June 15, 2012
NIH Podcast Episode #0161
Balintfy: Welcome to episode 161 of NIH Research Radio. NIH Research Radio bringing you news and information about the ongoing medical research at the National Institutes of Health – NIH . . . Turning Discovery Into Health®. I'm your host Joe Balintfy, and coming up in this episode, can drinking coffee lower your risk of death? Infectious diseases: measles and TB; and helping father’s and their families stay healthy. But first, a news update with Craig Fritz. And Craig, I understand the first story you have for us this episode is a follow-up to a feature we had in last episode number 160.
Fritz: That’s right Joe. Last podcast we talked about the Discovering New Therapeutic Uses for Existing Molecules program and this is a partnership between NIH and the pharmaceutical industry that basically companies are coming on board and giving NIH and researchers nationwide access to compounds and drugs that they’ve already done a lot of research on but maybe weren’t necessarily effective in the diseases they were aimed to treat, or maybe were not pursued for business reasons. So this program is opening up these compounds to researchers across the country, that have already passed certain milestones in safety and are safe in humans and so they are looking for new applications for these compounds that may benefit other diseases that there were not originally intended.
Balintfy: The example that we cited in that last report was the drug AZT that was originally designed as a cancer drug, and turned out to be the first effective treatment for HIV, the virus that causes AIDS. And in that earlier report it was discussed that there were three pharmaceutical companies participating. That number has increased now?
Fritz: That’s right we have now five more pharmaceutical companies that have come on board as part of this program. And, we’re up to 58 compounds used in the discovery efforts which is double from where we were just earlier in the year.
Balintfy: And of course to hear more about the whole program and the idea of discovering New Therapeutic Uses for Existing Molecules you can reach back to episode 160.
Fritz: A new agreement to collaborate on clinical research studies involving young children will encourage greater insight into early origin and development of disease and discovery of new treatments for rare disorders. The Translational Research in Pediatrics Program is a joint effort from NIH and Children’s National Medical Center in Washington, D.C. The clinical expertise and infrastructure of Children’s National to support a very young patient population and the state-of-the-art research facilities at the NIH Clinical Center will allow investigators to develop new studies addressing rare conditions at an earlier age. Through the program, NIH investigators will identify a research partner at Children's National, and Children’s National will offer access to its clinical research center for outpatient visits. Children’s National has authorized 20 inpatient hospital admissions under the program using private funds. The NIH Clinical Center sees more rare disease patients than any place else in the nation. As researchers work to pinpoint the genetic causes of rare conditions and develop treatment options, they want to be able to intervene earlier in the course of diseases.
For this NIH news update, I’m Craig Fritz.
Balintfy: News updates are compiled from information at www.nih.gov/news. Coming up, two infectious diseases, Father’s Day tips and coffee’s link to lower risk of death. That’s next on NIH Research Radio.
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NIH study finds that coffee drinkers have lower risk of death
Balintfy: Are you a coffee drinker? This may be good news for you: A NIH study has found that people who drank coffee, both caffeinated and decaffeinated, had a lower risk of death than people who did not drink coffee. Wally Akinso brings us the details.
Akinso: Researchers have found an association between coffee drinking and a lower risk of death for older adults. Dr. Neal Freedman, an NIH researcher who helped lead the study, says coffee drinkers in the study were less likely to die from a number of different causes.
Freedman: We saw a very similar association for people drinking both decaffeinated or caffeinated coffee.
Akinso: Dr. Freedman and his colleagues examined the association between coffee drinking and risk of death in 400,000 U.S. men and women ages 50 to 71 who participated in the NIH-AARP Diet and Health Study.
Freedman: So over the course of our study we found that coffee drinkers have a lower risk of dying from heart disease, stroke, diabetes, respiratory disease and infections but not for cancer. So for cancer we observed no association for women but for men there was a borderline statistically significant increased risk with higher amounts of coffee consumed.
Akinso: Dr. Freedman points out that coffee is one of the most widely consumed beverages in America, but the association between coffee consumption and risk of death has been unclear.
