been able to do — prevent the long-term and continuing damage that often follows serious brain injury.

“This is an exciting finding that we hope can be readily tested in patients with traumatic brain injury,” Burns said.

Georgetown University has applied for a patent for the technology involved in the research, the news release said.

“Much attention has been given to the role of obesity in the development of type 2 diabetes, but stress may be as important in this at-risk population,” study co-author Anastasia Georgiades, of Duke University in Durham, N.C., said in a news release.

The study included 62 healthy, non-diabetic black women who were asked to recall stressful life events. As they did, the researchers measured the women’s levels of blood sugar and epinephrine, the “fight or flight” hormone that’s released in reaction to stress.

Women with high epinephrine levels (25 picograms or more per milliliter of blood) while recalling stressful events and with more belly fat (33 percent or more of total body fat) had significantly higher fasting glucose scores (about 100 milligrams per deciliter) than women with lower epinephrine levels and less belly fat (85 mg/dl). A fasting blood glucose level of 100 mg/dl is considered within the low range of pre-diabetes, and a level of 125 mg/dl is the benchmark for type 2 diabetes.

Women with high epinephrine levels and more belly fat also had bigger increases in blood sugar levels during the stress test.

The findings were to be presented this week at the annual scientific meeting of the American Psychosomatic Society.

“While we don’t fully understand the nature of the association, women with abdominal obesity may be more vulnerable to the impact of stress — causing their body to increase blood sugar production and elevating their risk for diabetes,” Georgiades said.

Further research is needed to determine exactly how epinephrine production affects blood sugar levels in black women. Nearly one in four black women in the United States has type 2 diabetes, according to the American Diabetes Association.