Shocking stat shows nearly 70 percent of Americans on at least one prescription drug

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In a study that shows our shocking dependence on big pharma, the Mayo Clinic today reports that nearly 70 percent of Americans are on at least one prescription drug, and more than half take two.

Antibiotics, antidepressants and painkilling opioids are most commonly prescribed, their study found. Twenty percent of patients are on five or more prescription medications, according to the findings, published online in the journal Mayo Clinic Proceedings.

Researchers find the data valuable because it gives insight into prescribing practices. The statistics from the Rochester Epidemiology Project in Olmsted County, Minn. are comparable to those elsewhere in the United States, says study author Jennifer St. Sauver, Ph.D., a member of the Mayo Clinic Population Health Program in the Mayo Clinic Center for the Science of Health Care Delivery.

"Often when people talk about health conditions they're talking about chronic conditions such as heart disease or diabetes," Dr. St. Sauver says. "However, the second most common prescription was for antidepressants — that suggests mental health is a huge issue and is something we should focus on. And the third most common drugs were opioids, which is a bit concerning considering their addicting nature."

Seventeen percent of those studied were prescribed antibiotics, 13 percent were taking antidepressants and 13 percent were on opioids. Drugs to control high blood pressure came in fourth (11 percent) and vaccines were fifth (11 percent). Drugs were prescribed to both men and women across all age groups, except high blood pressure drugs, which were seldom used before age 30.

Overall, women and older adults receive more prescriptions. Vaccines, antibiotics and anti-asthma drugs are most commonly prescribed in people younger than 19. Antidepressants and opioids are most common among young and middle-aged adults. Cardiovascular drugs are most commonly prescribed in older adults. Women receive more prescriptions than men across several drug groups, especially antidepressants: Nearly 1 in 4 women ages 50-64 are on an antidepressant.

For several drug groups, use increases with advancing age.

"As you get older you tend to get more prescriptions, and women tend to get more prescriptions than men," Dr. St. Sauver says.

Prescription drug use has increased steadily in the U.S. for the past decade. The percentage of people who took at least one prescription drug in the past month increased from 44 percent in 1999-2000 to 48 percent in 2007-08. Spending on prescription drugs reached $250 billion in 2009 the year studied, and accounted for 12 percent of total personal health care expenditures. Drug-related spending is expected to continue to grow in the coming years, the researchers say.

The study was funded by the National Institute on Aging and the Mayo Clinic Center for the Science of Health Care Delivery.

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Vitamin D deficiency may raise allergy and asthma risk in obese children, teens

One reason why obese children and teenagers are more likely to have hard-to-control asthma and allergies may be vitamin D deficiency, a new study finds. Results of the study will be presented at The Endocrine Society's 95th Annual Meeting in San Francisco.

"The increased risk for asthma and allergies, and for more severe cases of allergic disease, in overweight and obese adolescents has not previously been understood," said Candace Percival, MD, lead investigator and a pediatric endocrinology fellow at Walter Reed National Military Medical Center, Bethesda, MD. "However, past research has shown that vitamin D is important for a normal immune system and that vitamin D deficiency is common in obese individuals."

The study, conducted in 86 subjects ages 10 to 18 years, aimed to determine whether vitamin D deficiency plays a role in the increased allergy risk in youth with excess weight.

Fifty-four study subjects were overweight or obese, as determined by their body mass index (BMI) being at or above the 85th percentile for their age and sex on growth charts. The remaining 32 subjects had a healthy weight. For each subject, the researchers calculated the BMI standard deviation, called the BMI Z-score. All subjects had a vitamin D blood test called serum 25-hydroxyvitamin D, and all obese subjects were vitamin D insufficient, Percival said.

She and her team also measured levels of certain hormones called adipokines that originate in fat cells. Specifically, they assessed leptin and adiponectin, which laboratory and animal studies have shown change with obesity, with leptin becoming elevated and adiponectin decreasing. They evaluated whether these two hormones correlate with vitamin D levels and, in some subjects, with the body's allergy signaling pathways—biochemical measures of allergic disease.