Freedman: We found that over the course of our follow up people who drank coffee had a lower risk of death than people who didn't drink coffee.
Akinso: He believes these results do provide some reassurance that coffee drinking does not adversely affect health. But the question remains, does coffee actually make people live longer?
Freedman: Not necessarily I should say. So our study is observational which means that at the start of the study we asked people about their coffee drinking and other habits. And then we followed them over time. And so we're not sure that coffee, itself, is actually having the effect and maybe something that goes along with coffee drinking.
Akinso: Dr. Freedman adds that coffee contains more than 1,000 compounds that might potentially affect health. The investigators caution that coffee intake was measured by self-report at a single time point and therefore might not reflect long-term patterns of intake. Also, information was not available on how the coffee was prepared, for example as espresso, boiled or filtered. The researchers consider it possible that preparation methods may affect the levels of any protective components in coffee. For more information on this study, which appears in the New England Journal of Medicine, visit www.cancer.gov. For NIH Radio, this is Wally Akinso.
Measles in the United States
Balintfy: Now we’re turning to a couple of stories about infectious diseases. This first, just in time for the summer travel season, highlights a recent report from the CDC that shows the most number of reported measles cases in the US in 15 years. Measles is an infectious disease caused by a virus that resides in the nose and throat of infected people.
Fauci: It is very, very easily spread from person to person by the respiratory route.
Balintfy: Dr. Anthony Fauci at the NIH explains the disease burden of measles was very serious.
Fauci: It resulted prior to widespread vaccination in close to 50,000 hospitalizations, 3 to 4 million cases, between 400 and 500 deaths. That’s really quite serious and I think what people don’t fully appreciate is that because we’ve been so successful in eliminating measles, for the most part as a year-round threat, people tend to forget or never even realize that it can be a really serious disease.
Balintfy: In fact, because of very high immunizations rates in the US, health experts declared measles eliminated in 2000. According to the CDC, between 2001 and 2010 there have only been about 60 cases reported each year. Now the CDC is reporting that in 2011, there was a spike in cases of measles in the US. Dr. Fauci points out mostly imported cases.
Fauci: Namely, people who come into the country who are unvaccinated and were infected and people who live in the United States who go traveling come back and bring it back and then they themselves expose other people who are unvaccinated and you get these mini little outbreaks. So this past year in 2011, there was a total of 222 cases, which involved 17 outbreaks in 31 states. So it isn’t just someone going to a country, getting infected with measles, coming back, and that’s it. That person can infect people who for one reason or other were not vaccinated even though they never left the United States.
Balintfy: Measles spreads when an infected person sneezes or coughs. Dr. Fauci describes the symptoms.
Fauci: Well it starts off with a fever, a significant fever and then after a couple of days or maybe even within a day or so of the fever, you wind up getting a running nose, you cough, you sneeze, and you get what’s called conjunctivitis or inflammation or red eye as it were. Then, after a period of a couple of days, you develop a rash, which starts off on the face and the neck and then goes to the trunk and to the extremities. You can get serious complications, which include anything from relatively mild like diarrhea, dehydration to more serious like pneumonia and in maybe 1 in a 1000 cases or so, you can get brain involvement with encephalitis and maybe even death in 1 in a 1000 cases.
Balintfy: There is no treatment for measles and young babies are especially susceptible. NIH’s Dr. Fauci says prevention is the best treatment for measles.
Fauci: You can treat the symptoms of dehydration and the symptoms of secondary infections for example when people get ear infections and other infections or pneumonia. But we have a phenomenally effective vaccine against measles and for that reason, measles vaccination should be as it is widespread. It’s about 92% adherence to measles vaccinations in this country and we need to get even better than that.
Balintfy: Health experts recommend that college and other students, health care personnel and anyone traveling internationally should have two appropriately spaced doses of vaccines. They’re concerned that with the summer travel season starting, travelers may bring back infection with measles, rather than proper souvenirs. For more information on measles, including vaccination and incidence, visit www.cdc.gov.
