US Pharm. 2007;1:109-110.

Almonds May Protect Against Heart Disease and Diabetes Risk
According to a study published in the Journal of Nutrition, eating almonds may play a role in avoiding blood sugar spikes after consumption of a carbohydrate-rich meal of foods that raise blood sugar levels.

"We found that eating almonds can have a significant impact in blunting the glycemic and insulin responses of the body when fed with a carbohydrate meal," said study coauthor Dr. Cyril Kendall from the University of Toronto. "Almonds have already been found to reduce LDL [low-density lipoprotein] cholesterol levels. Incorporating almonds in the diet may help in the management of blood glucose levels and the onset of such illnesses as diabetes, while promoting a healthy heart."

Arthritic Knees May Benefit from Walking Barefoot
Despite what your mother told you, walking barefoot may have advantages in helping to avoid osteoarthritis. According to a research article published in the journal Arthritis and Rheumatism, data support the fact that walking in shoes increases the peak joint loads at the hips and knees. The researchers found that walking barefoot resulted in an 11.9% decrease in knee adduction movement. They also discovered that walking without shoes significantly changed the stride, cadence, and range of motion at the lower extremity joints but could not explain how this was connected to the reduction in the peak joint loads.

The investigators concluded that since shoes may detrimentally increase loads on lower extremity joints, modern shoes and walking practices may need to be reevaluated with regard to their effects on prevalence and progression of osteoarthritis.

Don't Be Fooled by Brewed "Decaf" Coffee
You may think you are drinking caffeine-free coffee when drinking brewed coffee labeled as "decaf," but according to a study published in the Journal of Analytical Toxicology, decaffeinated beverages are known to contain caffeine in varying amounts. According to the study's coauthor, there could still be enough caffeine content to cause physical dependence.

Based on the samples used in their study, researchers from the University of Florida College of Medicine in Gainesville believe that there could be enough caffeine in brewed "decaf" coffees to have "physiological and behavioral effects on a person." They concluded that more research is needed to determine the potential for physical dependence on low doses of caffeine.

Incidence of Stroke Decreased over Past 50 Years
A study in JAMA shows that while stroke continues to be a major public health concern, its incidence over the past half-century has decreased.

Researchers at Boston University examined data from the Framingham Study to determine long-term trends in the incidence, lifetime risk, severity, and 30-day risk of death. The Framingham Study was a health study that involved participants initially recruited in 1948. According to Raphael Carandang, MD, and his colleagues at Boston University, their investigation included the original 9,152 Framingham Study participants and offspring undergoing follow-up for up to 50 years over three consecutive time periods (1950-1977, 1978-1989, and 1990-2004). They found that the age-adjusted annual incidence of clinical stroke and atherothrombotic brain infarctions in those participants ages 55 to 94 decreased over the three periods. The lifetime risk of clinical stroke decreased from 19.5% to 14.5% in men age 65 and from 18% to 16.1% in women.

The authors noted, "The severity of stroke has not decreased and 30-day mortality has decreased significantly only in men, perhaps due to an older age at onset of stroke and more severe strokes in women." They added that "while improved control of risk factors has lowered incidence of stroke, there is a need for greater primary prevention efforts to reduce the lifetime risk, severity, and 30-day mortality following stroke.

Sleep-Deprived Children Have Higher Obesity Risk
Childhood obesity may be linked to not getting enough sleep. That is the conclusion of a British study published in the Archives of Disease in Childhood. According to Dr. Shahrad Taheri of the University of Bristol, while the lack of sleep may not be the only factor for the worldwide obesity pandemic, a good night's sleep should be part of any approach to preventing obesity.

Dr. Taheri believes that the lack of sleep may affect the body's energy balance. And since being overweight in childhood generally continues into adulthood, it is important that children get adequate amounts of sleep, in addition to watching their diet, to help keep the pounds off. The investigators observed that short sleep duration at the age of 30 months is associated with obesity at age 7 years.

"Although changes in the basic balance between energy intake (food calories) and expenditure (physical activity) are obviously responsible for the current obesity pandemic, our understanding of the factors that alter this balance remains incomplete. Intriguingly, sleep may be a factor that alters both sides of the energy balance," said Dr. Taheri.

Risk of Hip Fractures Linked to Acid Suppression Drugs
Popular drugs known as proton pump inhibitors (PPIs), used to reduce the release of stomach acid in disorders such as gastroesophageal reflux disease (GERD), are associated with a greater risk of hip fracture, according to a recent study published in JAMA.

Although PPIs have helped millions of patients plagued with acid-related diseases, research has shown that the PPI therapy may decrease insoluble calcium absorption or bone density in certain patients, increasing the risk for hip fracture, which has a death rate of 20% during the first year after the fracture. And if a patient should survive the first year, 20% of this population may require emergency room visits, hospitalization, surgery, rehabilitation, and nursing home care.

According to a study led by Yu-Xiao Yang, MD, MSCE, at the University of Pennsylvania School of Medicine, Philadelphia, it was observed that "PPI therapy is associated with a significantly increased risk of hip fractures, with the highest risk seen among those receiving a high-dose PPI therapy." Dr. Yang and his colleagues concluded that physicians should use the "lowest effective dose" of PPIs in treating patients with acid-related diseases. "For elderly patients who require long-term and particularly high-dose PPI therapy, it may be prudent to reemphasize increased calcium intake, preferably from a dairy source, and coingestion of a meal when taking insoluble calcium supplements," they added.

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