A subgroup of 39 subjects (19 with overweight or obesity and 20 with a healthy weight) underwent blood tests to measure their levels of immunoglobulin E (IgE), which is one of the main players in allergic reactions. Of these 39 subjects, 36 (17 overweight/obese and 19 healthy-weight) also underwent measurements of chemical messengers called cytokines that contribute to allergy and asthma, specifically interleukins (IL) 4, 6, 10 and 13 and interferon-gamma.

The investigators found significant correlations between the severity of the subjects' obesity, the adipokine levels and some biochemical measures of allergic disease. As expected, the higher the BMI Z-score was (indicating greater obesity), the higher the level of leptin and the lower the levels of adiponectin and vitamin D, the authors reported. Obese subjects also had increased levels of IgE, IL-6 and IL-13. However, Percival said, "the relationship between the BMI-Z score and the adipokines and markers of allergic disease seemed to depend on the vitamin D deficiency seen in the more obese patients, leading us to conclude that the increased risk for allergy in obesity may be mediated by vitamin D to some degree."

"This is the first study, to our knowledge, that ties together the relationship of vitamin D deficiency and increased allergy risk and severity in obese and overweight adolescents," she said.
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BPA linked to a common birth defect in boys

A new study links fetal exposure to a common chemical pollutant, bisphenol A (BPA), to defects of a testicular hormone in newborn boys with undescended testicles. The results, which were presented Monday at The Endocrine Society's 95th Annual Meeting in San Francisco, suggest yet another potential harmful effect of BPA, which is widely used in many plastics, liners of food cans and dental sealants.

"Alone, our study cannot be considered as definitive evidence for an environmental cause of undescended testis," said lead author Patrick Fenichel, MD, PhD, professor and head of reproductive endocrinology at the University Hospital of Nice in France. "But it suggests, for the first time in humans, a link that could contribute to one co-factor of idiopathic [unexplained] undescended testis, the most frequent congenital malformation in male newborns."

Cryptorchidism, the medical name for undescended testicles, occurs in 2 to 5 percent of full-term male newborns, according to Fenichel. Sometimes the testicles descend on their own within six months after birth. If the condition persists and goes untreated, however, it carries an increased risk in adulthood of decreased fertility and testicular cancer, he said.

Fenichel and his colleagues studied 180 boys born after 34 weeks' gestation between 2003 and 2005. Fifty-two were born with one or two undescended testicles, 26 of whom still had the condition at 3 months of age. The other 128 newborns did not have this birth defect and were matched for pregnancy term, weight and time of birth (the control group). Using sensitive immunoassays of the infants' umbilical cord blood, the researchers measured the newborns' levels of BPA and insulin-like peptide 3, one of the two testicular hormones that regulate descent of the testicles.

Testosterone level, which also controls fetal testicular descent, did not differ between the groups and was normal in the whole population, according to Fenichel.

The infants with cryptorchidism had significantly lower levels of insulin-like peptide 3, compared with the controls, the authors reported. These infants did not have greatly increased levels of BPA or several other environmental endocrine disrupters that were measured. However, in all 180 infants, the BPA level inversely correlated with the level of insulin-like peptide 3, meaning that the higher the BPA level, the lower the level of this important testicular hormone.

Fenichel speculated that BPA, an estrogenic endocrine disruptor, might repress, as other research has shown for estrogens in rodents, expression of the gene for insulin-like peptide 3. This could be a co-factor in the development of cryptorchidism, he said.

Animal research also has linked fetal BPA exposure to an increased risk of reproductive disorders and other health problems.

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Geneticist says menopause caused by men's preference for younger women

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After decades of laboring under other theories that never seemed to add up, a team led by biologist Rama Singh has concluded that what causes menopause in women is men.

