OREGON STATE UNIVERSITY

heath and nutrition

Lack of pharmacy access sends some patients back to the hospital

PORTLAND, Ore. – Hospital readmissions, a $17 billion annual problem, are higher in rural, remote or smaller communities that sometimes have significantly less access to pharmacies, according to a study published today that was one of the first to examine this issue.

Researchers at Oregon State University and Oregon Health & Science University found that the average number of readmissions from rural areas was 15.3 percent, compared to 14.7 percent for their urban counterparts where the days and hours a person could find an open pharmacy were much higher.

Unplanned hospital readmissions are such a serious national problem that recent changes in federal law are penalizing hospitals that have high readmission rates. It can be a problem with various groups: older adults; people who have several medical conditions; those taking multiple medications; and people who have difficulty adhering to their medication regimen.

The study was done in Oregon with census data of patients over 65, studying 507 pharmacies and 58 hospitals. It was supported by the OHSU Layton Alzheimer Disease Center, which is funded by the National Institutes of Health.

“It’s a huge burden both on a patient and our medical system when they have to be readmitted to a hospital,” said David Lee, an assistant professor in the OSU/OHSU College of Pharmacy, and senior author on a new study in the Journal of the American Pharmacists Association.

“The modern pharmaceutical profession is increasingly being recognized as an important partner in health care, and as its services continue to expand it will help even more. This research shows that pharmacy access can help people from going back to the hospital. For older populations who often find hospital experiences quite exhausting, that’s extremely important to their overall health.

“The sooner a person gets out and stays out of a hospital, the better off they usually will be.”

In some rural areas of Oregon, Lee noted, a person might have to drive 100 miles or more to find a pharmacy. In one of Oregon’s rural communities there is a single pharmacy that’s open 54 hours a week; by comparison, in some major urban areas a person might be able to find multiple pharmacies that collectively are open more than 3,800 hours a week.

These challenges of availability, distance and convenience to professional pharmaceutical products, service and counsel are a problem, researchers said. Another interesting corollary to the issue, they said, is identification of what have been called “pharmacy deserts” even within major urban areas, such as Chicago.

“Large, urban, predominantly white communities usually have a lot of pharmacies and access,” said Sarah Bissonnette, lead author on this study and an OSU postdoctoral fellow. “But in some lower socioeconomic areas even within cities, it’s much more difficult to find an open pharmacy.”

If more conventional pharmacies are not economically viable, the researchers said, a possible remedy to the problem is growth and improvement of what’s called “telepharmacy,” or mail-order services that are carefully backed up by personal advice, monitoring and counsel from professional pharmacists.

Improved hospital discharge medication counseling has been shown to increase adherence to use of new or changed medications, the study indicated. And some hospitals around the country have also taken it upon themselves to open community and 24-hour pharmacies in an attempt to reduce readmission rates.

Nonadherence to medication usage ranges from 25-50 percent in the United States, depending on the disease state, and is associated with increased illness and death, the study noted.  Causes can include adverse side effects, insurance coverage, costs, education levels, cognition and pharmacy access.

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David Lee, 503-494-2258

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Pharmacist consult
Pharmacist consult

Teens who smoke daily are more likely to report health complaints

CORVALLIS, Ore. – As fewer teens overall take up smoking, those who do smoke daily are reporting more health complaints than in years past, a new study indicates.

“Teens who smoke report significantly higher levels of health complaints than nonsmoking teens, and we found that this gap has widened over the years, even as the overall prevalence of teen smoking has dropped,” said Marc Braverman a professor, lead author and Extension specialist in the College of Public Health and Human Sciences at Oregon State University, who worked with collaborators in Norway.

“Some adolescents smoke as an attempt to cope with their health problems, and that subgroup may represent a growing proportion of teen smokers, as fewer teenagers are taking up smoking for social reasons.”

The researchers believe it is the first time that this shifting relationship between daily smoking and health complaints in adolescence has been reported. The results were published recently in the journal Nicotine and Tobacco Research.

Smoking is on the decline among adults and adolescents in most places around the world, which is very welcome news, said Braverman, whose research expertise includes smoking prevention and tobacco control policy.

But as smoking rates decline, reducing them further becomes more challenging. Some tobacco researchers believe that the remaining smokers tend to be more “hard-core” smokers, who have been smoking for long periods and either do not wish to quit or believe they would not be successful if they tried, he said.

