Processed meat increased heart disease risk

A new systematic review and meta-analysis of 20 studies involving more than 1.2 millions people from 10 countries found that processed meat such as bacon, salami, sausages, hot dogs and processed deli, was linked to increased risk of heart disease and diabetes, but red meat was not.

Participants were followed up to 18 years and found that those who ate 50 gram a day of processed red meat had 42% higher risk of heart disease and 19% higher risk of type 2 diabetes than those who did not eat processed red meat.

Researchers said that the processed meat contain much higher salt and preservatives ( rather than fats) than unprocessed meat and this could explain the difference. They found the same even when lifestyle factors were taken into account and suggested that these types of meats should be studied separately in future research.

Source: "Red and Processed Meat Consumption and Risk of Incident Coronary Heart Disease, Stroke, and Diabetes Mellitus. A Systematic Review and Meta-Analysis". Circulation. 2010 Published online before print May 17, 2010 ( f/t via Athens)

Statins raise small diabetes risk

Statins have been used as cholesterol-lowering drugs to prevent heart attacks and strokes although trials of statins have produced conflicting results.

A new report based on a meta-analysis of 13 randomised controlled trials of statins between 1994 and 2009 involving 91,000 patients showed that there was a clear link between statin treatment and a small but significant increased risk of diabetes - 9% increase over 4 years in those using the drug than those without the treatment. The researchers said that the risk is very low and outweighed by the benefits of this drug and concluded that patients with moderate or high cardiovascular risk should not stop taking this drug.

Critics say this is a well-conducted review, when all the results were combined into a meta-analysis, the diabetes risk was relatively small, however various unidentified cofounding factors may have affected the observed results. The study was published in The Lancet online.

Source: "Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials". The Lancet, Early Online Publication, 17 February 2010

Doubts over aspirin use in diabetes

UK guidelines recommend a daily dose of aspirin as a "preventive" treatment in the diabetics as they are at a much higher risk of cardiovascular disease. However, a study published in the BMJ found no benefit from either aspirin or antioxodants in preventing heart attacks. It also increases the risk of internal bleeding.

The study invloved 1,276 adult patients with diabetes mellitus from 16 diabetic clinics in Scotland between November 1997 and July 2001. Participants were randomly assigned in four groups to receive the aspirin tablet + antioxidant capsule, or aspirin tablet + placebo capsule, or placebo tablet + antioxidant capsule or both a placebo tablet and a placebo capsule.

The findings show that in adults with diabetes and no symptoms of cardiovascular disease, there was no evidence that aspirin or antioxidants use prevented heart attacks, strokes, amputations or death. However, the drug was beneficial in people who already have a history of heart attack or stroke.

Experts said the study was "extremely important" because it confirms the concerns of aspirin use by the general population and it is worth revisiting the guidelines.

Source: Belch J, MacCuish A, Campbell I, et al. The prevention of progression of arterial disease and diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. BMJ 2008; Published 16 October ( f/t via Athens)

Food packaging chemical links to diabetes and heart disease

Multiple newspapers reported a study published in JAMA that found higher level of bisphenol A (BPA), a chemical widely used in food and drink packaging, in adults' urine increased the risk of heart disease and diabetes.

Researchers looked at the data of a survey that assessed the health and diet of the general US population invloving 1455 adults aged 18 - 74 to investigate associations between BPA concentrations in urine and adult health status.

Critics say that this is the first cross-sectional study on this subject, it can only show the relationships between exposure and risk but it cannot prove BPA cause these chronic diseases. Further research will be needed to confirm these findings.

Source: Lang IA, Galloway TS, Scarlett A, et al. Association of Urinary Bisphenol A Concentration With Medical Disorders and Laboratory Abnormalities in Adults. JAMA 2008; 300(11):1303-1310

Daily orange juice could increase diabetes risk

Newspapers reported a large study of 70,000 female nurses in the US to determine the links between diet and risk of various outcomes.

During the 18-year follow-up, 4529 new cases of diabetes were reported. Reserachers found that drinking one or more cups of orange juice per day increased the risk of diabetes by about 24% compared with drinking less than one cup a month, whereas the same increase in whole fruit consumption was associated with a lower risk of developing diabetes. Also found that an increase of 1 serving/day in green leafy vegetable consumption was associated with a modestly lower risk of diabetes.

Critics say the link between fruit juice consumption and risk of type 2 diabetes may be related to the high sugar content in the juice and the results warrent further study.