Singh, an evolutionary geneticist, backed by computer models developed by colleagues Jonathan Stone and Richard Morton, has determined that menopause is actually an unintended outcome of natural selection – the result of its effects having become relaxed in older women.

Over time, human males have shown a preference for younger women in selecting mates, stacking the Darwinian deck against continued fertility in older women, the researchers have found.

"In a sense it is like aging, but it is different because it is an all-or-nothing process that has been accelerated because of preferential mating," says Singh, a professor in McMaster's Department of Biology whose research specialties include the evolution of human diversity.

Stone is an associate professor in the Department of Biology and associate director of McMaster's Origins Institute, whose themes include the origins of humanity, while Morton is a professor emeritus in Biology.

While conventional thinking has held that menopause prevents older women from continuing to reproduce, in fact, the researchers' new theory says it is the lack of reproduction that has given rise to menopause.

Their work appears in the online, open-access journal PLOS Computational Biology. The paper is available here: http://www.ploscompbiol.org/article/info:doi/10.1371/journal.pcbi.1003092.

Menopause is believed to be unique to humans, but no one had yet been able to offer a satisfactory explanation for why it occurs, Singh says.

The prevailing "grandmother theory" holds that women have evolved to become infertile after a certain age to allow them to assist with rearing grandchildren, thus improving the survival of kin. Singh says that does not add up from an evolutionary perspective.

"How do you evolve infertility? It is contrary to the whole notion of natural selection. Natural selection selects for fertility, for reproduction -- not for stopping it," he says.

The new theory holds that, over time, competition among men of all ages for younger mates has left older females with much less chance of reproducing. The forces of natural selection, Singh says, are concerned only with the survival of the species through individual fitness, so they protect fertility in women while they are most likely to reproduce.

After that period, natural selection ceases to quell the genetic mutations that ultimately bring on menopause, leaving women not only infertile, but also vulnerable to a host of health problems.

"This theory says that natural selection doesn't have to do anything," Singh says. "If women were reproducing all along, and there were no preference against older women, women would be reproducing like men are for their whole lives."

The development of menopause, then, was not a change that improved the survival of the species, but one that merely recognized that fertility did not serve any ongoing purpose beyond a certain age.

For the vast majority of other animals, fertility continues until death, Singh explains, but women continue to live past their fertility because men remain fertile throughout their lives, and longevity is not inherited by gender.

Singh points out that if women had historically been the ones to select younger mates, the situation would have been reversed, with men losing fertility.

The consequence of menopause, however, is not only lost fertility for women, but an increased risk of illness and death that arises with hormonal changes that occur with menopause. Singh says a benefit of the new research could be to suggest that if menopause developed over time, that ultimately it could also be reversed.
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Using Papaya seeds and clay could cut cost of water purification in developing countries; save lives

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An inexpensive new material made of clay and papaya seeds removes harmful metals from water and could lower the cost of providing clean water to millions of people in the developing world, scientists are reporting. Their study on this "hybrid clay" appears in the journal ACS Sustainable Chemistry & Engineering.

Emmanuel Unuabonah and colleagues explain that almost 1 billion people in developing countries lack access to reliable supplies of clean water for drinking, cooking and other key uses. One health problem resulting from that shortage involves exposure to heavy metals such as lead, cadmium and mercury, released from industrial sources into the water. Technology exists for removing those metals from drinking water, but often is too costly in developing countries. So these scientists looked for a more affordable and sustainable water treatment adsorbent.

They turned to two materials readily available in some developing countries. One was kaolinite clay, used to make ceramics, paint, paper and other products. The other: seeds of the Carica papaya fruit. Both had been used separately in water purification in the past, but until now, they had not been combined in what the scientists term "hybrid clay." Their documentation of the clay's effectiveness established that the material "has a strong potential for replacing commercial activated carbon in treatment of wastewater in the developing world."

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