Mental illness common in sleepless patients

The study, published in the journal Clinical Drug Investigation, reports that more than 3 million people per year complained to their doctor about insomnia -- a sleep disorder marked by difficulty falling asleep -- in the years 1995 and 1996. Of these, just 18.8% of people were actually diagnosed with insomnia.

Yet 57.4% were diagnosed with a non-sleep related mental illness. Of these, about 30% were diagnosed with depression, the researchers found. By contrast, about 16% of people in the general population who do not report difficulty sleeping have mental illnesses, the study authors point out.

``The key finding is that insomnia is a serious problem which should signal patients to seek medical advice in order to identify the underlying cause of their sleeplessness,'' lead researcher Tracy L. Skaer, assistant dean of the College of Pharmacy at Washington State University, told Reuters Health. Oftentimes, insomnia is masking serious conditions including depression, other mental illnesses, or pain caused by diseases like arthritis, she explains.

When it comes to the link between depression and insomnia, ''it's the chicken and egg story,'' she comments. ``You can't tell if insomnia is the cause of the depression or if depression is inducing the insomnia, but the new findings help to clarify a link between the two conditions,'' she adds.

``My advice is not to take insomnia lightly, it could be a symptom of a very serious underlying problem. If it remains a persistent problem, seek advice from a healthcare professional,'' Skaer suggests.

``Today, there are a variety of prescription medications available to help treat insomnia, which are not habit forming'' Skaer notes. Plus, there are many medications available that can help treat the underlying causes of the sleeplessness including depression, she adds.

SOURCE: Clinical Drug Investigation 1999:18;161-167.

Blueberries reverse signs of aging in rats

``Nutritional intervention with fruits and vegetables may play an important role in reversing the deleterious effects of aging on neuronal function and behavior,'' report a team of researchers led by Dr. James Joseph of the USDA Human Nutrition Research Center on Aging at Tufts University in Boston, Massachusetts. Their report is published in the September 15th issue of the Journal of Neuroscience.

Forty male rats, at 19 months considered the age-equivalent of humans in their 70s, were randomly assigned to receive plain chow (the 'control' group) or chow supplemented with extract of either blueberry, strawberry, or spinach. After 8 weeks, the four groups of animals were given a battery of tests evaluating their motor function, memory, and cognitive ability.

The rats that received blueberry supplement performed significantly better than the other groups on motor tests that required balance and coordination. All three supplement groups did better than the control rats on tests of working memory and learning. Analysis of the rats' brains showed that those receiving the supplements, particularly blueberries, had improved neurological functioning as well.

The authors noted that fruits and vegetables contain phytochemicals that may protect cells against oxidative stress -- damage that occurs when the by-products of energy production accumulate in the cells. Foods high in these antioxidants may also protect the human body against cancer and cardiovascular disease.

In an earlier study with younger rats, the authors found that these foods slowed the process of age-related cognitive decline. But this is the first study to find that antioxidant-rich fruits and vegetables can actually reverse part of the aging process.

In addition to protecting cells against oxidative stress, Joseph and his colleagues suggest, fruits and vegetables may make cell membranes more fluid, allowing nutrients to pass in and out more easily.

``Whether results found in this study will also prove true for humans remains to be seen,'' said Dr. Marcelle Morrison-Bogorad, director of the National Institute on Aging's (NIA) Neuroscience and Neuropsychology of Aging Program. ``The only way to determine whether particular food ingredients actually work to show age-related cognitive decline in humans as well is to conduct controlled clinical trials,'' add Morrison-Bogorad in an NIA statement.

Officials at the NIA have recently funded additions to two clinical trials already in progress that are testing ``whether a number of over-the-counter agents, including antioxidants such as vitamin E, influence the rate of cognitive decline in older women,'' according to the statement.

SOURCE: Journal of Neuroscience 1999;19:8114-8121.

When parasitic worms are welcome - Part II

A Swedish study in the Lancet, a medical journal, found this year that children of families who used antibiotics and vaccinations had more allergies than children of families who avoided them. And researchers in Israel found that rats raised in germ-free environments developed more arthritis and diabetes than other rats.

