Archive for the ‘General Health findings’ Category

Claims That Don’t Hold Water

Friday, November 16th, 2012

You may be surprised to know that you don’t need to drink eight glasses of water a day to prevent dehydration and stay healthy.

Don’t schools and countless experts advise it? What about those people chugging from water bottles all day long? It’s still a myth, and no one really knows where it came from originally. Today this claim is often made by (no surprise) the bottled water industry.

The notion that we don’t drink enough water — that is, at least eight glasses a day — is not only nonsense, but is “thoroughly debunked nonsense,” according to an editorial in the British journal BMJ.

Here are some other water myths. Drinking lots of water does not improve kidney function or help kidneys eliminate toxins — let alone improve overall health. It won’t bathe your organs in extra fluid and thus improve their function. Don’t expect it to lower blood pressure, boost concentration in kids, improve skin tone, or prevent headaches, despite the claims.

Yes, water is a great drink. If it comes from the tap, it’s cheap and environmentally friendly. And yes, it may help you control your weight if it replaces caloric beverages. But that doesn’t mean water promotes weight loss.

How much to drink? If you’re healthy and not exercising or working hard in the heat, thirst is your best guide. Most fruits and vegetables are about 90 percent water. Other beverages also provide fluid, as do soups and stews. Coffee and tea supply water, too; it’s a fallacy that they cause a net water loss.

Older people do need to try to drink more water — older bodies cope less well with heat, and thirst may be a less reliable indicator. People with recurring kidney stones may also benefit from drinking more water.

The article above is from Berkeley Wellness Alerts

Beer and Bone Health

Friday, November 9th, 2012

Hey Guys, Drink a Beer to Bone Health

Memo to all the guys out there (and the women who love you): Quit walking to the kitchen every time those bone-health commercials come on. (Sally Fields, we love you. Really, we do.) All the talk about osteoporosis is not for women only.

Twelve million men have bones that are getting thinner and more brittle each day. (Is there a fracture in your future?) We’ve got some irresistible ways to keep yours safe, strong, and young.

How about a beer? Ah, now you’re paying attention! The bone-saving secret in brewskis is silicon, a chemical that stimulates collagen production. What’s collagen? A protein that makes your bones denser and your joints more flexible. Brews with the most hops and malted barley are the richest in silicon. (Here’s another surprising drink for better bones.) Not big on beer? Bananas and brown rice also are silicon-packed.

Anyone for Chinese food? Great! Many dishes (nonfried, please!) are full of broccoli, bok choy, and edamame (soybeans), which means they’re bursting with bone-strengthening calcium. But go easy on the soy sauce; salt flushes out calcium. (Beyond calcium: Learn what else your bones need.)

Buff up those biceps. Weight-bearing exercises like push-ups, hiking, and carrying your sweetie’s groceries toughen bones as well as muscles.

Munch zinc-rich dark chocolate, peanuts, or walnuts, and take your vitamins. Men with osteoporosis are often low in zinc, which is used in the bone-building process. If you don’t eat these zinc-rich foods, consider a 15 milligram zinc supplement. Add a bone-strengthening combo supplement with 600 milligrams of calcium, 1,000 international units of vitamin D3, and 200 to 300 milligrams of magnesium. We take one daily.

This is an article from “RealAge”. Hope this helps!!

HAPPY INVESTMENTS

Monday, October 29th, 2012

Does money make people happier? Less than you may think. Here are 6 tips from experts on the science of happiness.
The wealthy are happier than the poor, studies have found, and wealthy countries are happier than poor ones–but only a little, on average.
That’s surprising, since money helps us live healthier, longer lives, allows us more time to spend with family and friends, and gives us more control over our lives–all key ingredients for happiness.
If that’s the case, why doesn’t money buy more happiness? “Because people don’t spend it right,” according to a recent paper in the Journal of Consumer Psychology.
The authors, who are professors of psychology and experts on the science of happiness, offer principles to help people spend money in ways that are likely to increase their happiness, including these:
1. Buy more experiences and fewer material goods. That is, spend on leisure activities–vacations, adult-education classes, concert tickets–instead of on more stuff. Experiences stay with you, but we adapt to possessions quickly so their pleasure wears off.
2. Spend money on others. Giving money or gifts strengthens social bonds (which amplify happiness) and activates brain areas associated with receiving rewards.
3. Buy many small pleasures rather than one large one, especially if money is limited. The buzz from even a big purchase wears off relatively quickly.
4. Delay consumption, prolong anticipation. Looking forward to an event is a great source of pleasure, even if the event ends up being a letdown.
5. Consider how purchases will affect your day-to-day life. Happiness is often shaped by the “uplifts” of daily life, and unhappiness by the hassles, more than by major life events.
6. Pay close attention to the happiness of others. Research suggests that the best way to predict how much you’ll derive pleasure from something is to see how much others have enjoyed it.

