What’s for Dinner?

Home-cooked 3-course Italian Dinner

Hungarian Pork

Ingredients

10 oz pork tenderloin, trimmed and thinly sliced
2 Tbsp butter
1 medium onion, cut into eight
2 garlic cloves, peeled and crushed
2 medium carrots, cut into julienne strips
4 large tomatoes, seeded and chopped
4 Tbsp pork or vegetable stock
2 tsp paprika
1/4 cup sour cream
2 Tbsp fresh parsley, chopped

Method

  1. Place all ingredients, except the sour cream and parsley, in a deep, heatproof bowl which fits into the steamer top.
  2. Put in the steamer and cover with a tight-fitting lid. Steam for 30 minutes until the meat is tender and cooked through.
  3. Add the sour cream and parsley to the bowl, stirring well. Replace the lid, and steam for a further 5 minutes.
  4. Serve with mashed or sauteed potatoes, or noodles.

Makes 4 servings.

Source: Steam Cuisine

Diet, Gut Microbes Affect Chemotherapy Outcomes

What we eat can affect the outcome of chemotherapy – and likely many other medical treatments – because of ripple effects that begin in our gut, new research suggests.

Scientists found that diet can cause microbes in the gut to trigger changes in the host’s response to a chemotherapy drug. Common components of our daily diets (for example, amino acids) could either increase or decrease both the effectiveness and toxicity of the drugs used for cancer treatment, the researchers found.

The discovery opens an important new avenue of medical research and could have major implications for predicting the right dose and better controlling the side effects of chemotherapy, the researchers report. The finding also may help explain differences seen in patient responses to chemotherapy that have baffled doctors until now.

“The first time we observed that changing the microbe or adding a single amino acid to the diet could transform an innocuous dose of the drug into a highly toxic one, we couldn’t believe our eyes,” said Eyleen O’Rourke, PhD, of UVA’s College of Arts & Sciences, the School of Medicine’s Department of Cell Biology and the Robert M. Berne Cardiovascular Research Center. “Understanding, with molecular resolution, what was going on took sieving through hundreds of microbe and host genes. The answer was an astonishingly complex network of interactions between diet, microbe, drug and host.”

How Diet Affects Chemotherapy

Doctors have long appreciated the importance of nutrition on human health. But the new discovery highlights how what we eat affects not just us but the microorganisms within us.

The changes that diet triggers on the microorganisms can increase the toxicity of a chemotherapeutic drug up to 100-fold, the researchers found using the new lab model they created with roundworms. “The same dose of the drug that does nothing on the control diet kills the [roundworm] if a milligram of the amino acid serine is added to the diet,” said Wenfan Ke, a graduate student and lead author of a new scientific paper outlining the findings.

Further, different diet and microbe combinations change how the host responds to chemotherapy. “The data show that single dietary changes can shift the microbe’s metabolism and, consequently, change or even revert the host response to a drug,” the researchers report in their paper published in Nature Communications.

In short, this means that we eat not just for ourselves but for the more than 1,000 species of microorganisms that live inside each of us, and that how we feed these bugs has a profound effect on our health and the response to medical treatment. One day, doctors may give patients not just prescriptions but detailed dietary guidelines and personally formulated microbe cocktails to help them reach the best outcome.

Researchers have observed microbes and diet affecting treatment outcomes before. However, the new research stands out because it is the first time that the underlying molecular processes have been fully dissected.

A New Model

The researchers’ new model is an extremely simplified version of the complex microbiome – collection of microorganisms – found in people. Roundworms serve as the host, and non-pathogenic E. coli bacteria represent the microbes in the gut. In people, the relationships among diet, microorganisms and host is vastly more complex, and understanding this will be a major task for scientists going forward.

The research team noted that drug developers will need to take steps to account for the effect of diet and microbes during their lab work. For example, they will need to factor in whether diet could cause the microorganisms to produce substances, called metabolites, that could interfere or facilitate the effect of the drugs.

The researchers suggest that the complexity of the interactions among drug, host and microbiome is likely “astronomical.” Much more study is needed, but the resulting understanding, they say, will help doctors “realize the full therapeutic potential of the microbiota.”

“The potential of developing drugs that can improve treatment outcomes by modulating the microbes that live in our gut is enormous,” O’Rourke said. “However, the complexity of the interactions between diet, microbes, therapeutics and the host that we uncovered in this study is humbling. We will need lots of basic research, including sophisticated computer modeling, to reveal how to fully exploit the therapeutic potential of our microbes.”

Source: University of Virginia

New Guidelines Say No to Probiotics for Digestive Woes

There isn’t enough scientific evidence to support using probiotics to treat most digestive disorders, according to a new American Gastroenterological Association (AGA) guideline.

