Medical Beat

The Coffee and Lipoprotein Metabolism (CALM) study included 187 people, randomized to three groups: one that drank three to six cups of caffeinated coffee a day; another that drank three to six cups of decaffeinated coffee a day; and a third, the control group, that drank no coffee.

Some studies have linked coffee drinking to heart disease, but others have suggested that it is not harmful.

"The problem with the results from these previous studies is that many of them were association studies, which looked broadly at free-living populations and drew associations between lifestyle factors, volitional coffee consumption, and disease risk. Our study randomized subjects to a specific type and amount of coffee consumption, brewed in a standardized manner, just like a drug study, " said H. Robert Superko, M.D., lead author of the study and chairman of molecular, genetic, and preventive cardiology at the Fuqua Heart Center and the Piedmont-Mercer Center for Health and Learning in Atlanta, Ga.

In this study researchers gave participants a nationally popular home-brewed caffeinated coffee and decaffeinated coffee brand, and coffee makers. Researchers then instructed participants on how to prepare the coffee in a standardized manner and asked them to drink only this coffee. All participants drank only black coffee.

"Whether coffee has caffeine is not the only thing that differentiates caffeinated from decaffeinated types," Superko said. "Caffeinated and decaffeinated coffees are often made from different species of beans. Caffeinated coffee, by and large, comes from a bean species called coffee Arabica, while many decaffeinated coffees are made from coffee Robusta. The decaffeination process can extract flavonoids and ingredients that give coffee flavor. So decaffeinated brands usually use a bean that has a more robust flavor."

Researchers measured the level of caffeine in the blood of the participants, as well as levels of the key heart-health indicators before and after the three-month study.

They sought to clearly demonstrate the effects of caffeinated and decaffeinated coffee consumption on key indicators of the metabolic syndrome, which is the umbrella term for a cluster of several harmful heart disease risk factors. Researchers looked at blood pressure, heart rate, BMI, total cholesterol, triglycerides, HDL (good cholesterol) levels of insulin, glucose, non-esterified fatty acids (NEFA, fat in the blood), apolipoprotein B (Apo, protein associated with LDL or "bad" cholesterol) and high-density lipoprotein 2 (HDL2, a type of "really good" cholesterol).

Researchers found no significant changes among the three groups' levels of blood insulin and glucose, or other major risk factors.

But they reported for the first time that, after three months of coffee drinking, the decaffeinated group experienced a rise in fatty acids, which is the fuel in the blood that can drive the production of low-density lipoprotein LDL.

ApoB went up 8 percent in the decaffeinated group but did not significantly change in the other two groups. ApoB is the only protein attached to LDL, and studies show that ApoB might be a better predictor of cardiovascular disease risk than one?s LDL level.

NEFA rose an average 18 percent in the decaffeinated group, while it did not change in the other two groups.

"NEFA is the fuel that can drive the increase in ApoB and LDL," Superko said. "These results are very surprising and have never been reported before for coffee consumption. This is the first non-industry-sponsored study of its kind. Until now, researchers had not reported on a randomized prospective study looking at the mechanism of how a particular kind of coffee consumption increases ApoB and LDL-cholesterol.

"There is a real difference between caffeinated and decaffeinated coffee and, contrary to what people have thought for many years, I believe it's not caffeinated but decaffeinated coffee that might promote heart disease risk factors that are associated with the metabolic syndrome, an expanding heart-health hazard in the United States."

In measuring HDL cholesterol, researchers looked specifically at HDL2, a type of HDL in which high levels are particularly associated with lower risk of heart disease. They found that HDL2 didn't change significantly overall among the three groups in the study. But in the decaffeinated group, it changed significantly according to participants' body fat.

For those who had body mass indexes (BMIs) of more than 25 (considered overweight), drinking decaffeinated coffee increased HDL2 by about 50 percent. But those in the decaffeinated group, who were not considered overweight according to BMI, saw their HDL2 drop by about 30 percent.

"This illustrates to the public that this is not a simple story of one coffee is good, one coffee is bad." he added. "It illustrates a concept that is becoming very important in medicine, which is the individualization of treatment. We have to individualize therapy based on the patient's characteristics. It is important for the public to appreciate that one diet or one drug is not the optimal treatment for every patient."

Coffee drinkers in the United States consume an average of 3.1 cups each day. However, "if you only drink one cup each day, the results of our study probably have little relevance because at that level your daily coffee dose is relatively low," Superko said.

Superko said people concerned about increasing fatty acids and LDL cholesterol should think twice about drinking a lot of decaffeinated coffee. "But those who are overweight and have low levels of HDL2 but normal levels of ApoB, might consider the potential benefit of drinking decaffeinated over caffeinated coffee," he said.

According to the American Heart Association, whether high caffeine intake increases the risk of coronary heart disease is still under study, however moderate coffee drinking, 1-2 cups per day, doesn't seem to be harmful.

DALLAS (AP) - It turns out dogs are more than man's best friend. They're pretty good at making the sick feel better, too, in ways that can be measured. A small study showed that visits from therapeutic dogs lowered anxiety, stress and heart and lung pressure among heart failure patients.

"I'm not surprised at all that something that makes people feel good also makes them feel less anxious, has measurable physiological effects," said Dr. Marc Gillinov, a cardiac surgeon at the Cleveland Clinic who was not involved in the study.

