Are You Properly Storing Vitamins & Supplements?

I'm guilty! Vitamins and prescriptions that I take on a daily basis have been in a basket on a kitchen counter (I don't have children in my home). Fortunately, I had already moved items everyone hopes to avoid anyway - you've got bigger problems if you need any of these - (cough drops, tablets, cold medicine tablets) used on a non-regular basis into a hallway storage area. That was the germ freak in me in action. Who knows that happened to the germ freak who didn't worry about the daily vitamins and prescriptions and all that takes place in the kitchen, go figure!

Kitchens, Bathrooms No Place for Vitamins

By Jennifer Warner
WebMD Health News

Reviewed by Laura J. Martin, MD

Humidity in Kitchens and Bathrooms Degrades Shelf Life of Vitamins, Study Finds

March 4, 2010 -- The kitchen or bathroom may be the worst place in the house to store your vitamins.

A new study shows high humidity and temperatures, such as those found in the bathroom and kitchen, can quickly degrade the potency of vitamin C and shorten the shelf life of vitamin supplements -- even if the bottle cap is on tightly.

Researchers found the most common types of vitamin C used in vitamin supplements and other fortified products are prone to a process called deliquescence, in which humidity causes a water-soluble substance to dissolve.

"Opening and closing a package will change the atmosphere in it. If you open and close a package in a bathroom, you add a little bit of humidity and moisture each time," researcher Lisa Mauer, associate professor of food science at Purdue University, says in a news release. "The humidity in your kitchen or bathroom can cycle up quite high, depending on how long of a shower you take, for example, and can get higher than 98%."

"If you get some moisture present or ingredients dissolve, they'll decrease the quality and shelf life of the product and decrease the nutrient delivery," Mauer says. "Within a very short time -- in a week -- you can get complete loss of vitamin C in some products that have deliquesced."

Humidity and Vitamin C Don't Mix

Powdered vitamin C is a popular ingredient for food fortification and is one of the most commonly added nutrients to vitamin supplements. Researchers say because vitamin C is very unstable and its content must be declared on nutrient labels, it is commonly used as an indication of the shelf life of foods and supplements.

For example, monitoring deterioration of vitamin C until it no longer meets its declared label value is one way to determine a product's shelf life.

Researchers say temperature and water are the two most frequently cited factors affecting shelf life. But information on deterioration and shelf life of vitamin C is based on models in which temperature and relative humidity were varied at the same time.

In contrast, this study looked at how various changes in relative humidity and temperature, such as those found in a bathroom or kitchen, affect the deterioration of two common forms of powdered vitamin C, ascorbic acid and sodium ascorbate.

The results, published in the Journal of Agricultural and Food Chemistry, showed relative humidity had the largest impact on vitamin C degradation, and this effect was magnified at elevated storage temperatures.

The study showed that at room temperature, sodium ascorbate and ascorbic acid deliquesce at 86% and 98% humidity, respectively. Once the humidity or temperature level was brought back down, the product will solidify again, but researchers say the damage has already been done.

"Any chemical changes or degradation that have occurred before resolidification don't reverse. You don't regain a vitamin C content after the product resolidifies or is moved to a lower humidity," Mauer says. "The chemical changes we've observed are not reversible."

They say keeping vitamin supplements away from warm, humid environments is the first step to maintaining their effectiveness.

The first signs of nutrient degradation are usually brown spots, especially on children's vitamins. Maurer recommends discarding any vitamin supplement that is showing signs of moisture in the container or browning.

"They're not necessarily unsafe, but why give a vitamin to a kid if it doesn't have the vitamin content you're hoping to give them?" Mauer says. "You're just giving them candy at that point with a high sugar content."

Warning: Attention Grabbing Headline Below

Who's at risk of dropping dead?
Take the test online:

The HeartAware test is a free online screening available to anyone but especially recommended for men over 40 and women over 50. It takes about seven minutes. Those who test at higher risk of heart disease can receive a free screening from the University of Miami. You can take the test at www.umiamihospital.com.

BY TERESA MEARStmears@mindspring.com

Everyone seems to know someone who appeared healthy and then suffered a sudden fatal heart attack. The death of celebrities such as NBC news commentator Tim Russert at 58 and TV product pitchman Billie Mays at 50 has brought new attention to the issue of sudden cardiac death.

It's an issue we're likely to hear about more as more Baby Boomers reach the vulnerable age for heart problems, 40 for men and 50 for women.

Dr. William W. O'Neill is executive dean for clinical affairs, professor of medicine and chief medical officer of the University of Miami Health System. He is a leader in interventional cardiology and in research into the diagnosis and treatment of obstructed heart arteries.

He also has a personal interest in heart disease. His father had a heart attack at 47, and his mother suffered from heart problems. When he and his three brothers underwent CT screening, three of them were fine but his youngest brother needed heart surgery, even though he had suffered no symptoms.

We asked O'Neill about sudden cardiac death. His answers have been edited for space.

Q: Everybody seems to know someone who appeared healthy and one day dropped dead of a heart attack. How common is that?

