Researchers from the Albert Einstein College of Medicine reported this week that a combination treatment made up of two FDA-approved drugs may be able to treat tuberculosis (TB) that is resistant to standard TB drugs. If true, the new treatment could help hundreds of thousands of people worldwide who suffer from multidrug resistant TB (MDR-TB), which does not respond to the two most common antibiotics used for TB, and extensively drug-resistant (XDR-TB) bacteria that resist at least four of the drugs used to treat TB.

In the study, published Thursday in the journal Science, the researchers used cultures of TB bacteria in a lab to show that the combination of the antibiotic meropenem and another drug called clavulanate is effective against 13 different strains of XDR-TB, the hardest type of TB to treat. The combination also killed MDR-TB and non-resistant TB strains.

The combination in an elegant solution to a vexing problem of TB treatment: the TB bacterium produces an enzyme called beta-lactamase that destroys penicillin-like antibiotics. This required the development of new drugs to treat the disease, most of which were developed in the 1950s and 60s. However, after nearly 50 years of use, TB bacteria have started to develop resistance to these drugs. So the researchers revisited the idea of using penicillin-like antibiotics against TB and developed a way to get around the problem of beta-lactamase. One of the drugs used in the combination, clavulanate, is a beta-lactamase inhibitor. The clavulanate basically acts as decoy molecule that preoccupies the beta-lactamase enzyme, allowing the other drug in the combination, a penicillin-like antibiotic called meropenem, to sneak in and kill the TB bacterium.

Two things make this finding especially exciting to researchers in the field of TB treatment. First, the drugs used in the combination treatment are FDA-approved, which should make it much easier to begin clinical trials on humans, although clavulanate is currently only commercially available in combination with other penicillin-like antibiotics such as amoxicillin.

The other exciting thing is that if this combination treatment proves effective in human, it could greatly simplify the treatment of TB. Current TB therapy requires four antibiotics that must be taken for at least six months. If a combination treatment involving just two drugs works against drug-susceptible, MDR-TB and XDR-TB, it could help could help patients better adhere to therapy and make it easier to treat TB in developing countries, where drug-resistant TB can be rampant.

Plans are underway for two clinical trials, one in South Korea beginning this year and involving approximately 100 XDR-TB patients and a separate trial to be conducted in South Africa.

For more information about TB, join the Healia Health Community for Tuberculosis.

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A study appearing today in the New England Journal of Medicine provides evidence that low-fat, low-carb, and high-protein diets all can lead to successful long-term weight loss, as long as they reduce a person’s calorie intake. While previous research has suggested that one type of diet may be better than another, the present study followed people for two years and found that lasting weight loss was similar among participants who followed diets that were similar to popular specialty weight-loss programs.

Researchers from the Harvard School of Public Health followed more than 800 overweight adults on one of four diets, each with a different distribution of nutrients: low-fat, high carb; low-fat, high-protein; high-fat, low-carb; and high-fat, high-protein. Though the diets were similar to commercial plans, the study did not directly compare popular diets. All four diets contained healthy fats, were high in whole grains, and were low in cholesterol.

Each dieter was encouraged to cut 750 calories a day from their diet, exercise 90 minutes a week, keep an online food diary, and meet regularly with diet counselors to chart their progress. After two years, the results showed that all four groups had the same average weight loss of 9 pounds and all lost an average of 2 inches off of their waistline. Most risk factors for cardiovascular disease improved for dieters as well including increases in HDL ("good") cholesterol and decreases in LDL ("bad") cholesterol, triglycerides, blood pressure, and insulin resistance.

The study also found that people who made good use of diet counseling saw better results. Those who attended the most meetings lost an average of 22 pounds, far more than the overall average of 9 pounds.

The researchers conclude that it does not matter what the nutrient composition of a diet is, as long as a diet reduces calorie-intake and remains heart healthy (high in fiber and low in saturated fats). They stress that following a restricted-calorie diet that is good for the heart allows dieters to eat a variety of foods and reduces monotony, which makes it easier for people stick with their diets. Instead of eliminating several foods from your diet, dieters just need to be reasonable about portion control. The key to successful weight loss is simply: eat less.

One researcher not involved in the study provided a different take on the results. In an accompanying editorial, she notes that after two years of very focused effort on the part of motivated participants who had access to several weight-loss resources, the average weight loss achieved was very modest. This leads her to conclude that the key to reversing the obesity epidemic may not lie in the hands of individuals. Instead, community-based programs that start in childhood and help encourage schoolchildren to eat better and move around more may be the best way to combat obesity.

Want to learn more about how to cut calories and maintain weight loss? See How can I control my weight? in the Healia Health Guide to Weight Management, or join the Healia Health Community for Weight Management.

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British researchers reported Tuesday that women who consume low to moderate amounts of alcohol face an increased risk of several types of cancers. Based on their data, they conclude that alcohol may account for nearly 13 percent of all cancers of the breast, liver, rectum, and upper digestive tract combined in the UK.

