Happy Cinco de Mayo!! Let’s celebrate!


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NPI Posture Analysis-Correction and Resistance Training CEC Workshops at College/University Campuses: NPI College-University Posture and Resistance Training CEC - CEU Workshops

Take that Vacation from the long Cold Winter-you deserve it! Attend NPI Workshops at San Diego State (June 7-8), Santa Barbara College (June 12-13) or Waikiki Beach, Hawaii (June 29-30). Attend NPI’s Resistance Training-Posture Correction CEC Workshop. Register: http://www.npionline.org/workshops/posture-workshops.html          

National Posture Institute News: Diabetes trials worldwide are not addressing key issues in affected populations

With only 1 in 10 studying prevention while almost two-thirds focus on drug therapy

An analysis of diabetes trials worldwide has found they are not addressing key issues relating to the condition with almost two thirds focusing on drug therapy while only one in ten addresses prevention or behavioural therapies. The research is published in Diabetologia, the journal of the European Association for the Study of Diabetes (EASD), and is by Dr Jennifer Green, Duke University Medical Center, Durham, NC, USA, and colleagues.

There are an estimated 371 million people with diabetes in the world. By 2030, there will be some 550 million with diabetes based on current trends. As such, research addressing the whole spectrum of diabetes care and treatment is essential. To examine whether current studies adequately address these needs, Green and colleagues analysed diabetes-related trials registered with ClinicalTrials.gov from 2007.

The researchers found 2,484 interventional trials by selecting those with disease condition terms relevant to diabetes. Of these, 75% had a primarily therapeutic purpose while just 10% were preventive. Listed interventions were mostly drugs (63%) while few were behavioural (12%). Most of the studies were also small to medium sized, and were designed to enrol 500 or fewer participants (91%) or 100 or fewer (59%) participants, with mean/median times to completion of 1.8/1.4 years.

A very small proportion of trials targeted persons aged 18 years and under (4%). This may be appropriate given the number of children currently affected by diabetes; however, the estimated 3% annual increase in incidence of type 1 diabetes may warrant greater representation. Furthermore, the increase in type 2 diabetes among adolescents, particularly noticeable in wealthier nations, is of considerable concern, since as Dr Green notes "it is unclear whether findings obtained from trials of adults with diabetes are readily translatable to paediatric/adolescent populations".

And despite the fact that nearly 20% of adults worldwide aged 65 years and over have diabetes, less than 1% of trials specifically targeted this age group, while 31% actually excluded patients over 65 years and almost all excluded those over 75 years.

"Only a tiny proportion of the trials analysed—1.4%—listed primary outcomes including mortality or clinically significant cardiovascular complications," says Dr Green. "Furthermore, distribution of registered trials by country does not reliably correlate with diabetes prevalence."

The International Diabetes Federation list of the 10 locations most affected by diabetes includes six Middle Eastern countries in which diabetes prevalence among adults is approximately 20% (Kuwait, Lebanon, Qatar, Saudi Arabia, Bahrain and the United Arab Emirates). However, this analysis by Green and colleagues, suggests that this region is minimally involved in the registered diabetes-related trials. Comparison of trial activities in countries with the highest diabetes prevalence among adults revealed 1126 trials in the USA. China, India and Mexico participated in 101 trials each; however, the Russian Federation (12.6 million persons with diabetes) and Brazil (12.4 million) are involved in fewer than 100 registered trials despite these heavy disease burdens.

Dr Green also says: "Rates of complications including diabetic retinopathy, lower extremity amputation, and end-stage renal disease vary among ethnic groups. To achieve the greatest impact upon clinical care, trials should enrol patients representative of populations disproportionately affected by diabetes and its complications. A better understanding of responses to interventions among diverse individuals and groups may inform individualised treatments of greater effectiveness and tolerability."

