Heart disease. Stroke. Diabetes. Asthma. Osteoporosis. These common scourges are often pegged to genes, pollution, or the wear and tear caused by personal choices like a poor diet, smoking, or too little exercise. David Barker, a British physician and epidemiologist, has a different and compelling idea: these and other conditions stem from a developing baby’s environment, mainly the womb and the placenta.
Barker was the invited speaker at this year’s Stare-Hegsted Lecture, which is a big deal at the Harvard School of Public Health. In just over an hour, he covered the basics of what the British Medical Journal used to call the Barker hypothesis. It has since come to be known as the developmental origins of chronic disease. (You can watch the entire talk here.)
It goes like this: During the first thousand days of development, from conception to age 2, the body’s tissues, organs, and systems are exquisitely sensitive to conditions in their environment during various windows of time. A lack of nutrients or an overabundance of them during these windows programs a child’s development and sets the stage for health or disease. Barker and others use low body weight at term birth is a marker for poor fetal nutrition.
When a fetus is faced with a poor food supply, it Read more »
*This blog post was originally published at Harvard Health Blog*
You don’t want this…
When it comes to the risk of stroke in atrial fibrillation, it pays to be a boy. Sorry, ladies.
An important question came up on my recent post on AF and stroke.
Why does being female give you an automatic point on CHADS2-VASc? I keep seeing it, but I don’t see why that is.
It doesn’t seem intuitive that female AF patients should have more strokes. Why? AF should equal AF.
But it does matter. When it comes to AF and stroke, women are very different.
Here are three references that support the fact that female gender increases the risk of stroke in AF.
–First: Read more »
*This blog post was originally published at Dr John M*
Eating a lot of chocolate was associated with a 37% reduction in cardiovascular disease and a 29% reduction in stroke compared eating less, researchers reported. But, people are trending toward record obesity by the year 2030, which is a cardiometabolic risk in its own right.
Willie Wonka’s factory wasn’t the only risky place for those with a sweet tooth.
In the first study, to evaluate the association of chocolate with the risk of developing cardiometabolic disorders, researchers performed a meta-analysis of randomized trials, six cohort and one cross-sectional, which reported the association between chocolate and the risk of cardiovascular disease (coronary heart disease and stroke), diabetes, and metabolic syndrome for about 114,000 people.
Because the studies reported chocolate consumption differently, researchers Read more »
*This blog post was originally published at ACP Internist*
“Bueno es saber que los vasos
nos sirven para beber;
lo malo es que no sabemos
para qué sirve la sed”.
Proverbios y cantares.XLI. Antonio Machado
(‘It’s good to know that glasses
are what can help us drink;
The trouble is, we don’t know
What is the purpose of thirst’)
The one thing you can’t afford to have missing when you start a scientific congress or any other professional meeting is not a notepad, a pencil or even an iPad – nowadays, it’s a bottle of water. Offices, airports, handbags and lecture halls, all of them are bursting with all kinds of bottles. It seems they are essential to work and even to stay alive.
Bordering nonsense, some people desperately search for a bottled water vending machine as soon as they arrive at the airport, even if that means gobbling it down in a minute before walking through the security checkpoints.
It is now a common belief that continously drinking water (6 to 8 glasses a day according to NHS, at least two litres -half a gallon- according to other sources) is the healthy thing to do. Read more »
*This blog post was originally published at Diario Medico*
Two studies published in this weeks’ British Medical Journal, one from the US and the other from the UK, report that users of drosperinone containing oral contraceptives (Yaz, Yasmin and their generics) have increased relative risks for non-fatal blood clots compared with users of pills containing levonorgestrel.
While neither study is perfect, and indeed have some very major limitations, they add to a growing body of evidence that pills containing drosperinone may impart higher risks for blood clots than older pills. Yaz is not alone in this regard – other studies have suggested that pills containing the newer progestins gestodene and desogestrel also impart slightly high clot risks than the so-called first and second generation pills containing the older progestins norethindrone and levonorgestrel.
I won’t go into the studies’ limitations here, but will say that trying to get our hands around comparative data on clot risks between various pills is an extraordinarily difficult process given that the diagnosis of blood clots is not always straightforward (or correct), pill choices are not randomized and fraught with prescribing bias, and confounding risk factors for clotting are numerous and difficult to control for. I wish folks would stop trying to answer these questions on the quick and cheap using claims and pharmacy databases without requiring chart review and strict diagnostic criteria. But that’s the way these studies are being done, and that’s the data I am being forced to contend with in my practice, so let’s talk about it. Read more »
*This blog post was originally published at The Blog That Ate Manhattan*