“Many public health officials are asking what kinds of new strategies might be needed to reduce smoking prevalence, to say, the low single digits, and what kinds of resources that might require,” Braverman said.  “Some smokers are more addicted to or dependent on cigarettes than others.”

Understanding the links between health and smoking among teens will help public health officials determine better smoking cessation strategies for that age group, particularly those who smoke on a daily basis, Braverman said.

For the study, researchers used data from the Health Behavior in School-Aged Children Study, an international collaborative project sponsored by the World Health Organization that began in the 1980s and currently includes 43 countries. Surveys of 11-, 13- and 15-year-olds are conducted every four years in participating countries.

The researchers examined smoking behavior and health problems among 15-year-olds in Norway over five waves of the survey, from 1993-94 to 2009-10. They focused on Norway in part because that country experienced dramatic declines in smoking rates over that time period, which allows for investigation of how smoking populations have changed, Braverman said.

As part of the survey, the students were asked about their smoking behavior and how often they experienced subjective physical and psychological health complaints such as headache, stomachache, backache, dizziness, irritability, nervousness, feeling “low” and sleep difficulties.

In addition to the changes in health complaints over time, the researchers found important differences in health complaints related to gender. Girls, in general, reported more health complaints than boys, but the difference between the sexes was significantly larger among smoking teens than nonsmoking teens. In particular, girls who smoked daily reported higher levels of health complaints than any other subgroup, Braverman said.

The data collected did not allow for an explanation of the reason for the finding, but the study raises concerns that adolescent girls might be at especially high risk for health problems associated with smoking, he said.

If teens are smoking as a coping mechanism for physical or psychological problems, they may be at greater risk for dependence and addiction than their peers who are smoking because of peer or social influences, Braverman said.

“And for those teens who smoke to cope with health problems, getting them to stop will likely require different strategies and more intensive intervention efforts than those that are commonly used,” Braverman said. “A ‘stop smoking’ media campaign probably won’t be enough.”

Co-authors of the study include Robert Stawski of OSU; Oddrun Samdal of the University of Bergen;    and Leif Edvard Aarø  of the Norwegian Institute of Public Health. Braverman’s work on the study was funded in part by a grant from the OSU Division of International Programs.

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Marc Braverman, 541-737-1021

marc.braverman@oregonstate.edu

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Marc Braverman
Marc Braverman

Vitamin E protects critical nutrient, prevents neurologic damage and death in embryos

CORVALLIS, Ore. – Researchers have discovered that a dietary deficiency of vitamin E in laboratory animals can cause significant neurological impairment in developing embryos, as well as physical abnormalities and embryonic death.

The study suggests that one mechanism leading to this damage may be loss of the role vitamin E plays in protecting levels of DHA, one of the most important of the omega-3 fatty acids that plays a crucial role in brain and cellular development.

The work, by scientists in the Linus Pauling Institute at Oregon State University, was done with zebrafish, a vertebrate that has neurologic development very similar to humans. They also have dietary needs that are more similar to humans than some other animal models.

In these fish, vitamin E-deficient embryos did not respond correctly to visual cues, had severe physical abnormalities as early as two days after fertilization, and many died before the end of five days.

The findings were published in Redox Biology, in work supported by the National Institutes of Health and the National Science Foundation.

They take on special significance, researchers say, because more than 90 percent of the adults in the United States who do not take supplements have diets deficient in vitamin E.

“DHA in a developing embryo is very important for cell signaling and membrane development,” said Melissa McDougall, an OSU graduate research assistant in the Linus Pauling Institute and the College of Public Health and Human Sciences, and lead author on this publication.

“Our research showed that adequate levels of vitamin E are important in preventing depletion of DHA in the embryo.

“Without enough DHA, there was also evidence for disruption of the structural integrity of cell membranes as a whole. It appears that vitamin E protects these critical lipids, such as DHA, from excessive depletion that can cause physical and behavioral damage.”

The study showed loss of locomotor activity in vitamin E-deficient embryos as a measure of impaired behavior. Vitamin E-deficient embryos were 82 percent less responsive to a light/dark stimulus.

