Eat Healthy and Control Type 2 Diabetes

Type 2 diabetes is an disease that has been on the rise over the last century. Diabetes is diagnosed when there is a defect in the production of insulin by the pancreas. Glucose (blood sugar) is the principal energy source for the body. Without insulin, the body cannot utilize this energy source. When this occurs, the sugar that circulates in the blood is too high while at the same time, the sugar that is absorbed in the body tissues is too low.

Diabetes mellitus, the medical term, is usually divided in two classifications: type 1 and type 2. In type one diabetes, the blood sugar must be controlled with a combination of insulin and food. In many cases type 2 diabetes can be controlled by food alone.

The food disease

Diabetes has frequently been called a food disease because it associated with the food. Diabetes, whether it be type 1 or type 2 is controlled, to a certain extent, by what the person eats. This disease is a disorder of how carbohydrates are metabolized. In this disease sweet or starchy foods are metabolized differently in diabetics. Type 1 diabetics control their disease with insulin and food. Type 2 diabetics usually control their disease with food and exercise. Exercise speeds up the metabolism and increases heart and lung health while sending oxygen through the body.

Overweight children

Until newly, type 2 of the disease was called adult onset diabetes because it was most frequently seen in overweight young adults. Now with the surge in overweight children and a parallel number of children with the disease, it has become apparent that there is a correlation of food and disease. In type 2 diabetes, the pancreas does generate some insulin, but the insulin generated is ineffective. Because of this, the body can restore its original function by careful attention to food and exercise.

In type 2 individuals, some insulin is generated. Many patients are given oral drug to help the pancreas generate sufficient of the insulin needed for the body to function properly. This drug may not be insulin but serves as a booster to help the pancreas continue to generate the insulin the body needs. Making wise food alternatives will help the body keep its sugar level stable. Today’s processed food is heavy on starch and sugar additives and low on fiber. This prevents the body from performing properly and using the food the way it is supposed to be used. A good rule of thumb is stay away from foods that come in a wrapper.

Choose good lean protein sources and fruits and vegetables that have not been mechanically processed. In addition to these suggestions, the benefit of daily exercise cannot be over conditiond. Exercise is the one thing that does not cost any money and is of great support to general good health.

Blood Sugar Levels

Keep track of sugar levels by testing blood in any case three times a day. Contact a physician if whatever seems out of the ordinary. Seek out a professional fooditian for the exact amount and type of foods for carbohydrate metabolism. Sweet or starchy foods are metabolized differently in diabetics.

Type 1 diabetics control their disease with insulin and food. Type 2 diabetics usually control their disease with food and exercise. comprehend your specific needs and always know your A1C level. Follow these simple suggestions and the type 2 diabetic should have well controlled sugar levels.

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Vitamin B12 Deficiency health effects

Today, as vitamin supplements gain in popularity, the potential to overdose has become a basic concern. However, one vitamin that tends to be overlooked and is of major importance is Vitamin B12. Deficiency in vitamin B12 is, in fact, among the highest nutritional deficiencies in developing counendeavors and potentially in the United conditions as well. Vitamin B12 is imperative in the correct formation of red blood cells and as well plays an essential role in maintaining healthy nerve tissue.

Without the proper amount of Vitamin B2, development of a blood condition referred to as pernicious anemia is probable and highly likely. This condition, once develop, does not allow an individual to generate the protein substance needed to allow the absorption of vitamin B12. An additional detriment of a b12 deficiency is the inability to absorb folic acid, another component the body needs to function properly.

Why Does B12 Affect Our Health?

Deficiencies in needed vitamins generally take place gradually and, at times, may take a number of years to develop.

FirstlyVitamin B12 deficiency symptoms can be small, barely noticed neurological or cognitive changes which tend to increase with time. As the deficiency becomes more serious, anemia and/or dementia may develop. In order to have proper multiplication of red blood cells the presence of vitamin b12 necessary. As the deficiency increases, the red blood cells drop and the individual subsequently develops anemia. Fatigue and palpitations are two of the basic symptoms of anemia created by a b12 deficiency.

