Erectile dysfunction (ED) is common with aging. Formerly ED treatment was offered mainly by urologists, but the approval and widespread use of phosphodiesterase inhibitors has enabled primary care clinicians to provide targeted ED treatment. Although large, multicenter clinical trials have shown efficacy and safety with these drugs, they are ineffective in 30–35% of men, may cause side-effects, and do not improve the underlying pathology. A thorough understanding of erectile physiology and causes of ED and a comprehensive treatment plan addressing all contributing factors may be more effective than pharmaceutical management and may improve aspects of psychological and physical health beyond erectile problems.
Effect of the Anti-Inflammatory Diet in People with Diabetes and Pre-Diabetes: A Randomized Controlled Feeding Study
Introduction: Inflammation underlies a variety of chronic medical conditions, including diabetes. The anti-inflammatory diet, one that excludes foods that may stimulate inflammation and includes foods that reduce inflammation, may improve inflammatory biomarkers in people with diabetes and pre-diabetes.
Study Design: Thirty participants with diabetes or pre-diabetes were randomized (2:1) in a controlled feeding study that compared the anti-inflammatory diet (n=20) to a control diet (n=10) based on the American Diabetes Association recommendations. Diets were matched for protein, carbohydrate, fat, and fiber content as closely as possible. Participants were fed an isocaloric diet for 2 weeks, followed by continued ad libitum feeding in their dietary group assignment for an additional 4 weeks. All meals were prepared by the study team.
Outcomes: Primary outcomes included inflammatory markers, including cytokines and hsCRP. Secondary outcomes included body weight and biomarkers for cardiovascular disease and diabetes.
Results: Both diets resulted in trends in reduced markers of inflammation, especially with weight loss. In addition, glucose, lipids, and triglycerides all trended downward, also non-significantly and equally in both groups.
Conclusion: Dietary change can improve inflammation as well as other cardiometabolic risk factors. In this study, the anti-inflammatory diet did not affect markers of inflammation more than the control diet.
The human body is dependent upon oxygen for its survival. Yet, various factors such as aging, psychological stress, obstructive sleep apnea, exposure to cigarette smoke, living at high altitude, high-intensity exercise, or a sedentary lifestyle can all lead to a hypoxic state. Hypoxia may be involved in the pathogenesis of a number of disorders including impaired immunity, hormonal imbalances, fibromyalgia, cardiovascular diseases, type 2 diabetes, depression, and anxiety. Hyperbaric oxygen therapy and massage are two means by which to improve oxygen perfusion. Certain dietary supplements such as Ginkgo biloba, coenzyme Q10, and beetroot juice can increase oxygenation through enhanced blood flow while branched-chain amino acids and omega-3 fatty acids can improve maximum oxygen consumption V̇o2max. Additionally, omega-3 fatty acids and vitamin D may reduce the incidence of sleep apnea while N-acetyl cysteine may protect against hypoxia injury related to sleep apnea.
The FDA is considering enacting legislation that would make it illegal to compound or possess these commonly prescribed natural substances.
What to Tell Your Patients: A Critical Review of the JAMA Cardiology Meta-Analysis “Associations of Omega-3 Fatty Acid Supplement use with Cardiovascular Disease Risks”
Authors of a meta-analysis recently published in JAMA Cardiology concluded that omega-3 fatty acids have no significant association with fatal or nonfatal coronary heart disease or any major vascular events. This critical review examines participant profile, intervention dosage, bioavailability of intervention, and duration of therapy for the cited trials and determines that the conclusion of the meta-analysis is tentative at best.
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