Annals of Internal Medicine is published by the American College of Physicians. These highlights are not intended to substitute for articles as sources of information. For an embargoed copy of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656. Leave fax or e-mail and article topics.
Two new studies of published research help to define the role of exercise in the treatment of lower back pain. A meta-analysis finds that exercise therapy has a small beneficial effect on pain and function in adults with chronic low back pain but no effect on pain that lasts less than six weeks (Review, p. 765). A systematic review finds that the two features of the most successful exercise therapy for chronic low back pain are close supervision and an individually designed program (Review, p. 776).
(These reviews are the subject of a video news release. Call for coordinates.)
A diet low in saturated fats and cholesterol and high in plant-based foods such as vegetables, fruits, beans and whole grains was better at lowering LDL cholesterol levels ('bad' cholesterol) than a similar diet without the veggies, a new study finds (Article, p. 725). In the four-week outpatient study, the two diets were identical in total fat, saturated fat, protein, carbohydrate and cholesterol but one included many more plant-based foods. An editorial writer says that the study puts diet back as a useful strategy for lowering cholesterol in an age of powerful drugs like statins (Editorial, p. 793).
Alendronate is not cost-effective in treating postmenopausal women with osteopenia or low bone mass, a new study finds (Article, p. 734). An editorial writer agrees but notes that older women with osteopenia or those with previous fractures are at higher risk for bone fractures than those with no fracture risk factor (Editorial, p. 796). For this group, alendronate therapy may be "justified and cost-effective," the writer says.