What Are B12 Deficiency Symptoms?

  1. In addition to fatigue and palpitations, symptoms include:
  2. Weight loss
  3. Pale skin
  4. Sore Mouth or tongue
  5. Higher incidence of contracting infections

If not corrected and the deficiency is accepted to continue a number of neurological symptoms may appear. Symptoms such as:

  1. Irritability
  2. Confusion
  3. Forgetfulness
  4. Numbness and/or tingling of the fingers and/or toes
  5. Overall muscle weakness
  6. Staggering
  7. Balance

Who is at Risk?

Virtually anyone has the potential of developing a vitamin b12 deficiency. However, vegans, those on a vegetarian food, babys and the elderly are generally placed in the group that is accept as true thated at high risk in developing this deficiency. Since vitamin b12 is derived solely from animal-related products, those who refrain from eating dairy, eggs or meat are at risk; however, vegetarians who do consume dairy products and eggs generally do not consume the advisable 2.4 mcg amount. As the population grows older, approximately 30% of individuals over 50 develop a stomach lining that is thinning or atrophic gastritis. With this condition, the small intestine is unable to absorb b12 which may potentially lead to more rigorous conditions. A multivitamin, eating a breakfast cereal that has been fortified or likely both is advisable for those accept as true thated at risk for a b12 deficiency. If any of these conditions are present, review your condition with your doctor and check on receiving a Vitamin B12 blood test.

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Vitamin A Benefits

Liquid Emulsified Vitamin A, 20,000 IU per dropVitamin A comes in two forms: retinol and beta carotene. Retinol is the animal source of vitamin A, while beta carotene is derived from a variety of yellow and orange fruits and vegetables as well as leafy greens. Beta carotene is converted into vitamin A in the intestine and as well in the liver.

Vitamin A Benefits

Vitamin A has many essential functions that include good eyesight, growth and tissue healing and a healthy skin. It as well plays an essential role as an antioxidant, lowers cancer risk and regulates genetic processes.

Vitamin A Deficiency

Studies have shown that around 25 percent of Americans get less than half the advisable daily allowance in their supplements for vitamin A. This is most obvious in people who do not eat many fruits and vegetables or those who eat highly processed foods which are lacking in vitamins. Fruits and vegetables actually are very essential foods for anyone wanting to get the required intake of nutrients.

Night blindness is one of the first symptoms of vitamin A deficiency along with poor vision, irritated or red eyes and eyes that tire easily. Vitamin A or beta carotene supplements will normally correct these predicaments. Less obvious deficiency symptoms can include atrophy of the thymus and spleen which are both essential for a healthy immune system. Low foodary levels of vitamin A have as well been linked to a number of cancers including breast, cervical, lung, prostrate and stomach.

Vitamin A Toxicity

As vitamin A is stored in the body and not readily excreted, there are some potential toxicity issues. Taking more than 25,000 IU a day of vitamin A retinol is not advisable. Animal liver meat has the highest concentration with beef liver containing around 15,000 IU. Toxicity is highly unlikely through food alone as most of the vitamin A we eat comes from vegetable sources. There are no toxicity concerns with beta carotene. The only side effect may be an orange or yellow discolouring of the skin.

Beta Carotene foods and Vitamin A Sources

The highest concentrations of vitamin A retinol are found in liver and fish liver oil, which is a general source for supplements. Egg yolks and milk generate including whole milk, cream and butter are as well good sources. Provitamin A in the form of beta carotene is found mainly in yellow and orange-coloured fruits and vegetables such as carrots, papaya and leafy green vegetables.

Drinking too much alcohol, vitamin E deficiency, extreme iron intake and cortisone drug can reduce absorption of this fat soluble vitamin.

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Healthy Eating for Lower Stress

American Country Breakfast served around Thank...

