Yogurt May Help Prevent Osteoporosis

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''Adequate nutrition plays a major role in the prevention and treatment of osteoporosis, and the micronutrients of greatest importance are calcium and vitamin D,'' says Jeri Nieves, PhD, MS, director of bone density testing at New York’s Helen Hayes Hospital.

Calcium has been shown to have beneficial effects on bone mass in people of all ages, although the results are not always consistent, says Nieves, also an assistant professor of clinical epidemiology at Columbia University.

''The combination of calcium and vitamin D has a clear skeletal benefit, provided the dose of vitamin D is sufficiently high,'' she adds.

And what qualifies as ''sufficiently high?''

Currently, 400 IU per day is considered an adequate intake of vitamin D for people ages 51-70, Nieves says. (Look for the Daily Value amount listed on food labels.) But more may be better.

''This amount is likely to be sufficient for most young adults for skeletal health, although many would argue that for overall health, more than the 400 IU may be required, even at these younger ages,'' Nieves said in an email interview.

Nieves believes that older people specifically can benefit from more vitamin D.

Many dairy products, including some yogurts, are made with added vitamin D. Find out which brands have added vitamin D by checking out the table below, and by reading labels when you shop.

Obesity May Raise Risk for Restless Legs Syndrome

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April 7, 2009 — Overweight patients are more likely to have restless legs syndrome, a new study shows. Reporting in the April 7 issue of Neurology, investigators found that people who were obese were nearly 1.5 times more likely to develop the movement disorder.

"Weight reduction could be a potential strategy in treating restless legs syndrome," lead author Xiang Gao, MD, from Brigham and Women's Hospital and Harvard Medical School, in Boston, Massachusetts, said during an interview.

"This is still only a cross-sectional study," he adds, "so it is too early to know whether there is a causal relationship, and this will need to be confirmed."

But given what researchers already know about the negative impact of excess weight on health, Dr. Gao says that encouraging weight loss — irrespective of its potential impact on restless legs syndrome — is a good idea.

Weight Loss Recommended

William Weiner, MD, from the University of Maryland, in Baltimore, said he agrees. "Being obese has all kinds of negative health consequences, so of course we should encourage patients to get their body mass down. But we really don't know whether this will have an effect on restless legs."

Asked by Medscape Neurology & Neurosurgery to comment on the study, Dr. Weiner called the work "interesting," but he urged caution in interpreting the results. He noted there have been a greater number of association studies recently, and he voiced concern over the confusion this can promote when conflicting results are made public.

"It's hard to know what is real, and this can cause problems for doctors and patients," Dr. Weiner said.

It is estimated that about 10% of adults in the United States have restless legs syndrome. The disorder can have a substantial impact on sleep, daily activities, and quality of life.

Using data from the Nurses' Health Study II and the Health Professional Follow-up Study, Dr. Gao and his team looked at more than 65,500 women and 23,000 men.

Participants were considered to have the movement disorder if they met diagnostic criteria recommended by the International Restless Legs Syndrome Study Group and experienced symptoms at least 5 times a month.

A total of 6.4% of the women and 4.1% of the men were identified as having restless legs syndrome. None of the participants had diabetes or arthritis or were pregnant.

The researchers found that people with a body-mass index (BMI) score over 30 were more likely to have restless legs syndrome than people who were not overweight. They also found that people who were in the top 20% of the group for highest waist circumference were more likely to have the movement disorder than those in the bottom 20% of the group.

Multivariate Adjusted Odds Ratios for Restless Legs

BMI	Odds Ratio	95% CI	P
> 30 vs < style="font-size: 0.85em; line-height: 0; ">2	1.42	1.3 – 1.6	< .0001
Highest vs lowest waist circumference	1.60	1.5 – 1.8	< .0001

The investigators report that a higher BMI in early adulthood was also associated with a higher prevalence of restless legs syndrome. This was independent of age, smoking status, anxiety score, use of antidepressants, and presence of a number of chronic diseases.

Dr. Gao points out that the mechanisms that may link obesity with restless legs are likely to be multiple. Some studies suggest that obese people have lower dopamine-receptor levels. "Since decreased dopamine function is believed to play a critical role in restless legs syndrome as well, this could be the link between the 2," he said.

Cardiovascular diseases are associated with an increased risk for both obesity and restless legs, and some have suggested that vascular pathology may also contribute to the movement disorder.

"We need to understand which comes first — the obesity and other cardiovascular risk factors or the restless legs syndrome," Dr. Gao said. "Our study showed that people who were obese in their early 20s, for example, had a much higher risk of developing restless legs later in life, but these results will need to be confirmed."

This study is funded by the National Institutes of Health and the National Institute of Neurological Disorders and Stroke. The researchers have disclosed no relevant financial relationships.

Neurology. 2009;72:1255-1261.

Combination Vaccine Is Safe and Effective for Infants

NEW YORK (Reuters Health) Jan 08 - A combination vaccine against diphtheria, tetanus, pertussis, polio and flu, which is routinely used in Canadian children, has been shown to be immunogenic and well tolerated in a U.S. study.

The randomized trial was conducted to support U.S. licensure of the vaccine -- DTaP5-IPV-Hib -- which incorporates diphtheria-tetanus-5-component acellular pertussis (DTaP5), inactivated poliovirus (IPV), and Haemophilus influenzae type B (Hib) vaccines.

Nearly 2000 infants were vaccinated at 2, 4, and 6 months of age, either with the DTaP5-IPV-Hib combination vaccine (Pentacel; Sanofi Pasteur Ltd., Toronto, Ontario) or with the DTaP5, IPV and Hib vaccines administered separately. Some babies in each group were also given fourth dose of DTaP5-IPV-Hib or of the DTaP5 and Hib vaccines as toddlers.

In the January issue of Pediatrics, Dr. Fernando A. Guerra of the San Antonio Metropolitan Health District in Texas and colleagues report that, compared with licensed vaccines, the combined vaccine produced similar or fewer injection site and systemic reactions with "noninferior" seroresponse and seroprotection rates, along with identical or higher concentrations of antibodies to pertussis toxoid, filamentous hemagglutinin, and Hib polysaccharide.

The children were followed up to age 5, at which time "the two groups had comparable persistence of antibodies...to all vaccine antigens in the DTaP5-IPV-Hib vaccine, except for pertactin," according to the article.

"The current results are reassuring and consistent with safety surveillance data in Canada, where for the past decade, the combination vaccine has been the only DTaP-containing vaccine used among infants and toddlers," the researchers conclude.

Pediatrics 2009;123:301-312.