Researchers at the University of Oxford examined the relationship between alcohol consumption and several types of cancer among nearly 1.3 million middle-aged women enrolled in the UK’s Million Women Study. About a quarter of the women in the study reported abstaining from alcohol, but among the other three-quarters, the average alcohol consumption was one drink per day; very few reported having more than three drinks per day.

In the study that appears in the February 24^th online edition of the Journal of the National Cancer Institute, researchers compared the lightest drinkers – those who consumed two or fewer drink per week – with those who drank more. After an average follow-up time of seven years, they found that each additional alcoholic drink regularly consumed per day was associated with 11 additional breast cancers per 1000 women up to age 75; one additional cancer of the oral cavity and pharynx; one additional cancer of the rectum; and an increase of 0.7 each for esophageal, laryngeal, and liver cancers. The background rate for all of these cancers combined is about 118 cases per 1,000 women. The type of alcohol consumed (wine, beer, or liquor) did not matter.

While the cancer risk to individuals conferred by drinking alcohol is not large, the researchers stress that given the prevalence of alcohol consumption in most Westernized countries, it likely results in a large number of cancers that are otherwise preventable, accounting for perhaps 13 percent of all cancers in the UK.

Previous studies have suggested that moderate alcohol consumption can benefit heart health and may reduce the chances of heart disease. While the present study did not address heart disease risk, the results call into question the health benefits of moderate alcohol consumption. However, heart disease is the leading cause of death for both women and men, ahead of all types of cancers combined, so there may still be an overall health benefit from moderate alcohol consumption.

Further research will hopefully shed light on who, if anyone, may benefit from moderate alcohol consumption and what is the "safest" amount to drink. Whether there is any overall health benefit to you from drinking alcohol may depend on your personal history and risk factors (e.g. family history of cancer or heart disease, cholesterol levels). Talk to your doctor about your risk factors and your alcohol consumption to find out if you should change your drinking habits.

For more information about breast cancer prevention, see How can I prevent breast cancer? in the Healia Health Guides. If you have a question about your alcohol consumption, ask the Healia Health Community on Alcohol or Ask the Experts at Healia Health Communities.

A new study reveals that a higher intake of calcium may reduce the overall risk of cancer for women and also reduce the risk of colorectal cancer and other digestive cancers for both men and women. The study appears in the February 23 edition of Archives of Internal Medicine.

Researchers from the National Cancer Institute (NCI) analyzed data from nearly 500,000 people who participated in the National Institutes of Health-AARP Diet and Health Study that began in 1995. Participants between the ages of 50 and 71 filled out a questionnaire reporting how often and in what quantities they consumed dairy products and a wide variety of other foods, and whether they took supplements. Their records were then linked with state cancer registries to identify new cases of cancer.

After an average of seven years of follow up, nearly 50,000 cases of cancer had occurred. Calcium intake was associated with a decrease in the overall risk for all cancers in women and the more calcium women got, the more the risk decreased. Beyond 1,300 milligrams of calcium per day, no further reduction occurred.

While men did not display the same overall reduction in cancer risk, calcium intake was associated with reduced risk of cancers of the digestive system for both men and women. The top 20 percent of men who consumed the most calcium through food and supplements (about 1,530 milligrams per day on average) had a 16 percent lower risk of digestive cancers than the bottom 20 percent who consumed the least calcium (526 milligrams per day).

For women, those in the top 20 percent of calcium consumption (1,881 milligrams per day) had a 23 percent lower risk of these cancers than those in the bottom 20 percent (494 milligrams per day). This risk reduction was particularly pronounced for colorectal cancer. The study found no relationship between calcium and prostate cancer, breast cancer or other cancers.

The researchers believe that calcium may help prevent digestive system cancers by reducing abnormal growth in cells in the gastrointestinal tract or by reducing damage to the mucous membrane in the large intestine.

Calcium has long been known to be associated with bone health and calcium intake is critical in preventing osteoporosis. However, previous research into the role of calcium in cancer prevention has produced mixed results. The present study is one of the largest ever undertaken, but it relied on interviews instead of blood tests and can therefore only estimate the amount of calcium each participant had consumed.

Does this mean you should run out and buy calcium supplements? Perhaps, but the researchers found that the benefits of calcium were mostly associated with calcium-rich foods rather than supplements, although calcium from supplements alone was still effective in reducing colon cancer risk in men. Foods with lots of calcium include dairy products such as milk and yogurt and leafy green vegetables. The recommended daily calcium intake for older people is 1,200 milligrams, while for younger adults it is 1,000mg. Adolescents should get 1,300 milligrams per day of calcium.

For more information about nutrition or dietary supplements, join the Healia Health Community for Diet and Nutrition or the Healia Health Community for Dietary Supplements. Find out more about colorectal cacner at the Healia Health Community for Colorectal Cancer.

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