The risks of eating a grapefruit with certain prescription drugs are greater than previously thought, scientists warn.

It was known that grapefruit can cause adverse reactions when combined with certain drugs, but now doctors say the risks are greater than previously thought.

The fruit can cause death, acute kidney failure, respiratory failure, gastrointestinal bleeding, bone marrow suppression in immunocompromised people, renal toxicity and other serious side effects because of its interactions with drugs.

There are more than 85 drugs that may interact with grapefruit, and 43 can have serious side effects.

The reaction occurs because an active ingredient in the fruit – furanocoumarins – inhibit an activating enzyme in the body. This can lead to the effect of multiple ‘doses’ of the drug being received with a single dose.

The drugs include certain statins, immuno-suppressants and anti-histamines.

Canadian scientists who discovered the interactions more than 20 years ago, looked at the latest research to help doctors better understand the serious effects the common food can have when consumed with certain prescription drugs .

Dr David Bailey said: “Many of the drugs that interact with grapefruit are highly prescribed and are essential for the treatment of important or common medical conditions.

“Recently, however, a disturbing trend has been seen. Between 2008 and 2012, the number of medications with the potential to interact with grapefruit and cause serious adverse effects…has increased from 17 to 43, representing an average rate of increase exceeding 6 drugs per year.

This increase is a result of the introduction of new chemical entities and formulations.

Unless health care professionals are aware of the possibility that the adverse event they are seeing might have an origin in the recent addition of grapefruit to the patient’s diet, it is very unlikely that they will investigate it.

“In addition, the patient may not volunteer this information. Thus, we contend that there remains a lack of knowledge about this interaction in the general healthcare community.”

Other citrus fruits such as Seville oranges, often used in marmalade, limes and pomelos also contain furanocoumarins.

These chemicals are innate to the fruit and cause the interaction by irreversible inhibition of the drug metabolizing CYP3A4 enzyme that normally inactivates the effects of an estimated 50% of all medication.

Drugs that interact with these chemicals have three characteristics: they are administered orally, they have very low to intermediate bioavailability – percentage of the oral dose of drug absorbed into the blood circulation unchanged – and they undergo drug metabolism in the gastrointestinal tract by CYP3A4.

For drugs with very low bioavailability, ingestion of a single normal amount of grapefruit can be analogous to consuming multiple doses of the drug alone.

This interaction can occur even if grapefruit is consumed many hours before taking the medication. This means that a modest solitary quantity of grapefruit can affect interacting drugs that are taken once a day at any time during the dosing interval.

Frequent daily consumption of a regular amount can further augment the effect. For example, simvastatin, a commonly used statin, combined with a 200-mL glass of grapefruit juice once a day for 3 days, produced a 330% systemic concentration of the drug compared with water.

People older than 45 years are the prime purchasers of grapefruit and receive the most prescriptions for drugs.

Because of the size of this population, substantial exposure to this interaction is likely. As well, older adults can have decreased ability to tolerate excessive systemic drug concentrations. Consequently, older people are especially vulnerable to these interactions.

Dr Bailey said: “The current trend of increasing numbers of newly marketed grapefruit-affected drugs possessing substantial adverse clinical effects necessitates an understanding of this interaction and the application of this knowledge for the safe and effective use of drugs in general practice.”

The findings are published in the Canadian Medical Association Journal.

Just as we were all settling in front of the television to watch the rugby, two new studies about the perils of sitting have spoiled our viewing pleasure.

The research, published in separate medical journals this month, adds to a growing scientific consensus that the more time someone spends sitting, especially in front of the television, the shorter and less robust his or her life may be.

To reach that conclusion, the authors of one of the studies, published in the October issue of The British Journal of Sports Medicine, turned to data from the Australian Diabetes, Obesity and Lifestyle Study, a large, continuing survey of the health habits of almost 12,000 Australian adults.

Along with questions about general health, disease status, exercise regimens, smoking, diet and so on, the survey asked respondents how many hours per day in the previous week they had spent sitting in front of the television.

Watching television is not, of course, in and of itself hazardous, unless you doze off and accidentally slip from the couch onto a hard floor. But television viewing time is a useful, if somewhat imprecise, marker of how much someone is engaging in so-called sedentary behavior.

“People can answer a question like, ‘How much time did you spend watching TV yesterday?’ much better than a question like ‘How much time did you spend sitting yesterday?’ ” says Dr. J. Lennert Veerman, a senior research fellow at the University of Queensland, who led the new study.

Australians, as it turns out, watch lots of telly. According to the survey data, in 2008, the year that the researchers chose as their benchmark, Australian adults viewed a collective 9.8 billion hours of television.

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Ginger has been revered for thousands of years in traditional Asian and Arabic medicine and today, scientific studies continue to find health benefits ranging from stress relief to improved digestion.

The fiery root contains essential oils – such as gingerols and shogaols – is a good source of magnesium, potassium, vitamin B6, copper and manganese, and is rich in antioxidants.