A: It's not surprising that everybody knows somebody because in the United States about 300,000 people a year drop over dead with sudden cardiac death.

Q: What causes sudden cardiac death?

A: The overwhelming culprit, in 90 percent of cases, is blockages of coronary arteries and a plaque rupture. The sudden rupture of a plaque in a blood vessel causes blood flow to lessen acutely in one of the arteries and leads to a severe irregularity of the heartbeat called ventricular fibrillation. The plaque ruptures, a severe arrhythmia occurs, and the people drop over dead. In about 10 percent of cases, there are other abnormalities, such as congenital problems or myocarditis, an intense inflammation of the heart muscle.

Q: Are there any symptoms?

A: About a third of the time, people have described symptoms that they ignored: pressure in the chest or discomfort while exercising. Unfortunately, more than half the time the first manifestation of the problem is sudden death.

Q: Are some people more at risk than others?

A: This is an illness of middle-aged people. In men it starts around age 40 and in women it starts around age 50. The risk factors for sudden death are the same as the risk factors for coronary artery disease: diabetes, high blood pressure, family history of heart disease, smoking, high cholesterol.

Q: What causes some people with those risk factors to suffer sudden cardiac death while others live a long life?

A: In people who drop over dead, blockages occur at very specific locations in the arteries that supply blood to the heart, the left main coronary artery and the anterior descending artery. We don't know why some people with coronary disease develop these plaques in these specific locations and other people in less dangerous locations. We think there may be some genes that predispose people to develop blockages in particular areas.

Q: What should people do if they fall into the high-risk group?

A: The best thing you can do is try to control risk factors. If you're got high blood pressure, be on medication. If your cholesterol is high, get it down with pills. If you're smoking, stop. If you're not exercising, try to do moderate regular exercise. It's not sexy. But those are the things you can do to dramatically lessen your risk. If you really have a concern, I'm a very strong advocate of CT angiography, a noninvasive procedure that puts dye in the veins to look specifically at the coronary arteries to see if there is plaque in dangerous locations.

Q: For which patients do you recommend CT angiography?

A: People who have three or more risk factors for heart disease.

Q: What is the HeartAware program?

A: There are a lot of people who don't even know they have risk factors for heart disease. We offer this online test and we offer a free screening where a nurse will actually check a blood pressure and do some other very simple things to let people know whether they have a risk for heart disease. If they're at medium or high risk for heart disease, then more screening can be performed.

Q: Beyond research into a genetic link, what other research is under way?

A: The holy grail that cardiology is facing now is to try to predict why a plaque would rupture. There are lots of plaques in the blood supply. Inexplicably, some of these plaques break open. If they break open in a dangerous location, people drop over dead. There is a lot of interest in trying to identify people with these vulnerable plaques.

Q: What's the most important thing for people to know?

A: Get to know your risk factors and modify them. There are a lot of risk factors that can be very easily modified while we're waiting for the major answer and the magic cure for sudden cardiac death.

Health Q&A runs every other week.

© 2009 Miami Herald Media Company. All Rights Reserved.
http://www.miamiherald.com

As a Patient, Advocate for Yourself!