Past research done elsewhere with rodents, McDougall said, has correlated low DHA levels with less memory and intelligence, and one study in Bangladesh with vitamin E-deficient pregnant women showed a higher level of miscarriage.

The recommended daily allowance of vitamin E for human adults is 15 milligrams a day, and the typical American diet rarely provides that. Vitamin E is most common in nuts, seeds, some leafy greens like spinach, and a few varieties of vegetable oils like sunflower and canola. Low-fat diets also present a special challenge in getting enough vitamin E.

Not all pre-natal vitamins even include vitamin E, McDougall said, although some of the better ones are now including not only vitamin E but also supplements of DHA, a nutrient most common in fatty fish. It’s worth noting, she said, that vitamin E cannot serve its role in protecting DHA if there is inadequate dietary DHA to begin with.

Most human brain development occurs during pregnancy, and some of the most important neurologic development happens during the first trimester.

The corresponding author on this publication was Maret Traber, the Helen P. Rumbel Professor for Micronutrient Research in the Linus Pauling Institute. Other collaborators were from the OSU College of Pharmacy, the Sinnhuber Aquatic Research Laboratory, the OSU Department of Environmental and Molecular Toxicology, and the OSU Environmental Health Sciences Center.

 

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Maret Traber, 541-737-7977

maret.traber@oregonstate.edu

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Zebrafish
Zebrafish

OSU researchers discover the unicorn – seaweed that tastes like bacon!

NEWPORT, Ore. – Oregon State University researchers have patented a new strain of a succulent red marine algae called dulse that grows extraordinarily quickly, is packed full of protein and has an unusual trait when it is cooked.

This seaweed tastes like bacon.

Dulse (Palmaria sp.) grows in the wild along the Pacific and Atlantic coastlines. It is harvested and usually sold for up to $90 a pound in dried form as a cooking ingredient or nutritional supplement. But researcher Chris Langdon and colleagues at OSU’s Hatfield Marine Science Center have created and patented a new strain of dulse – one he has been growing for the past 15 years.

This strain, which looks like translucent red lettuce, is an excellent source of minerals, vitamins and antioxidants – and it contains up to 16 percent protein in dry weight, Langdon said.

“The original goal was to create a super-food for abalone, because high-quality abalone is treasured, especially in Asia,” Langdon pointed out. “We were able to grow dulse-fed abalone at rates that exceeded those previously reported in the literature. There always has been an interest in growing dulse for human consumption, but we originally focused on using dulse as a food for abalone.”

The technology of growing abalone and dulse has been successfully implemented on a commercial scale by the Big Island Abalone Corporation in Hawaii.

Langdon’s change in perspective about dulse was triggered by a visit by Chuck Toombs, a faculty member in OSU’s College of Business, who stopped by Langdon’s office because he was looking for potential projects for his business students. He saw the dulse growing in bubbling containers outside of Langdon’s office and the proverbial light went on.

“Dulse is a super-food, with twice the nutritional value of kale,” Toombs said. “And OSU had developed this variety that can be farmed, with the potential for a new industry for Oregon.”

Toombs began working with OSU’s Food Innovation Center in Portland, where a product development team created a smorgasbord of new foods with dulse as the main ingredient. Among the most promising were a dulse-based rice cracker and salad dressing.

The research team received a grant from the Oregon Department of Agriculture to explore dulse as a “specialty crop” – the first time a seaweed had made the list, according to Food Innovation Center director Michael Morrissey.

That allowed the team to bring Jason Ball onto the project. The research chef previously had worked with the University of Copenhagen’s Nordic Food Lab, helping chefs there better use local ingredients.

“The Food Innovation Center team was working on creating products from dulse, whereas Jason brings a ‘culinary research’ chef’s perspective,” said Gil Sylvia, director of the Coastal Oregon Marine Experiment Station at OSU’s Hatfield Marine Science Center in Newport. “The point that he and other chefs make is that fresh, high-quality seaweed is hard to get. ‘You bring us the seaweed,’ they say, ‘and we’ll do the creative stuff.’”

Several Portland-area chefs are now testing dulse as a fresh product and many believe it has significant potential in both its raw form and as a food ingredient.

Sylvia, who is a seafood economist, said that although dulse has great potential, no one has yet done a full analysis on whether a commercial operation would be economically feasible. “That fact that it grows rapidly, has high nutritional value, and can be used dried or fresh certainly makes it a strong candidate,” he said.

