Monday, December 15, 2008

Kopi menghambat pertumbuhan janin

Bagi ibu hamil yang gemar minum kopi ada baiknya memperhatikan penelitian berikut.
Penelitian ini dilakukan di Inggris terhadap >2600 ibu hamil normal (usia kehamilan 8-12 minggu).
Hasil penelitian menunjukkan bahwa semakin besar konsumsi kafein selama kehamilan semakin besar pula risiko gangguan pertumbuhan janin.
Sehingga dianjurkan untuk mengurangi konsumsi kafein sebelum dan selama hamil.
 
Abstract
BMJ 3 November 2008;337:a2332 © 2008 BMJ Publishing Group Ltd
Maternal caffeine intake during pregnancy and risk of fetal growth restriction: a large prospective observational study. CARE Study Group.
 
Objective To examine the association of maternal caffeine intake with fetal growth restriction.

Design Prospective longitudinal observational study.

Setting Two large UK hospital maternity units.

Participants 2635 low risk pregnant women recruited between 8-12 weeks of pregnancy.

Investigations Quantification of total caffeine intake from 4 weeks before conception and throughout pregnancy was undertaken with a validated caffeine assessment tool. Caffeine half life (proxy for clearance) was determined by measuring caffeine in saliva after a caffeine challenge. Smoking and alcohol were assessed by self reported status and by measuring salivary cotinine concentrations.

Main outcome measures Fetal growth restriction, as defined by customised birth weight centile, adjusted for alcohol intake and salivary cotinine concentrations.

Results Caffeine consumption throughout pregnancy was associated with an increased risk of fetal growth restriction (odds ratios 1.2 (95% CI 0.9 to 1.6) for 100-199 mg/day, 1.5 (1.1 to 2.1) for 200-299 mg/day, and 1.4 (1.0 to 2.0) for >300 mg/day compared with <100 mg/day; test for trend P<0.001). Mean caffeine consumption decreased in the first trimester and increased in the third. The association between caffeine and fetal growth restriction was stronger in women with a faster compared to a slower caffeine clearance (test for interaction, P=0.06).

Conclusions Caffeine consumption during pregnancy was associated with an increased risk of fetal growth restriction and this association continued throughout pregnancy. Sensible advice would be to reduce caffeine intake before conception and throughout pregnancy.

Wednesday, November 26, 2008

Vitamin tidak mencegah kanker

Suplemen vitamin dianggap berperan penting untuk mencegah kanker.
 
Penelitian yang dilakukan terhadap >5000 wanita berusia >42 tahun selama >7 tahun, membandingkan secara random efek suplementasi vitamin (folat, vitamin B6 dan vitamin B12) terhadap plasebo, membuktikan bahwa pemberian folat, vitamin B6 dan vitamin B12 tidak signifikan mencegah kanker.
 
Abstrak
 
Effect of Combined Folic Acid, Vitamin B6, and Vitamin B12 on Cancer Risk in Women

A Randomized Trial

Shumin M. Zhang, MD, ScD; Nancy R. Cook, ScD; Christine M. Albert, MD, MPH; J. Michael Gaziano, MD, MPH; Julie E. Buring, ScD; JoAnn E. Manson, MD, DrPH

JAMA. 2008;300(17):2012-2021.

Context  Folate, vitamin B6, and vitamin B12 are thought to play an important role in cancer prevention.

Objective  To evaluate the effect of combined folic acid, vitamin B6, and vitamin B12 treatment on cancer risk in women at high risk for cardiovascular disease.

Design, Setting, and Participants  In the Women's Antioxidant and Folic Acid Cardiovascular Study, 5442 US female health professionals aged 42 years or older, with preexisting cardiovascular disease or 3 or more coronary risk factors, were randomly assigned to receive either a daily combination of folic acid, vitamin B6, and vitamin B12 or a matching placebo. They were treated for 7.3 years from April 1998 through July 31, 2005.

