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5 February 2002 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 internal medicine physicians and medical students. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656.

"Prudent" Diet Reduces Risk for Developing Type 2 Diabetes

A large study of men's health habits found that men who eat a "prudent" diet (more fresh fruits, vegetables, whole grains, fish and poultry) were significantly less likely to develop type 2 diabetes than men who ate a "Western" diet (fewer fruits and vegetables, more red meat, processed meat, French fries, high fat dairy products, sweets and desserts) (Article, p. 201). This research is important because the incidence of type 2 diabetes is increasing rapidly in the United States. According to the authors, avoiding weight gain and eating a prudent diet may substantially reduce risk for type 2 diabetes. The study indicates that the pattern of foods consumed, not individual foods or ingredients such as fat, influence the development of type 2 diabetes (This study is highlighted in a video news release produced by the American College of Physicians-American Society of Internal Medicine to be released on Monday, Feb. 4 at 5 p.m., EST.

Internal Medicine Organizations Renew Vows to Professionalism

(See news release.)

Chiropractic Treatment at a Crossroads

Chiropractic treatment, while widespread in the United States, is still considered a "complementary or alternative medicine," says an author and chiropractor (Academia and Clinic, p. 216). After reviewing the profession's history, practice, and training, as well as current governmental regulations, the author says that the "profession has not resolved questions of professional and social identity" and has "not come to a consensus on the implications of integration into mainstream" health systems.

Moderate Alcohol May Be Good for the Heart, but the Line Between Its Risks and Benefits on Heart Health is Still Tricky-Two Studies in Today's Annals

A new analysis of data from the Framingham Heart Study found that the amount of alcohol consumed is not associated with increased risk for congestive heart failure, even among heavy drinkers (Article, p. 181). In moderation, alcohol even seems to protect against congestive heart failure. (Editorial, p. 153). The risk for congestive heart failure was lower among men at all levels of alcohol consumption compared with men who consumed less than one drink per week. The risk for congestive heart failure was lowest among men who consumed eight to 14 drinks per week. Alcohol consumption did not affect women's risk for congestive heart failure.

Most doctors believe that people with alcoholic cardiomyopathy (disease of the heart muscle) should avoid all alcohol. A four-year study of 55 alcoholic men with cardiomyopathy found that the hearts of men who continued drinking heavily progressively deteriorated, and 10 died (Article, p. 192). However, the heart function of those who reduced their drinking to a moderate level improved about the same as the hearts of those who abstained.

Both of these studies challenge current thinking about alcohol and heart failure. An accompanying editorial says that moderate alcohol consumption may actually protect against heart failure (Editorial, p. 247). However, "given the widespread use of alcoholic beverages in the Western world" and the effect of alcohol on organs other than the heart, the writer does not think that physicians should encourage patients to drink in order to protect their hearts.

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