"You can see it on their face, first you see a smile and then you see the worries of the world roll off their shoulders," said Kathie Cole, a nurse at the University of California Los Angeles Medical Center who led the study presented Tuesday at an American Heart Association meeting.

Take Charles Denson, for example. His face brightened as a speckled Australian Shepherd named Bart cuddled next to him as he rested in his hospital bed in a cardiac care unit.

"You've got a pretty coat," the 51-year-old said, while petting Bart's soft fur.

Cole and her colleagues studied 76 heart failure patients - average age 57 - who got either a visit from a volunteer, a volunteer plus a dog, or no visit. The scientists meticulously measured patients' physiological responses before, during and after the visits. Anxiety as measured by a standard rating scale dropped 24 percent for those visited by the dog and volunteer team, but only by 10 percent for those visited by just a volunteer. The scores for the group with no visit remained the same.

Levels of epinephrine, a hormone the body makes when under stress, dropped about 17 percent in patients visited by a person and a dog, and 2 percent in those visited just by a person. But levels rose about 7 percent in the unvisited group. Heart pressure dropped 10 percent after the visit by the volunteer and dog. It increased 3 percent for those visited by a volunteer and 5 percent for those who got no visit. Lung pressure declined 5 percent for those visited by a dog and a volunteer. It rose in the other two groups. Gillinov said the study was especially impressive because of the hard data it provided as opposed to observations. Cole said that she hopes the study, funded by the Pet Care Trust Foundation, a nonprofit that promotes the value of animals in society, helps show that pet therapy is a credible addition to patient care, not just a nicety.

"It makes the hospital seem less like a hospital and it lowers people's blood pressure," said Linda Marler, education coordinator for Baylor Institute for Rehabilitation and animal assisted therapy coordinator for Baylor Healthcare System. Her program has grown from its beginnings in 1985 with one dog to 84. The dogs used in the study - which ranged from a poodle to a golden retriever to a miniature schnauzer - were carefully screened at UCLA and had to pass a behavior test and checkup by a veterinarian, Cole said. Patients were also asked if they liked dogs and wanted to be part of the study.

Dr. George Dennish, a cardiologist at Scripps Memorial Hospital in La Jolla, Calif., said that he occasionally uses dogs in therapy. "(The patients) felt better, they felt calmer, they felt more satisfied," Dennish said.

But he said more long-term studies with more people need to be done. For bypass patient Danny Smith, being visited by a furry friend was a highlight of his stay at Scripps Memorial. "It was very relieving because all they want to do was give you love," said Smith, 57, of Oceanside, Calif. After his visit to Denson at Baylor University Medical Center in Dallas, Bart padded into 68-year-old John Coleman's room. The predictable smile emerged and Coleman began reminiscing: "Last dog I had was a Dachshund."

(HealthDay News) - A new drug called febuxostat may speed relief for those suffering from gout, researchers report.

Gout is a painful arthritic condition affecting the joints, most often the toes and feet. It's caused by a build-up of uric acid in the blood and affects more than 5 million Americans, usually men.

Febuxostat may be more effective at lowering levels of serum uric acid in people with gout than the drug allopurinol and placebo, according to a U.S. study to be presented Wednesday at the annual meeting of the American College of Rheumatology in San Diego.

This study compared different doses of febuxostat to treatment with placebo and allopurinol, a current standard gout treatment. Some patients received daily doses of 80mg, 120mg or 240 mg of febuxostat over 28 weeks. Their results were compared to patients receiving either 100mg or 300 mg of allopurinol and patients receiving a placebo.

By their last three monthly visits, 69 percent of patients taking 240 mg/day of febuxostat had uric acid levels less than 6 mg/dL, compared with 65 percent of those taking 120 mg/day, 48 percent of those taking 80 mg/day, 22 percent of patients taking allopurinol and zero percent of those taking the placebo.

All the groups had similar adverse events such as headache, digestive disturbances and liver abnormalities. Of the 34 serious adverse events experienced by patients in the study, most were cardiac disorders among patients with pre-existing cardiovascular disease.

"The study is very encouraging because it shows that febuxostat was superior at lowering serum uric acid levels compared to allopurinol, the current standard of treatment," lead researcher Dr. Robert Wortmann, professor of medicine at the University of Oklahoma, said in a prepared statement.

Similar findings about febuxostat's effectiveness in lowering serum acid levels in gout patients were outlined in a study presented at the ACR meeting last year.

Be in the Know with Bay News 9 Now!

Get news, weather, and traffic alerts delivered directly to your computer desktop, e-mail, or cell phone with Bay News 9 Now.

• Subscribe for free!

More Bay Area Stories

• FDLE: Condoms, smokes, beer bought on govt's dime
• Weather blog: Anniversary of the nation's worst tornado
• Tampa Bay On Demand's tour of Irish pubs
• Your Web Poll Comments
• Traffic reporter tests Google Maps' new biking routes
• St. Patrick's Day Quiz Wrong Answer
• St. Patrick's Day Quiz Answers
• Do you have 'Luck of the Irish'? St. Patrick's Day QUIZ
• Blog: Chuck asked, and you answered

• Listen live
• Employee blogs
• Twitter page

• Breaking alerts
• RSS news feed
• Upload video