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Our daily diet is more than just a source of nutrition. It can trigger memories, bringing forth nostalgic feelings that had been all but forgotten.

It can be comforting or exciting and the difference it can make on one’s day is impressive. But even with everything else food can be, it is still a means to an end. Food is the fuel that drives the body to keep going and just as machinery needs different categories of fluids to keep things running smoothly, the body requires various categories as well.

What Stress Does to the Body

There are good stresses and bad stresses constantly assaulting the body. Avoiding stress is an improbable venture, and one that would not be good to attempt. The body needs stress to function; it is designed to react to stress automatically. Almost no voluntary thought is needed when the body responds to a stressful condition. Muscles tense, hormones are released, the pulse quickens, adrenaline is generated, and blood pressure and heart rate are elevated involuntarily. It is a organic process that serves to prepare the body for the condition that caused it.

The Harmful Side of Stress

When harmful stresses are exerted on the body for expanded periods of time it becomes a chronic condition that the body reacts to negatively. Since the organic reaction for stress is for the body to be ready to react, a constant stress will have the body in a continuous condition of nervousness. Blood pressure and heart rates stay elevated for expanded periods of time rising the chance for either stroke or heart attack. The digestive system is slowed which may cause diarrhea or heartburn. The body is not made to be under constant attack and it cannot function properly in that surroundings.

Why is food so essential?

Food is one of the few constants in any person’s life. Food, air and water are the three basics that are needed to sustain life, so it makes sense to diligently select the ways in which we get those basic needs. Clean air and water is the preferred method of choice for two of the needs but with food the story is different. Taste buds can fool almost anyone into choosing an unhealthy dish over the healthy one. For those with a penchant for sweets, a piece of cake would be more satisfying to the palate than an apple, even though the apple contains the sugar the body needs for energy it does not comfort the mind the way that piece of cake will. That is because food is not simply sustaining the physical body it is sustaining the psychological body as well. food is cultural, regional, and familial and its preparation and presentation is as much a part of its importance as the real nutritional value is. in any case, it is to the mind.

Make Healthy alternatives

A lifetime of bad habits regarding food can be changed. It begins with a decision, the decision to begin now to alter those habits and give the body what it wants and needs to function properly.

  • limit caffeine –High levels of caffeine can increase irritability and nervousness and can raise the amount of stomach acid being generated.
  • reduce sugar – Sugar that has been added to food is frequently processed in a factory and does not contain the required nutrients such as nutrients that the body needs.
  • increase fiber – Fiber slows the absorption of fat in the body and cleans the digestive system. Avocados, sunflower seeds, and chick peas are a few of the foods that are rich in fiber.
  • eat breakfast – A healthy breakfast that is low in fat and high in fiber will keep hunger at bay and provide energy throughout the morning.

Always Remember That food is Controllable

There are many things in life that are circumstantial and cannot be controlled but food is not one of them. Each person has the final say in what goes inside their mouth. That little bit of knowledge alone may be sufficient to combat some of the stress that plagues the population on a daily basis. The body never goes on break, giving it what it needs to run effectively is an easy way to lighten its load. A well oiled, properly tuned machine will last longer than a abused and neglected one will.

Sources:, *”Fiber list” (accessed May 25, 2010), *”Fiber” (accessed May 30, 2010), *”Stress” (accessed June 1, 2010)

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Health Benefits of Grapes

Wine grapes.

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Grapes have been eaten since the pre-historic era and were cultivated far back in 5000 B.C.E. In the ancient Roman and Greek civilizations, the fruit was worshipped for its use in wine making.

Nutritional Highlights of Grapes

Grapes are endowed with innumerable vital nutrients and powerful anti-oxidants, that forestall the event of several deadly ailment and proffer remarkable benefits in the treatment of a host of disorders.

