For Cascade Discovery July 2002

Health & Medicine Journal

By Paul Van Camp MD

Following are brief summaries of research published in recent medical journals. Topics are selected to be of interest to Cascade Discovery readers for general health and significant medical advances.

This is a two-part story about five college students who changed our understanding of fitness in health. Then they did it again thirty years later.

It was 1966 at Southwestern Medical Center in Texas: A research team selected five very healthy college men in their early twenties. They were not extraordinary athletes, just very fit and active. (One of them, Mr. Hill, jogs up to 75 miles per week.) They were put through an extremely thorough medical and fitness evaluation, including extensive laboratory tests, body composition analysis, lung tests, and muscle biopsies. The works. Then they underwent a maximum exercise test on a treadmill to measure their aerobic fitness, oxygen capacity (VO2 max), and endurance.

Next, they were assigned to twenty days of enforced inactivity. They became extreme couch potatoes for three weeks. They were even taken to the bathroom in wheelchairs. At the end of this period, they were again given the same intensive treadmill exercise test. The researchers were astonished the men had become so weak and debilitated. They had to be supported by straps from the ceiling in order to stay on the treadmill. Some of them fainted during the test. They were sore for weeks afterward.

The men had lost over 25% of their aerobic exercise capacity in this short time. It took them eight weeks on a rigorous training program to recover what they had lost in just three weeks. These results were so surprising that, when published in the journal Circulation in 1968, it changed medical practice. Doctors no longer prescribed bed rest after heart attacks, but started early rehabilitative exercise programs. Early mobilization has been the norm ever since.

Now jump ahead thirty years to 1998. The same five men are reunited at Southwestern Medical Center for a re-evaluation. They had gradually slipped into the typical pattern for middle-aged American men. They each had gained more than twenty pounds. Mr. Hill, the long distance runner, had gone from 150 pounds up to 210. Another one, Lee, now weighed in at 360. While some were still active, none had maintained a consistent exercise regimen. Yet, when tested, they had not lost as much aerobic fitness as they had during the twenty days of inactivity thirty years earlier.

Then they hit the gym, and jogging trails or whatever aerobic exercise they preferred. They started slowly with just two 20-minute sessions the first week. This was gradually increased up to 5 hours per week total exercise time. They used heart rate monitors to keep the intensity at moderate yet effective levels. The excess weight began to drop away. After six months on this program, they were again carefully tested for aerobic fitness capacity. Surprisingly, each of them had regained 100% of the maximum aerobic capacity they had at the beginning, thirty years earlier. They might not be as fast as they were in their 20’s, but they had lost none of their endurance and aerobic capacity. These results were published in Circulation in 2001. It is very good news for all of us. It is never too late too regain our youthful fitness- all of it.

Deep Vein Thrombosis (DVT) is a dangerous yet unfortunately common condition of blood clots forming in the deep veins of the legs. These might not cause symptoms or they can occasionally travel through the veins and block blood flow in the lungs. (This is called pulmonary embolism). Previous studies have suggested that DVT can occur in travelers on air flights lasting over four hours.

This study looking at DVT in air travel was published in the journal Lancet in May 2001. They recruited 215 healthy volunteer over 50 years old who would be flying for at least eight hours in coach-class on two or more flights within a six-week period. First, they were tested for any pre-existing clots by ultrasound and their blood was tested for normal clotting. Then half of them were assigned to wear compression stockings during their flights. The others did not use compression stockings.

Ultrasound testing after the flights revealed that blood clots (DVT) had developed in 12 of the 100 volunteers who did not wear compression stockings. Yet, none of the 115 who did wear the compression stockings had DVT. Deep Vein Thrombosis seems to be a common condition after prolonged air travel. Yet, it can be effectively prevented with use of compression stockings. Fortunately, most persons who develop DVT during travel do not seem to develop symptoms from it.

Soy products such as extracts and tofu contain plant substances called isoflavones which have been promoted as a natural way to reduce menopause symptoms such as hot flushes. Are they effective?

80 women were randomly assigned to either a daily capsule containing 100 mg. of soy isoflavones, or to an inactive placebo containing soy protein without the isoflavones. The women were followed over a four month period. The results were published in Obstetrics and Gynecology in March 2002.

Menopausal symptoms such as hot flushes were reduced modestly in only the women taking the isoflavones. In addition, the isoflavone group had lower total and LDL ("bad") cholesterol and higher blood estrogen levels. No adverse effects were noted. Soy isoflavones do seem to be moderately effective in helping with menopause symptoms while improving cholesterol levels.

Applying a topical Vitamin-C solution or lotion to the face has been shown to protect against sun damage by its antioxidant and ultraviolet light absorbing properties. However, can Vitamin-C actually reverse existing sun damage? Vitamin-C is unstable in liquid form because it is sensitive to light and oxygen. Therefore, it takes a well-designed product to deliver Vitamin-C effectively to the skin. A study in the March 2002 journal Dermatologic Surgery reported a double blind study in which patients used active vitamin-C (10% Vitamin-C plus 7% lipid-soluble) on one side of their face, and a placebo lotion on the other side for three months. Wrinkles improved between 13% and 19% on the Vitamin-C side, but no improvement occurred on the other side. Pigment spots did not improve. Microscopic analysis showed that more new collagen was present and the healthy collagen layer was 40% thicker on the treated side. Vitamin-C can indeed help with some types of sun damage. We recommend applying it daily in addition to an effective sun-block. (At Aesthetics MD, we use Vitamin C Gel to enhance laser and light-based photo-rejuvenation therapies. See www.lasermedicalcenter.com)

Researchers at the University of Minnesota Heart Institute studied the relationship between emotional and physical types of stress in survivors of cardiac arrest heart attacks. For the men, 40% had been exercising, straining or other physical stress prior to the attack. However, in women only 5% reported physical exertion. In contrast, more women (40%) were experiencing emotional stress at the time of the attack versus only 16% in the men. The authors speculate that the biologic events leading to cardiac arrest may be different for men than for women. Men and women may indeed be from different planets. Nevertheless, we all should seek immediate emergency care for chest pain or other heart attack symptoms.

The above summaries are presented for education purposes and not to recommend treatment for any individual or condition. Dr. Paul Van Camp is a physician and medical director of Aesthetics MD. 115 SW Allen Road Bend 97702. Further information is available at www.aesthetics-md.com References to original publication of the studies discussed is available upon request.