does it matter what time of the day you eat certain foods?

I workout every day right before dinner. When I look at what I eat, I usually eat high protein breakfasts , usually protein lunch and high carbs for dinner. I know protein helps rebuild your muscles after a workout so does it matter if I'm not eating protein for dinner? Should I eat a higher carb lunch

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Statins Plus Certain Antibiotics May Set Off Toxic Reaction: Study

Harmful effects in older patients include muscle, kidney damage, researchers say

By Steven Reinberg

HealthDay Reporter

MONDAY, June 17 (HealthDay News) -- Doctors should avoid ordering certain antibiotics for older patients who take cholesterol-lowering statin drugs, such as Lipitor, Canadian researchers say.

Statins, which are taken by many millions of people, don't mix well with the antibiotics clarithromycin or erythromycin, according to a study, published in the June 18 issue of the Annals of Internal Medicine.

These two commonly used antibiotics inhibit the metabolism of statins and increase statin concentration in the blood, which can cause muscle or kidney damage, and even death, the researchers said.

"These drugs do interact and cause difficulties for patients," said lead researcher Dr. Amit Garg, a professor in the department of epidemiology and biostatistics at the University of Western Ontario in London, Ontario.

These adverse reactions are rare, Garg added. "Most people will be fine," he said. "But at a population level, hundreds of preventable hospitalizations are occurring."

For someone taking a statin, the study suggests that substituting a different antibiotic -- azithromycin -- is safer because it doesn't interfere with the metabolism of statins.

Another strategy is to stop the statin until the antibiotic course is finished, Garg said.

The study of more than 144,000 statin users over the age of 65 compared those prescribed clarithromycin or erythromycin with those taking azithromycin.

In terms of absolute risk, the odds of kidney damage increased 26 percent among people who took clarithromycin or erythromycin and statins compared with patients who took azithromycin with statins.

Also, hospitalizations for muscle damage (a condition called rhabdomyolysis) and deaths were slightly higher -- 0.02 percent and 0.25 percent, respectively -- in the clarithromycin or erythromycin groups compared to the azithromycin group, the study authors found.

Dr. Gregg Fonarow, a spokesman for the American Heart Association, said patients should not stop taking statins, which are known to prevent heart disease. Instead, doctors should prescribe another antibiotic, he suggested.

"It is well documented that certain medications that inhibit the liver enzyme cytochrome P450 isoenzyme 3A4 can increase the drug level of statin medications," said Fonarow, a professor of cardiology at the University of California, Los Angeles. "Nevertheless, large-scale randomized clinical trials and clinical effectiveness studies have demonstrated [that] the benefits of statin therapy in reducing fatal and nonfatal cardiovascular events outweigh the potential risks."

The study data included more than 73,000 patients prescribed clarithromycin, about 3,200 prescribed erythromycin and more than 68,000 people who took azithromycin. Almost three-quarters of the statin users were taking atorvastatin (Lipitor). The other commonly used statins were simvastatin (Zocor) and lovastatin (Altoprev, Mevacor).

Clarithromycin and erythromycin are often prescribed for respiratory illness such as pneumonia. Previously, the U.S. Food and Drug Administration warned that statins don't interact well with these and certain other drugs used to treat HIV and hepatitis.

The study authors noted that younger patients are less likely than older adults to experience serious side effects from drug interactions.

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Certain Parents Less Likely to Follow Doctors' Advice: Poll

Title: Certain Parents Less Likely to Follow Doctors' Advice: Poll
Category: Health News
Created: 3/25/2013 6:36:00 PM
Last Editorial Review: 3/26/2013 12:00:00 AM

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Certain Lifestyle Factors Linked to Arthritis in Study Patients

Title: Certain Lifestyle Factors Linked to Arthritis in Study Patients
Category: Health News
Created: 3/25/2013 2:35:00 PM
Last Editorial Review: 3/26/2013 12:00:00 AM

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Certain Diabetes Medications May Lower Heart Failure Risk

Study found people taking newer drugs were 44 percent less likely to be hospitalized with the condition

By Maureen Salamon

HealthDay Reporter

SUNDAY, March 10 (HealthDay News) -- A newer class of diabetes drugs may offer an extra benefit: A new study suggests these medications lower the odds of suffering heart failure.

Researchers from Henry Ford Hospital in Detroit found that patients taking so-called GLP-1 drugs -- including brand-name medications such as Byetta, Januvia and Victoza -- were more than 40 percent less likely to be hospitalized for heart failure than patients prescribed other blood sugar-lowering medications. GLP-1 diabetes drugs have been in use for only the last several years and are considered second-line treatments after well-established medications such as metformin, physicians said.

"I don't think we can say this will magically prevent all heart failure deaths, but the strength of the association warrants more investigation," said study author and cardiologist Dr. David Lanfear. "Heart failure is a very common disease . . . but something about diabetics make them definitely at increased risk for developing heart failure."

The study is to be presented Sunday at the American College of Cardiology's annual meeting in San Francisco. Evidence presented at medical meetings has not been peer-reviewed and is considered preliminary.

According to the U.S. National Institutes of Health, about 6 million Americans suffer from heart failure, which occurs when the heart can't efficiently pump blood through the body. Diabetics, who now number 25 million in the United States, are between two and four times more likely than those without the condition to die of heart disease, which includes heart attacks, heart failure and other cardiac problems.

In the retrospective study, Lanfear and his colleagues examined data from more than 4,400 patients taking diabetes medications between 2000 and 2012. About 1,500 were taking GLP-1 medications and nearly 3,000 were not.

Over an average nine-month follow-up period, patients taking GLP-1 medications were 41 percent less likely than others to be hospitalized with heart failure. Additionally, these patients were 44 percent less likely to be hospitalized for any reason, and 80 percent less likely to die of any cause.

But neither Lanfear nor a doctor not involved with the research could point to reasons why this newer class of diabetes drugs seems to dampen the risk of heart failure.

"We don't know the mechanism yet. It's under active investigation," Lanfear said. "There are clues, but they would be a guess."

Lanfear noted that of the total 20,000 patients at Henry Ford Hospital identified as taking diabetes drugs during the study period, only about 1,500 were taking GLP-1 medications, or about 7 percent.

"We were surprised a little bit by the strength of the association [between the GLP-1 drugs and lower heart failure], but the results still need to be confirmed by other studies," he said. "We can't take this as an endorsement of these drugs."

Calling the study promising, Dr. David Friedman, chief of heart failure services at North Shore-LIJ's Plainview Hospital in Plainview, N.Y., said future research should be prospective instead of analyzing past data.

"Heart failure is a huge problem among diabetics. Every year, there are about a half-million new heart failure patients, and a tremendous portion are those who've survived heart attacks and a fair number have diabetes," Friedman said.

"With diabetes and obesity issues constantly on the radar now, and with the onset of more heart failure cases, we need to find more novel approaches," he added. "If we can improve outcomes in this way, we'll have more hope for these patients."

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Codeine Risky for Kids After Certain Surgeries, FDA Says

Title: Codeine Risky for Kids After Certain Surgeries, FDA Says
Category: Health News
Created: 2/21/2013 2:36:00 PM
Last Editorial Review: 2/22/2013 12:00:00 AM

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