Balintfy: Now onto another infectious disease: tuberculosis or TB. It remains one of the major causes of disability and death worldwide.
Fauci: TB is a challenge because it is one of the most pervasive diseases, certainly infectious diseases in the world.
Balintfy: Dr. Anthony Fauci is an NIH institute director. He explains that TB is a contagious and an often severe airborne disease caused by a bacterial infection, typically in the lungs.
Fauci: If we look at the big killers, HIV, AIDS, malaria, tuberculosis, tuberculosis, there are about 8 million plus new active cases per year; there are about 1.45 million deaths per year. About one-third of the entire world's population is infected with tuberculosis, usually latent tuberculosis, but that's always a threat for activation. So this is a huge, huge problem of immense dimensions, so it's just one of those things that we have to start getting our arms around.
Balintfy: NIH researchers point out that although recent progress against the disease is heartening, the control and eventual elimination of TB will require a long-term, multifaceted commitment from the global health and research communities.
Fauci: We have done well in some respects with tuberculosis, but we have a lot of gaps that we need to fill. The theme of this year's World Tuberculosis Day is “Eliminating Tuberculosis in My Lifetime,” which is a very bold statement. But I think it is feasible. It's feasible because we finally have reawakened and rekindled the interest and the resources in filling major research and implementation gaps with tuberculosis.
Balintfy: Dr. Fauci adds that TB research needs to be brought into the 21st century.
Fauci: Some of the tools that we are still using are 19th century tools like the microscope for the diagnostics of smears, of sputum for tuberculosis. We have not really developed a brand-new drug exclusively for tuberculosis in over 40 years. We have a vaccine that does not work at all in pulmonary tuberculosis. We don't understand the pathogenesis of TB. We don't know why people have latent tuberculosis and why some go on to activate. There are so many things that we don't understand that we are just now starting to really scratch the surface of.
Balintfy: Of note the World Health Organization is now including biomedical research as a critical part of the global fight against TB. And at NIH, TB clinical research capacity for adults and children, with and without HIV co-infection, is increasing.
Fauci: So I have a lot of optimism that with the enhanced implementation of the tools that we already have, together with a major push on developing countermeasures in the form of diagnostics, therapeutics, and hopefully a vaccine, that I think the theme of this year's World Tuberculosis Day is something that's not completely out of the realm of reality.
Balintfy: To see a complete statement regarding World TB Day, which was last month, and for more information on TB and TB research efforts, visit www.niaid.nih.gov.
And coming up, Father’s Day tips for the whole family, that’s next.
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Fathers lead the family in living healthier
Balintfy: Welcome back to NIH Research Radio. Father’s Day is this weekend. It’s a time when attention is turned to the men in the family. We’re talking with Dr. Griffin Rodgers, director of the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases. So Dr. Rodgers, what are some things dads can do to lead the family in living healthier?
Rodgers: Father’s Day is a perfect time to celebrate dads and encourage them to make staying healthy a priority—for themselves and for the family. We know that being overweight or obese may increase a dad’s chances of developing heart disease, diabetes, kidney disease, and certain cancers. A plan that encourages dads to eat better and get regular exercise can help them-and their family-stay healthy.
Balintfy: What do you recommend including in a healthy eating plan, Dr. Rodgers?
Rodgers: Dads should follow a healthy eating plan that includes a variety of nutrient-rich foods such as whole grain breads and cereals, vegetables, fruits, beans, and peas, lean meats and seafood, low-fat or fat-free milk products, and poultry. Eating a variety of healthy foods and eating smaller portion sizes may help dads control their weight and stay healthy.
Healthy dads should regularly do aerobic and strengthening activities. Dads should start with a level of physical activity that feels doable and slowly increase the frequency, time and intensity of their exercise. They should pick an activity that they enjoy and will stick with. This activity should get their heart and breathing rates up, but they should not be so tired that they can’t talk while doing it. Aim for at least 30 minutes of exercise five or more times a week. A brisk walk at lunch or after dinner, weight training with a friend or playing soccer on a local team are activities that dad can consider.