Excerpt from Berkeley Wellness Alerts

NUTS ABOUT PEANUTS

Wednesday, August 1st, 2012

Peanuts are the most frequently consumed “nut” in the U.S., even though technically they are not nuts. In some ways, peanuts are even better for you than true nuts.

Unlike “tree nuts” (almonds, cashews, pecans, pistachios, walnuts, among others), peanuts grow on the ground and belong to the legume family (which includes beans, lentils, and peas). They are typically grouped with tree nuts because they have many physical and nutritional attributes in common.

What’s in a peanut?

Plenty of good things for your heart, including B vitamins (notably folate), vitamin E, magnesium, iron, copper, potassium, and fiber, along with an array of phytochemicals, such as arginine (which helps relax blood vessels and lower blood pressure), phytosterols (which lower cholesterol), and phenols (antioxidants).

Peanuts are the only “nuts” that have resveratrol, an antioxidant found in grapes, wine, and soy that may be heart-healthy and have other benefits. Peanuts also have more protein than any tree nut–ounce for ounce, as much as poultry, fish, or meat. It’s true they are high in fat and thus calories (160 per ounce), but as with all nuts, most of the fat is heart-healthy unsaturated fat.

Goober research

Studies have shown that all kinds of nuts have beneficial effects on blood fats, inflammation, blood vessel function, and overall heart disease risk. Few have looked at peanuts alone, but a study in the Journal of the American College of Nutrition found lower triglyceride levels in people eating peanuts. And in a study in the journal Lipids, women had lower cholesterol when they consumed peanuts (one to two ounces a day for six months) in place of other fats and some meat. Moreover, peanuts have been linked with reduced oxidation of LDL cholesterol (oxidation makes this “bad” cholesterol even more damaging to arteries) and lower insulin levels.

People who regularly eat nuts, including peanuts, tend to be healthier, in general. And they tend to weigh less (or at least don’t weigh more) than people who don’t eat them. Like all nuts, peanuts are filling because of their protein and fiber.

Smooth or crunchy?

Peanut butter has the same nutritional benefits as peanuts. In the Nurses’ Health Study, women who reported eating a tablespoon of peanut butter at least five times a week had a lower risk of cardiovascular disease, compared to those not eating it.

But check the ingredients: most peanut butters have added salt and sugar. And some contain added partially hydrogenated oil, a source of unhealthful trans fat, though the amounts are very small. Natural peanut butters tend to be nothing but ground peanuts.

Bottom line: Unless you are allergic, there’s good reason to enjoy a handful (an ounce or so) of nuts most days, with peanuts as one variety. Eat them in place of other foods, particularly snacks that are high in calories and low in nutrients.

7 Worst Foods for Tooth Enamel Loss

Monday, June 11th, 2012

Tooth enamel is the hardest substance in your body, but some foods may be stronger.

Soft Drinks

Guess what? Sugar isn’t the biggest culprit when it comes to a fizzy drink’s impact on teeth. These beverages — diet or not — strip minerals from tooth enamel because of their high acid content. We’re talking corrosive acids like phosphoric, malic, citric, and tartaric. And the flavor of the fizz matters. They all have an impact, but in a study, clear, citrus-flavored bubbly beverages dissolved enamel two to five times more than colas did.
Sports Drinks

Hydration during exercise is important, but reconsider guzzling sports drinks unless you’re a true endurance athlete. In a study comparing the erosive effects of five different beverages — including juice and soda — sports drinks did the most harm. Their high concentration of strong acids produced the deepest enamel damage in teeth.