  • Grapes are loaded with flavanoids, which are wonderful anti-oxidants. The darker the color of the grape, the higher is the concentration of flavanoids in it.
  • They are rich in resveratrol, a compound which is a potent anti-oxidant, and is being touted as an anti-aging agent.
  • Grapes as well supply lots of thiamine, riboflavin, vitamin C, vitamin B6, and potassium.

Health Benefits of Grapes

Grapes provide nutritional benefits similar to a lot of berries. However, their nutritional quality can be augmented by eating the seeds, which are found in some varieties. The following are the exceptional benefits provided by grapes :

  • Prevent atherosclerosis: The flavanoids present in grapes are actually strong and forceful anti-oxidants, and have the capacity to reverse atherosclerosis and its debigating effects. Atherosclerosis is the build up of plaque within the arterial walls, leading to constriction of the arteries, subsequent increase in blood pressure and a range of lethal cardiac disorders.Grapes protect against vascular damage, oxidative damage, they prevent platelets from aggregating together, thus, putting a stop to the formation of clots, which could be potentially hazardous, and reduces the plaque and cholesterol build up in the arteries.
  • Exert powerful anti-cancer effects: Studies show that flavanoids and resveratrol, offer significant protection from cancer and avert its development. These anti-oxidants are powerful free radical scavengers and battleers, that stave off DNA damage.
  • Boost immunity: Resveratrol boosts the immune system functioning and defense mechanisms of the body. It increases the body’s resilience to surroundingsal stressors, adverse weather and checks bacterial / viral infections.
  • Treat varicose veins: Grape seeds additionalcts, packed with flavanoids, have been used extensively to treat varicose veins. These additionalcts manage the varicosity of the blood vessel, prevent inflammatory conditions and handle most venous disorders successfully.

Quick Serve concepts for Grapes

Grapes, when bought, should be plump, firm and wrinkle free. It is advisable to wash grapes with a solution of additive free soap to get rid of all pesticide and insecticide residues.

  • Salads : grapes make wonderful additions to fruits salads, green salads and juices.
  • Curries and stewed vegetables : can be given an added punch and fruity flavor, by including fresh grapes in the recipe.
  • Stewed grapes can be served with podiscomfortd chicken breast as a light and wholesome dish.

Reference :

Am J Cardiol, Miyagi, Y., K. Miwa and H. Inoue, Inhibition of Human Low Density Lipoprotein Oxidation by Flavanoids in Red Wine and Grape Juice, 1997.

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Chocolate Milk Refuels Muscles After Workout

A glass of chocolate milk.

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Fat-free chocolate milk beat out carbohydrate sports drinks at helping to rebuild and refuel muscles after exercise, researchers report.
The combination of carbohydrates and protein in low-fat chocolate milk appears to be “just right” for refueling weary muscles, says William Lunn, PhD, an exercise scientist at the University of Connecticut.

“It’s not just a dessert item, but it’s very healthy, especially for endurance athletes,” Lunn tells WebMD.

The research involved eight male runners in good physical shape who ate a balanced diet for two weeks. At the end of each week, they took a fast paced, 45-minute run.

Following each run, the men drank either 16 ounces of fat-free chocolate milk or 16 ounces of a carbohydrate-only sports beverage with the same number of calories.

Post-exercise muscle biopsies showed increased skeletal muscle protein synthesis — a sign that muscles were better able to rebuild — after the milk drink, compared with the carb-only beverage.

Additionally, drinking fat-free chocolate milk led to a higher concentration of glycogen, or muscle fuel, in muscles 30 and 60 minutes after exercise, compared with the sports drink. Replenishing glycogen after exercise helps future performance, Lunn says.

The findings were presented at the American College of Sports Medicine conference in Baltimore this week.

While only men were studied, one would expect women to gain the same post-workout benefits from chocolate milk, he says.

While the studies were small, there’s no reason not to reach for fat-free chocolate milk after your next workout, says sports nutritionist Nancy Clark, MS, RD, of Healthworks Fitness Center in Chestnut Hill, Mass.