There are no commercial operations that grow dulse for human consumption in the United States, according to Langdon, who said it has been used as a food in northern Europe for centuries. The dulse sold in U.S. health food and nutrition stores is harvested, and is a different strain from the OSU-patented variety.

“In Europe, they add the powder to smoothies, or add flakes onto food,” Langdon said. “There hasn’t been a lot of interest in using it in a fresh form. But this stuff is pretty amazing. When you fry it, which I have done, it tastes like bacon, not seaweed. And it’s a pretty strong bacon flavor.”

The vegan market alone could comprise a niche.

Langdon, a professor in the Department of Fisheries and Wildlife at OSU and long-time leader of the Molluscan Broodstock Program, has two large tanks in which he can grow about 20-30 pounds of dulse a week. He has plans to up the production to 100 pounds a week. For now, they are using the dulse for research at the Food Innovation Center on dulse recipes and products.

However, Toombs’ MBA students are preparing a marketing plan for a new line of specialty foods and exploring the potential for a new aquaculture industry.

“The dulse grows using a water recirculation system,” Langdon said. “Theoretically, you could create an industry in eastern Oregon almost as easily as you could along the coast with a bit of supplementation. You just need a modest amount of seawater and some sunshine.”

The background of how Langdon and his colleagues developed dulse is outlined in the latest version of Oregon’s Agricultural Progress at : http://bit.ly/1fo9Doy

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Chris Langdon, 541-867-0231, chris.langdon@oregonstate.edu;  Chuck Toombs, 541-737-4087, Charles.Toombs@oregonstate.edu;

Michael Morrisey, 503-872-6656, Michael.Morrissey@oregonstate.edu;  Gil Sylvia, 541-867-0284, gil.sylvia@oregonstate.edu

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Dulse in its seaweed form

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Dulse prepared in a dish

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Chris Langdon near a vat of growing dulse

Be Well Run, Walk N’ Roll celebrates fifth year

CORVALLIS, Ore. – Runners, race walkers and anyone looking for a brisk fall stroll are invited to participate in a 5-kilometer run/1-mile walk on Oct. 17 at Oregon State University. It is free and open to the public. 

The event, which is sponsored by Be Well, OSU Healthy Campus Initiatives and Recreational Sports, celebrates Beaver Nation’s commitment to health and well-being. The run/walk kicks off at 3:30 p.m.

This is the fifth year of the “Run, Walk, N’ Roll” event, which draws hundreds to the Memorial Union quad. While many participate in the 5K run, others take a more relaxed approach and walk, roll or stroll through a mile-long route.

This year, the event fair includes a ‘body shop’ starting at 3 p.m., giving participants a chance to test their flexibility, balance, heart rate, blood pressure and to try out biofeedback.

“Every year it’s fun to see so many OSU and Corvallis community folks coming out to enjoy this event,” said Lisa Hoogesteger, director of Healthy Campus Initiatives. “A lot of people bring their whole family and teams dress up in fun costumes. It’s a party atmosphere, and it really emphasizes that physical activity can be fun and social as well.” 

The long course takes runners out Campus Way past the covered bridge and almost to the fairgrounds and back, while the short course ends by the east greenhouses on Campus Way and circles back around.

Registration is free and those who pre-register are guaranteed to receive a T-shirt. Pre-registration is encouraged to avoid lines the day of the event.

To register, go to http://oregonstate.edu/recsports/bewell5k. Check in for the event and day-of registration will be available on site in the Memorial Union Quad starting at 3 p.m. on the day of the event.

For photos of last year’s event: https://www.flickr.com/photos/oregonstateuniversity/sets/72157636549485256/

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Lisa Hoogesteger, 541-737-3343; lisa.hoogesteger@oregonstate.edu

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Last year's event

“Brain Breaks” increase activity, educational performance in elementary schools

CORVALLIS, Ore. – A recent Oregon survey about an exercise DVD that adds short breaks of physical activity into the daily routine of elementary school students found it had a high level of popularity with both students and teachers, and offered clear advantages for overly sedentary educational programs.

Called “Brain Breaks,” the DVD was developed and produced by the Healthy Youth Program of the Linus Pauling Institute at Oregon State University, and is available nationally.