Energy Drinks

Need a liquid pick-me-up? Skip this tooth stripper. In the study comparing five beverages, energy drinks were second worst after sports drinks — mainly because they had little ability to buffer the acids in the beverage. And drinks like these are an especially bad idea for adolescents and young adults, whose tooth enamel is less mature and more porous

Fruit Juices

Fruit juices, especially citrus, apple, and berry varieties, are loaded with the kinds of acids that wear down tooth enamel. Of course, juices also have some great-for-you qualities, too — like vitamins and antioxidants. So don’t write them off completely. Just drink them in moderation. Frequent fruit juice consumption has been linked to an increased risk of enamel erosion. As an extra measure, rinse afterward. And choose calcium-fortified juices that may pose less of a hazard to tooth enamel.

Fruit

Ever seen someone suck on a slice of lemon or lime? Here’s why that’s a bad idea: fruits from the citrus family — including oranges, lemons, and limes — contain enamel-damaging acids. Berries do, too. Still, you don’t want to ditch fruit and all the RealAge benefits they confer. Just eat fruit with a meal to help minimize acid effects.

Sour Candy

Can’t resist those SweeTarts and Sour Patch Kids? Try. In a study comparing regular chewy candy, hard candy, and licorice to their sour counterparts, sour varieties were significantly harder on tooth enamel. Candy manufacturers add more acids — or different kinds of acid — to sour candy varieties to give them that pucker factor. And it’s those “tangy” acids that can create deep craters in your tooth enamel.

Vinegar

Vinegar turns up in lots of places — salad dressings, sauces, potato chips, pickles. And each one could spell trouble for tooth enamel. In a study, teenagers who frequently consumed vinegar-containing foods had a 30%–85% increased risk of enamel erosion compared with teens who didn’t consume those foods. Teens are more vulnerable to erosion because of less mature tooth enamel. But it’s a good idea for people to be aware of the potential impact that vinegar can have. Vinegar is a low-fat way to add flavor, but rinse afterward to protect your teeth

Smile-Saving Habits

You can’t always avoid enamel-eroding foods, so use these tips to minimize acid wear:
1. Avoid snacking in between meals to minimize acid attacks.
2. Don’t swish or hold acidic beverages in your mouth. Sip them through a straw to reduce the amount of time the acids come into contact with your teeth.
3. Rinse your mouth with water or chew sugarless gum after meals to help neutralize acid attacks.
4. Consume high-calcium milk or cheese before or with meals to help reharden enamel. Eating foods high in iron, such as liver or broccoli, may help as well.
5. If you do consume acidic foods or beverages, wait at least 30 minutes before brushing. This gives softened enamel a chance to reharden, so it’s less prone to damage.
6. Brush with fluoride toothpaste to help fortify enamel.
7. See your dentist for regular checkups and scheduled cleanings to help prevent tooth decay.
Healthy tooth enamel means healthy teeth. And enamel damage is irreversible. So take the time to protect those pearly whites.

Excerpt from RealAge.com

The Rundown on Warm-Ups and Cool-Downs

Wednesday, May 16th, 2012

For years coaches and sports medicine experts counseled athletes, professional and weekend types alike, to warm up before exercising and cool down afterwards. Is that good advice–or not?

The rationale was that warming up with calisthenics, brisk walking, or other activity helps ease the body into a strenuous workout and may reduce injuries. Cooling down is supposed to gradually reduce your heart rate and return your body to a state of rest, thus lowering the risk of soreness and even heart attacks. Or so the exercise physiology textbooks taught for decades.

The problem is, there’s little solid research backing up this advice, and much of what’s out there is conflicting. In terms of stretching, which many people include in their pre-exercise routines (though it’s technically not a warm-up, since it doesn’t raise heart rate much), most studies have found that it does not protect against exercise-induced injuries.

Cool on warm-ups

A review in the journal Sports Medicine tried to make sense of 25 years of research on the effect of warming up on the risk of injuries. The authors concluded that overall the weight of evidence suggests that a “warm-up and stretching protocol should be implemented prior to physical activity.” However, they acknowledged that studies’ conclusions were all over the map, and called for more research.