“Athletes can consider it an inexpensive nutritional alternative to engineered sports beverages for help with post-workout recovery,” she tells WebMD.

The studies were supported by a grant from the National Dairy Council and National Fluid Milk Processor Promotion Board.

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the “peer review” process, in which outside experts scrutinize the data prior to publication in a medical journal.

SOURCES: American College of Sports Medicine’s 57th Annual Meeting, Baltimore, June 1-5, 2010.

William Lunn, PhD, associate professor of exercise science, University of Connecticut.

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The benefits of Dietary Fiber

Cereals in a pot

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Foods rich with fiber contains various components such as – cellulose, insoluble fiber, soluble fiber, lignans, inositol and fructo-oligosaccharides. These elements, all have an essential part to play in sustaining optimum health.

The Physiological benefits of  Fiber

Experts say, a 30 gram intake of foodary fiber, per day, is sufficient to stave off various ailment and encourage good health. The following are the major effects of foodary fiber :

  • Increased Stool Weight and Decreased Intestinal Transit Time:
    The insoluble fiber helps add weight / bulk to the stools, as a result of its water holding properties. Consequently, stool weight increases. A bulkier stool passes easily through the colon, and is effortlessly expelled out of the rectum. What’s more, it requires lesser straining, during the process of evacuation. A high fiber food checks the event of hemorrhoids (or piles), and varicose veins, closely linked to straining at stool. Most essentially, a larger stool diminishes the transit time in the gut. Feces pass smoothly and quickly out of the colon. The longer the stools remain in the colon, the longer is the individual exposed to cancer causing compounds present in the intestine.
  • Recovers digestion:
    High fiber make sures that the food that is consumed, is released gradually from the stomach, into the intestine. (Fiber speeds up the passage from the intestine to the rectum.) This make sures that the blood sugar level rises gradually and no spiking occurs. as well, recoverd digestion guarantees better absorption and assimilation of the very essential nutrients. additionally, the secretion and activity f pancreatic enzymes recovers in the presence of fiber.
  • Lipid Metabolism:
    Water soluble fiber is able to lower the blood cholesterol level and serum triglyceride level significantly, by augmenting their fecal excretion, and as well preventing their synthesis by the liver. Thus, lowered cholesterol levels keep cardiovascular ailment and diabetes at bay.
  • Helps in the Management of Obesity:
    A food that is lacking in fiber is an essential and key cause for gaining weight and obesity. Fiber helps shed superfluous weight by – inducing satiety, enhancing blood sugar control, rising purging of wastes from the bowels, and greatly slowing down the eating process.
  • Maintains a Suitable Intestinal Flora:
    A high fiber intake promotes a healthy balance between the harmful bacteria and the beneficial bacteria in the colon. High fiber increases the production of short chain fatty acids, which decrease the colon’s pH, thus creating a hospitable surroundings for the friendly bacteria.

Best Sources of Fiber

Wheat bran, oat bran, whole cereals, legumes, guar gum, fruits, sea weeds, flax seeds, and vegetables are noteworthy sources of fiber. Stepping up the daily intake of these foods will yield significant and far-reaching health benefits.

Dietary fiber in supplements

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Reference :

Curr Pharm Des, Andoh, A.,T. Tsujikawa, and Y. Fujiyama, Role of foodary Fiber and Short Chain Fatty Acids in the Colon, 2003

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Exercise Recommended for Cancer Patients

New Guidelines Call for Physical Activity Before, During, and After Treatment

Though cancer patients have long been told to take it easy, they can – and should – be as physically active as possible before and during treatment, according to new guidelines from the American College of Sports Medicine (ACSM).

“We have to get past the idea that exercise is harmful for cancer patients,” says Kathryn Schmitz, PhD, MPH, lead author of the guidelines and associate professor of epidemiology and biostatistics at Abramson Cancer Center of the University of Pennsylvania School of Medicine.

Physical activity brings many benefits, including improved aerobic fitness and strength, decreased fatigue, better quality of life, and improved body image, Schmitz tells WebMD.