Posted on Tue, Feb. 09, 2010

Cardiologist's advice about No. 1 killer of women

BY TERESA MEARStmears@mindspring.com

The leading killer of women isn't breast cancer or any other kind of cancer, but heart disease, which kills nearly twice as many women each year as die from all forms of cancer combined. During February, which is American Heart Month, many groups focus on women's heart health with screenings and the American Heart Association's ``Go Red'' movement to raise awareness. There was a time when women didn't respond well to treatment such as heart bypasses and stents, but that is changing, says Dr. Stratego ``Stacey'' Castanes, an interventional cardiologist who has been active in Miami-Dade heart health awareness events. ``One of the reasons we're doing better is patient education, women being advocates for themselves,'' says Castanes, who is in private practice and is also associated with the South Miami Heart Center. We talked to Castanes about women and heart disease. Her answers have been edited for space. Q: How is heart disease different in women than in men? A: The biggest difference is the symptoms, especially of heart attacks. The things that we classically describe to patients -- chest discomfort like an elephant sitting on the chest, radiation to the jaw and down the arm -- aren't quite the symptoms women feel. We still don't know how to describe the classic symptoms women feel. I've had women who were having a massive heart attack and they just felt as if all they needed to do was burp and it would get better. It fools everyone. My recommendation to women is if you're feeling bad enough to think that something's wrong and it's persistent and it continues to make you feel worse -- women still feel some kind of chest discomfort and some type of shortness of breath -- you should go to the emergency room. Q: What is the most important thing women can do to protect their hearts? A: The most important thing is exercise. Exercise can decrease your risk for breast cancer, treat depression, prevent heart attacks and strokes, control blood pressure, prevent adult-onset diabetes. The other important thing is having the same due diligence that women have for seeing their ob-gyn to seeing a cardiologist to determine their risk. Q: What are the risk factors for women? A: Smoking brings on heart disease, 10 to 20 years earlier. Strong family history of heart disease is a risk factor. Post-menopausal for women is a strong risk factor. Diabetes. High blood pressure. High cholesterol. The risk factors are basically the same for men. Q: Who needs cholesterol-lowering medication? A: There was an interesting study done in 2007 where they used criteria to determine if someone was low risk, intermediate risk or high risk for heart disease. Then they looked at patients who had reported a heart attack or stroke. The scariest part of the study was that 80 percent of the people, before their event, were considered low risk. Cholesterol is one of those things where there is no such thing as normal. Depending on the risk factors, you have to make the decision of whether to treat cholesterol. A cholesterol of 130 might be OK for one person but for another person who has a family risk of heart disease and is a smoker, that's not OK and that cholesterol needs to be treated. Q: Should women take a daily aspirin to lower their risk of heart disease? A: We have gone back and forth and been very confused throughout the years about what to recommend. For men it's very clear-cut. If you're in your 40s you should be on aspirin to prevent heart attack and stroke. Women tend to get heart disease later in life and there's an increased risk of bleeding with the aspirin. We initially didn't have clear-cut guidelines. Now the guidelines say if you're above 60 with one risk factor for coronary disease you should consider aspirin. If you have two risk factors, you should definitely be on aspirin. Q: What is the link between diabetes and heart disease? A: Basically we consider diabetes equivalent to heart disease. Diabetics are three to five times more likely to have coronary disease than their counterparts with all the same problems but not diabetes. Blood pressure needs to be very tightly controlled, even tighter than usual. Cholesterol needs to be tightly controlled. It seems that a lot of heart disease is linked to an inflammatory process. Diabetes is a constant inflammatory process. The endothelium, the tissue in the lining of the arteries, needs to work a certain way for the heart to function normally. Inflammatory states such as diabetes cause dysfunction of that endothelium, which results in coronary artery disease. Q: Why is blood pressure important? A: Blood pressure is important because it's so closely linked to increased risk of heart attack or stroke. On a very basic level, the endothelium gets pounded with these high blood pressures all day, which results in inflammation and damage to the endothelium. Q: What's your advice about diet? A: Physicians are always asked about diet, and the sad thing is we take less of a month of it in medical school. Nutritionists know this much better. One of the simplest things is that you should have as much color on your plate as possible. Yellow all over the plate -- pasta, corn, potatoes -- is not good.

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© 2010 Miami Herald Media Company. All Rights Reserved.
http://www.miamiherald.com

Quick Chest Pain Test Simplifies Discharge Decision

Hallelujah!  Which of my local hospitals will be offering this 'simple, inexpensive test'?  Moreover, will it be available at my cardiologist's office?!  It's so frustrating being told to go to the emergency room (where the emergency room doctor's call my cardiologist and ask what to do...).  A lot of waste (especially when I've gone in at night, they automatically admit me into the hospital overnight, no if's, and's or but's.  Quite a lot of expense in the end.  I don't want it to sound like I make a bee line for the ER every time my heart skips a beat (I've gone twice since my heart attack, for my heart).  I'm very happy for all heart patients about this new test!  Article below:

Quick Chest Pain Test Simplifies Discharge Decision

Thursday, February 11, 2010

CT scan lets doctors see any blockage in arteries, study finds

A simple, inexpensive test can tell doctors whether it's safe to discharge a patient who has come to the emergency room with chest pain, a new study shows.

The coronary artery calcium scoring (CACS) test detects coronary artery disease. A CT scan is used to quickly provide doctors with a detailed image of the heart that shows calcium build-up in the coronary arteries.

This study of 1,031 chest pain patients found that those with a CACS score of zero can be safely sent home without further heart testing. Of the patients in the study, 61 percent had a CACS of zero.

"It is imperative to accurately diagnose patients who come to the emergency department with chest pain. Unfortunately, diagnosing chest pain is often expensive and time-consuming. This new data could save millions of health-care dollars and countless hours spent waiting on unnecessary tests," principal investigator Dr. John Mahmarian, a cardiologist at the Methodist DeBakey Heart & Vascular Institute in Houston, said in a news release.

The study was published online Feb. 8 in the Annals of Emergency Medicine.

Beta Blockers May Have Side Effects

Health Tip: Beta Blockers May Have Side Effects

Thursday, February 4, 2010

But most people have no adverse reactions

(HealthDay News) -- Beta blockers often are prescribed to treat various heart conditions, including congestive heart failure and an irregular heartbeat. They also may be used to help treat high blood pressure.

As with any drug, beta blockers may cause side effects in some people. The American Academy of Family Physicians says although most people have no side effects from beta blockers, it offers this list of possible adverse reactions:

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  Fatigue or lack of energy.

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  Decreased libido or impaired sexual function in men.

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  Dizziness or lightheadedness.

If you have serious side effects from one of these medicines -- including difficulty breathing, chest pain, slowed heart rate of fewer than 50 beats per minute, unexplained weight gain or swelling of the hands, legs or feet -- contact your doctor immediately.