News in Dietary Supplements

The use of dietary supplements is becoming increasingly popular. But are they safe? Are they necessary? Researchers are working to find that out. Two supplements that have recently worked their way into the news are selenium and Vitamin D.
Selenium is a trace element used in proteins (selenocysteine) and is transported in blood plasma. It is a mineral considered healthful in small amounts, but may be harmful in large quantities. In March 2008, the Food and Drug Administration found up to 200 times the label level of selenium in about 1,200 bottles of Total Body Formula and Total Body Mega Formula, which were distributed in sixteen states and over the internet. The products were recalled on March 27, but continuous reports of people with illness indicate people are still using it. Though no deaths have been reported as a result of selenium toxicity, one person has been hospitalized. Symptoms of toxicity include hair loss, discoloured and painful fingernails, muscle cramps, arthralgia, and fatigue. Symptoms usually present five to ten days after beginning consumption of the supplement. Interestingly, another study suggests that selenium may not even be as necessary as once believed. According to researchers published in Genome Biology, as humans evolved, they lost some of their need for selenium. Although it is essential part of one’s diet, use of it has decreased since humans have evolved from other mammals. Deficiencies in the micronutrient have been associated with such conditions as Keshan’s disease and Myxedermatous Endemic Cretinism, but whether or not our bodies need enough to require a supplement is up for debate. Supplements are taken to maximize the amount of proteins that rely on it, but it is unknown which groups actually benefit from this.
In contrast to recent evidence that selenium supplements may cause more harm than good, several studies have recently been published that vitamin D may do more good than once thought. Results of recent research suggest that vitamin D may play a role in protecting against peripheral artery disease (PAD), which is a common disease in which arteries in the legs are narrowed by fatty deposits, resulting in pain, numbness, and an impaired ability to walk. Scientists are only beginning to explore vitamin D’s effect on the cardiovascular system, but they believe it makes sense because cells in the blood vessels have vitamin D receptors. The results of the study showed that vitamin D levels are correlated with the incidence of PAD; higher levels of vitamin D were strongly associated with lower incidences of PAD. It is too soon to tell whether it is actually vitamin D causing the improvement or if it is just a marker for other health practices. However, recent findings also indicate that vitamin D is important to brain development and function as well as prevention against breast cancer. Evidence supporting the notion that vitamin D aids in brain function includes the wide distribution of receptors throughout the brain. It also affects proteins that are known to be directly involved in learning and memory, motor control, and possibly maternal and social behaviour. It is suggested, but not proven, that vitamin D deficiency may lead to behavioural and cognitive consequences. In other study, results showed that women with very low blood levels of vitamin D (25{OH)D, specifically), had a significantly increased risk of breast cancer. Investigation focused on vitamin D receptors, whose genes are found in several variants called polymorphisms. A finding of this study is carriers of the Taql polymorphism have a slightly increased risk of breast tumors that carry receptors for estrogen on their surface, but no effect on the overall risk of cancer was found. One possible explanation is that vitamin D can exert its cancer-preventing effect by counteracting the growth-promoting effect of estrogens. Researchers argue that the current recommended levels of the vitamin are way too low.

References:

High Blood Levels Of Vitamin D Protect Women From Breast Cancer, Study Suggests. (2008, April 22). Science News. Retrieved May 1, 2008, from Science Daily Web site: http://http://www.sciencedaily.com/releases/2008/04/080418094101.htm

Selenium Supplements May Not Be Needed, Study Suggests. (2008, April 7). Science News. Retrieved May 1, 2008, from Science Daily Web site: http://www.sciencedaily.com/releases/2008/04/080404114428.htm

Stobbe, M. (2008, April 18). CDC: Mounting illness reports linked to supplement. In USA Today. Retrieved May 1, 2008, from USA Today Web site: http://www.usatoday.com/news/health/2008-04-18-2861922464_x.htm

Vitamin D Important in Brain Development and Function. (2008, April 23). Science News. Retrieved May 1, 2008, from Science Daily Web site: http://http://www.sciencedaily.com/releases/2008/04/080421072159.htm

