Health and Fitness News and Notes

Obesity’s Ties to Diabetes

Type 2 diabetes is almost twice as common in African-Americans as it is in whites. Obesity, not racial factors, is to blame, a study in JAMA reports.

Researchers began with 4,251 black and white men and women ages 18 to 30 who were not diabetic. They then followed up with periodic interviews and health examinations over an average of 25 years. Compared to whites, black men were 67 percent more likely, and black women almost three times as likely, to develop diabetes.

When they controlled for a long list of modifiable risk factors — fasting glucose, body mass index, waist circumference, blood pressure, blood lipids, location of residence, socioeconomic status and more — the difference in diabetes incidence between the races disappeared. The key cause, the researchers determined, is obesity, which is tied to all of these risk factors.

“The benefit of capturing these behaviors over time is that we can study how the accumulation of unhealthy risk factors contributes to the development of diabetes,” said the senior author, Mercedes R. Carnethon, an associate professor of preventive medicine at Northwestern University. “Modifiable risk factors matter. The answer is simple, but the strategy to achieve change is complicated.”

Cost-Effective Shingles Vaccine

The new shingles vaccine is expensive, but worth it, according to a new analysis in JAMA Internal Medicine.

Shingles is a painful and sometimes debilitating nerve inflammation and blistering skin rash caused by the same virus that causes chickenpox. Anyone who has had chickenpox is susceptible to it many years later.

The old vaccine, Zostavax, is about 50 percent effective. The new one, Shingrix, provides 90 percent protection. It is given in two shots at $140 each; it’s recommended for people older than 50. It may soon be covered by Medicare Part D and other insurers.

Using data from randomized trials, researchers calculated that using the new vaccine would save money over the long term, based on statistical measures that quantify the cost effectiveness of health care measures.

“Our findings are subject to the proposed price — $280,” said the lead author, Phuc Le, with the Cleveland Clinic. “Any price change in the future may change the calculation.”

The recipient’s age and failure to get the second shot could change the cost effectiveness. But even allowing for such variables, if the new vaccine costs $350 for two doses, it would still be more cost effective than the old one.

Antioxidants and Soreness

Many people take antioxidants before or after exercise in the belief that this prevents muscle soreness. A thorough review of the scientific literature has found no solid evidence that it works.

Data was pooled from 50 randomized placebo-controlled trials involving 1,089 participants. Some studies looked at antioxidant supplements taken before exercise, some after.

The type of antioxidant studied varied — cherry juice, pomegranate juice, vitamins C and E, black tea extract and others in various doses.

The pooled data, in the Cochrane Database of Systematic Reviews, showed some small advantage for using antioxidants, but none that would add up to a meaningful difference from taking a placebo at any time after exercise. None of the trials measured recovery time — that is, the time it took to being able to exercise again without soreness. Two trials found antioxidants caused mild gastrointestinal problems in a small number of participants.

“Muscle soreness is something you get from unaccustomed or high-intensity exercise, and there are some ways to reduce it — hot baths, cold baths, massage,” said the lead author, Mayur K. Ranchordas a senior lecturer at Sheffield Hallam University in England. “But the evidence for antioxidant supplements is pretty poor.”