Most of the studies have been small and focused on certain types of athletes, age groups, and just men or women. What helps a 25-year-old female triathlete, for example, may not help a 75-year-old man who cycles two or three times a week.

Research has also been inconsistent on the effect of warm-ups on performance. An Australian study in the European Journal of Applied Physiology, for instance, found that warm-ups that included some static stretching actually decreased muscle power among young people doing vertical jumps. But an analysis in the Journal of Strength and Conditioning Research found that warm-ups improved performance.

Lukewarm about cool-downs

Good studies on the potential benefits of cooling down are even more scarce. While it feels right and sensible to gradually diminish the intensity of your workout, there hasn’t been much research showing benefits. Still, the American College of Sports Medicine (ACSM) recommends cooling down because it lowers heart and breathing rates and helps prevent pooling of blood in the legs, which can cause light-headedness and fainting. In particular, ACSM advises people taking medication for hypertension to cool down, since some of these drugs can cause blood pressure to drop even lower following an abrupt end to vigorous exercise.
Bottom line: Regular exercise has many proven health benefits; warming up and cooling down do not. Still, if you enjoy doing them and they feel good, there’s little or no downside. In fact, many people find they get a psychological, if not physical, boost from easing into and out of vigorous exercise, and who can argue with that?

Top 10 Foods For A Good Night’s Sleep

Monday, April 30th, 2012

The secret to getting a solid 7 to 8 hours? About 90 minutes before you want to nod off, head for the kitchen and make yourself a sleepy-time snack. Keep it light (around 200 calories), so you don’t overload your digestive system. And include one or two foods from the list below. All help to relax tense muscles, quiet buzzing minds, and/or get calming, sleep-inducing hormones — serotonin and melatonin — flowing. Yawning yet?
1. Bananas — They’re practically a sleeping pill in a peel. In addition to a bit of soothing melatonin and serotonin, bananas contain magnesium, a muscle relaxant.
2. Chamomile tea — Chamomile is a staple of bedtime tea blends because of its mild sedating effect, which makes it the perfect natural antidote for restless minds and bodies.
3. Warm milk — It’s not a myth. Milk has some tryptophan, an amino acid that has a sedative-like effect, and calcium, which helps the brain use tryptophan. Plus, there’s the psychological throwback to infancy, when a warm bottle meant “relax, everything’s fine.”
4. Honey — Drizzle a little in your warm milk or herb tea. Lots of sugar is stimulating, but a little glucose tells your brain to turn off orexin, a recently discovered neurotransmitter that’s linked to alertness.
5. Potatoes — A small baked spud won’t overwhelm your gastrointestinal tract as it clears away acids that can interfere with yawn-inducing tryptophan. To up the soothing effect, mash the potato with warm milk.
6. Oatmeal — Oats are a rich source of sleep-inviting melatonin, and a small bowl of warm cereal with a splash of maple syrup is cozy — and if you’ve got the munchies, it’s filling, too.
7. Almonds — A handful of these heart-healthy nuts can send you snoozing because they contain both tryptophan and a nice dose of muscle-relaxing magnesium.
8. Flaxseeds — When life goes awry, and feeling down is keeping you up, try sprinkling 2 tablespoons of these healthy little seeds on your bedtime oatmeal. They’re rich in omega-3 fatty acids, a natural mood lifter.
9. Whole-wheat bread — A slice of toast with your tea and honey will release insulin, which helps tryptophan get to your brain, where it’s converted to serotonin and quietly murmurs “time to sleep.”
10. Turkey — It’s the best-known source of tryptophan, credited with all those Thanksgiving naps. But that’s actually modern folklore. Tryptophan works when your stomach’s basically empty rather than overstuffed and when there are some carbs around rather than tons of protein. But put a lean slice or two on some whole-wheat bread midevening and you’ve got one of the best sleep-inducers in your kitchen.
Article from RealAge.com

Omega-3 Rich Fish

Monday, April 23rd, 2012

Omega-3 fatty acids lower your risk of heart disease mainly by lowering triglycerides and countering inflammation.