Brain Breaks leads children in 5-7 minute segments of physical activity, demonstrated by OSU students and elementary school children from Corvallis, Oregon. The short periods of exercise aim to improve the physical health, mental awareness and educational success of children.

“We’re increasingly recognizing the importance of physical activity for children even as the academic demands placed on them are cutting into the traditional programs of recess and physical education,” said Gerd Bobe, an assistant professor in the OSU College of Agricultural Sciences, an expert in public health nutrition and behavior, and principal investigator with the Linus Pauling Institute.

“Kids need to move, they can’t just sit all day long,” Bobe said. “Given the time constraints and multiple demands that schools are facing, we really believe the concept of short activity breaks, right in the classroom, is the way to go.”

Oregon law, for instance, mandates that by 2017 elementary schools will be required to have 30 minutes a day of physical education classes, in addition to recess periods. But a survey conducted by the Healthy Youth Program found that 92 percent of Oregon public elementary schools currently do not meet this standard. And sometimes, Bobe said, elimination of recess is used as a disciplinary tool, potentially taking activity away from those students who may need it the most.

Brain Breaks was created to bring more activity back into classrooms, especially when it may be most useful – in the afternoon after lunch, for instance, when attention spans and concentration tend to waver. Research has shown that physical activity can increase academic performance, student focus and classroom behavior, Bobe said.

The program offers a variety of segments, including six based on stretching and relaxation, five on endurance, and one on strength, with imaginative concepts such as “space adventures” and “crazy kangaroos.” No equipment is needed, other than a chair for the strength segment, and all activities can be done in a classroom setting. An abstract of the work has been published in the Journal of Nutrition Education and Behavior.

A recent survey of the Healthy Youth Program that was sent to participating Oregon school districts found that:

  • Almost all teachers said the program was appropriate for their classes and well-understood by the class;
  • More than 90 percent of teachers said the exercise segments had the right length, and that students were more focused after using the program;
  • All of the segments were popular with more than 80 percent of students, but the stretching and relaxation activities had the highest approval, at 95 percent, and were also most frequently used by teachers;
  • About three-fourths of the teachers were using the program two to three times per week, and more than 90 percent plan to continue its use.

“Longer periods of exercise have a place, but research shows that these short programs can be very valuable as well,” Bobe said. “They can increase oxygen consumption, range of motion, endurance, and get kids in the habit of being more active. A little bit of exercise can go a long way.”

A second edition of the DVD is being developed, Bobe said. More information on the DVD is available online at http://bit.ly/1o6rcHk, including a video trailer and how to buy a copy.

“This survey shows a program that’s working and is valuable,” Bobe said. “We hope it becomes popular across the nation.”

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Gerd Bobe, 541-737-1898

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Exercise

Exercise breaks

Concern grows over pet pills and products, as well as those of owners

CORVALLIS, Ore. – Scientists have long been aware of the potential environment impacts that stem from the use and disposal of the array of products people use to keep themselves healthy, clean and smelling nice.

Now a new concern is emerging – improper disposal of pet care products and pills.

Dog shampoos, heartworm medicine, flea and tick sprays, and a plethora of prescription and over-the-counter medicines increasingly are finding their way into landfills and waterways, where they can threaten the health of local watersheds. An estimated 68 percent of American households have at least one pet, illustrating the potential scope of the problem.

How bad is that problem? No one really knows, according to Sam Chan, a watershed health expert with the Oregon Sea Grant program at Oregon State University.

But Chan and his colleagues aim to find out. They are launching a national survey (online at: http://tinyurl.com/PetWellbeingandEnvironment)  of both pet owners and veterinary care professionals to determine how aware that educated pet owners are of the issue, what is being communicated, and how they dispose of  “pharmaceutical and personal care products” (PPCPs) for both themselves and their pets. Pet owners are encouraged to participate in the survey.

“You can count on one hand the number of studies that have been done on what people actively do with the disposal of these products,” Chan said. “PPCPs are used by almost everyone and most wastewater treatment plants are not able to completely deactivate many of the compounds they include.”

Increasingly, Chan said, a suite of PPCPs used by pets and people are being detected at low levels in surface water and groundwater. Examples include anti-inflammatory medicines such as ibuprofen, antidepressants, antibiotics, estrogens, the insect repellent DEET, and ultraviolet (UV) sunblock compounds.

