Daily Archives: May 3, 2010

Your life span may be as wide as your smile

A quirky new study looks at smiles in pictures of baseball players and compares death rates. What did they find? The bigger the smile, the longer the life!

Past research shows that people who smile a lot are usually happier, have more stable personalities, more stable marriages, better cognitive skills and better interpersonal skills.

Science has just uncovered another benefit of a happy face. People who have big smiles live longer.

Researchers at Wayne State University used information from the Baseball Register to look at photos of 230 players who began their careers in professional baseball before 1950.

The players’ photos were enlarged, and a rating of their smile intensity was made (big smile, no smile, partial smile). The players’ smile ratings were compared with data from deaths that occurred from 2006 through 2009. The researchers then corrected their analysis to account for other factors associated with longevity, such as body mass index, career length, career precocity and college attendance.

For those players who had died, the researchers found longevity ranged from an average of 72.9 years for players with no smiles (63 players) to 75 years for players with partial smiles (64 players) to 79.9 years for players with big smiles (23 players).

This isn’t a bunch of psycho-hooey, the authors said.

Smiles reflect positive emotion. Positive emotion has been linked to both physical and mental well-being. They added a caveat to their study: “The data source provided no information as to whether expressions were spontaneous or in response to a photographer’s request to smile.” Still, big smiles are more likely to reflect true happiness than partial smiles.

Maybe the non-smilers were thinking about batting averages.

The study is published in the journal Psychological Science and discussed in a news release from the journal.

By the way, if this topic is of interest to you, you may want to read a copy of one of my newest books, 10 Essentials of Happy, Healthy People.

  • You can order an autographed copy here.
  • You can view the Table of Contents here.
  • You can read the Forward here.
  • You can read Chapter One here.
  • You can download a free Reader’s Study Guide here.

Study fails to find evidence that bisphosphonates cause atypical femoral fractures

ABC World News has been doing report after report on the possibility that the osteoporosis medications, called bisphosphonates (like Boniva, Fosamax, Actonel, Reclast, and Zometa) may be associated with atypical and severe fractures of the femur. No one knew for sure if this was a problem or not, but we sure had quite a number of patients call our office. They were very concerned. But now, a new study is giving reassurance to healthcare professionals and our patients.

The study published in the New England Journal of Medicine “seems to give the reassurance that long-term use” of osteoporosis drugs “does not raise the risk of a thigh bone breaking.”

The New York Times reports that the study “fails to find clear evidence that bisphosphonates are causing” femoral fractures.

In fact, the University of California-San Francisco researchers “report that the thighbone fractures are so rare, even in women taking bisphosphonates for up to 10 years, that it is not clear whether the drugs make them more likely. And, they report, if there is a risk, it is far outweighed by the drugs’ clear benefit in preventing fractures of the hip and spine in people with osteoporosis.”

To examine the risk of thighbone fractures, “researchers combined results from three large studies involving more than 14,000 women who were given Fosamax [alendronate], Reclast [zoledronic acid], or dummy treatments for three to 10 years,” the AP reports.

Altogether, “284 hip and leg fractures occurred, including 12 of the unusual upper-thigh type.”

While “there was a trend toward more of these unusual fractures among bisphosphonate users … the difference was small enough to have occurred by chance.”

MedPage Today reported that in an editorial accompanying the study, endocrinologist Elizabeth Shane, MD, of Columbia University, “urged physicians with concerns about atypical femoral fractures and bisphosphonates to avoid a ‘rush to judgment.'”

Yet, on the other hand, they argued that bisphosphonates definitely do prevent other types of fractures. On the basis of the FIT and HORIZON trials, they calculated that 3,000 patient-years of treatment would prevent 71 vertebral fractures, 11 hip fractures, and 18 other types of fracture.

“We concluded that if you treat 1,000 women with osteoporosis for three years, these drugs would prevent 100 fractures, including 11 hip fractures,” Dennis M. Black, PhD, of the University of California, San Francisco, tells WebMD. “And even if you posit a threefold increase in fracture risk from these drugs, only one of those 1,000 women would have an upper thigh fracture.”

“These fractures do seem to occur and they are frightening, yet the evidence so far suggests that relative to common hip fractures they are quite rare,” Columbia University endocrinologist Elizabeth Shane, MD, told WebMD.

“The concern doctors have is that people will forget about the many thousands of hip fractures prevented by bisphosphonates and focus on the relatively rare fractures that may or may not be caused by them.”

Edward Puzas, a professor of orthopedics and director of orthopedic research at the University of Rochester Medical Center in New York, took a similar stance. “There is absolutely no reason and no evidence to stop this medication based on the fact of these unusual fractures,” he said.

“The chance of breaking a bone because of osteoporosis and all the subsequent consequences are so much more severe than these rare instances of a fracture that we don’t even know are caused by bisphosphonates,” Puzas said. “People should not discontinue this medication based on what we’re talking about right now.”

So, the bottom line, to me and my patients, is this: these medications seem safe and effective. Not only is it not likely that they cause fractures, but probable that they significantly prevent fractures.

A hot product on the Internet, but should you consider L-methylfolate instead of plain old folic acid?

My favorite natural medicines website is the Natural Medicines Comprehensive Database. The NMCD has new information about L-methylfolate which is being heavily promoted, especially on the Internet, by some manufacturers as a more active form of folic acid. Are they telling the truth? Here’s the information from NMCD:

L-methylfolate is in many prenatal vitamins such as Optinate, Neevo DHA, Prenate Elite; and regular vitamin supplements including Optimized Folate, MegaFolinic, and others. It’s also being used in medical foods for memory loss or depression, in products such as CerefolinNAC and Deplin.

According to the NMCD, “folates” are a mixture of different forms of the vitamin that occur naturally in food. Most supplements contain folic acid, a synthetic form of the vitamin. In the body, all of these forms are converted to L-methylfolate before entering the bloodstream and being stored by the body.”

The Database reports, “It is true that L-methylfolate is slightly better absorbed than folic acid. You’ll hear claims that L-methylfolate is a better alternative than folic acid because many patients have reduced activity of an enzyme that metabolizes folic acid to L-methylfolate. “

However, “so far there’s no proof that this makes a clinical difference.”

For example, studies show that equivalent doses of folic acid and L-methylfolate raise folate levels in pregnant women equally well.

Also, there is also no proof that L-methylfolate is any better than folic acid for preventing neural tube defects.

The NMCD tells us physicians, “Explain to patients that L-methylfolate is just as safe as folic acid for supplementation, but there is no reliable evidence that it’s more efficacious.”

Also, keep in mind that doses in some products are very high. Deplin contains 7500 mcg and CerefolinNAC contains 5600 mcg. These amounts are much higher than the 1000 mcg/day that has been linked to a higher cancer risk in some patients.

The NMCD webstite cautions, “Clinical research shows that taking folic acid daily in doses of 800-1200 mcg for 3-10 years significantly increases the risk of developing cancer and adverse cardiovascular effects compared to placebo.” This has been reported in studies in 2004 and 2006 studies in the New England Journal of Medicine, a 2009 study in the Journal of the National Cancer Institute, and a 2009 study in the Journal of the American Medical Association.

Also, according to the NMCD, researchers have recommended that “Doses above 1000 mcg per day should be avoided if possible to prevent precipitation or exacerbation of neuropathy related to vitamin B12 deficiency. However, there is some evidence that doses of 5 mg per day orally for up to 4 months can be used safely if vitamin B12 levels are routinely measured.

So, the bottom line, from my perspective, is that it’s likely safer and as or more effective to just use old time folic acid.