You can find these fats in a variety of sources, including spinach, mustard greens, wheat germ, walnuts, flaxseed (and flaxseed oil), soybean and canola oil, and even pumpkin seeds. But the very best source is fish.

Not all fish are created equal, however. This handy chart will help you choose fish with the highest omega-3 content.
Type of fish

Total omega-3 content per 3.5 ounces (grams)
Mackerel

2.6
Trout, lake

2.0
Herring

1.7
Tuna, bluefin

1.6
Salmon

1.5
Sardines, canned

1.5
Sturgeon, Atlantic

1.5
Tuna, albacore

1.5
Whitefish, lake

1.5
Anchovies

1.4
Bluefish

1.2
Bass, striped

0.8
Trout, brook

0.6
Trout, rainbow

0.6
Halibut, Pacific

0.5
Pollock

0.5
Shark

0.5
Sturgeon

0.4
Bass, fresh water

0.3
Catfish

0.3
Ocean perch

0.3
Flounder

0.2
Haddock

0.2
Snapper, red

0.2
Swordfish

0.2
Sole

0.1

Source: The Health Effects of Polyunsaturated Fatty Acids in Seafoods
©

Bubbles May Mean Bad Teeth

Tuesday, April 17th, 2012

Yellow stains aside, brewed coffee or tea may not be the worst thing you could swish past your pearly whites.
Other drinks tested in a recent study produced much more wear and tear on tooth enamel, especially bubbly soft drinks. But here’s the surprise: It didn’t matter if the sodas were diet or not.
Erosion Explosion
When your tooth enamel starts to erode, you’ve got major problems on your hands. And certain foods like sweets and sodas may hasten this process. All carbonated drinks in a recent study had some impact on tooth enamel (with the one possible exception being root beer — its impact on tooth enamel was slight). Citrus-flavored sodas hit teeth hardest, but colas caused problems, too. And it didn’t matter if the drinks were diet or full-sugar.
It’s the Acids
Contrary to what you might think, it’s not only the sugars in bubbly beverages that erode tooth enamel. It’s also the acids. The total acid content and acid type — look for names like phosphoric, citric, malic, and tartaric — in a beverage affect how strong the attack is on your choppers. Rinsing after sipping a soda may hasten the acids out of your mouth.
References
Dissolution of dental enamel in soft drinks. von Fraunhofer, J. A., Rogers, M. M., General Dentistry 2004 Jul-Aug;52(4):308-312.
From an article on RealAge.com

Inflammation key to understanding periodontal disease

Thursday, March 29th, 2012

By Nancy A. Melville, DrBicuspid.com contributing writer

February 15, 2012 — In the quest to better understand the causes of periodontal disease, researchers are making big strides on two key fronts: understanding the nature of the bacteria that stimulate gingival inflammation, and the genetic and physiologic foundations that can determine the body’s response to that stimulus.

As a common denominator for a broad range of medical conditions, inflammation has become an especially hot topic in periodontal research. Study after study has set out to try and understand why some people have an inflammatory response to certain bacteria and others don’t, according to Pamela McClain, DDS, president of the American Academy of Periodontology (AAP).

“Our understanding of periodontal disease is veering away from what was considered to be just bacteria causing the disease to the role of inflammation, which is believed to be the most important factor in the progression of the disease,” she explained. “That response can truly vary from one individual to the next. You can have a husband and wife with similar bacteria in their mouths — and studies show they commonly do — yet one gets inflammation and the other doesn’t. We know the bacteria start the process, but it’s the response to those bacteria that ultimately results in the loss of the attachment between the bone and the periodontal ligament.”

Genetic factors

Genetics is one of the most significant factors in that response. Genetic factors ranging from gender — more specifically, being female — to carrying some distinctive single nucleotide polymorphism are believed to play a role in 30% of periodontal disease cases. In two separate studies, Alexandre Vieira, DDS, PhD, and colleagues at the University of Pittsburgh found evidence that genes could, in fact, account for as much as 50% of an individual’s susceptibility to developing caries or periodontitis.