Some of the impacts from exposure to these products are becoming apparent. Fish exposed to levels of antidepressants at concentrations lower than sewage effluence, for example, have been shown to become more active and bold – making them more susceptible to predation, noted Chan, an OSU Extension Sea Grant specialist.

“Triclosan is another concern; it is a common anti-microbial ingredient in soaps, toothpaste, cosmetics, clothing, cookware, furniture and toys to prevent or reduce bacterial contamination for humans and pets,” Chan said. “It is being linked to antibiotic resistance in riparian zones, as well as to alterations in mammal hormone regulation – endocrine disruptor – and impacts on immune systems.”

Another common endocrine disruptor, the researchers say, is coal tar, a common ingredient in dandruff shampoo for humans, and pet medicines for skin treatment.

Jennifer Lam conducted a preliminary survey of veterinary practitioners as part of her master’s thesis at Oregon State University and found awareness by veterinary professionals of the environmental issues caused by improper disposal of PPCPs was high. Yet many did not share that information with their clients.

In fact, veterinarians only discussed best practices for disposal with their clients 18 percent of the time, her survey found.

“The awareness is there, but so are barriers,” Lam said. “Communicating about these issues in addition to care instructions takes time. There may be a lack of educational resources – or a lack of awareness on their availability. And some may not think of it during the consultation process.”

The National Sea Grant program recently partnered with the American Veterinary Medicine Association to promote the reduction of improper PPCP disposal. The national survey is a first step in that process.

“Most people tend to throw extra pills or personal care products into the garbage and in fewer instances, flush them down the drain,” Chan said. “It seems like the right thing to do, but is not the most environmentally friendly method for disposing unused or expired PPCPs. Waste in landfills produce leachates and these contaminates may not be fully deactivated by current wastewater treatments. They can get into groundwater and streams, where they can cause a variety of environmental problems and create a health risk as well.”

When disposing of expired or unneeded medications, the researchers say, don’t flush them. Instead, take to them to a drug take-back event or depository. New rules to be implemented by the U.S. Drug Enforcement Agency (DEA) later this fall will make drug take-back options more available.

Chan and Lam suggest that in areas where take-back options are not available, people should mix unused or unwanted drugs with coffee grounds or kitty litter – something that will be unpalatable to pets. Then put the mixture in a sealed container and deposit it in the trash.

Results from the national survey led by Oregon Sea Grant will provide much-needed information to guide education, watershed monitoring and improvements on ways to reduce PPCP contamination and their environmental impacts.

The survey will continue until Nov. 1.

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Sam Chan, 503-679-4828, sam.chan@oregonstate.edu;

Jennifer Lam, lamj@onid.oregonstate.edu

Lipoic acid helps restore, synchronize the “biological clock”

CORVALLIS, Ore. – Researchers have discovered a possible explanation for the surprisingly large range of biological effects that are linked to a micronutrient called lipoic acid: It appears to reset and synchronize circadian rhythms, or the “biological clock” found in most life forms.

The ability of lipoic acid to help restore a more normal circadian rhythm to aging animals could explain its apparent value in so many important biological functions, ranging from stress resistance to cardiac function, hormonal balance, muscle performance, glucose metabolism and the aging process.

The findings were made by biochemists from the Linus Pauling Institute at Oregon State University, and published in Biochemical and Biophysical Research Communications, a professional journal. The research was supported by the National Institutes of Health, through the National Center for Complementary and Alternative Medicine.

Lipoic acid has been the focus in recent years of increasing research by scientists around the world, who continue to find previously unknown effects of this micronutrient. As an antioxidant and compound essential for aerobic metabolism, it’s found at higher levels in organ meats and leafy vegetables such as spinach and broccoli.

“This could be a breakthrough in our understanding of why lipoic acid is so important and how it functions,” said Tory Hagen, the Helen P. Rumbel Professor for Healthy Aging Research in the Linus Pauling Institute, and a professor of biochemistry and biophysics in the OSU College of Science.

“Circadian rhythms are day-night cycles that affect the daily ebb and flow of critical biological processes,” Hagen said. “The more we improve our understanding of them, the more we find them involved in so many aspects of life.”

Almost one-third of all genes are influenced by circadian rhythms, and when out of balance they can play roles in cancer, heart disease, inflammation, hormonal imbalance and many other areas, the OSU researchers said.