Dr. Weinstock's team believes that Crohn's disease flares up when an immune system that has evolved to deal with multiple invaders finds itself unable to adapt to a more sterile environment.

Dr. Hanauer says the concept seems sound. "There are other potential explanations," he said. "There are a lot of processed foods in first-world countries, and you're exposed to different toxins. But this is an interesting concept because it is holistic across the other immune diseases."

Dr. Weinstock got the idea for the worm cure three years ago while editing journal articles on parasites of the liver and intestine. In looking over decades of literature, he kept running across the idea that all well-adapted parasites perform some useful function for their hosts. If only to ensure that the host survives to give them a home.

He and his colleagues began wondering about helminths, which have been with humans for millions of years. "We were racking our brains trying to think of what the benefits of these guys might be," he said. "Then the autoimmune-disease hypothesis came up."

The hypothesis is based on the widely held theory that the immune system, when challenged by an invader, fights back with white blood cells of the Th1 or the Th2 type. Th1 cells attack the body's infected cells, while Th2 cells go after dangerous microbes before they even invade the body's cells.

Dr. Weinstock believes inflammatory-bowel diseases develop when the body overreacts to the normal bacteria in the digestive tract, unleashing a salvo of Th1 that end up damaging the colon and bowel. Helminths, he says, trigger a Th2 response, which dampens the Th1 response.

The worm cure, if it proves effective, could have the side benefit of rehabilitating the reputations of parasitic worms, which have remained widely reviled even as some intestinal bacteria such as acidophilus and lactobacillus have become popular over-the-counter supplements. The parasites, Dr. Weinstock said, have been the victims of unfair, if understandable, prejudice. "Some worms do cause problems," he said, "but some cause very little problems. "

On the other hand, he cautioned against ingesting worms without proper medical supervision. For this reason, he would not identify the precise species of helminth he uses in his research. "We don't want people going of to Mexico or who knows where else trying to expose themselves to helminths that are not controlled and getting who knows what kinds of consequences. "

When parasitic worms are welcome

But there may be a downside to all this hygiene. Children in industrialized countries` which are relatively worm-free, have a much greater tendency than those in other countries to grow into adults with autoimmune disorders, in which the body makes antibodies that can cause disease: rheumatoid arthritis, multiple sclerosis, lupus, inflammatory-bowel disease.

Maybe this is a coincidence, but maybe not. Recently, researchers at the University of Iowa gave a drink containing the eggs of helminths, a parasitic worm, to six people suffering from acute, chronic inflammatory-bowel disease. Five went into remission, and the sixth improved substantially.

None got sick from the worms; all relapsed after the worms left their systems. "Every one of those patients is begging to be retreated," said lead researcher Joel Weinstock.

The sample was admittedly small. But the preliminary results, which made a big splash at a conference of the American Gastroenterological Association in May, could offer hope for the hundreds of thousands of people who suffer from inflammatory-bowel diseases, mainly Crohn's disease and Ulcerative colitis, which cause chronic and often bloody diarrhea, pain and weight loss.

"It's very interesting work," said Dr. Stephen Hanauer, co-director of the inflammatory-bowel disease centre at the University of Chicago School of Medicine and an international authority in the field, who was not connected with the study. "It needs to be substantiated in controlled trials, but there is some biological sense to it."

Dr. Weinstock is one of a growing number of subscribers to what is known as the hygiene hypothesis -- the idea that the war on germs and other contaminants is producing some unintended consequences. (Continued in )

Nutritionist Backs Flatulence For Health

``Better an empty house than a bad tenant,'' said O'Neill, in New Zealand to promote a national fit food campaign run by health agencies.

O'Neill said that flatulence was so common for men it was an effective icebreaker for them to discuss their bodies and male health issues.

``If you ask people to count how often they pop off in a day it would be double figures.''

However O'Neill said men could help ease the stink from their flatulence.

``If men eat more fiber they will be producing a lot of hot air, and that's about it -- it won't be as smelly. It's the pies, beer and steak that make the smelly ones.

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