In the first study, Dr. Vieira and colleagues in Pittsburgh and Brazil analyzed 389 individuals in 76 nuclear families and found an association between two variants of the gene FAM5C and periodontal disease (PLoS One, April 7, 2010, Vol. 5:4, p. e10053).

In the second study, published in the Journal of Dental Research (June 2010, Vol. 89:6, pp. 631-636), Dr. Vieira and his co-authors found that people with a variant of the gene DEFB1 (defensin, beta 1) were more than five times more likely to have decayed, missing, or filled teeth compared with those who didn’t carry the variant. Patients with another variant, the rs179946 (G-52A), were only a third as likely to have the dental problems (p = 0.014).

Interestingly, the FAM5C gene has also been associated with another inflammatory condition: heart disease.

“There are a number of common etiological factors modulating these diseases,” said Dr. Vieira, an associate professor and the director of clinical research at the University of Pittsburgh Center for Craniofacial and Dental Genetics. “It appears that the association between these two groups of diseases could be in part related to individual genetic background.”

The same genes modulate inflammation regardless of the process that is happening in the oral cavity or elsewhere, he added.

“Individual responses to specific external factors, since they are modulated by the same genes, can be similar, and this can partly explain associations reported between periodontal diseases and other systemic conditions,” he said.

Other experts agree that the discovery of similarities between the inflammatory process in periodontal disease and that of other chronic inflammatory diseases could represent one of the most promising areas of research.

“It is uncanny how the inflammatory reaction occurs in other chronic inflammatory diseases and periodontitis,” said Samuel Low, DDS, a past president of the AAP and a professor of periodontology at the University of Florida College of Dentistry. “With diabetes, cardiovascular disease, Alzheimer’s disease, and rheumatoid arthritis, for instance, if you review the way the inflammatory process works in those diseases, it is very close to the way it works with periodontal disease.”

One important advantage that periodontal disease has over the other inflammatory conditions, Dr. McClain noted, is a clearly defined stimulus: bacteria.

“With rheumatoid arthritis, the body is attacking the joints with inflammation. Likewise with periodontal disease, the inflammation is in the attachment between the bone and the attachment of the gum tissue,” she said. “But at least with periodontal disease, we know the bacteria are stimulating this whole response. In rheumatoid arthritis or other conditions, we often don’t know.”

New bacteria insights

That being said, more headway is being made in understanding the behavior of the bacteria itself.

Intriguing new research on one of the most notorious of periodontal disease offenders, Porphyromonas gingivalis, implicates the bacterium as a “keystone pathogen” that, in fact, doesn’t directly cause damage, but instead manipulates the oral environment so that otherwise benign bacteria change course and infect the tooth’s supportive structures (Journal of Oral Biosciences, 2011, Vol. 53:3, pp. 233-240).

“In this regard, P. gingivalis’ tactics to undermine innate immunity may promote the survival of other members of the periodontal biofilm community,” wrote the study authors, from the University of Louisville School of Dentistry.

Based on observations on mice, the researchers found that P. gingivalis, in effect, reprograms the front-line immune cells that protect the space in the subgingival crevice, causing them to let down their defenses. Once that’s accomplished, benign bacteria — and not P. gingivalis — then rise in numbers and march in to infect the tooth’s periodontium.

“These subversive strategies of P. gingivalis may explain, at least in part, its ability to persist and establish chronic infections in the periodontium,” the authors wrote.

Interestingly, in a previous study, researchers with the University of Michigan found that people carrying an antibody to a protein of P. gingivalis, called HtpG, have a lower risk of periodontal disease (PLoS One, April, 23, 2008, Vol. 3:4, p. e1984).

The antibody “offers significant potential as an effective diagnostic target and vaccine candidate,” the authors concluded.

Nongenetic causes

Genetics holds plenty of clues to the causes of periodontal inflammation and disease, but it doesn’t paint the whole picture. Other well-known risk factors include everything from smoking to pregnancy (and the state of hormonal flux that it involves), but one key condition is looming ever larger as an important factor in periodontal disease: obesity.

Research demonstrating the role of being overweight and obesity in periodontal disease has mounted in recent years, with one of the more interesting studies coming out of the Case Western Reserve University School of Dental Medicine

(Journal of Periodontology, October 20, 2011). The study authors found significant improvements in periodontal health among gastric bypass patients following their surgeries and weight loss.