No one is saying you should go out and run a marathon during chemotherapy. “You know your own body, do what’s comfortable,” she says.
Many cancer patients who stop being physically active during treatment and early recovery never start up again, says Jennifer Ligibel, MD, of  Dana-Farber Cancer Institute in Boston.

“If we can prevent cancer patients from decreasing physical activity in the first place, we can stop them from going down that slippery slope,” she tells WebMD.

Ligibel led a discussion on the guidelines here at the annual meeting of the American Society of Clinical Oncology.

Moderate Activity Is Recommended

The 13-person ACSM panel came up with the exercise recommendations after reviewing published studies looking at the safety and effectiveness of physical activity during and after cancer therapy. The panel focused on breast, prostate, hematologic, colon, and gynecologic cancers.

In general, the same 30 minutes a day, five days a week, of moderate-paced activity such as walking recommended for the general population is beneficial for cancer patients, even during treatment, according to the guidelines.

But it’s not a one-size-fits-all prescription, and regimens should be
tailored to individuals, taking into account their overall fitness, diagnoses, and other factors that could affect safety, the panel recommends.

For example, people with stomach or other gastrointestinal cancer as well those whose cancers have to spread to the bone may be advised to avoid heavy weight training.

People with compromised immune systems may want to avoid exercising in public gyms.

If you have loss of sensation, or feelings of pins and needles, in your hands and feet – a condition called peripheral neuropathy that’s a common side effect of many cancer treatments – a stationary bike may be preferable to weight-bearing exercise, the panel says.

Yoga generally appears safe, Schmitz says. As for Pilates, there was no
published evidence for the panel to review, so a recommendation could not be made.

Women with breast cancer can do upper body training, “but it should be done very slowly, which is not how many people approach it,” Ligibel says.

In general, cancer patients do not need any formal testing, such as stress testing, prior to starting a moderate-intensity exercise program, she says. But patients should check with their doctors.

People with heart conditions, whether related to their cancer or not, as well as those who are morbidly obese, may require additional supervision and exercise modifications, the guidelines state.

“The important thing,” Schmitz says, “is to avoid inactivity.”

American College of Sports Medicine’s 57th Annual Meeting, Baltimore, June 1-5, 2010.
American Society of Clinical Oncology Annual Meeting 2010, Chicago, June 4-8, 2010.

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Links between Birth Defects and Valproic Acid

Pregnancy in the 26th week.

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6 Birth Defects More Common in Pregnant Women Who Take Epilepsy Drug

Women with epilepsy who take valproic acid during the first trimester of pregnancy are more likely to have children with birth defects than women who took other epilepsy drugs or no medicine to control their seizures during pregnancy.

The findings appear in the June 10 issue of the New England Journal of

Valproic acid is also used to treat other illnesses, including bipolar disorder and migraines. Brand names include Depakote, Depakene, Depacon, and Stavzor.

Almost 3 million people in the U.S. have some form of epilepsy, according to
the Epilepsy Foundation.

“Our findings provide further support for the recommendation of the American Academy of Neurology to avoid the use of valproic acid, if possible, in pregnant women,” conclude the researchers, who were led by Janneke Jentink, MSc, of the University of Groningen in Groningen, Netherlands. “Since switching drugs during or just before pregnancy is difficult, the risks associated with valproic acid use should be routinely considered in choosing therapy for women with childbearing potential.”

The researchers reviewed data from eight studies that highlighted 14 birth
defects that were more common among offspring of women who took this epilepsy
drug during the first trimester. Next, they identified infants with these 14
birth defects from the European Surveillance of Congenital Anomalies (EUROCAT) antiepileptic-study database, and compared them to a group of infants with birth defects not previously connected to use of this drug and to a group of infants with chromosomal abnormalities.