Balintfy: What are some other things dads can do to maintain their health?
Rodgers: Well, in addition to following a healthy eating plan, being active and keeping at a healthy weight, Dads can also improve their overall health by getting adequate sleep and quitting smoking if they are smoking.
Balintfy: Father’s Day celebrations may also be a time when the extended family gets together to celebrate. How can you make health a priority when the whole family is together?
Rodgers: Take advantage of family gatherings to share information about your family’s health history. Many conditions run in families, and dads can lead the family in living healthier together. He can talk with members of older generations to better understand health conditions that have affected family members. Armed with this information, he can share it with younger members of the family, and help them learn to break some of those unhealthy habits and cycles.
Dads can be family health champions. They can lead the family in physical activity and games after lunch or dinner. And they can ensure their favorite dish that they request on their special day are healthier options the entire family will enjoy.
Balintfy: I’m sure some families have a hard time talking about health, wellness, and even illness during celebrations and family gatherings. How do you begin the conversation, Dr. Rodgers?
Rodgers: Dads are powerful members of the family. They can lead by example by tackling overweight or obesity in the family. They should encourage the family to play together to increase physical activity. And they should talk about health conditions, such as diabetes, high blood pressure, and cardiovascular disease, and how these conditions—if not managed—can lead to other chronic diseases, such as chronic kidney disease.
While you cannot change your family’s health history, knowing about it can give you the information you need to work with your health care team to take action on the things you can change. Dads can lead the family in taking those actions.
One health condition that really should be talked about is diabetes. Another is kidney disease. Having diabetes or high blood pressure puts you at risk for kidney disease. In fact, most people with type 2 diabetes or kidney disease have a family member – such as a mother, father, brother, or sister – with the disease.
To help get your family members talking about their health history of diabetes or kidney disease, we recommend asking the following questions:
One, does anyone in the family have type 2 diabetes or kidney disease? Who has type 2 diabetes or kidney disease?
Second, has anyone in the family been told they might get diabetes or kidney disease?
Three: Has anyone in the family been told they need to lose weight or increase their physical activity to prevent type 2 diabetes?
And finally, did your mother get diabetes when she was pregnant? This condition is also known as gestational diabetes.
Dads can use the National Kidney Disease Education Program’s Family Reunion Health Guide to find ways to talk about health, particularly kidney disease, at family gatherings. The Guide includes talking points Dads can follow to talk about kidney health. It emphasizes kidney health conversations at family reunions, but the information can be used at any time, with any family gathering.
Balintfy: If someone is concerned that they may be at risk for diabetes, what can they do to prevent or delay the onset of type 2 diabetes?
Rodgers: Well, if you have a family history of type 2 diabetes or are concerned that you are at risk, you should talk with your health care provider.
The good news is that research has shown that people at high risk for developing type 2 diabetes can prevent or delay this disease by making important lifestyle changes, such as losing a small amount of weight – about 5 or 7 percent or approximately 10 or 14 pounds if you weigh 200 pounds – and becoming more physically active. And the whole family can benefit by making healthy food choices and being more active.
Balintfy: What are some tips that people should keep in mind when it comes to preventing diabetes and maintaining a healthier lifestyle?
Rodgers: Well in addition to what I mentioned earlier about making healthy food choices and being more physically active, people can write down all the foods you eat and drink and the number of minutes you are active and review it every day. This will help you reach your goals. NDEP’s GAME PLAN can also help. And you can download it at www.YourDiabetesInfo.org.
Balintfy: That’s it for this episode of NIH Research Radio. Please join us again on Friday, June 29 when our next edition will be available. If you have any questions or comments about this program, or have story suggestions for a future episode, please let me know. Send an email to NIHRadio@mail.nih.gov. Also, please consider following NIH Radio via Twitter @NIHRadio, or on Facebook. Until next time, I'm your host, Joe Balintfy. Thanks for listening.
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