Restricting carbohydrates appears not to harm bones

THE QUESTION Following a diet that’s low in carbohydrates and high in protein and animal fats tends to make people excrete more calcium and absorb less of it, leading some to surmise that the bones will suffer. Does this contention hold true?

THIS STUDY assigned 30 overweight adults, mostly women, to adhere to a strict low-carb diet or a normal American diet that had no food restrictions. The low-carb group consumed fewer than 20 grams of carbohydrates a day for a month and then no more than 40 grams daily. After three months, the low-carb group lost an average of 14 pounds, and the others lost two pounds. Based on blood tests that revealed biochemical indicators of bone makeup, the participants had, in essence, the same rate of bone turnover, meaning their bodies continued to lose and replace bone at a normal pace.

WHO MAY BE AFFECTED BY THESE FINDINGS? People who opt to follow a low-carb diet, such as Atkins, South Beach or Sugar Busters.

CAVEATS The study involved a small number of participants and was of short duration; whether a low-carb diet would affect bones differently over a longer period remains unclear. The study was funded by Procter & Gamble, which produces a prescription drug to treat the bone loss of osteoporosis.

FIND THIS STUDY May 23 online issue of Osteoporosis International; abstract available at www.osteofound.org (click on the journal cover image, then on the “Website” link and then “Online First”).

LEARN MORE ABOUT diet and health at www.health.gov/dietaryguidelines and www.fda.gov (search for “healthier eating”).

Caregivers may exacerbate behavioral problems

THE QUESTION People with dementia often ask the same questions over and over. Some are gripped by hallucinations; others wander away from home. Their behavior can lead to stress and depression in those charged with their care. But might the reverse be true as well — might the characteristics and behavior of caregivers affect the behavior of people with dementia?

THIS STUDY involved 5,788 people with moderate to severe dementia and their caregivers. Nearly 90 percent of the caregivers, who averaged 64 years old, were related to the person they cared for, and most lived with that person. The caregivers’ physical and mental health and functional abilities were assessed using standardized scales. The most common troublesome behaviors the caregivers reported dealing with were repetitive questions, constant talking, delusions, agitation, unreasonable anger and sleep disruptions. More problems were found in people cared for by the youngest and less-educated caregivers, as well as by those who were more depressed, felt more burdened or spent more time each week giving care. The youngest caregivers reported 50 percent more behavior problems than the oldest.

WHO MAY BE AFFECTED BY THESE FINDINGS? People with dementia, including Alzheimer’s disease, and those who care for them. Nearly all people with dementia develop behavioral problems at some point, often resulting in the person’s being moved to a nursing home or Alzheimer’s care facility.

CAVEATS Findings were based on reports from the caregivers. Frequency and severity of behaviors were not determined. The study suggested that older caregivers and spouses may be more familiar with the person’s pre-dementia personality and more apt to make adjustments that prevent problems. An author emphasized that it’s the dementia, not the caregiver, that causes the problems but other factors “may exacerbate the behaviors.”

FIND THIS STUDY May issue of the Journal of the American Geriatrics Society; abstract available online at www.americangeriatrics.org (click “Journals”).

LEARN MORE ABOUT caring for people with dementia at www.caregiver.org (click on “Fact Sheets,” then “Caregiving Issues”) and http://familydoctor.org (search for “caregiver stress”).

Breathing exercises may lead to an easing of symptoms

THE QUESTION Simply taking a breath can be difficult for people with asthma, leading to frequent use of medicated inhalers to ease symptoms. Might they be helped by exercises designed to improve breathing technique?

THIS STUDY randomly assigned 57 adults with mild to moderate asthma who used an inhaler frequently to do twice-daily breathing exercises that they learned from an exercise video they watched once each day. One group learned upper-body mobility exercises and relaxation techniques, practicing about 15 minutes a day; the others focused on exercises to enhance nasal breathing and slow exhaling, for about the same amount of time. Both groups were instructed to rely on the breathing techniques to quell their breathing problems, using inhalers only if symptoms persisted. After seven months, lung function had not changed in either group, but use of inhalers had dropped 86 percent (from an average of three puffs a day to one puff every third day) and the dose of inhaled corticosteroid was about 50 percent less in both groups.

WHO MAY BE AFFECTED BY THESE FINDINGS? Anyone who uses an inhaler for asthma. About 20 million people in the United States have asthma, nearly a third of them children.

CAVEATS The study did not compare people who did breathing exercises with those who did not. The authors theorized that the improvements were not due to the type of exercise but to the requirement that participants do exercises “that reinforce a message of relaxation and self-efficacy and provide a deferral strategy for (inhaler) use.” The study was funded in part by pharmaceutical companies AstraZeneca, Aventis and Glaxo-SmithKline.

FIND THIS STUDY June 5 online issue of Thorax; abstract available at www.thoraxjnl.com (click on “1st Line”).

LEARN MORE ABOUT controlling asthma at www.nhlbi.nih.gov/health and www.mayoclinic.com.