6 Birth Defects Linked to Valproic Acid

The researchers found that six birth defects were more common among children of women who took valproic acid during first trimester than children of women who did not take antiseizure drugs:

  1. Spina bifida
  2. Atrial septal defect (a hole in the heart)
  3. Cleft palate
  4. Hypospadias (an abnormality in the opening of the urethra in boys)
  5. Polydactyly (extra fingers or toes)
  6. Craniosynostosis (one or more sutures on a baby’s skull close prematurely)

When compared with other epilepsy drugs, valproic acid increased the risk for all of these birth defects except craniosynostosis, the study showed. It also showed an increased risk of ventricular septal defect (a hole in the heart) when compared to other epilepsy drugs.

“These findings support a relationship of these malformations with valproic
acid specifically rather than to antiepileptic drugs generally or to underlying
epilepsy,” the researchers write. The use of this drug is not considered a
marker for more severe epilepsy, but information on the type or severity of
epilepsy was not available. The new study also did not include information on
the doses of valproic acid that women used during pregnancy.

“It’s a phenomenal drug for seizures and bipolar illness, but I won’t use it
during pregnancy if I can help it,” says Catherine Birndorf, MD, a reproductive psychiatrist in New York City and the founding director of the Payne Whitney Women’s Program at The New York Presbyterian Hospital-Weill Cornell Medical Center in New York. Birndorf typically counsels women who take this drug to treat bipolar disorder, not epilepsy.

It all comes down to a woman’s personal risk and benefit profile, she says. “The risk of untreated illnesses are great to both the woman and fetuses, and
sometimes taking this medication may be the best choice,” she says. “You need to look at it on a case-by-case basis, and look at reasonable alternatives.
Sometimes there are no other choices because to stay well, you must be on this specific medication at high doses.”

“If you are on [valproic acid] and it’s working well, don’t do anything rash
like going off your medication,” she says. “Go to your doctor and figure out if
there are safer alternatives for treating your seizure or bipolar disorder
during pregnancy.”

Ideally this conversation should take place before you become pregnant. “Once you are pregnant, it’s a different can of worms,” she says.

Counseling Women Before Pregnancy

“The study provides further verification of our concerns of valproic acid
standing out as high risk for birth defects during pregnancy and [conferring a]
higher risk than other medications we can choose to prescribe for treatment of epilepsy, migraine, and bipolar disorder during pregnancy,” says Page B.
Pennell, MD, a neurologist and the director of research in the division of
epilepsy at Brigham and Women’s Hospital in Boston, and the chairwoman of the professional advisory board for the Epilepsy Foundation.

The study also provides information on the specific birth defects that are
increased in the offspring of women with epilepsy who took the drug during their first trimester, she says.

“It is necessary to discuss these risks with women prior to pregnancy,” she
tells WebMD. “I tell all my patients to try and switch to a safer medication
because these birth defects can have a huge impact on a child’s life.”

“It is prudent and necessary for us to try and find another medication to
control epilepsy or bipolar disorder among women of childbearing age,” she says.
“There are several medications that we can choose from, and almost any other medication will be a safer option for the developing fetus.”

The good news is that more than 90% of women with epilepsy will have normal, healthy infants, according to the Epilepsy Foundation.

Fully half of all pregnancies are unplanned, Pennell says. This conversation
needs to take place as soon as a woman hits puberty and continue through all of her childbearing years.

Depakote Manufacturer Responds

Depakote is manufactured by The Abbott Laboratories in Abbott Park, Ill.

“The risk of birth defects associated with valproic acid is well known and
clearly stated in Depakote’s medication labeling,” says Abbott spokeswoman DeAnna DuBose.

“Because both the seizures themselves and the medications used to treat those seizures pose risks, it is crucial that women who are pregnant or may become pregnant work extensively with their physicians to balance the importance of seizure control with any potential effects of epilepsy therapy,” she says.