She concludes: "The majority of diabetes-related trials include small numbers of participants, exclude those at extremes of age, are of short duration, involve drug therapy rather than preventive or non-drug interventions, and do not focus upon significant cardiovascular outcomes. Recently registered diabetes trials may not sufficiently address important diabetes care issues or involve affected populations...Although many trials will provide valuable information upon completion, our review suggests that the current portfolio does not adequately address disease prevention, management, or therapeutic safety. This information may be meaningful in the allocation of future research activities and resources."

Awesome news!  The National Posture Institute's Posture Analysis, Correction, and Resistance Training Workshop was approved by Mass Physical Therapy Board for 11.5 CECs. Physical Therapist in Massachusetts’s can attend the NPI’s workshop at Boston University Sept 21-22, 2013 to renew your licensure. 

Learn more and Register: http://www.npionline.org/workshops/bu


 

National Posture Institute Research: Eating fish associated with lower risk of dying among older adults

Risk of dying from heart disease significantly lowered

Boston, MA – Older adults who have higher levels of blood omega-3 levels—fatty acids found almost exclusively in fatty fish and seafood—may be able to lower their overall mortality risk by as much as 27% and their mortality risk from heart disease by about 35%, according to a new study from Harvard School of Public Health (HSPH) and the University of Washington. Researchers found that older adults who had the highest blood levels of the fatty acids found in fish lived, on average, 2.2 years longer than those with lower levels.

"Although eating fish has long been considered part of a healthy diet, few studies have assessed blood omega-3 levels and total deaths in older adults," said lead author Dariush Mozaffarian, associate professor in the Department of Epidemiology at HSPH. "Our findings support the importance of adequate blood omega-3 levels for cardiovascular health, and suggest that later in life these benefits could actually extend the years of remaining life."

The study—the first to look at how objectively measured blood biomarkers of fish consumption relate to total mortality and specific causes of mortality in a general population—appears online April 1, 2013 in Annals of Internal Medicine.

Previous studies have found that fish, which is rich in protein and heart-healthy fatty acids, reduces the risk of dying from heart disease. But the effect on other causes of death or on total mortality has been unclear. With this new study, the researchers sought to paint a clearer picture by examining biomarkers in the blood of adults not taking fish oil supplements, in order to provide the best assessments of the potential effects of dietary consumption of fish on multiple causes of death.

The researchers examined 16 years of data from about 2,700 U.S. adults aged 65 or older who participated in the Cardiovascular Health Study (CHS), a long-term study supported by the National Heart, Lung, and Blood Institute. Participants came from four U.S. communities in North Carolina, California, Maryland, and Pennsylvania; and all were generally healthy at baseline. At baseline and regularly during follow-up, participants had blood drawn, underwent physical examinations and diagnostic testing, and were questioned about their health status, medical history, and lifestyle.

The researchers analyzed the total proportion of blood omega-3 fatty acids, including three specific ones, in participants' blood samples at baseline. After adjusting for demographic, cardiovascular, lifestyle, and dietary factors, they found that the three fatty acids—both individually and combined—were associated with a significantly lower risk of mortality. One type in particular—docosahexaenoic acid, or DHA—was most strongly related to lower risk of coronary heart disease (CHD) death (40% lower risk), especially CHD death due to arrhythmias (electrical disturbances of the heart rhythm) (45% lower risk). Of the other blood fatty acids measured—eicosapentaenoic acid (EPA) and docosapentaenoic acid (DPA)—DPA was most strongly associated with lower risk of stroke death, and EPA most strongly linked with lower risk of nonfatal heart attack. None of these fatty acids were strongly related to other, noncardiovascular causes of death.

Overall, study participants with the highest levels of all three types of fatty acids had a 27% lower risk of total mortality due to all causes.

When the researchers looked at how dietary intake of omega-3 fatty acids related to blood levels, the steepest rise in blood levels occurred when going from very low intake to about 400 mg per day; blood levels rose much more gradually thereafter. "The findings suggest that the biggest bang-for-your-buck is for going from no intake to modest intake, or about two servings of fatty fish per week," said Mozaffarian.