Vitamin D May Protect Against Peripheral Artery Disease. (2008, April 20). Science News. Retrieved May 1, 2008, from Science Daily Web site: http://http://www.sciencedaily.com/releases/2008/04/080416140954.htm

Changing a Woman's Dietary Habits May Influence the Sex of Her Baby

http://www.usatoday.com/news/health/2008-04-24-1849445902_x.htm

Above is a link posted on USA Today's website. The article summarizes a recent study done in the United Kingdom that suggests a mother's diet may play a role in the sex of her fetus. Although sex is determined by the male, certain nutrients or eating patterns prior to conception may make a woman's body more hospitable for sperm carrying the male or female chromosome. In other words, the environment in her womb as a result of dietary habits may be more suited for a male chromosome-carrying sperm, or female chromosome-carrying sperm, increasing the chances that that type of sperm will fertilize an egg. A hearty appetite, not skipping breakfast, and potassium-rich foods apparently raise the odds that the fetus will be a boy. This is consistent with other studies in which, in test tube fertilization, male embryos thrive best with longer exposure to nutrient-rich lab cultures, as well as studies that show male embryos are not likely to survive in lab cultures with low sugar levels. Skipping meals may result in low sugar levels.
The results of the study showed significant statistical correlations between a woman's diet and the likelihood of whether her fetus was a male. Women whose diets were high in calories and potassium were more likely to produce males. The results are plausible from the evolutionary perspective that since boys tend to be bigger, it only makes sense that it would take more calories to create them.
Although these correlations are striking, dietary habits may be indicative of other factors involved that could influence sex, including time of intercourse.



I think this is an interesting theory, and I look forward to learning the conclusions of follow-up studies. It certainly does make sense that the woman has somewhat of an influence on what sex her baby is. Sperm is very sensitive to the environment in the uterus; small changes in pH or temperature, for example, lead to drastic changes in a sperm's ability to survive. The conditions must be perfect.
This does raise some ethical issues. As technology is becoming more advanced, scientists and doctors are finding ways to manipulate the fertilization process: conception can occur outside of the body, the parents can determine the eye colour of the baby, and conception is more controllable (thanks to contraceptives or fertility meds). Though a baby's sex can be genetically determined, altering one's diet seems much more natural- and cost effective- than doing it in a lab. However, is it more ethical? Although this theory has not been proven, and even if it were, it would not guarantee parents get the desired sex, it still makes me wonder whether women trying to get pregnant should start changing their diets to influence the sex of the fetus. Would that be "playing God", by changing what would/should have been to what one wants it to be? Is it fair to one sex to determine the other? What if this leads to an unbalanced population? What if this leads to faster evolution, by parents picking desirable traits over undesirable ones? Although some of these questions are far-fetched, there is certainly logic behind them. I feel, regardless of one's ethical and moral beliefs, changing one's diet to influence the sex is equal in moral value to determining the sex in a lab. Regardless, I think this is a major discovery (if it turns out to be true), and I am very interested in learning more.

Popline Bans 'Abortion' as a Search Term

The following is a link to an article recently posted in the New York Times:

http://www.nytimes.com/2008/04/05/us/05popline.html?_r=2&ref=health&oref=slogin&oref=slogin

In summation, Johns Hopkins University programmed its database, Popline, to ignore the word 'abortion' in searches after federal officials "raised questions" on two articles in the database. The dean of the Public Health School lifted these restrictions. The ban was set after two articles about abortion advocacy were found. According to a school spokesman, the articles "did not face database criteria", and were removed. The dean demanded the ban be lifted, as the purpose of the database is to provide information, not restrict it. Popline is the world's largest database on reproductive health; therefore, according to protesters, restricting searches on an important topic in this field is absurd. Many pro-abortion advocates argue that the Bush administration "politicized science", imposing its conservative views on the federally-funded medical database. Supporters of the act claim that information about unwanted pregnancy can be found using other search terms. Those opposed argue that "abortion" is a perfectly good word, and is not completely synonymous with terms like "unwanted pregnancy" and "fertility control". Not surprisingly, the ban was largely protested.