Of particular importance is the dysfunction of circadian rhythms with age.

“In old animals, including elderly humans, it’s well-known that circadian rhythms break down and certain enzymes don’t function as efficiently, or as well as they should,” said Dove Keith, a research associate in the Linus Pauling Institute and lead author on this study.

“This is very important, and probably deserves a great deal more study than it is getting,” Keith said. “If lipoic acid offers a way to help synchronize and restore circadian rhythms, it could be quite significant.”

In this case the scientists studied the “circadian clock” of the liver. Lipid metabolism by the liver is relevant to normal energy use, metabolism, and when dysfunctional can help contribute to the “metabolic syndrome” that puts millions of people at higher risk of heart disease, diabetes and cancer.

Researchers fed laboratory animals higher levels of lipoic acid than might be attained in a normal diet, while monitoring proteins known to be affected by disruption of the circadian clock in older animals.

They found that lipoic acid helped remediate some of the liver dysfunction that’s often common in old age, and significantly improved the function of their circadian rhythms.

In previous research, scientists found that the amount of lipoic acid that could aid liver and normal lipid function was the equivalent of about 600 milligrams daily for a 150-pound human, more than could normally be obtained through the diet.

A primary goal of research in the Linus Pauling Institute and the OSU Center for Healthy Aging Research is to promote what scientists call “healthspan” – not just the ability to live a long life, but to have comparatively good health and normal activities during almost all of one’s life. Research on lipoic acid, at OSU and elsewhere, suggests it has value toward that goal.

Continued research will explore this process and its role in circadian function, whether it can be sustained, and optimal intake levels that might be needed to improve health.

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Tory Hagen, 541-737-5083

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Shifting rhythms

Rhythms decline with age

Findings point toward one of first therapies for Lou Gehrig’s disease

CORVALLIS, Ore. – Researchers have determined that a copper compound known for decades may form the basis for a therapy for amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s disease.

In a new study just published in the Journal of Neuroscience, scientists from Australia, the United States (Oregon), and the United Kingdom showed in laboratory animal tests that oral intake of this compound significantly extended the lifespan and improved the locomotor function of transgenic mice that are genetically engineered to develop this debilitating and terminal disease.

In humans, no therapy for ALS has ever been discovered that could extend lifespan more than a few additional months. Researchers in the Linus Pauling Institute at Oregon State University say this approach has the potential to change that, and may have value against Parkinson’s disease as well.

“We believe that with further improvements, and following necessary human clinical trials for safety and efficacy, this could provide a valuable new therapy for ALS and perhaps Parkinson’s disease,” said Joseph Beckman, a distinguished professor of biochemistry and biophysics in the OSU College of Science.

“I’m very optimistic,” said Beckman, who received the 2012 Discovery Award from the OHSU Medical Research Foundation as the leading medical researcher in Oregon.

ALS was first identified as a progressive and fatal neurodegenerative disease in the late 1800s and gained international recognition in 1939 when it was diagnosed in American baseball legend Lou Gehrig. It’s known to be caused by motor neurons in the spinal cord deteriorating and dying, and has been traced to mutations in copper, zinc superoxide dismutase, or SOD1. Ordinarily, superoxide dismutase is an antioxidant whose proper function is essential to life.

When SOD1 is lacking its metal co-factors, it “unfolds” and becomes toxic, leading to the death of motor neurons. The metals copper and zinc are important in stabilizing this protein, and can help it remain folded more than 200 years.

“The damage from ALS is happening primarily in the spinal cord and that’s also one of the most difficult places in the body to absorb copper,” Beckman said. “Copper itself is necessary but can be toxic, so its levels are tightly controlled in the body. The therapy we’re working toward delivers copper selectively into the cells in the spinal cord that actually need it. Otherwise, the compound keeps copper inert.”

“This is a safe way to deliver a micronutrient like copper exactly where it is needed,” Beckman said.

By restoring a proper balance of copper into the brain and spinal cord, scientists believe they are stabilizing the superoxide dismutase in its mature form, while improving the function of mitochondria. This has already extended the lifespan of affected mice by 26 percent, and with continued research the scientists hope to achieve even more extension.

The compound that does this is called copper (ATSM), has been studied for use in some cancer treatments, and is relatively inexpensive to produce.