Source :"Intake of Fruit, Vegetables, and Fruit Juices and Risk of Diabetes in Women." Diabetes Care 2008; 31:1311-1317

Smoking associated with increased risk of diabetes

According to an article published in the current issue of JAMA , a review of 25 studies involving a total of 1.2 m patients showed that smoking is linked to an increased risk of diabetes.


Analysis of the data indicated that active smokers have a 44% increased risk of developing type 2 diabetes compared with non-smokers. The risk increased with the number of cigarettes smoked, heavy smokers had 61% of increased risk compared with lighter smokers (29%), but the authors said there is a need for further studies to establish whether this association is causal.


Source: "Active Smoking and the Risk of Type 2 Diabetes - A Systematic Review and Meta-analysis" JAMA. 2007;298(22):2654-2664 (abstract only)

Being overweight does not increase death risk from cancer or heart disease

A new American federal report found that overweight increase the risks of dying from diabetes and kidney disease but not cancer or heart disease. The findings are based on decades of cause-of-death data collected by federal scientists. They also found a protective effect against all other causes of death.

Some dismissed the findings as fundamentally flawed while others saw that the dangers of being fat have been exaggerated. The author said the findings does not mean being overweight is good, but is associated with less mortality than expected.

Source : "Cause-Specific Excess Deaths Associated With Underweight, Overweight, and Obesity" JAMA. 2007;298(17):2028-2037

Selenium supplements may increase diabetes risk

US researchers expected to find selenium improves gluocose metabolism as suggseted by animal studies, but in a new randomized, double-blinded and placebo-controlled study of 1202 patients who were taking part in a clinical trial to assess the effect of selenium supplementation on skin cancer, the researchers were surprised to find that the incidence of type 2 diabetes was significantly higher in the selenium group than in the placebo group.

They concluded that long term use of selenium supplements may increase the risk of developing type 2 diabetes. More significantly, the higher the blood level of selenium, the greater the risk for developing the disease.

This is an important finding for public health because selenium supplements (30 - 200 mg) are used by people throughout the US and the western world. Read more...

The findings will be published in the August issue of Annals of Internal Medicine: 21 August 2007, vol 147, issue4. "Effects of Long-Term Selenium Supplementation on the Incidence of Type 2 Diabetes: A Randomized Trial"

Obesity drug Rimonabant questioned

Rimonabant (Acomplia) by Sanofi-Aventis, was licensed for use in the UK since June 2006 for the treatment of obesity.


However, adverts have claimed the drug can cut levels of potentially harmful cholesterol, fats and sugars in the blood to a greater extent than would be expected by weight loss alone. In theory, this should help to reduce the risk of developing type 2 diabetes and heart disease.

A report published in The Drug and Therapeutics Bulletin (DTB) on 30 May 2007 said there was no proof that the drug had any beneficial effects outside those expected by weight loss. The drug had not been effectively compared with other less expensive drug treatment for obesity.

The DTB authors said Orlistat (Xenical), costs less and approved for use in the NHS is the drug for obesity with the most evidence for efficacy and safety to date, and they have previously concluded that it is a reasonable option for obese patients where diet and exercise and/or behavioural measures alone have failed.

Avandia and myocardial infarction

A leading cardiologist, Steven Nissen, found that Avandia (generic name: rosiglitazone), a diabetes drug, "was associated with significant increase in the risk of myocardial infarction and with an increase in the risk of death from cardiovascular causes that had borderline significance."

The study concluded that despite the study's limitation, " patients and providers should consider the potential for serious adverse cardiovascular effects of treatment with rosiglitazone for type 2 diabetes."

His findings were based on an analysis of 42 RCTs and published online on May 21 by NEJM. "Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes". The article will appear in the June 14 issue of the Journal.

Avandia is a top-selling diabetes drug manufacturered by GlaxoSmithKline, introduced in 1999 and is widely used to lower blood glucose levels in patients with type 2 diabetes mellitus. Nissen’s analysis on Avandia has caused the Glaxo stock down more than 6% in midday trading.

Dr. Nissen is a strong critic on drug safety, he and colleague, Eric Topol, a well-known cardiologist, raised concerns about the safety of Vioxx in JAMA in 2001 that led to the withdrawal of the drug from the market in 2004. Dr Topol lost his job after testimony against the drug manufacturer Merck in federal trial.