Intervention  Daily supplementation of a combination of 2.5 mg of folic acid, 50 mg of vitamin B6, and 1 mg of vitamin B12 (n = 2721) or placebo (n = 2721).

Main Outcome Measures  Confirmed newly diagnosed total invasive cancer or breast cancer.

Results  A total of 379 women developed invasive cancer (187 in the active treatment group and 192 in the placebo group). Compared with placebo, women receiving the active treatment had similar risk of developing total invasive cancer (101.1/10 000 person-years for the active treatment group vs 104.3/10 000 person-years for placebo group; hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.79-1.18; P = .75), breast cancer (37.8/10 000 person-years vs 45.6/10 000 person-years, respectively; HR, 0.83; 95% CI, 0.60-1.14; P = .24), or any cancer death (24.6/10 000 person-years vs 30.1/10 000 person-years, respectively; HR, 0.82; 95% CI, 0.56-1.21; P = .32).

Conclusion  Combined folic acid, vitamin B6, and vitamin B12 treatment had no significant effect on overall risk of total invasive cancer or breast cancer among women during the folic acid fortification era.

Wednesday, November 12, 2008

Omega3 mencegah gagal jantung

Gagal jantung merupakan penyebab morbiditas dan mortalitas kardiovaskuler. Beberapa penelitian menunjukkan manfaat asam lemak tak jenuh n-3 (n-3 polyunsaturated fatty acids disingkat PUFA) dalam menurunkan mortalitas karena efek anti-inflamasi dan aman serta toleransi yang baik. Penelitian GISSI-HF adalah penelitian double blind multicenter yang dilakukan pada 326 pusat kardiologi dan 31 pusat internist di Italia, melibatkan hampir 7000 subyek dan follow-up selama 4 tahun.
 
Hasil penelitian mendukung temuan sebelumnya. Sehingga disimpulkan bahwa pemberian n-3 PUFA 1000mg memberikan benefit dalam hal menurunkan morbiditas dan mortalitas kardiovaskuler pada pasien2 gagal jantung.
 
The Lancet, Volume 372, Issue 9645, Pages 1223 - 1230, 4 October 2008
 
Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial
 
Background
 
Several epidemiological and experimental studies suggest that n-3 polyunsaturated fatty acids (PUFA) can exert favourable effects on atherothrombotic cardiovascular disease, including arrhythmias. We investigated whether n-3 PUFA could improve morbidity and mortality in a large population of patients with symptomatic heart failure of any cause.

Methods

We undertook a randomised, double-blind, placebo-controlled trial in 326 cardiology and 31 internal medicine centres in Italy. We enrolled patients with chronic heart failure of New York Heart Association class II—IV, irrespective of cause and left ventricular ejection fraction, and randomly assigned them to n-3 PUFA 1 g daily (n=3494) or placebo (n=3481) by a concealed, computerised telephone randomisation system. Patients were followed up for a median of 3·9 years (IQR 3·0—4·5). Primary endpoints were time to death, and time to death or admission to hospital for cardiovascular reasons. Analysis was by intention to treat.

Findings

We analysed all randomised patients. 955 (27%) patients died from any cause in the n-3 PUFA group and 1014 (29%) in the placebo group (adjusted hazard ratio [HR] 0·91 [95·5% CI 0·833—0·998], p=0·041). 1981 (57%) patients in the n-3 PUFA group and 2053 (59%) in the placebo group died or were admitted to hospital for cardiovascular reasons (adjusted HR 0·92 [99% CI 0·849—0·999], p=0·009). In absolute terms, 56 patients needed to be treated for a median duration of 3·9 years to avoid one death or 44 to avoid one event like death or admission to hospital for cardiovascular reasons. In both groups, gastrointestinal disorders were the most frequent adverse reaction (96 [3%] n-3 PUFA group vs 92 [3%] placebo group).

Interpretation

A simple and safe treatment with n-3 PUFA can provide a small beneficial advantage in terms of mortality and admission to hospital for cardiovascular reasons in patients with heart failure in a context of usual care.