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19 June 2001 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. Full content of the issue is available on the Internet at

Diet Low in Fat, High in Fruits, Vegetables Good for Heart and Blood Vessels

Two studies in today's Annals find important links between diet and health. An analysis of large studies of nurses and other health professionals finds that diets rich in fruits and vegetables help prevent heart disease (Article, p. 1106). Fruits, green leafy vegetables and vegetables high in vitamin C were particularly beneficial. A second study compared the effects of a high-fat diet, a low-fat diet and the Mediterranean diet (high in monounsaturated fats found in olive oil) on 22 men with high cholesterol (Brief Communication, p. 1115). Both the low-fat diet and the Mediterranean diet reduced cholesterol levels and greatly improved function of the blood vessel lining. The Mediterranean diet also improved the elasticity of the blood vessels.

Doctors Often Not Open With Dying Patients About Chances for Survival

A study found that doctors with terminally ill cancer patients in hospice care would give 38 percent of their patients an accurate estimate of how long they would live (Article, p. 1096). But they would give 40 percent of the patients different estimates (either suggesting more time or less time to live than they actually estimated) and would not give 23 percent of the patients any survival information at all. The study's authors were not able to explain why the disparity exists between making an assessment of survival time and giving the patient this estimate, but they point out that other studies show doctors' survival predictions are wrong about 20 percent of the time. An editorial points out that the doctors in the study had placed the patients in hospice care and so presumably had talked with them about their terminal conditions (Editorial, p. 1142). The editorial writer believes doctors should give patients survival information "vague enough to include the truth - 'usually weeks or months' - and specific enough to help people plan their lives and deaths."

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