This is a disappointment. It is the institution's responsibility to provide the most accurate and unbiased information possible to the public so readers who turn to the database for answers can make informed decisions about their health and well-being. Ignoring the word "abortion" is a highly unethical and potentially dangerous practice. Whether or not one agrees with the act of abortion should not determine whether or not the information on the topic is available.

Survey Research

I am currently taking Development and Evaluation of Health Programs, and for that class my group is working with the Guthrie Clinic to develop a survey evaluating the attitudes of health professionals toward preventative screenings. Our aim is to analyze the opinions of physicians on the clinic's guidelines for screenings, as well as any perceived barriers for administering the screenings.
The survey is composed of 35 questions that are broken up into sections. The first section deals with the clinic's guidelines. The second section inquires about any perceived barriers to preventative screenings. The third questions how the physician personally complies with the guidelines. The following section includes sentences that the subjects rate and include any additional comments, and the last section questions the demographics of the sample. Each section has a Likert scale format, except for the last two, which are short answer and multiple choice, respectively. The survey will be e-mailed to every Guthrie health care professional.
We opted to use a survey to acquire our data for a variety of reasons. First, the research committee at Guthrie clinic recommended we use a survey. Second, it is the most convenient. We don't need to gather physicians or interrupt anyone's busy schedule too much. We also figure more people would be willing to sit for a few minutes and do a survey while checking their e-mail than go out of their way to participate. Third, it was the best way to reach the most people. Lastly, our data is quantitative, so a survey with multiple choice or rating questions are the easiest to interpret and analyze.
Actually conducting the survey is interesting because it helps me better understand what is being learned in this class, but I also can apply what I learned to it.

Ethics in Research: The "John/Joan" Case

I. This study fell into the lap of Dr. John Money, a psychologist and sexologist pioneering gender identity, back in the 1960's. Bruce Reimer was born in Winnipeg, Manitoba, Canada in 1965 as a perfectly healthy boy, with an exception of phimosis, a condition of the penis in which the foreskin cannot be fully retracted. He had a twin with the same condition. At the age of 8 months, he underwent surgery for a circumcision. However, the surgeon used a Bovie cauterization machine, which is unsuitable for small appendages such as the penis. The penis was destroyed beyond repair. Therefore, it was converted into a vagina following a suggestion by Dr. Money, who believed that one's sexual identity could be molded at an early age. He used Reimer as a case study to determine the effects of the sex change. This was ideal, because his twin, who did not have surgery for the condition, was a perfect control for the study because their genes, environment, and overall condition were exactly the same.
Money believed that identity was relatively plastic in infancy and proposed that it was influenced by social learning in early childhood. Also, while a destroyed penis is completely dysfunctional, a constructed vagina would be more likely to become a successful, functional organ. Money convinced Reimer's parents that sexual reassignment would be in his best interest, so they consented to a surgery to have his testes removed.
After the surgery, Bruce was renamed Brenda and was raised as a girl. "She" continued to see Dr. Money for psychological treatment and outcome assessment. Money believed his case was successful, citing how much more feminine Bruce was than her twin brother. Estrogen was given to Bruce upon adolescense to induce secondary female sex characteristics.
Bruce viewed these visits to Money as highly traumatic. He began pressuring the family to consent to a second reconstructive surgery to create a vagina, but because Bruce was so psychologically stressed by the visits, they discontinued them. He threatened to commit suicide if he had to visit Money again. Money published nothing afterward that suggested his study was not successful.
Bruce admitted that he never identified as female. He was made fun of by peers, and experienced suicidal depression at a young age. At age 15, his parents told him the truth about his past, at which point he began to assume a male identity. He named himself David.
His twin Brian, experienced a pattern of mental disturbances and developed schizophrenia after learning of his relationship with his now "ex-sister". Years later, Bruce underwent treatment to reverse his previous sex change, including testosterone injections and several surgeries. He married a woman and became a stepfather to her three children. He gained popularity and financial security by making his story public, however he separated from his wife, had severe problems with his parents, and experienced the death of his brother from a toxic combination of alcohol and antidepressants. In 2004, at the age of 38, Bruce committed suicide.