Probiotics are living, microscopic organisms found in foods or dietary supplements, according to the AGA. They include certain bacteria and yeasts.

An estimated 3.9 million American adults have taken probiotics and many do so to improve their digestive health, so the AGA reviewed published research on their use for digestive disorders.

The review found insufficient evidence to recommend probiotics for treatment of Crohn’s disease, ulcerative colitis, irritable bowel syndrome (IBS) and C. difficile infection, the AGA reported June 9 in the journal Gastroenterology.

“Patients taking probiotics for Crohn’s, ulcerative colitis or IBS should consider stopping,” said Dr. Grace Su, a professor of gastroenterology at the University of Michigan in Ann Arbor, who led the guideline panel. “The supplements can be costly and there isn’t enough evidence to prove a benefit or confirm lack of harm. Talk with your doctor.”

The new AGA guideline also recommends against the use of probiotics to treat acute infectious gastroenteritis in children.

The guideline does support the use of certain probiotic formulations in three situations: prevention of C. difficile infection in adults and children taking antibiotics; prevention of necrotizing enterocolitis in preterm, low birth weight infants; and management of pouchitis, a complication of inflammatory bowel disease.

“While our guideline does highlight a few use cases for probiotics, it more importantly underscores that the public’s assumptions about the benefits of probiotics are not well-founded, and that there is also a major variation in results based on the formulation of the probiotic product,” Su said in an AGA news release.

The AGA said well-designed clinical trials are needed to refine probiotics guidelines and investigate other relevant clinical conditions.

The association said gastroenterologists should suggest probiotics to their patients only if there is clear benefit. They should keep in mind that the effects of probiotics apply to specific strains of bacteria and combinations of strains, the AGA added.

Source: HealthDay

Blood Pressure Medications Help Even the Frailest Elderly People Live Longer

Taking blood pressure medication as prescribed helped even the frailest elderly people (65 and older) live longer, and the healthiest older people had the biggest survival boost, according to a large study in northern Italy published today in Hypertension, an American Heart Association journal.

“We knew that high blood pressure medication was protective in general among older people, however, we focused on whether it is also protective in frail patients with many other medical conditions who are usually excluded from randomized trials,” said Giuseppe Mancia, M.D., lead study author and professor emeritus at the University of Milano-Bicocca in Milan, Italy.

Researchers reviewed data on almost 1.3 million people aged 65 and older (average age 76) in the Lombardy region of northern Italy who had 3 or more high blood pressure medication prescriptions in 2011-2012. Examining the public health care database, researchers calculated the percentage of time over the next seven years (or until death) that each person continued to receive the medications. Because almost all medications are free or low-cost and dispensed by the public health service, this corresponds roughly to people’s adherence in using the medication in Italy.

To look separately at outcomes among older people with various medical conditions, researchers used a previously developed score that accounts for 34 different health factors and has a close relationship with mortality.

Researchers compared roughly 255,000 people who died during the 7-year follow-up with age-, gender-, and health-status-matched controls who survived and divided them into four groups of health status: good, medium, poor or very poor.

The probability of death over 7-years was 16% for people rated in good health at the beginning of the study. Mortality probability increased progressively to 64% for those rated in very poor health.

Compared with people with very low adherence to blood pressure medications (dispensed pills covered less than 25% of the time period), people with high adherence to blood pressure medications (more than 75% of the time period covered) were:

  • 44% less likely to die if they started in good health; and
  • 33% less likely to die if they started in very poor health.

A similar pattern was seen with cardiovascular deaths. The greatest survival benefit was among the people who started in good health, and the most modest survival benefit was in those who started in very poor health.

“Our findings definitely suggest that even in very frail people, antihypertensive treatment reduces the risk of death; however, the benefits may be smaller in this group,” Mancia said.

No matter what a person’s initial health status, survival benefits were greatest in those who received blood pressure medication to cover more than 75% of the follow-up period, compared with those with intermediate (25-75%) or low levels (less than 25%) of coverage, highlighting the importance of consistent use of blood pressure medications.

“Do your best to encourage and support patients to take their medications, because adherence is crucial to getting the benefits. Medications do nothing if people don’t take them,” Mancia said.

Prescription medications given to elderly people living in nursing homes or assisted-living homes in Italy are not included in the national database, so the study’s results may only apply to elderly people living in the community. In addition, all data for this analysis are from Italy, where hospitalizations and blood pressure medications are available for free or at low cost, thus, the study’s findings may not be generalizable to countries with a different health care system.

Source: American Heart Association


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