Friday, February 23, 2007

D upright vitamin for the old folks

I'm not sure when my mom last got out in the sun. She, like other housebound seniors, is at high risk for D vitamin deficiency. A Harvard study recently published in the Journal of the American Geriatric Society confirms that extra D--800 or more units/day--can significantly prevent the elderly from going to ground.
The investigators randomized a group of old old folks (average age 89) to various levels of D supplementation. Defining a fall as "a sudden, unintentional change in position causing a resident to fall to the ground," they checked out which doddery test subject experienced such sudden changes as a function of their D intake.

While daily D doses of 400 units or less didn't make a bit of D-ference with respect to unintentional position changes, those residents assigned to the 800 unit group were 72% less likely to end up on the ground over 5 months compared to their colleagues.

While D alone will not necessarily keep the old perpendicular to the floor, the vitamin does promote muscle strength as well as bone strength and should be considered an important nutrtional supplement for the elderly.

Changing thresholds

In the past few years, lab work that used to be 'normal' is now redefined risky. In particular, fasting blood sugar was considered normal up to 110, but the new acceptable cut-off has dropped to 99. Fasting blood sugars 100-125 are now considered 'prediabetes' or 'impaired fasting glucose (IFG).'

This down-graded normal threshold is based on population studies that show risk of diabetes and heart disease rises significantly in persons with these low level elevations. A new study from the State University of New York at Buffalo confirms that prediabetes, like prehypertension (see previous post) is definitely pretrouble.

Investigators there looked at women who developed abnormal fasting blood sugars over a six year period while participating in the Western New York Health Study. Blood samples collected and frozen at the start of the study were pulled out for re-examination after the IFG diagnosis was made, comparing these results with those from control subjects who did not become prediabetic. The samples were checked for endothelial markers--tests that indicate an active inflammatory process occurring in the blood vessel wall which, in turn, greatly increases the risk of coronary artery disease.

Not only did prediabetics have significantly elevated endothelial markers before they ever manifested any blood sugar abnormality, the women with elevated fasting sugars had more abnormal baseline tests of blood vessel inflammation than did the prediabetic men. The researchers theorized that this may explain why diabetic women are known to have a higher risk of heart disease than diabetic men.

Tuesday, February 20, 2007

Stroke risk for postmenopausal women

The increased risk of stroke for those women of the Women's Health Initiative Study on hormone therapy vs. those on none was 55%. But here's stroke news from the WHI that never made headline news:

Those women among over 60,000 studied over 7 years who had pre-hypertension were nearly twice as likely to experience a stroke compared with their colleagues who had ideal blood pressure less than 120/80. Pre-hypertension is also known as 'high normal' or 'borderline high' or 'sort'a okay' blood pressure from 120 to 139 systolic and 80-90 diastolic.

No more 'not bad/not good' dismissive comments from me on these pre-hypertensive readings. I'm not okay with these 'not-okay' BPs from now on.