We bring you ten health benefits linked to the rhizome of the plant Zingiber officiale, which was praised by Confucius and became a trending food fad of the Roman Empire:

In one study of 80 new sailors who were prone to motion sickness, those who took powdered ginger had less vomiting and cold sweats than those who took a placebo, said the University of Maryland’s Center for Integrative Medicine.

Natural pain relief: 

Ginger can reduce symptoms of menstrual pain, according to the U.S. National Library of Medicine. One study showed that taking a ginger extract at the beginning of the menstrual period reduced pain symptoms in 62 per cent of women.

A study at the University of Sydney found that the active ingredients in ginger directly affected pain pathways and recduced inflammation.

Natural arthritis relief:

Taking ginger can reduce pain in people suffering from osteoarthritis.  One study found that taking a ginger extract reduced arthritic pain in the knee after three months of treatment.

Research also showed that a ginger extract could reduce pain and stiffness upon standing and after walking. 

Stress reducer:

“Ginger contains potent gingerol, which helps cleanse the harmful chemicals that our bodies produce when we’re worried, so ginger can help psychological stress,” Dietician Alice Mackintosh told the Daily Mail.

Ginger extract showed “significant antidepressant activity” in a study that was published in the International Research Journal of Pharmacy.

Anti-inflammatory:

Studies show that ginger inhibits several genes that contribute to inflammation, which causes or contributes to a range of health problems including cardiovascular disease, obesity and Alzheimer’s disease.

Antibiotic:

Ginger was more effective than antibiotic drugs in fighting two bacterial staph infections, according to a study published in the Journal of Microbiology and Antimicrobials.

Cold and flu prevention and treatment:

Ginger contains almost a dozen anti-viral compounds and scientists have identified several that can fight the most common cold virus, the rhinoviruses. Other compounds in ginger – gingerols and shogaols – help relieve cold symptoms because they reduce pain and fever and suppress coughing.

Aids digestion:

“Stomach acid is crucial to human digestion and when we’re stressed its production can break down. Ginger stimulates the taste buds, triggering digestive secretions,” said Mackintosh.

“Hot water with a slice of lemon and chopped ginger is an excellent way to stimulate digestion.”

A study published in the European Journal of Gastroenterology and Hepatology found that ginger stimulates digestion by speeding up the movement of food from the stomach.

Fights diabetes:

Ginger can help to manage blood sugar levels in long-term diabetic patients, according to research conducted recently at Sydney University.

Professor of pharmaceutical chemistry Basil Roufogalis, who led a study that was published in the natural health journal Planta Medica, said ginger extracts increased the uptake of glucose into muscle cells independently of insulin.

Boosts circulation:

Gingerols prevent platelets from sticking together, which helps to thin the blood and prevent clotting in the arteries. 

Fire it up:

Choose fresh ginger root over the dried form – it tastes better and has higher levels of gingerol and anti-inflammatory compounds. Unpeeled ginger can be stored for up to three weeks in the fridge and up to six months in the freezer.

Adults should not eat more than four grams of ginger per day and pregnant woman should limit their intake to one gram a day, according to the University of Maryland Medical Center. Ginger should not be given to children under two, it said.

Ginger tea is, of course, widely available in stores but this home-made fresh ginger tea takes only a minute or two:

Peel a small section of a fresh ginger root, grate about a quarter of a teaspoon into a cup, add boiling water and a sweetener of your choice.

Bonum appetitionem, as the Romans (probably) used to say.

Read more: http://www.smh.com.au/lifestyle/diet-and-fitness/ginger-up-20121018-27tif.html#ixzz29mhJU1Rs

A diet rich in tomatoes may reduce the risk of having a stroke, according to researchers in Finland.

They were investigating the impact of lycopene – a bright red chemical found in tomatoes, peppers and water-melons.

A study of 1,031 men, published in the journal Neurology, showed those with the most lycopene in their bloodstream were the least likely to have a stroke.

The Stroke Association called for more research into why lycopene seemed to have this effect.

The levels of lycopene in the blood were assessed at the beginning of the study, which then followed the men for the next 12 years.

They were split into four groups based on the amount of lycopene in their blood. There were 25 strokes in the 258 men in the low lycopene group and 11 strokes out of the 259 men in the high lycopene group.

The study said the risk of stroke was cut by 55% by having a diet rich in lycopene.

‘Major reduction’

Dr Jouni Karppi, from the University of Eastern Finland in Kuopio, said: “This study adds to the evidence that a diet high in fruits and vegetables is associated with a lower risk of stroke.

“The results support the recommendation that people get more than five servings of fruits and vegetables a day, which would likely lead to a major reduction in the number of strokes worldwide, according to previous research.”

He said lycopene acted as an antioxidant, reduced inflammation and prevented blood clotting.

Dr Clare Walton, from the Stroke Association, said: “This study suggests that an antioxidant which is found in foods such as tomatoes, red peppers and water-melons could help to lower our stroke risk.

“However, this research should not deter people from eating other types of fruit and vegetables as they all have health benefits and remain an important part of a staple diet.

“More research is needed to help us understand why the particular antioxidant found in vegetables such as tomatoes could help keep our stroke risk down.”