II. This study was unethical in myriad ways. According to the Nuremberg Code, the first item is that consent is required, and must be voluntary. Because Bruce was too young to consent, his parents did. However, they were pressured into it by Dr. John Money, who assured them that this was for their son's own good. He also failed to inform them of any possible dangers of the study, including psychological distress, possible physiological malfunction, trauma experienced by friends and family members, etc.
The second item is that the study must be conducted only to benefit society, and only if no other means of study will work. The knowledge gained can certainly benefit society. However, the study was only performed because Money made it so. There could have been other ways to learn.
This case yielded immeasurable amounts of unnecessary physical and emotional suffering, which violates the fourth item of the Code.
Although Bruce eventually was able to terminate his "treatment", he was able to only after threatening to end his own life. Money pressured him and his parents into continuing the treatment until that point. According the the ninth item of the Code, subjects should be able to end the experiment at any point they wish, with discouragement or pressure to continue.
The tenth item states that the researcher must be able to end the study if he believes it will result in any type of injury. John Money ignored the fact that Bruce was being severely mentally harmed by the experiment. Even after Bruce terminated the treatment, Money claimed it was a successful procedure. He neglected to include any data in his publishings that did not concur with his beliefs about sexual identity.

III. David Reimer. (n.d.). Wikipedia. Retrieved September 23, 2007, from Wikipedia
Web site: http://en.wikipedia.org/wiki/David_Reimer

An Analysis of a Primary Research Study

"Differences in Club Drug Use Between Heterosexual and Lesbian/Bisexual Females"

1. What was the question?
The purpose of the study was to "examine the patterns and contexts of club drug use among people who frequent dance club venues". The researchers sought to investigate any connections between sexual identity and drug use. Because the majority of research focuses primarily on men, this study focuses on women.

2. What was done?
The study took place in various, randomly selected clubs in Manhattan from December 2004 through July 2005. 1104 females were sampled. Field staff randomly approached club patrons and asked them to do a quick, five minute survey. Surveys were conducted with the use of palm pilots with those who consented, and the age, gender, and ethnicity were noted of those who did not. The survey included whether or not the patron used club drugs, which ones were used, and frequency of use. The data was interpreted using Chi-square analyses to examine the differences in rates of drug use, and by using stepwise logistic regression analyses to examine the predictive nature of age and sexual orientation in club drug use.

3. What was found?
Of the women studied, 53.3% were heterosexual, while 46.3 identified as lesbian or bisexual. The ages ranged from 18 to 49. Whites accounted for 57.9% of the sample, while Latinas comprised 15.9%, blacks 10.4%, Asians/Pacific Islanders 5.7%, and other or mixed roughly 10%. The majority of those surveyed (72.2%) reported to previous drug use, with MDMA or ecstasy being the most common. One in 5 women were "active" drug users (they used at least once within the past three months). Older women (over the age of 30) reported higher lifetimes rates, though younger women admitted to higher active club drug use. Lesbian and Bisexuals were significantly more likely to use drugs than heterosexuals. Overall, a lesbian or bisexual identity is predictive of lifetime use of almost every club drug, as well as current or active use.

4. What does the study mean?
While older women were more likely to be lifetime users, younger women were more likely to be active users. This means that prevention and education should be aimed at younger women. Also, because lesbian and bisexual women were more likely to use club drugs than heterosexuals, more prevention programs need to be targeted toward them. Because health promotion programs are primarily aimed at gay men, it is easy to see why lesbian and bisexual women need more attention. Future research should be aimed at learning and understanding the prevalence rates within and between female subgroups because as of now, too little information is available.




Parsons, J. T., Kelly, B. C., & Wells, B. E. (2006, December). Differences in
Club Drug Use Between Heterosexual and Lesbian/Bisexual Females.
Addictive Behaviors, 31(12), 2344-2349. Retrieved September 18, 2007,
from Science Direct database.