Although Hormone Replacement Therapy (HRT) with estrogen or estrogen/progestin continue to be the most effective treatment for women with bothersome menopausal symptoms such as hot flushes, many such women are interested in non-hormonal options.

In a blinded 8-week trial, investigators randomized 340 perimenopausal and postmenopausal women with a mean of 8 bothersome hot flushes daily to oral treatment with estradiol, venlafaxine or placebo.

At 8 weeks, compared with baseline, mean frequency of hot flushes fell by 53 % in the estradiol (HRT) group, 48% in the venlafaxine group and 29% in the placebo group.
All treatments were well tolerated (JAMA Intern Med 2014 May 26).

Venlafaxine is a serotonin-norepinephrine reuptake inhibitor and seems to offer an alternative to HRT. It was compared in this study with a suboptimal HRT-dose though, because normally one would prescribe double the dose of what was tested in this study.

But still: it has a distinct safety profile from estrogen and may be of help in many cases.

With a little bit of non-scientific wishful thinking one should try to combine all three treatments and obtain by this a 53+48+29 = 130% reduction of hot flushes causing a sensation of chilliness which might be welcome in a Spanish summer…

As the numbers of food allergies increases in western countries, the practice of delaying the introduction of allergenic foods to infants in the hope of preventing food allergies and other allergic diseases has been called into question. Guidelines nowadays recommend earlier introduction of ALL foods at the age of 4 – 6 months.

Researchers examined the association between introducing food during the first year of life and developing allergic diseases by age 6 among over 800 rural European newborns. Half the children had at least one parent with allergies.

Food diversity was measured by the number of common foods that were introduced during the first year: vegetables/fruit, cereals, bread, meat, cake and yoghurt.

Increasing food diversity was associated inversely with lowered risk for allergic asthma and food allergies before age 6. Children introduced to fewer than 4 common foods during the first year had more than three times the risk of asthma and more than four times the risk for food allergies!

Fish, egg and dairy consumption during the first year was associated with more than 50% fewer food allergies and asthma (J Allergy Clin Immunol 2014 Apr;133:1056)!
One still recommends exclusive breast feeding in the first 4 months but then parents are encouraged to let the little ones try what mum and dad are eating. Let them bite a carrot when they are teething, banana with yoghurt is a classic as much as a chunk of bread.

I have gotten to know too many young adults who would not eat vegetables but only meat and sausages – apart from the immune system it’s the palate which needs education as well.

Let’s feast on diversity.

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