Calcium, Vitamin D May Help Prevent Premenstrual Syndrome
Premenstrual syndrome, commonly referred to as PMS, is the name given to a collection of symptoms that occur in females between ovulation and a woman's menstrual period. Although the symptoms of PMS may vary between individuals, they typically include depression, irritability, fatigue, abdominal cramps, breast tenderness, and headaches, and are often severe enough to interfere with one's activities of daily living. In this nested, case-control study, researchers examined calcium and vitamin D intake in approximately 3,000 women ages 27 to 44, including 1,057 women who had developed PMS during a 10-year period. Intake was measured at three intervals throughout the study period (1991, 1995 and 1999), along with factors such as age, body mass index, and smoking status. In addition, because it is considered an excellent source of both calcium and vitamin D, milk consumption was also monitored.

Results: After adjusting for age and other factors, women in the highest quintile for total calcium intake were shown to have a lower relative risk of developing PMS (.80) compared to women with the lowest calcium intake. High total vitamin intake was also associated with a significantly lower risk of PMS; compared with women in the lowest quintile, those with the highest vitamin D intake had a relative risk of .59. Finally, frequent milk consumption was associated with a reduced incidence of PMS. The relative risk for women consuming four servings of skim or low-fat milk per day, compared to those reporting one serving or less per week, was .54.

The study's authors concluded that their findings "suggest that a high intake of calcium and vitamin D may reduce the risk of PMS." They recommended that future clinical trials be conducted, and that "in the interim, given that calcium and vitamin D may also reduce the risk of osteoporosis and some cancers, clinicians may consider recommending these nutrients even for young women."
Bertone-Johnson ER, Hankinson SE, Bendich A, et al. Calcium and vitamin D and risk of incident premenstrual syndrome. Archives of Internal Medicine 2005;165:1246-1252. 
 
 
Antibiotics May Not Be Necessary for Pediatric Ear Infections
Acute otitis media, or AOM, is believed to be responsible for up to 60 percent of all antibiotic prescriptions written for children. The use of this therapy in the treatment of AOM remains controversial, however; in fact, many scientists cite overuse of antibiotics as a contributing factor to the emergence of drug-resistant bacteria. A new study published in Pediatrics suggests that a nonprescription-based alternative to antibiotic administration may be just as effective in the treatment of AOM.

In this study, 223 children (ages 6 months to 12 years) with nonsevere AOM were randomized to receive a course of antibiotics (ABX; amoxicillin plus symptom medication), or watchful waiting (WW), in which symptom medication was administered (but no antibiotics). Children were evaluated for the severity of AOM at enrollment, after which the children's parents received information about the risk and benefits of WW, and how to recognize if an AOM infection increased in severity. The degree of infection was measured during follow-up visits at 12 days and 30 days, and instances in which parents returned with the child for an interim visit because of treatment failure or recurrence of AOM.

Results showed that while parents in the ABX group gave their children fewer doses of pain medication, and the failure rate was 16 percent lower among patients in the ABX group than patients in the WW group, strains of streptococcus pneumoniae bacteria obtained from children given antibiotics were more likely to be drug-resistant than children in the watchful waiting group. In addition, parent satisfaction scores among both groups were nearly identical, and the costs of treatment were an average of $35.98 less per patient in the watchful waiting group compared to patients in the ABX group.

Conclusion: "Our results suggest that some children with nonsevere AOM may be observed with WW as long as they maintain nonsevere status and are kept comfortable with appropriate symptom management. Under these conditions, WW seems to be an alternative that is acceptable to parents, reduces the number and cost of ABX prescriptions, and reduces the percent of multidrug-resistant bacteria colonizing the nasopharynx of children after an episode of AOM."
McCormick DP, Chonmaitree T, Pittman C, et al. Nonsevere acute otitis media: a clinical trial comparing outcomes of watchful waiting versus immediate antibiotic treatment. Pediatrics June 2005;115(6):1455-1465.

Frequent Consumption of Red Meat Linked to Colorectal Cancer
The association between high red meat intake and increased risk of colorectal cancer has been established in the scientific literature for approximately two decades. Less well-known is the association between colorectal cancer and the intake of fish. A recent study of men and women in 10 European countries has solidified the relationship between red meat and colorectal cancer, while finding that high fish consumption can substantially reduce colorectal cancer risk.

In this analysis, scientists examined the health records of more than 478,000 men and women (ages 35 to 70) who had participated in a prior study designed to investigate the relationships between diet, lifestyle, genetic and environmental factors, and the incidence of cancer. Among the variables measured in the study were intake red meat, processed meat, and fish. At the start of the study, all of the participants were free of cancer; after a mean follow-up examination of 4.8 years, 1,329 patients had been diagnosed with colorectal cancer.

Analysis of the questionnaires revealed that people who ate an average of 160 or more grams of red or processed meat per day were 35% more likely to develop bowel cancer than those who ate less than 20 grams per day. Increased fish intake, meanwhile, was associated with a reduced risk of colorectal cancer. Participants who consumed more than 80 grams of fish per day had a 31% reduction in the incidence of colorectal cancer compared to those eating less than 10 grams of fish per day. Subjects with high intakes of red meat and low intakes of fish were 63% more likely to develop colorectal cancer compared to subjects with low red meat intake and high fish intake.

"We found a consistent positive association between high intake of red and processed meat and colorectal cancer, and an inverse association between high intake of fish and colorectal cancer," noted the authors in their conclusion. "These findings held in models adjusted for age, sex, and energy and in models adjusted for other covariates."
Norat T, Bingham S, Ferrari S, et al. Meat, fish, and colorectal cancer risk: The European Prospective Investigation Into Cancer and Nutrition. Journal of the National Cancer Institute, June 15, 2005;97(12):906-916. 
 
Dr. Nykwest's Notes: This report fails to identify what "red meat" was consumed. While the phrase "red meat" is used almost synonymously with beef in the US, in Europe the consumption of Venison, Moose and Stag (our equivalent of Elk) is much more prevalent than in the US and the difference should have been distinguished in this article. All game meats contain much less fat than domestic meats, especially beef. Venison contains approximately 23% more protein than than beef with only 1% of the fat. It is the fat in the red meat that has usually been identified of as the source of the carcinogenic effect. In balance, there are several other health concerns with fish, from certain bacteria and toxins to heavy metals such as Mercury that are not present in meat, so the overall combined risks of both foods is less clear. Overall, we should probably just eat more fruits & vegetables!

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