Epilepsy Foundation web site.
Catherine Birndorf, MD,founding director, Payne Whitney Women’s Program, The New
York Presbyterian Hospital-Weill Cornell Medical Center, New York.
Page B. Pennell, MD, director of research, division of epilepsy, Brigham and
Women’s Hospital, Boston; chair, professional advisory board, the Epilepsy
DeAnna DuBose, spokeswoman, Abbott Laboratories, Abbott Park, Ill.
Jentink, J. New England Journal of Medicine, 2010; vol 362: pp 2185-2193.
© 2010 WebMD, LLC. All rights reserved.

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Genes May Play a Role in Vitamin D Deficiency

Study Shows 4 Gene Variants May Indicate Risk of Having Low Levels of Vitamin D

Having too little vitamin D may not be due solely to diet orlack of sunlight, but may be due to your genes.

An international consortium of researchers and doctors has identified four gene variants that may play a role in vitamin D deficiency, a condition which may affect up to half of all healthy adults in the developed world. It can contribute to poor musculoskeletal health as well as potentially increase the risk of diabetes, cardiovascular disease, and certain types of common cancers.

Knowing who carries the gene variants could help doctors identify who is at risk for vitamin D deficiency and could potentially help reduce the risk of low vitamin D before the problem advances.

Researchers in the SUNLIGHT Consortium (Study of Underlying Genetic Determinants of Vitamin D and Highly Related Traits) analyzed data from 15 epidemiologic groups that included nearly 34,000 whites of European ancestry.

The team looked at vitamin D concentration levels in the blood as well as genetics. Vitamin D insufficiency was defined as concentrations lower than 75 nmol/L (nanomoles per liter) or 50 nmol/L.

Three common gene variants — including those involved with cholesterol, vitamin D metabolism, and transporting vitamin D throughout the body — were associated with vitamin D deficiencies. The researchers found that the more of these variants an individual had, the greater the risk of having low vitamin D levels.

In fact, individuals who had inherited several of the gene variants and who fell in the highest quartile in the group had a two-and-a-half times increased risk of having a blood vitamin D concentration that was lower than 75 nmol/L when compared with those in the lowest quartile, who had fewer of these gene variants and were at a lower risk.

The findings will be published in The Lancet and were released online early.

Rethinking Treatment Strategy

The researchers say the results may make doctors rethink treatment strategies for improving patients’ vitamin D deficiencies. However, they note that they only studied white populations, so it is unclear if these gene variants would be identified in other racial/ethnic groups.

“It’s possible that these results could explain why some people respond well to vitamin D supplements and others don’t, but that needs to be studied further since we didn’t specifically examine response to supplementation,” said Thomas Wang, MD, a consortium member and cardiologist at Massachusetts General Hospital in Boston, who co-authored the report. “We also need to investigate how genetic background can modify response to sunlight, whether these associations are seen in other populations, and if these gene variants have an impact in the chronic diseases that appear to be associated with vitamin D deficiency.”

In an accompanying editorial published in The Lancet, Roger Bouillon, MD, from the Katholieke Universiteit in Leuven, Belgium, writes: “Today’s results only partly explain the wide variability of vitamin D status, and whether these genetically based variations modify the health outcomes in vitamin D deficiency is not known. Therefore the battle against vitamin D deficiency will probably not be modified by these new findings. We need additional studies to explain the mechanisms underlying the pandemic of vitamin D deficiency and, above all, we need a strategy to correct this serious worldwide deficiency.”

Vitamin D is essential for calcium absorption and bone health; it helps regulate immune function, among other roles. Vitamin D is naturally produced in the skin when you are outside exposed to ultraviolet light from the sun.

Foods that naturally contain vitamin D include fish (particularly salmon and tuna) shrimp, and eggs. Many foods are now fortified with vitamin D, including milk and other dairy products, to boost overall vitamin D intake. Taking a dietary supplement containing vitamin D is also a common way to maintain sufficient vitamin D levels.


Wang, T. The Lancet, published online.
News release, The Lancet.
News release, Massachusetts General Hospital.
National Institutes of Health.

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