The study included 30 obese people with chronic periodontitis. The researchers compared the participants before and after half of the subjects underwent bypass surgery and had fat cells removed from the abdomen. Compared with those who did not have the weight loss surgery, the bypass patients showed greater improvements in periodontal attachment, bleeding, probing depths, and plaque levels.

Importantly, the gastric bypass patients also showed declines in glucose levels following the procedure. The researchers theorized that by making insulin less resistant, weight loss improves diabetic status, which in turn improves response to periodontal treatment. They also speculated that the surgery reduced the production of the appetite hormone leptin, which has been implicated in the regulation of metabolism and may be linked to inflammation due to its role in increasing the production of cytokines and C-reactive protein.

Other studies also have shown evidence of weight loss resulting in reduced periodontal disease, and the combined research supports the suggestion of a relationship between the increased fat cells that occur with obesity and periodontal inflammation, Dr. Low said.

“Belly fat, interestingly enough, becomes an endocrine gland within itself, and with the increase of the fat cells, there is an overstimulation of the inflammatory process,” he said.

Dr. Low noted that diabetes is the second-highest risk factor for periodontal disease, behind smoking.

The relationship between the two diseases is believed to be somewhat reciprocal, with gingival inflammation undermining blood sugar control while diabetes-associated high blood sugar in turn may trigger periodontal inflammation. But the fact that obesity is a leading cause of diabetes would appear to further compound the damage the disease can wage on periodontal tissue.

Prescription drugs

Other known culprits in the development of periodontal disease are medications. Prescription drugs known to potentially cause gingival ulcerations include aantihypertensive drugs, calcium channel blockers, and even some anti-inflammatories.

Some of the newer offenders include certain chemotherapy drugs, antidepressants, and antianxiety medications, which can all cause xerostomia, according to Dr. Low.

“There are probably more than 500 medications out there that create dry mouth,” he said. “Antidepressants and antianxiety medications, for instance, can cause this, and the danger is that saliva is one of the best protectors against inflammation. It contains powerful anti-inflammatory products. So if you don’t have saliva, you lose your natural defense system.”

Certain medications can cause swelling of the gum tissues and result in pseudo or false pockets, making it easier for the disease to progress, Dr. Low added.

Xerostomia resulting from medications can trigger a particularly vicious cycle of erosion on the teeth and gums, Dr. McClain emphasized.

“When you have less saliva being produced, you’re not washing away the bacteria or having the good enzymes that are necessary to fight the bacteria,” she said. “That results in more plaque formation and a bigger challenge in managing periodontal issues.”

Dental practitioners should stay informed of data on new drugs and new drug classes in the marketplace, Dr. McClain added. “We often don’t know the effects of these medications on the teeth or gums until patients have been on them for a long time,” she said.

The issue is tricky, however — some medications may clearly be essential in treating a patient’s medical condition, and Dr. Low warned dentists to use caution in advising patients on their prescription drugs.

“We recommend that dentists tell patients to ask their physician if there is an alternative medication if the current medication they are taking is risking periodontal health,” he said. “If the patient’s doctor says the condition is life-threatening and there is only one drug, then we’ll deal with the dry mouth. But if we find that the dry mouth is contributing to either decay or periodontal disease, then it’s important to see if there is an alternative.”

Fatty acids: Bad and good

Aside from medications, the causes of periodontal disease may also simply lie in the foods patients consume. When it comes to the causes of inflammation, recent research has revolved around fatty acids, both bad and good.

Not surprisingly, many of the same fatty acids implicated in increasing bad cholesterol levels and potentially raising the risk of cardiovascular disease have been linked to periodontal disease.

In one recent study out of Japan, for instance, older nonsmokers who consumed higher levels of saturated fatty acids, including those found in meat fats, milk, butter, lard, and some oils, had a relative risk of periodontal disease that was 1.92 times higher than that of people of the same age with a low saturated fatty acid intake (Journal of Dental Research, July 2011, Vol. 90:7, pp. 861-867).