“In this case, the result was just the opposite of what one might have expected,” said Blaine Roberts, lead author on the study and a research fellow at the University of Melbourne, who received his doctorate at OSU working with Beckman.

“The treatment increased the amount of mutant SOD, and by accepted dogma this means the animals should get worse,” he said. “But in this case, they got a lot better. This is because we’re making a targeted delivery of copper just to the cells that need it.

“This study opens up a previously neglected avenue for new disease therapies, for ALS and other neurodegenerative disease,” Roberts said.

Other collaborators on this research include OSU, the University of Melbourne, University of Technology/Sydney, Deakin University, the Australian National University, and the University of Leeds in the United Kingdom.

Funding has been provided by the Australian National Health and Medical Research Council, the U.S. National Institutes of Health, the Linus Pauling Institute and other groups in Australia and Finland.

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Joseph Beckman, 541-737-8867

One in five older Americans take medications that work against each other

PORTLAND, Ore. – About three out of four older Americans have multiple chronic health conditions, and more than 20 percent of them are being treated with drugs that work at odds with each other – the medication being used for one condition can actually make the other condition worse.

This approach of treating conditions “one at a time” even if the treatments might conflict with one another is common in medicine, experts say, in part because little information exists to guide practitioners in how to consider this problem, weigh alternatives and identify different options.

One of the first studies to examine the prevalence of this issue, however, found that 22.6 percent of study participants received at least one medication that could worsen a coexisting condition. The work was done by researchers in Connecticut and Oregon, and published in PLOS One.

In cases where this “therapeutic competition” exists, the study found that it changed drug treatments in only 16 percent of the cases. The rest of the time, the competing drugs were still prescribed.

“Many physicians are aware of these concerns but there isn’t much information available on what to do about it,” said David Lee, an assistant professor in the Oregon State University/Oregon Health & Science University College of Pharmacy.

“Drugs tend to focus on one disease at a time, and most physicians treat patients the same way,” Lee said. “As a result, right now we’re probably treating too many conditions with too many medications. There may be times it’s best to just focus on the most serious health problem, rather than use a drug to treat a different condition that could make the more serious health problem even worse.”

More research in this field and more awareness of the scope of the problem are needed, the scientists said. It may be possible to make better value judgments about which health issue is of most concern, whether all the conditions should be treated, or whether this “competition” between drug treatments means one concern should go untreated. It may also be possible in some cases to identify ways to treat both conditions in ways that don’t conflict with one another.

A common issue, for example, is patients who have both coronary heart disease and chronic obstructive pulmonary disease, or COPD. Beta blockers are often prescribed to treat the heart disease, but those same drugs can cause airway resistance that worsens the COPD.

“There are several types of beta blocker that don’t cause this negative interaction, but many of the other types are still prescribed anyway,” Lee said. “It’s this type of information that would be of value in addressing these issues if it were more widely known and used.”

The chronic conditions in which competing therapies come into play include many common health concerns – coronary artery disease, diabetes, COPD, dementia, heart failure, hypertension, high cholesterol, osteoarthritis and others.

This study was done by researchers from OSU and the Yale University School of Medicine, with 5,815 community-living adults between the years 2007-09. The lead author of the study was Dr. Mary E. Tinetti at Yale University, and it was supported by the National Institutes of Health. The analysis included a nationally representative sample of older adults, and both men and women.

The research identified some of the most common competing chronic conditions, in which medications for one condition may exacerbate the other. They included hypertension and osteoarthritis; hypertension and diabetes; hypertension and COPD; diabetes and coronary artery disease; and hypertension and depression. These issues affect millions of older Americans.

“More than 9 million older adults in the U.S. are being prescribed medications that may be causing them more harm than benefit,” said Jonathan Lorgunpai, a medical student at the Yale School of Medicine and co-author of the study. “Not only is this potentially harmful for individual patients, it is also very wasteful for our health care system.”

Direct competition between medications is just one of the concerns, the report noted. Use of multiple medications can also lead to increased numbers of falls and delirium, dizziness, fatigue and anorexia.

The researchers pointed out that the presence of competing conditions does not necessarily contraindicate the use of needed medications, but rather the need for this competition to be more seriously considered in treatment.

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David Lee, 503-494-2258