Conversely, just as polyunsaturated fats, including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are associated with a host of health benefits, ranging from cardiovascular to neurological, so too are the fats emerging as potential key players in the prevention of inflammation and disease.

One recent study involving more than 9,000 adults showed the prevalence of periodontitis to be approximately 20% lower among individuals who reported consuming the highest amount of dietary DHA; reduction, although smaller, was also seen with consumption of EPA (Journal of the Academy of Nutrition and Dietetics, November 2010, Vol. 110:11, pp. 1650-1652).

“We found that omega-3 fatty acid intake, particularly DHA and EPA, are inversely associated with periodontitis in the U.S. population,” stated co-author Asghar Naqvi, MD, MPH, from Beth Israel Deaconess Medical Center, in a press release. “To date, the treatment of periodontitis has primarily involved mechanical cleaning and local antibiotic application. Thus, a dietary therapy, if effective, might be a less expensive and safer method for the prevention and treatment of periodontitis.”

Another line of research on omega-3s adds that the inclusion of low-dose aspirin (81 mg) significantly improves the ability of omega-3 fatty acid supplementation to resolve inflammation.

In one study of 80 human subjects, including 40 who received scaling and root planing and 40 who also received the treatment in addition to supplementation with low-dose aspirin and omega-3 fatty acid (900 mg of EPA and DHA), significant reductions in probing depths and attachment gain were observed after three and six months in the supplementation group, compared with the control group (Journal of Periodontology, November 2010, Vol. 81:11, pp. 1635-1643).

“Omega-3- and omega-6-based polyunsaturated fatty acids play a major role as defense-supporting/catalyzing lipids. The problem is that humans (and many mammals) do not have the means to metabolize these lipids and cannot produce them in sufficient quantities,” said Alpdogan Kantarci, DDS, PhD, of the Forsyth Institute and co-author on several key studies examining the issue. “What we produce is very limited, and their half-lives are very short. Therefore, we need to consume external sources such as fish or plants.”

Aspirin prolongs the half-life of such compounds in blood and dampens the inflammatory reactions by counteracting the mediators and cells that are produced as the first line of defense against pathogens, he added.

“The more we appreciate these mechanisms, the more targeted our treatment would become in inflammatory diseases, including the periodontal diseases,” he said.

In a previous study on mice and rabbits (Journal of Immunology, November 15, 2007, Vol. 179:10, pp. 7021-7029), the researchers even found that omega-3 benefits appeared to extend to the bones, Dr. Kantarci said.

“We have shown that such an approach cannot only reverse the inflammatory process, but also can help in regenerating the lost bone and hard tissues, so there is a lot of exciting potential,” he said.
“Research has demonstrated that supplementation of 900 mg of omega-3 and 81 mg of aspirin can decrease periodontal disease.”
– Samuel Low, DDS

As more becomes known about the mechanism of omega-3 fatty acids, the more valuable they may become as a nonpharmaceutical approach in the prevention or treatment of inflammatory diseases, including periodontal disease.

“This does not mean that the antibiotics will be replaced soon, since many infections will most probably still require elimination or decrease of bacterial load,” Dr. Kantarci said. “But in complex infecto-inflammatory diseases, modulation of the host response can provide novel ways to control and treat the process.”

Dr. Low already recommends that his patients at risk for periodontal disease take omega-3 supplements — and low-dose aspirin.

“We’re very excited about this because research has demonstrated that supplementation of 900 mg of omega-3 and 81 mg of aspirin can decrease periodontal disease,” he said. “The omega-3s basically suppress bad inflammation and express good inflammation. We can also throw in calcium and vitamin D for the bones, but to me the more appropriate approach is anything that is anti-inflammatory.”

Looking ahead

The periodontal community can likely expect to see much more intriguing research as the secrets of chronic inflammatory diseases unfold. Dr. Low recommends dentists simply stay tuned and follow the science.

“What we don’t want to see is dentists falling back on anecdotal data,” he cautioned. “The ‘I’ve seen patients for 25 years and when I’ve seen this, I do that’ approach is just not wise at this point in time. What we want is an approach that respects the scientific relationship between the risk factors, the genetic factors, and the progression of the disease.”